Home  |  Patients  |  Physicians  |  In the News  |  Hours/Location  |  Contact
        Bio-Identical Hormones
             Hormones for Women
             Hormones for Men
             Hormone Drug Info
      • Erectile Dysfunction
      • HCG Weight Loss
      • NasoNeb & Sinus Meds
      • Pain Management
      • LDN, MS & Autoimmune
      • Sterile Clean Room
      • Veterinary Compounding

             Drug Shortages
             AMA Recognition
             Legal Information
             Insurance Services
        Nutritional Products
             Product Review Process
             Synergy Blends
        Veterinary Products
             Drug Shortages
        What is the Rose Garden
        Compression Hosiery
        Bras & Camisoles
        Swim Suits
        Hats & Turbans
        Lymphedema Garments

     • Rental, Repair, Sales
     • NasoNeb & Sinus Meds
     Breast Pumps & Nursing
     • Product List

        Product List
        Product Review Process
        Synergy Blends
        Veterinary Products
        •  Compounds
        •  Supplements

        PCAB Accreditation
        Legal Information
      • Staff Members
        History of Mark Drugs

Content 7


The Doctor and the Pharmacist

Radio Show Articles:
May 17, 2014

Back to Specialties button

Progesterone for Preterm Birth Prevention in the Real World
Never Too Late to Adopt Healthy Habits
Are Dietary FODMAPs a Cause of Irritable Bowel Syndrome?
Oral Naltrexone and Acamprosate Reduce Various Measures of Alcohol Consumption
MS Imaging Activity, Relapses Tied to Vitamin D Levels in First Year
Types 1 and 2 Diabetes Increasing Substantially in American Youth
Improving Six Risk Factors Could Delay 37 Million Deaths
Diabetes Prevalence Continues to Rise, Especially Among Minorities
A Distinctive Microbiome in Children with New-Onset Crohn Disease
Metformin Might Reduce Gastric Cancer Risk
Early Introduction of Complementary Foods Reduces Risk for Allergic Disease at Age 6 Years

MM: Bio-identical or Natural Progesterone is an amazing chemical that can help give a new life a good start or can change an existing life by providing stabilization of it in a hectic world. Whatever the stage of life that a woman or in some cases a man may need this hormone, it may be beneficial. Unfortunately, many clinicians confuse natural progesterone and synthetic progestins. This confusion can lead to barriers for people who will truly benefit from Progesterone. Fortunately, there are forms of this wonderful product that are available without a prescription. They are relatively inexpensive and if used properly can bestow wonderful benefits upon the patient.
Obstet Gynecol 2014 Jan; 123:34
Progesterone for Preterm Birth Prevention in the Real World
Lowering barriers to receiving progesterone supplementation may be just as important as the agent itself.
Preterm birth is a public-health burden that is greater in some communities than others. Recurrent preterm births are reduced among women who receive supplemental progesterone during the second and third trimesters (NEJM JW Womens Health Aug 19 2003). Despite the proven efficacy of this strategy, clear benefit in real-world settings is harder to demonstrate. Investigators at a preterm birth prevention clinic used longitudinal data from their practice to explore this issue.
Over the course of 14 years, 1066 women with prior spontaneous preterm births were cared for in the Ohio State University Prematurity Clinic, an urban, academic practice serving a primarily black, Medicaid-eligible population. Between 1998 and the adoption of progesterone supplementation for preterm birth prevention in 2004, 0.6% of women received progestins. This proportion rose to 51% between 2004 and 2007. In 2008, steps were taken to remove barriers to effective use of progestins (e.g., accelerated appointments for women with prior preterm deliveries, earlier initial visits, timely application for insurance coverage). Between 2008 and 2012, 80% of women received progestin prophylaxis. Compared with women who delivered before 2008, those who delivered after 2008 were significantly less likely to have preterm births (adjusted odds ratio for birth before 35 weeks, 0.70).
Comment: Although the gold standard for determining efficacy of an intervention is the randomized, placebo-controlled trial, such studies are generally conducted under ideal conditions that are far from the real world. This study demonstrates the importance of recognizing and addressing barriers to implementing efficacious therapies. Often the very populations that need these interventions most face the greatest impediments to receiving them. Translational studies of this type, which bring discoveries from bench to bedside to our communities, are greatly needed in women's health.
Citation(s): Markham KB et al. Preterm birth rates in a prematurity prevention clinic after adoption of progestin prophylaxis. Obstet Gynecol 2014 Jan; 123:34.
Top of Page


MM: I like this article because it gives us hope. Hope that we are not doomed to our past mistakes. Hope that we can improve our lot in life no matter at what point in life we may be in. Granted, as we age it becomes more difficult but that is no reason that we should not strive to make those improvements. The HCG Metabolic Syndrome Management Protocol is a tool to help realize those hopes that this article describes. Call Mark Drugs for more information or for a referral to a clinician who can help you achieve your healthcare goals.
Circulation 2014 Apr 28
Never Too Late to Adopt Healthy Habits
In the CARDIA cohort, young adults who acquired or dropped healthy lifestyle factors had concordant increases or decreases in markers of atherosclerosis.
Can making health behavior changes as an adult improve coronary artery disease risk? Investigators for the National Heart, Lung, and Blood Institute–sponsored, prospective CARDIA cohort study assessed five healthy lifestyle factors (HLFs) (not being overweight or obese, having a low alcohol intake, eating a healthy diet, being physically active, and not smoking) among some 3500 young adults between ages 18 and 30. HLFs were assessed again 20 years later to determine whether the change from year 0 to 20 as a continuous composite HLF score (range, −5 to +5) was associated with coronary calcification (CAC) and carotid intima–media thickness (IMT) at year 20, after adjustment for demographics, medications, and baseline HLFs.
Over the 20-year period, 25% of the sample improved (HLF change, ≥1), while 40% deteriorated (had fewer HLFs), and 34% stayed the same. Coronary artery calcium was detectable in 19% of the group as a whole. Each incremental increase in HLFs was associated with significantly reduced odds of detectable CAC (odds ratio, 0.85) and lower IMT (carotid bulb, β=−0.024), whereas each decrease was associated with similarly greater odds of CAC (OR, 1.17) and greater IMT (β=+0.020).
Comment: In this study, healthy lifestyle changes during young adulthood were associated with decreased markers of subclinical atherosclerosis, while adoption of unhealthy lifestyle changes were associated with increased risk for subclinical atherosclerosis in middle age. These results should help clinicians reinforce the importance of maintaining (or adopting) a healthy lifestyle at any point in adult life.
Citation(s): Spring B et al. Healthy lifestyle change and subclinical atherosclerosis in young adults: Coronary Artery Risk Development in Young Adults (CARDIA) study. Circulation 2014 Apr 28; [e-pub ahead of print].
Top of Page


MM: Fodmaps are becoming more and more interesting as we see more patients who have most of their intestinal problems improve by using a low to gluten free diet. When these same patients see added improvement by utilizing a low to no fodmap diet then we note that there may be other factors besides gluten to consider. although this is a relatively small study, the results are rather significant and should be considered in our special patient and seemingly gluten sensitive patients.
Gastroenterology 2014 Jan; 146:67
Are Dietary FODMAPs a Cause of Irritable Bowel Syndrome?
In a randomized trial, IBS symptoms improved with a diet low in these short-chain carbohydrates.
The idea that dietary constituents called FODMAPs (Fermentable, Oligo-, Di-, Monosaccharides, And Polyols) might be responsible for some cases of irritable bowel syndrome (IBS) is gaining traction. FODMAPs are poorly absorbed, short-chain carbohydrates that include fructose, lactose, fructans (found in wheat), galactans, and polyol sweeteners.
In this randomized, crossover trial from Australia, 30 patients who met IBS criteria and 8 healthy controls consumed either a low-FODMAP diet (prepared by the researchers) or a “typical Australian diet” for 3 weeks, followed by the opposite diet for another 3 weeks; the two diet periods were separated by a 3-week washout. Patients were blinded to diet constituents.
At baseline, the mean symptom score for IBS patients was 36 (on a 100-point scale); mean scores declined to 23 during the low-FODMAP period and increased to 45 during the typical-diet period — a highly significant difference (P<0.001). Regardless of IBS subtype, patients were more satisfied with stool consistency during the low FODMAP diet. In controls, symptom scores were low at baseline and did not change during either diet period.
Comment: This is the first randomized trial to provide high-quality evidence that FODMAPs contribute to irritable bowel symptoms. One potential confounding dietary constituent is gluten, because a low-FODMAP diet (which eliminates wheat, rye, and barley because of their fructan content) is also low in gluten; however, in a recent study by the same research group, FODMAPs — and not gluten — likely were responsible for gastrointestinal symptoms in nonceliac patients with perceived gluten sensitivity (NEJM JW Gen Med Sep 19 2013). Information on low-FODMAP diets is available from this research team's institution and from other sources (e.g., Stanford University). Clinicians should consider recommending a low-FODMAP diet to IBS patients with abdominal bloating, flatus, and diarrhea.
Citation(s): Halmos EP et al. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology 2014 Jan; 146:67.

Top of Page


MM: Oral naltrexone seems to have a wide range of potential benefits. One use that I have recently come across is taking naltrexone 50mg tablets prior to drinking. This is called the Sinclair Method and is becoming more popular as a means of helping people with alcohol addiction. It appears to block the opiate/ethanol receptors thereby acting as a positive psychological reinforcement to discourage drinking alcohol. I have a number of questions as to the long term benefits of this approach but it may be a useful tool for a certain subset of patients suffering from ethanol dependency.
JAMA 2014 May 14; 311:1861
Oral Naltrexone and Acamprosate Reduce Various Measures of Alcohol Consumption
Nalmefene and topiramate also are somewhat effective, but disulfiram is not.
A systemic review of 123 clinical studies (essentially all randomized, controlled trials; duration range, 12–52 weeks; 23,000 total patients) of FDA-approved medications and medications that are used off-label in patients with alcohol-use disorders (i.e., alcohol abuse or dependence) showed clinical value for four medications. Most patients were enrolled in these studies after detoxification or a period of sobriety. Most studies included a range of psychosocial interventions and support.
Acamprosate (a glutamine antagonist and γ-aminobutyric acid agonist) and oral naltrexone (an opioid antagonist) were about equally effective in preventing resumption of any drinking. Naltrexone also was effective in reducing heavy drinking, but acamprosate was not. The magnitude of effectiveness translates to needing to treat between 12 and 20 patients in order for 1 patient to benefit. Injectable naltrexone was associated with fewer heavy drinking days but did not affect other measures. Disulfiram (an acetaldehyde dehydrogenase inhibitor) did not reduce alcohol consumption.
Two off-label medications conferred clinical value. Nalmefene (Revex; an opioid antagonist) and topiramate (an anticonvulsant) were associated with improvements in various measures of heavy drinking. Researchers found insufficient or no evidence for using a wide range of off-label medications, including selective serotonin reuptake inhibitors, tricyclic antidepressants, atypical antipsychotics, and gabapentin.
Comment: Editorialists believe that these findings should encourage primary care clinicians to be more involved in caring for patients with alcohol-use disorders. Primary care physicians should realize that, because effective medications exist to supplement psychosocial interventions, they can engage patients more assertively in shared decision-making, take primary responsibility for managing mild-to-moderate alcohol-use disorder, and coordinate effective referrals for complex patients.
Citation(s): Jonas DE et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings. JAMA 2014 May 14; 311:1889. (http://dx.doi.org/10.1001/jama.2014.3628) Bradley KA and Kivlahan DR.Bringing patient-centered care to patients with alcohol use disorders. JAMA 2014 May 14; 311:1861. (http://dx.doi.org/10.1001/jama.2014.3629)
Top of Page


MM: Again we see that higher levels of vitamin D3 are beneficial in patients with MS. This study ranks in importance with the June 2010 study that was in the journal, Neurology that demonstrated that patients taking 40,000IU daily of vitamin D3 for 23 weeks demonstrated universal improvement of symptoms and no adverse effects even though their mean 25(OH)D levels were in the 200-240ng/ml range (2-2.5 times greater than the accepted high end of the "appropriate" range).
JAMA Neurol 2014 Jan 20
MS Imaging Activity, Relapses Tied to Vitamin D Levels in First Year
An analysis of a large clinical trial bolsters the theory that high vitamin D levels have a beneficial effect on multiple sclerosis disease activity.
Low Vitamin D levels have been associated with multiple sclerosis (MS) disease risk and activity, but the issue remains unsettled due to variances in study methodologies. In this current study, researchers retrospectively evaluated vitamin D status within the BENEFIT trial, a prospective, phase IV clinical trial that compared early versus late treatment with a beta-interferon in preventing a second clinical event after presentation with a clinically isolated syndrome and abnormal magnetic resonance imaging (MRI) scan. Serum samples from baseline, 6, 12, and 24 months were available for measuring 25-hydroxyvitamin D (25[OH]D), with 465 patients having at least one measurement and 303 all four measurements. Patients were followed for up to 5 years, with long-term average 25(OH)D levels determined for up to 2 years.
Based on a 25(OH)D cut-off of 50 nmol/L, those with higher vitamin D levels had 52% reduced conversion rate to clinically definite MS, a 39% lower rate of new active lesion formation over 5 years, and a 34% reduction in brain volume loss after the first year — all significant findings. Nonsignificant trends were apparent for clinical outcomes, with a 27% reduction in relapses (P=0.19) and a 0.16 reduction in average EDSS score (P=0.11). MRI measures demonstrated a dose-response when 25(OH)D serum level was categorized based upon quintiles.
Comment: The association of serum vitamin D levels in this cohort with MRI activity in early multiple sclerosis is compelling. Study strengths include prospective data collection under strict clinical trial protocols, comprehensive statistical analysis, large patient numbers, having all patients start at first MS presentation, and consistency of the effect across imaging and clinical endpoints. The effect seemed to be greatest after the first year, suggesting that early vitamin D levels may have consequences for years to come. Whether intervention on 25(OH)D serum levels can result in improved disease outcomes remains to be determined. Such intervention trials are currently under way and should soon provide answers.
Citation(s): Ascherio A et al. Vitamin D as an early predictor of multiple sclerosis activity and progression. JAMA Neurol 2014 Jan 20; [e-pub ahead of print].
Top of Page


MM: I hate to beat a dead horse but "an ounce of prevention is worth a pound of cure". That adage cannot be more true than when it applies to diabetes prevention. Tools to achieve this may include: elimination of environmental negatives such as toxins, eating whole foods, consuming probiotics, vitamin D3 and other appropriate nutrients and promoting outdoor activities. The first step is always the most difficult but if we work as a large community, then we have a greater chance of being successful in the prevention of both of these conditions.
Types 1 and 2 Diabetes Increasing Substantially in American Youth
By Kelly Young
The prevalence of diabetes among U.S. children and adolescents increased by over 20% during an 8-year period, according to a JAMA study.
Researchers assessed the number of children who had a diagnosis of type 1 or type 2 diabetes at five sites in the U.S. in 2001 and 2009. For type 1 diabetes, the adjusted prevalence rose from 1.60 to 1.94 per 1000, an increase of 21%. For type 2 diabetes, the adjusted prevalence rose from 0.37 to 0.48 per 1000, an increase of 31%.
The authors conclude: "The increases in prevalence reported herein are important because such youth with diabetes will enter adulthood with several years of disease duration, difficulty in treatment, an increased risk of early complications, and increased frequency of diabetes during reproductive years, which may further increase diabetes in the next generation."
Top of Page


MM: Note that 1/2 of the recommendations relate directly to excessive weight, empty caloric consumption and lack of physical activity.
Improving Six Risk Factors Could Delay 37 Million Deaths
By Kelly Young
Achieving global targets for six modifiable risk factors could delay or prevent roughly 37 million deaths over 15 years, according to a Lancet study.
Researchers used country data on mortality to estimate the effects of achieving the following targets:

If all six targets are achieved by 2025, it could lead to a roughly 20% reduction in the probability of premature death (ages 30 to 70) from four noncommunicable diseases. The largest benefits, the authors write, would come from reducing tobacco use and blood pressure.
A commentator writes: "These are remarkable potential health gains in view of the highly cost-effective interventions available, which could be readily scaled up in all countries."
Top of Page


MM: Many clinicians will tell their patients that if their HbA1c is less than 7.0, then they are "OK". Personally, I do not agree with this. An ideal HbA1c is about 4.3. This should be the goal for all people irrespective of whether they are diabetic, pr-diabetic or merely living life. This lower HbA1c has been demonstrated to put people in a better position relative to diabetes, hypertension and a host of potential morbidities that worsen the quality of life and in fact, shorten life. Lifestyle changes should be the first approach taken to improve these lab numbers. Those activities are appropriate diet, weight loss/maintenance and exercise.
Ann Intern Med 2014 Apr 15; 160:517
Diabetes Prevalence Continues to Rise, Especially Among Minorities
About 6% of the U.S. population had diabetes in 1988; that fraction was 9% in 2010.
Using data from >15,000 people (age, ≥20) that were collected as part of the U.S. National Health and Nutrition Examination Survey (NHANES), researchers evaluated trends in diabetes during the past 2 decades (1988–1994 and 1999–2010). Laboratory data included glycosylated hemoglobin (HbA1c) and fasting plasma glucose levels. Participants who reported physician-diagnosed diabetes were classified as confirmed diabetic; participants without diagnosed diabetes were categorized as undiagnosed diabetic (HbA1c, ≥6.5%; or fasting glucose, ≥126 mg/dL), prediabetic (HbA1c, 5.7%–6.4%; or fasting glucose, 100–125 mg/dL), or normal glycemic.
The prevalence of obesity among people without confirmed diabetes increased from 21% in 1988–1994 to 32% in 2005–2010. During the same time, prevalence of diabetes (confirmed plus undiagnosed) increased from 5.5% to 9.3%, whereas prevalence of undiagnosed diabetes remained stable at approximately 1%. Prevalence of prediabetes increased from 5.8% to 12.4% based on HbA1c values or from 25% to 29% based on fasting glucose values. Among patients with confirmed diabetes, the proportion of individuals with HbA1c <7% increased from 51% to 59%. Finally, racial disparities persisted: Hispanics and non-Hispanic blacks had significantly higher rates of diabetes overall and of undiagnosed diabetes, and good glucose control among confirmed diabetics in these cohorts was lower.
Comment: This cross-sectional study confirms that rates of obesity and diabetes are rising significantly, and these rates are even higher among minorities.
Citation(s): Selvin E et al. Trends in prevalence and control of diabetes in the United States, 1988–1994 and 1999–2010. Ann Intern Med 2014 Apr 15; 160:517.
Top of Page


MM: Probiotic and pre-biotic mixtures that encourage or guide the micro-biome of the gut into a more appropriate status will help to reduce inflammation and enhance the workings of the immune system throughout the body. Although the effective dose may vary from person to person and condition to condition, it is my opinion that a minimum of 20 billion units daily is necessary to effect any kind of significant change and that doses of 50-100 billion CFU daily is of greater value. Prebiotics in the form of inulin or FOS (fructooligosaccharides) often provide added benefit(s) and should be dosed from 1-3 grams daily for most patients and conditions.
Cell Host Microbe 2014 Mar 12; 15:382
A Distinctive Microbiome in Children with New-Onset Crohn Disease
Certain gut bacteria were amplified in ileal and rectal biopsy specimens.
In recent years, researchers have reported that the microbiome of the gut is associated with inflammatory bowel disease, including Crohn disease (NEJM JW Gen Med Dec 31 2013). In various studies, not all researchers have identified the same microbiome “fingerprint” (the pattern of increased or decreased numbers of bacterial species). However, these reports have involved small numbers of patients, studied before and (often) after treatment, which makes interpreting the data difficult.
In a new multi-institutional study, investigators prospectively collected ileal and rectal biopsy specimens (and, often, stool specimens) from 447 children with new-onset, untreated Crohn disease and from 221 children with noninflammatory abdominal conditions. The presence and number of specific bacterial genera and species were determined with rapid gene sequencing technologies. Amplified numbers of certain bacteria (including Enterobacteriaceae and Fusobacteriaceae), and diminished numbers of others (including Bacteroidales and Clostridiales) predicted Crohn disease with relatively high reliability; organisms found on ileal and rectal biopsy specimens were better predictors than were organisms found in stool.
Comment: This study is, by far, the largest and most rigorous attempt to find a distinctive microbiome for new-onset Crohn disease. Whether this microbiome is a cause of or just an effect of the disease remains to be determined. This study surely will trigger more studies of whether the microbiome predicts disease course and whether altering the microbiome with probiotics is effective therapy.
Citation(s): Gevers D et al. The treatment-naive microbiome in new-onset Crohn's disease. Cell Host Microbe 2014 Mar 12; 15:382.

Top of Page


MM: Metformin's benefits relative to gastric cancer appear to be limited in diabetics who use insulin. This may be due to the limited enhanced sensitivity to insulin effects that this drug provides. When an exogenous source of insulin is provided, there may be too much present to obtain the protective benefits. There may be a variety of reasons that this occurs, but one might be that many tumors thrive when an abundance of insulin is present. It is entirely possible that some of the newer insulin dosage forms may not exhibit this response.
Aliment Pharmacol Ther 2014 Apr; 39:854
Metformin Might Reduce Gastric Cancer Risk
In a retrospective analysis, using metformin for >3 years reduced gastric cancer risk by 43% in patients with type 2 diabetes who did not use insulin. David
The oral antidiabetic drug metformin has demonstrated anticancer activity in limited studies. To investigate whether metformin use is associated with reduced risk for gastric cancer, researchers in Korea used national insurance claims data to retrospectively assess cancer incidence in metformin users versus nonusers among 40,000 patients with type 2 diabetes. Among a total of 7000 regular insulin users, 5900 had used metformin, and among 33,000 insulin nonusers, 27,000 had used metformin.
Gastric cancer incidence was lower in patients taking metformin compared with those not taking metformin among insulin nonusers (P=0.047) but not among regular insulin users. In a multivariate regression model, longer duration of metformin use was associated with reduced risk for gastric cancer (adjusted hazard ratio, 0.88; 95% confidence interval, 0.81–0.96). In a second model that assessed duration of use in blocks of time, metformin use >3 years was associated with reduced risk for gastric cancer (adjusted HR, 0.57; 95% CI, 0.38–0.87).
Comment: A few study limitations should be noted. The overall and annual data analyses barely achieved statistical significance. Also, because of inherent confounding in retrospective database studies, results should be interpreted with caution. Compared with the main findings, those showing reduced cancer risk with long-term use of metformin are more compelling and consistent with reduced risks for cancers in other studies. However, perhaps most compelling was the finding that gastric cancer risk was doubled in insulin users versus nonusers, regardless of metformin use. Understanding the mechanisms by which both insulin and metformin might affect cancer risk requires additional study.
Citation(s): Kim Y-I et al. Long-term metformin use reduces gastric cancer risk in type 2 diabetics without insulin treatment: A nationwide cohort study. Aliment Pharmacol Ther 2014 Apr; 39:854.

Top of Page


MM: We have addressed this issue in the past but I feel that it is worth repeating.
J Allergy Clin Immunol 2014 Apr; 133:1056
Early Introduction of Complementary Foods Reduces Risk for Allergic Disease at Age 6 Years
In a prospective study, more food diversity was associated with greater benefit.
Previous guidelines recommended delaying the introduction of allergenic foods to infants in hopes of preventing food allergy and other allergic disease. This practice has been called into question as rates of food allergy increase in western countries. Recent guidelines now recommend earlier introduction (ages 4-6 months) of all foods (NEJM JW Pediatr Adolesc Med Feb 20 2013). Researchers prospectively examined the association between the introduction of food during the first year of life and development of allergic disease by age 6 years in a birth cohort of 856 rural European newborn infants.
Half the children grew up on farms and half had at least one atopic parent. Food diversity was measured by the number (0-6) of common foods that were introduced during the first year: vegetables or fruits, cereals, bread, meat, cake, and yogurt. Consumption of egg, nuts, and fish were also recorded. Increasing food diversity was inversely associated with risk for asthma, food allergy, and food sensitization up to age 6 years. Children introduced to fewer than four common foods during the first year had more than three times the risk for asthma and more than four times the risk for food allergy, compared with children introduced to all six foods. Fish, egg, and dairy consumption during the first year were associated with >50% reduction in food allergy, and dairy and egg consumption were associated with >50% reduction in asthma. Children with greater food diversity had evidence of greater gene transcription for regulatory T-cells associated with tolerance.
Comment: This study provides further evidence that early introduction of complementary foods prevents allergic disease. We should still recommend exclusive breast milk during the first 4 months of life but then encourage food diversity during the remainder of the first year. Children who have eczema or a sibling with food allergy remain at high risk for food allergy regardless of the age foods are introduced, so pediatric clinicians should discuss this risk with parents.
Citation(s): Roduit C et al. Increased food diversity in the first year of life is inversely associated with allergic diseases. J Allergy Clin Immunol 2014 Apr; 133:1056.

Top of Page

Home | Contact | Roselle (630) 529-3400 | Deerfield (877) 419-9898 | Careers | Sitemap