Archive for November 2010

Does vitamin D offer protection against cancer, heart disease, autoimmune diseases, and diabetes

Tuesday, November 30, 2010

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The majority of Americans and Canadians are getting enough vitamin D and calcium to meet their needs, says a new report from the Institute of Medicine. Most people up to age 70 need no more than 600 international units, or IUs, of vitamin D per day, and those 71 and older may need as much as 800 IUs, the report finds. The amount of calcium needed ranges, based on age, from 700 to 1,300 milligrams per day.

A large amount of evidence reviewed by the committee that wrote the report confirms the roles of calcium and vitamin D in promoting skeletal growth and maintenance and the amounts needed to avoid poor bone health. The committee also reviewed hundreds of studies and reports on other possible health effects of vitamin D, such as protection against cancer, heart disease, autoimmune diseases, and diabetes. While these studies point to possibilities that warrant further investigation, they have yielded conflicting and mixed results and do not offer the evidence needed to confirm that vitamin D has these effects.

Sunlight triggers the natural production of vitamin D in skin and contributes to people's vitamin D levels. Individuals' sun exposure varies greatly, however, so the committee assumed minimal exposure to establish the intake values. The new intake levels for vitamin D cover the needs of individuals who get little sun.

Getting too much calcium from dietary supplements has been associated with kidney stones, while excessive vitamin D can damage the kidneys and heart. Evidence about other possible risks associated with routine vitamin D supplementation is still tentative, but some signals suggest there are greater risks of death and chronic disease associated with long-term high vitamin D intake. The report also set upper intake levels, which represent the upper safe boundary rather than amounts people should strive to consume. The upper intake levels and the amounts people require based on age and gender are detailed at www.iom.edu/vitamind.

Confusion about the amount of vitamin D necessary to ward off deficiency has arisen in recent years as tests that measure blood levels have become common. The measurements of sufficiency and deficiency that laboratories use to report test results are not standardized and different labs use different cutpoints. There may be an overestimation of deficiency because many labs appear to be using cutpoints that are higher than the evidence indicates are appropriate.
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Walking slows progression of Alzheimer's

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Walking may slow cognitive decline in adults with mild cognitive impairment (MCI) and Alzheimer's disease, as well as in healthy adults, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"We found that walking five miles per week protects the brain structure over 10 years in people with Alzheimer's and MCI, especially in areas of the brain's key memory and learning centers," said Cyrus Raji, Ph.D., from the Department of Radiology at the University of Pittsburgh in Pennsylvania. "We also found that these people had a slower decline in memory loss over five years."

Alzheimer's disease is an irreversible, progressive brain disease that slowly destroys memory and cognitive skills. According to the National Institute on Aging, between 2.4 million and 5.1 million Americans have Alzheimer's disease. Based on current population trends, that number is expected to increase significantly over the next decade.

In cases of MCI, a person has cognitive or memory problems exceeding typical age-related memory loss, but not yet as severe as those found in Alzheimer's disease. About half of the people with MCI progress to Alzheimer's disease.

"Because a cure for Alzheimer's is not yet a reality, we hope to find ways of alleviating disease progression or symptoms in people who are already cognitively impaired," Dr. Raji said.

For the ongoing 20-year study, Dr. Raji and colleagues analyzed the relationship between physical activity and brain structure in 426 people, including 299 healthy adults (mean age 78), and 127 cognitively impaired adults (mean age 81), including 83 adults with MCI and 44 adults with Alzheimer's dementia.

Patients were recruited from the Cardiovascular Health Study. The researchers monitored how far each of the patients walked in a week. After 10 years, all patients underwent 3-D MRI exams to identify changes in brain volume.

"Volume is a vital sign for the brain," Dr. Raji said. "When it decreases, that means brain cells are dying. But when it remains higher, brain health is being maintained."

In addition, patients were given the mini-mental state exam (MMSE) to track cognitive decline over five years. Physical activity levels were correlated with MRI and MMSE results. The analysis adjusted for age, gender, body fat composition, head size, education and other factors.

The findings showed across the board that greater amounts of physical activity were associated with greater brain volume. Cognitively impaired people needed to walk at least 58 city blocks, or approximately five miles, per week to maintain brain volume and slow cognitive decline. The healthy adults needed to walk at least 72 city blocks, or six miles, per week to maintain brain volume and significantly reduce their risk for cognitive decline.

Over five years, MMSE scores decreased by an average of five points in cognitively impaired patients who did not engage in a sufficient level of physical activity, compared with a decrease of only one point in patients who met the physical activity requirement.

"Alzheimer's is a devastating illness, and unfortunately, walking is not a cure," Dr. Raji said. "But walking can improve your brain's resistance to the disease and reduce memory loss over time."
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Light exercise may prevent osteoarthritis

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People at risk for osteoarthritis may be able to delay the onset of the disease or even prevent it with simple changes to their physical activity, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).

"According to the results of our study, participating in a high-impact activity, such as running, more than one hour per day at least three times a week appears associated with more degenerated cartilage and potentially a higher risk for development of osteoarthritis," said the study's senior author Thomas M. Link, M.D., professor of radiology and chief of musculoskeletal imaging at the University of California, San Francisco (UCSF). "On the other hand, engaging in light exercise and refraining from frequent knee-bending activities may protect against the onset of the disease."

Osteoarthritis is a degenerative joint disease that causes pain, swelling and stiffness. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, osteoarthritis is the most common form of arthritis and affects an estimated 27 million Americans over the age of 25.

For the study, the researchers recruited 132 asymptomatic participants at risk for knee osteoarthritis who were enrolled in the National Institutes of Health Osteoarthritis Initiative, as well as 33 age- and body mass index-matched controls. Study participants included 99 women and 66 men between the ages of 45 and 55. The participants were separated into three exercise and strength-training levels, based on their responses to the Physical Activity Scale for the Elderly (PASE) questionnaire. Exercise levels included sedentary, light exercisers and moderate to strenuous exercisers, strength-training groups included none, minimal and frequent. Knee-bending activities were also analyzed.

MRI exams revealed that light exercisers had the healthiest knee cartilage among all exercise levels, and patients with minimal strength training had healthier cartilage than patients with either no strength training or frequent strength training.

Moderate to strenuous exercise in women who did any amount of strength training was associated with higher water content and more degenerated collagen architecture in the knee.

"The results for this group indicate that moderate to strenuous exercise may accelerate cartilage degeneration, putting these women at even greater risk of developing osteoarthritis," said study coauthor Keegan K. Hovis, B.S., R.N., research associate in the Department of Radiology at UCSF.

In addition, the findings showed that frequent knee-bending activities, such as climbing up at least 10 flights of stairs a day, lifting objects weighing more than 25 pounds, or squatting, kneeling or deep knee bending for at least 30 minutes per day, were associated with higher water content and cartilage abnormalities.

According to Dr. Link, known risk factors for cartilage degeneration include excess weight, knee injuries, frequent knee bending and severe or strenuous physical activity.

"People can reduce their risk for osteoarthritis by maintaining a healthy weight and avoiding risky activities and strenuous exercise," he said. "Lower-impact sports, such as walking, swimming or using an elliptical trainer are likely more beneficial than high-impact sports, such as running or tennis."

"Our findings indicate that light exercise, particularly frequent walking, is a safer choice in maintaining healthy cartilage," Hovis added.
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Moderate alcohol consumption lowers the risk of metabolic diseases

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With the emergence of an epidemic of obesity and type 2 diabetes (DM) throughout the world, the association of lifestyle habits that may affect the risk of metabolic diseases is especially important. Most prospective studies have shown that moderate drinkers tend to have about 30% lower risk of developing late onset diabetes than do non-drinkers, and moderate drinkers also tend to be at lower risk of developing metabolic syndrome (MS). A cross-sectional analysis of 6172 subjects age 35 -75 in Switzerland related varying levels of alcohol intake to the presence of DM, MS, and an index of insulin resistance (HOMA-IR).

Alcohol consumption was categorized as non-drinkers (0), low-risk (1󈝹 drinks a week), medium-to-high-risk (14󈞎) and very-high-risk (= 35) drinkers. 73% of participants consumed alcohol, 16% were medium-to-high-risk drinkers and 2% very-high risk drinkers

Study findings: In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non-drinkers, 19% in low-risk, 20% in medium-to-high-risk and 29% in very-high-risk drinkers. Adjusted prevalence of diabetes was 6.0% in non-drinkers, 3.6% in low-risk, 3.8% in medium-to-high-risk and 6.7% in very-high-risk drinkers. These relationships did not differ according to beverage types.

Moderate drinkers also had the lowest weight, tryglycerides, and blood pressure. All drinkers had higher HDL-cholesterol values (that is 'good cholesterol) than did non-drinkers.

Forum comments:

Metabolic syndrome is the name given to a so called 'lifestyle disease', where patients exhibit multiple medical problems including high blood pressure, late on set diabetes, and high cholesterol.

The strengths of this paper include being population-based and having a large number of subjects who reported that they consumed 14 or more drinks/week. Also, there was a good percentage (27%) of subjects reporting no alcohol intake during the one week of assessment used for classifying subjects. Another strength is the careful confirmation of drinking status with state-of-the-art laboratory tests. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. No differences were noted according to the type of beverage consumed.

This is a cross-sectional analysis, so a causative relation between alcohol intake and the metabolic outcomes cannot be assessed. Still, the data supports much that has been shown in prospective studies. Several Forum members commented on potential problems when considering a number of physiologic conditions as the "metabolic syndrome" and focusing therapy on the syndrome; they believed that each metabolic factor should be evaluated and treated singly.
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Jon's Health Tips - Part II

Saturday, November 27, 2010

Among the healthy choices I have abandoned for the most part during my health crisis, I forgot to mention fish and fish oil.

Any way, I am still behind on my health research reports, so here are some more:

I have managed to continue to take my statin (I wish it were I higher dose):

Statin use associated with statistically significant reduction in colorectal cancer

"Observational studies have suggested that long‐term use of statins is associated with reduced risk of several cancers, including breast, prostate, lung, pancreas and liver. Our findings suggest that randomized controlled trials designed to test the hypothesis that statins reduce the risk of colorectal cancer are warranted," added Dr. Samadder


Cholesterol-lowering statins boost bacteria-killing cells


Widely prescribed for their cholesterol-lowering properties, recent clinical research indicates that statins can produce a second, significant health benefit: lowering the risk of severe bacterial infections such as pneumonia and sepsis.

More Intensive Statin Treatment Reduces Heart Risk Further

More intensive treatment using statin drugs to lower levels of bad cholesterol leads to even greater reductions in the risk of a heart attack or stroke than with regular statin doses.

The reduction in risk is proportional to the reduction achieved in bad cholesterol levels, even in patients with already low levels. This suggests that a wide range of people at risk of heart disease may benefit from using statins to reduce their bad cholesterol levels further, whatever their starting point.

The researchers found that using more intensive statin treatment produced a highly significant 15% further reduction in major vascular events over standard statin doses.

But:
Statin RX may be overprescribed in healthy people without evidence of diseased arteries

"Our results tell us that only those with calcium buildup in their arteries have a clear benefit from statin therapy, and those who are otherwise healthy and have no significant calcification should with their physician focus on aggressive lifestyle improvements instead of early initiation of statin medications," says study lead investigator Michael Blaha, M.D., M.P.H.

"While statin therapy can benefit healthy men and women with normal or even low cholesterol levels," adds Blaha, a cardiology fellow at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute, "it certainly is not the case that all adults should be taking it to prevent heart attack and stroke, because half are at negligible risk of a sudden coronary event in the next five to 10 years."

Long-Term Statin Use Is Unlikely to Decrease Cancer Risk, Study Finds

Before I began statin therapy I was taking red yeast rice as a satin substitute:


Active Ingredient Levels Vary Among Red Yeast Rice Supplements


Different formulations of red yeast rice, a supplement marketed as a way to improve cholesterol levels, appear widely inconsistent in the amounts of active ingredients they contain, according to a report in the Oct. 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, one in three of 12 products studied had detectable levels of a potentially toxic compound.

I certainly hope to return to a healthy, Mediterranean style diet and overall lifestyle:

Healthy Lifestyle Cuts Colorectal Cancer Risk


Almost a quarter of colorectal (bowel) cancer cases could be prevented if people followed healthy lifestyle advice in five areas. These included being physically active for at least 30 minutes a day, having no more than seven drinks a week for women and 14 drinks a week for men, being non-smoker, having a waist circumference below 88 cm for women and 102 cm for men and consuming a healthy diet.

Healthy Lifestyle Has Bigger Impact on Cardiovascular Health Than Genetics, Studies Show

Two large studies from Northwestern Medicine confirm a healthy lifestyle has the biggest impact on cardiovascular health. One study shows the majority of people who adopted healthy lifestyle behaviors in young adulthood maintained a low cardiovascular risk profile in middle age. The five most important healthy behaviors are not smoking, low or no alcohol intake, weight control, physical activity and a healthy diet. The other study shows cardiovascular health is due primarily to lifestyle factors and healthy behavior, not heredity.



High alpha-carotene levels (from fruits and vegetables) associated with longer life
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High blood levels of the antioxidant alpha-carotene appear to be associated with a reduced risk of dying over a 14-year period.

Eating Mostly Whole Grains = Lower Body Fat

I have been taking more afternoon naps:

Taking an Afternoon Nap Can Lead to More Active Lives

I'm not inclined to use B vitamins to my regimen yet, but I certainly hope I don't forget to in later years:


B-Complex Vitamins May Help Slow Progression of Dementia



Large doses of B-complex vitamins could reduce the rate of brain shrinkage by half in elderly people with memory problems and slow the progression of dementia.

A two-year clinical trial in England has shown that B vitamins, including B-6, B-12 and folic acid, slow down mild cognitive impairment (MCI), a condition which is a major risk factor for Alzheimer disease and other forms of dementia.

Vitamin B12 May Reduce Risk of Alzheimer's Disease

A new study shows that vitamin B12 may protect against Alzheimer's disease, adding more evidence to the scientific debate about whether the vitamin is effective in reducing the risk of memory loss.

I'm not allergic to wine, but my wife may be:

Low-allergenic wines could stifle sniffles and sneezes in millions of wine drinkers

Scientists have identified a mysterious culprit that threatens headaches, stuffy noses, skin rash and other allergy symptoms when more than 500 million people worldwide drink wine. The discovery could help winemakers in developing the first low allergenic vintages — reds and whites with less potential to trigger allergy symptoms, they say.

I've also stopped taking glucosamine for my knees, although I don't think I was ever taking too much.


Too Much Glucosamine Can Cause the Death of Pancreatic Cells, Increase Diabetes Risk


I have been drinking much too much Coke to ease stomach pains:

Sodas, Other Sugary Beverages Linked to Increased Risk of Type 2 Diabetes, Metabolic Syndrome



The findings showed that drinking one to two sugary drinks per day increased the risk of type 2 diabetes by 26% and the risk of metabolic syndrome by 20% compared with those who consumed less than one sugary drink per month. Drinking one 12-ounce serving per day increased the risk of type 2 diabetes by about 15%.
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High alpha-carotene levels (from fruits and vegetables) associated with longer life

Wednesday, November 24, 2010

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High blood levels of the antioxidant alpha-carotene appear to be associated with a reduced risk of dying over a 14-year period, according to a report posted online today that will be published in the March 28 print issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Oxygen-related damage to DNA, proteins and fats may play a role in the development of chronic diseases like heart disease and cancer, according to background information in the article. Carotenoids—including beta-carotene, alpha-carotene and lycopene—are produced by plants and microorganisms and act as antioxidants, counteracting this damage. Carotenoids in the human body are obtained mainly through eating fruits and vegetables rich in the nutrients, or through antioxidant supplements.

Although studies suggest eating more fruits and vegetables is associated with lower risk of chronic diseases, randomized controlled trials have not shown any benefit for beta-carotene supplements, the authors note. "Therefore, carotenoids other than beta-carotene may contribute to the reduction in disease risk, and their effects on risk of disease merit investigation," the authors write.

Chaoyang Li, M.D., Ph.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues assessed the relationship between alpha-carotene and the risk of death among 15,318 adults age 20 and older who participated in the Third National Health and Nutrition Examination Survey Follow-up Study. Participants underwent a medical examination and provided blood samples between 1988 and 1994, and were followed through 2006 to determine whether and how they died.

Over the course of the study, 3,810 participants died; the risk for dying was lower with higher levels of alpha-carotene in the blood. Compared with individuals with blood alpha-carotene levels between 0 and 1 micrograms per deciliter, the risk of death during the study period was 23 percent lower among who had concentrations between 2 and 3 micrograms per deciliter, 27 percent lower with levels between 4 and 5 micrograms per deciliter, 34 percent lower with levels between 6 and 8 micrograms per deciliter and 39 percent lower with levels of 9 micrograms per deciliter or higher.

Higher alpha-carotene concentration also appeared to be associated with lower risk of dying from cardiovascular disease or cancer individually, and of all other causes. "The association between serum alpha-carotene concentrations and risk of death from all causes was significant in most subgroups stratified by demographic characteristics, lifestyle habits and health risk factors," the authors write.

Alpha-carotene is chemically similar to beta-carotene but may be more effective at inhibiting the growth of cancer cells in the brain, liver and skin, they note. "Moreover, results from a population-based case-control study of the association between the consumption of fruits and vegetables and risk of lung cancer suggest that consumption of yellow-orange (carrots, sweet potatoes or pumpkin and winter squash) and dark-green (broccoli, green beans, green peas, spinach, turnips greens, collards and leaf lettuce) vegetables, which have a high alpha-carotene content, was more strongly associated with a decreased risk of lung cancer than was consumption of all other types of vegetables," the authors write.

The results support increasing fruit and vegetable consumption as a way of preventing premature death, and suggest a need for clinical research into the health benefits of alpha-carotene, they conclude.
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Vitamin B12 May Reduce Risk of Alzheimer's Disease

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A new study shows that vitamin B12 may protect against Alzheimer's disease, adding more evidence to the scientific debate about whether the vitamin is effective in reducing the risk of memory loss.

The research will be published in the October 19, 2010, issue of Neurology®, the medical journal of the American Academy of Neurology.

"Our findings show the need for further research on the role of vitamin B12 as a marker for identifying people who are at increased risk of Alzheimer's disease," said study author Babak Hooshmand, MD, MSc, with Karolinska Institutet in Stockholm, Sweden. "Low levels of vitamin B12 are surprisingly common in the elderly. However, the few studies that have investigated the usefulness of vitamin B12 supplements to reduce the risk of memory loss have had mixed results."

For the seven-year study, researchers took blood samples from 271 Finnish people age 65 to 79 who did not have dementia at the start of the study. During that time, 17 people developed Alzheimer's disease. Blood samples were tested for levels for homocysteine, an amino acid associated with vitamin B12, and for levels of the active portion of the vitamin, called holotranscobalamin. Too much homocysteine in the blood has been linked to negative effects on the brain, such as stroke. However, higher levels of vitamin B12 can lower homocysteine.

The study found that for each micromolar increase in the concentration of homocysteine, the risk of Alzheimer's disease increased by 16 percent, whereas each picomolar increase in concentration of the active form of vitamin B12 reduced risk by two percent. The results stayed the same after taking into account other factors, such as age, gender, education, smoking status, blood pressure and body mass index. The addition of folate did not appear to raise or lower the risk of Alzheimer's disease.

"More research is needed to confirm these findings before vitamin B12 should be used solely as a supplement to help protect memory," said Hooshmand.

Vitamin B12 can be found in fish, poultry and other meat products.
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Long-Term Statin Use Is Unlikely to Increase Cancer Risk, Study Finds

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Researchers have further established that long-term use of statins is unlikely to substantially increase or decrease overall cancer risk, according to study results presented at the Ninth Annual AACR Frontiers in Cancer Prevention Research Conference, held Nov. 7-10 in Philadelphia.

Statins are a class of drugs commonly used in the United States to lower cholesterol and reduce the risk of cardiovascular disease. While study results to date have shown that short-term use of statins has little effect on risk of developing cancer, not much is known about long-term statin use and incidence of many cancers.

Eric J. Jacobs, Ph.D., strategic director of pharmacoepidemiology at the American Cancer Society, and colleagues examined the association between use of cholesterol-lowering drugs, predominantly statins, and the incidence of the 10 most common cancers, as well as overall cancer incidence.

The study included 133,255 participants in the Cancer Prevention Study II Nutrition Cohort.

Participants completed several questionnaires that included information about a range of lifestyle and medical factors, including use of cholesterol-lowering drugs, and were followed over a period of about 10 years, according to Jacobs. During this time frame, more than 15,000 participants were diagnosed with cancer.

Using cholesterol-lowering drugs for five years or longer was not associated with overall cancer incidence, or incidence of bladder, breast, colorectal, lung, pancreatic, prostate, or renal cell cancer, but was associated with lower risk of melanoma, endometrial cancer and non-Hodgkin lymphoma.

"The lower risk of endometrial cancer and melanoma among long-term users has not been seen in most previous studies and was surprising," Jacobs said. "The lower risk of non-Hodgkin lymphoma among statin users has been seen in some, but not all, previous studies."
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Spice in Curry Could Prevent Liver Damage

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Curcumin, a chemical that gives curry its zing, holds promise in preventing or treating liver damage from an advanced form of a condition known as fatty liver disease, new Saint Louis University research suggests.

Curcurmin is contained in turmeric, a plant used by the Chinese to make traditional medicines for thousands of years. SLU's recent study highlights its potential in countering an increasingly common kind of fatty liver disease called non-alcoholic steatohepatitis (NASH). Linked to obesity and weight gain, NASH affects 3 to 4 percent of U.S. adults and can lead to a type of liver damage called liver fibrosis and possibly cirrhosis, liver cancer and death.

"My laboratory studies the molecular mechanism of liver fibrosis and is searching for natural ways to prevent and treat this liver damage," said Anping Chen, Ph.D., corresponding author and director of research in the pathology department of Saint Louis University.

"While research in an animal model and human clinical trials are needed, our study suggests that curcumin may be an effective therapy to treat and prevent liver fibrosis, which is associated with non-alcoholic steatohepatitis (NASH)."

High levels of blood leptin, glucose and insulin are commonly found in human patients with obesity and type 2 diabetes, which might contribute to NASH-associated liver fibrosis.

Chen's most recent work tested the effect of curcumin on the role of high levels of leptin in causing liver fibrosis in vitro, or in a controlled lab setting.

"Leptin plays a critical role in the development of liver fibrosis," he said.

High levels of leptin activate hepatic stellate cells, which are the cells that cause overproduction of the collagen protein, a major feature of liver fibrosis. The researchers found that among other activities, curcumin eliminated the effects of leptin on activating hepatic stellate cells, which short-circuited the development of liver damage.
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Sodas, Other Sugary Beverages Linked to Increased Risk of Type 2 Diabetes, Metabolic Syndrome

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A new study has found that regular consumption of soda and other sugar-sweetened beverages is associated with a clear and consistently greater risk of metabolic syndrome and type 2 diabetes. According to the Harvard School of Public Health (HSPH) researchers, the study provides empirical evidence that intake of sugary beverages should be limited to reduce risk of these conditions.

The study appears online October 27, 2010, in the journal Diabetes Care and will appear in the November print edition.

"Many previous studies have examined the relationship between sugar-sweetened beverages and risk of diabetes, and most have found positive associations but our study, which is a pooled analysis of the available studies, provides an overall picture of the magnitude of risk and the consistency of the evidence," said lead author Vasanti Malik, a research fellow in the HSPH Department of Nutrition.

Consumption of sugary drinks, the majority of which are sodas, has increased substantially in the U.S. and across the globe and previous scientific studies have shown consistent associations with weight gain and risk of obesity. However, this study is the first meta-analysis to quantitatively review the evidence linking sugar-sweetened beverages with type 2 diabetes and metabolic syndrome. (Metabolic syndrome is a group of risk factors, such as high blood pressure and excess body fat around the waist, that increase the risk of coronary artery disease, stroke and diabetes.)

The researchers, led by Malik and senior author Frank Hu, professor of nutrition and epidemiology at HSPH, did a meta-analysis that pooled 11 studies that examined the association between sugar-sweetened beverages and those conditions. The studies included more than 300,000 participants and 15,043 cases of type 2 diabetes and 19,431 participants and 5,803 cases of metabolic syndrome.

The findings showed that drinking one to two sugary drinks per day increased the risk of type 2 diabetes by 26% and the risk of metabolic syndrome by 20% compared with those who consumed less than one sugary drink per month. Drinking one 12-ounce serving per day increased the risk of type 2 diabetes by about 15%.

"The association that we observed between soda consumption and risk of diabetes is likely a cause-and-effect relationship because other studies have documented that sugary beverages cause weight gain, and weight gain is closely linked to the development of type 2 diabetes," said Hu.

While a number of factors are at work in the development of type 2 diabetes and metabolic syndrome, sugar-sweetened beverages represent one easily modifiable risk factor that if reduced will likely make an important impact, say the researchers. "People should limit how much sugar-sweetened beverages they drink and replace them with healthy alternatives, such as water, to reduce risk of diabetes as well as obesity, gout, tooth decay, and cardiovascular disease," said Malik.
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B-Complex Vitamins May Help Slow Progression of Dementia

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Large doses of B-complex vitamins could reduce the rate of brain shrinkage by half in elderly people with memory problems and slow the progression of dementia.

A two-year clinical trial in England has shown that B vitamins, including B-6, B-12 and folic acid, slow down mild cognitive impairment (MCI), a condition which is a major risk factor for Alzheimer disease and other forms of dementia.

Dr. Gustavo C. Román, medical director of the Alzheimer & Dementia Center at the Methodist Neurological Institute in Houston, said that patients who already exhibit signs of dementia and test positive for high levels of homocysteine are more likely to respond well to the large doses of B vitamins. Homocysteine is an amino acid in the blood, and high blood levels are linked to an increased risk of developing Alzheimer disease.

Román has seen the impact of these B vitamins in his patients and found that injections of B-complex vitamins are more effective than oral supplements.

"I'm not saying that everyone who takes B vitamins will prevent dementia," Roman said. "But in the right dosage and for the appropriate patients, the vitamin B-12 treatment could be a step toward modifying disease progression."

Approximately 50 percent of people diagnosed with MCI go on to develop Alzheimer disease within five years. More than five million Americans are estimated to have Alzheimer disease, the most common form of dementia. Román said it is time to seek a medical professional if you notice the following signs that could be symptoms for Alzheimer's:

* Forgetting recently learned information
* Problems with planning and/or solving problems, as working with numbers becoming increasingly difficult
* Great difficulty in completing daily tasks
* Losing track of the time or day; confusion about being in a particular location, like not remembering how they got there
* Difficulty reading and/or judging distances, depth perception, etc.
* Language problems that arise when speaking or writing
* Misplacing items and not being able to retrace steps to recover them
* Loss of skills in judgment making
* Social withdrawal
* Noticeable changes in mood and personality, irritability, aggression
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More Intensive Statin Treatment Reduces Heart Risk Further

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More intensive treatment using statin drugs to lower levels of bad cholesterol leads to even greater reductions in the risk of a heart attack or stroke than with regular statin doses. That's the conclusion of two Oxford University-led studies published in the medical journal The Lancet.

The reduction in risk is proportional to the reduction achieved in bad cholesterol levels, even in patients with already low levels. This suggests that a wide range of people at risk of heart disease may benefit from using statins to reduce their bad cholesterol levels further, whatever their starting point.

The first study, jointly coordinated by the Clinical Trial Service Unit (CTSU) at the University of Oxford and the NHMRC Clinical Trials Centre at the University of Sydney, brought together data from some 170,000 people from 26 randomised trials in a new analysis.

The researchers found that using more intensive statin treatment produced a highly significant 15% further reduction in major vascular events over standard statin doses.

'Using aggressive statin treatment to lower levels of bad cholesterol further than would be achieved using standard doses produces even greater reductions in the incidence of heart attacks or strokes,' says Professor Colin Baigent of CTSU, who led this study. 'This is particularly relevant to people who have had heart attack or stroke and are at risk of recurrent problems.'

The second study, a randomized trial in around 12,000 heart attack survivors, assessed intensive statin therapy using 80 mg simvastatin against a daily 20 mg dose of simvastatin. This large trial was led by Professor Jane Armitage, also of the CTSU at Oxford University.

People receiving 80 mg simvastatin showed a greater reduction in bad cholesterol levels over the 6-7 year course of the trial. This reduction produced a 6% further reduction in major vascular events. Although this result was not statistically significant on its own, it is entirely consistent with the benefit that, based on the results of the analysis in the first study, would be expected from a cholesterol reduction of this size.

Muscle weakness, or myopathy, is a rare side effect sometimes reported in people taking statins. There were two (0.03%) cases of muscle weakness in patients taking 20 mg simvastatin daily, but there were 53 (0.9%) cases among the 6000 patients in the 80 mg group, including 7 cases of more serious muscle damage.

Dr Louise Bowman, clinical coordinator of the trial at CTSU, explains: 'Myopathy is a rare side-effect of statins. It occurs in only about 1 in 10,000 patients per year with standard daily doses of 20-40 mg simvastatin but in this trial we saw that myopathy is more common with 80mg simvastatin daily. So, it may be safer to lower cholesterol using low doses of more potent statins rather than by increasing the dose of simvastatin -- the most commonly used statin.

'In light of these new findings, the current NICE guidelines for statins may need to be re-examined,' she adds.

'Taken together, these two studies suggest that using statins more intensively to reduce levels of bad cholesterol is generally safe, effective and does lead to further benefits in reducing risk of heart disease,' says Professor Armitage. 'This is true even if people have low levels of bad cholesterol in their blood already.'
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DHA Improves Memory and Cognitive Function in Older Adults

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A study published in the November edition of Alzheimer's & Dementia: The Journal of the Alzheimer's Association suggests that taking docosahexaenoic acid (DHA) may improve memory and learning in older adults with mild cognitive impairments. This is promising news for many aging Americans who are searching for options to maintain memory and support overall cognitive health.

The "Memory Improvement with Docosahexaenoic Acid Study" (MIDAS) was a randomized, double-blind, placebo-controlled study to evaluate the effects of DHA -- the principle omega-3 fatty acid in the brain -- on improving cognitive functions in healthy older adults with age-related cognitive decline. The study found that DHA taken for six months improved memory and learning in healthy, older adults with mild memory complaints.

"The results of this study are very encouraging for those consumers concerned about maintaining memory. We know that lower DHA levels are associated with cognitive decline in healthy elderly and Alzheimer's patients, and higher DHA levels help reduce the risk of Alzheimer's disease," said Duffy MacKay, N.D., vice president, scientific & regulatory affairs, for the Council for Responsible Nutrition (CRN). "Memory loss, dementia and the development of Alzheimer's disease are prominent health concerns for older individuals. The more we learn about the valuable role DHA plays in supporting brain function, the more options aging Americans have towards managing cognitive decline."

These findings underscore the importance of early DHA intervention. While the MIDAS study focused on a population of healthy adults with age-associated memory impairment, a study recently published in the Journal of the American Medical Association (JAMA), conducted in a population that had previously been diagnosed with Alzheimer's disease, did not indicate DHA provided a statistically significant benefit to cognitive function. The lead author of the JAMA study also highlighted that their results may have been different had DHA been administered before the participants' disease progressed.

"This study reinforces the principle that consumers will reap the most benefit from their DHA supplements -- and many supplements -- when they are taken over time and before a health concern is imminent," continued Dr. MacKay. "When included as a part of a proactive health regimen that includes a well-balanced diet, regular physical activity and routine visits with a healthcare professional, dietary supplements offer an important tool to help support many systems in the body, including memory and cognitive function."

The MIDAS study was conducted in a total of 485 subjects, aged 55 and older with a subjective memory complaint and who met criteria for age-related cognitive decline (or "age-associated memory impairment"). Subjects were randomly assigned 900 mg/d of algal DHA orally or a placebo for 24 weeks.

DHA is an omega-3 fatty acid and is available as a dietary supplement. Many Americans turn to dietary supplements each year help manage age-related challenges. According to CRN's Consumer Survey on Dietary Supplements, among Americans aged 55+ who take supplements, 13 percent report they do so for "memory" and 39 percent for "healthy aging."
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Too Much Glucosamine Can Cause the Death of Pancreatic Cells, Increase Diabetes Risk,

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High doses or prolonged use of glucosamine causes the death of pancreatic cells and could increase the risk of developing diabetes, according to a team of researchers at Université Laval's Faculty of Pharmacy. Details of this discovery were recently published on the website of the Journal of Endocrinology.

In vitro tests conducted by Professor Frédéric Picard and his team revealed that glucosamine exposure causes a significant increase in mortality in insulin-producing pancreatic cells, a phenomenon tied to the development of diabetes. Cell death rate increases with glucosamine dose and exposure time. "In our experiments, we used doses five to ten times higher than that recommended by most manufacturers, or 1,500 mg/day," stressed Professor Picard. "Previous studies showed that a significant proportion of glucosamine users up the dose hoping to increase the effects," he explained.

Picard and his team have shown that glucosamine triggers a mechanism intended to lower very high blood sugar levels. However, this reaction negatively affects SIRT1, a protein critical to cell survival. A high concentration of glucosamine diminishes the level of SIRT1, leading to cell death in the tissues where this protein is abundant, such as the pancreas.

Individuals who use large amounts of glucosamine, those who consume it for long periods, and those with little SIRT1 in their cells are therefore believed to be at greater risk of developing diabetes. In a number of mammal species, SIRT1 level diminishes with age. This phenomenon has not been shown in humans but if it were the case, the elderly -- who constitute the target market for glucosamine -- would be even more vulnerable.

"The key point of our work is that glucosamine can have effects that are far from harmless and should be used with great caution," concluded Professor Picard.

The results obtained by Picard and his team coincide with recent studies that cast serious doubt on the effectiveness of glucosamine in treating joint problems.
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Active Ingredient Levels Vary Among Red Yeast Rice Supplements ScienceDaily (Oct. 27, 2010) — Different formulations of red yeast rice, a supplement

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Different formulations of red yeast rice, a supplement marketed as a way to improve cholesterol levels, appear widely inconsistent in the amounts of active ingredients they contain, according to a report in the Oct. 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, one in three of 12 products studied had detectable levels of a potentially toxic compound.

"Chinese red yeast rice, also known as Hong Qu, is a medicinal agent and food colorant made by culturing a yeast, Monascus purpureus, on rice," the authors write as background information in the article. The process produces compounds called monacolins, one of which (monacolin K) has been purified and marketed as lovastatin. "Several studies have shown that specific formulations of red yeast rice reduce low-density lipoprotein cholesterol (LDL-C) significantly compared with placebo. This is likely related to the effects of monacolin K and the 13 other monacolins in the supplement, which also works to lower the production of cholesterol in the liver."

In 2008, American consumers spent about $20 million on this supplement, often in response to recommendations from clinicians. However, to avoid being considered an unapproved drug by the U.S. Food and Drug Administration, manufacturers do not standardize or disclose the levels of monacolin K or other monacolins in their products, the authors note. Ram Y. Gordon, M.D., of Chestnut Hill Hospital, Philadelphia, and Abington Memorial Hospital, Abington, Penn., and colleagues evaluated monacolin levels in 12 commercial red yeast rice formulations and also tested for citrinin, a toxin from fungus that is potentially harmful to the kidneys.

Across the 12 products, levels of total monacolins ranged from 0.31 milligrams to 11.15 milligrams per capsule and levels of monacolin K or lovastatin ranged from 0.10 milligrams to 10.09 milligrams per capsule. Four of the formulations had elevated levels of citrinin.

"Red yeast rice has been used for centuries for its medicinal properties and is an increasingly popular alternative lipid-lowering therapy that may benefit patients with a history of coronary disease who cannot take statins, subjects who refuse statins or who prefer a 'natural' approach to pharmacotherapy, or patients with a history of statin-associated myalgias," or muscle pains, the authors write.

"However, our study found dramatic variability of monacolin levels in commercial products and the presence of citrinin in one-third of formulations. Further oversight and standardization of the production and labeling of red yeast rice products may address some of the concerns raised in this study. Until these issues are addressed, physicians should be cautious in recommending red yeast rice to their patients for the treatment of hyperlipidemia [high cholesterol] and primary and secondary prevention of cardiovascular disease."
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Eating Mostly Whole Grains= Lower Body Fat

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People who consume several servings of whole grains per day while limiting daily intake of refined grains appear to have less of a type of fat tissue thought to play a key role in triggering cardiovascular disease and type 2 diabetes, a new study suggests.

Researchers at the Jean Mayer USDA Human Nutrition Researcher Center on Aging (USDA HNRCA) at Tufts University observed lower volumes of Visceral Adipose Tissue (VAT) in people who chose to eat mostly whole grains instead of refined grains.

"VAT volume was approximately 10 % lower in adults who reported eating three or more daily servings of whole grains and who limited their intake of refined grains to less than one serving per day," says first author Nicola McKeown, PhD, a scientist with the Nutritional Epidemiology Program at the USDA HNRCA. "For example, a slice of 100% whole wheat bread or a half cup of oatmeal constituted one serving of whole grains and a slice of white bread or a half cup of white rice represented a serving of refined grains."

McKeown and colleagues, including senior author Caroline S. Fox, MD, MPH, medical officer at The Framingham Heart Study of the National Heart Lung and Blood Institute (NHLBI), examined diet questionnaires submitted by 2,834 men and women enrolled in The Framingham Heart Offspring and Third Generation study cohorts. The participants, ages 32 to 83, underwent multidetector-computed tomography (MDCT) scans, to determine VAT and subcutaneous adipose tissue (SAT) volumes.

Visceral fat surrounds the intra-abdominal organs while subcutaneous fat is found just beneath the skin. "Prior research suggests visceral fat is more closely tied to the development of metabolic syndrome, a cluster of risk factors including hypertension, unhealthy cholesterol levels and insulin resistance that can develop into cardiovascular disease or type 2 diabetes," explains co-author Paul Jacques, DSc, director of the Nutritional Epidemiology Program at the USDA HNRCA and a professor at the Friedman School of Nutrition Science and Policy at Tufts. "Not surprisingly, when we compared the relationship of both visceral fat tissue and subcutaneous fat tissue to whole and refined grain intake, we saw a more striking association with visceral fat. The association persisted after we accounted for other lifestyle factors such as smoking, alcohol intake, fruit and vegetable intake, percentage of calories from fat and physical activity."

Published online Sept. 29 by The American Journal of Clinical Nutrition, the present study builds on prior research that associates greater whole grain intake with reduced risk of metabolic syndrome and insulin resistance. "However, because these studies are observational, future research that specifically investigates whole grain intake and body fat distribution in a larger, more diverse study population is needed to identify the mechanism that is driving this relationship," Jacques adds.

Additionally, in the present study, the authors observed that participants who consumed, on average, three daily servings of whole grains but continued to eat many refined grains did not demonstrate lower VAT volume. "Whole grain consumption did not appear to improve VAT volume if refined grain intake exceeded four or more servings per day," says McKeown, who is also an assistant professor at the Friedman School. "This result implies that it is important to make substitutions in the diet, rather than simply adding whole grain foods. For example, choosing to cook with brown rice instead of white or making a sandwich with whole grain bread instead of white bread."
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Taking an Afternoon Nap Can Lead to More Active Lives

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Experts at the University of Surrey discovered that many older people felt that they may be branded lazy for taking afternoon naps so they tried hard to avoid nodding off.

But the occasional nap can make older people more able to lead a fully active life by giving them enough energy to take part in recreational and social activities.

Susan Venn, of the Department of Sociology said: "Sleep is central to health and well-being, but as people get older, the quality of their sleep can deteriorate. They shouldn't feel guilty or think themselves lazy for having a nap."

The new research also found that as older people often have more disturbed sleep patterns at night they try to avoid taking a nap during the day only to fall asleep watching television during the early evening. As a result they may end up feeling exhausted..

Another finding was that older men and women lose sleep because of having to get up several times a night to go to the toilet, so they may cut down on drinking fluids during the day believing this will help, even though they may become dehydrated.

One interviewee, called Anne, aged 71, from Berkshire, said "My main sleep problem is waking up in the early hours of the morning and not being able to get back to sleep.

"I sometimes find on a particularly bad night that I'm awake for three or four hours. I don't want to disturb my husband by tossing and turning, and trying to get back to sleep, so I tend to get up and do the housework, watch DVDs or use the computer.

"Sleep at the moment is a disappointment I suppose, because I feel I've improved my life style by doing all the things, diet, exercise and all this, and I'd hoped that the sleep would improve more than it has."

Susan Venn, of the Department of Sociology, a researcher on the project, explained: "Many of the older people we talked to described how disturbed their sleep was, especially in terms of waking up a lot in the night.

"Anne was like many of the older people we spoke to in that being active during the day was very important to them, and if they slept badly, it impacted on how much could be achieved.

"Many older people are prescribed medications to help them sleep, but research has shown that sleeping medication may impact on the lives of older people, such as increasing the risk of falls."

The new research called "Understanding poor sleep in the community" is linked to an academic conference on sleep issues among older people, based on the SomnIA (Sleep in Ageing) project (www.somnia.surrey.ac.uk).

The research by academics at the University of Surrey, along with colleagues at other institutions, tried to find ways of improving the sleep patterns of older people.

Researchers talked to 62 older men and women who are living in their own homes about their poor sleep patterns and three key findings emerged:

* Whilst many older people do not sleep well and feel tired during the day, they often do not want to take a nap because they believe daytime sleeping is a sign of laziness.
* Older people often get up in the night to go to the toilet, sometimes even several times a night. So, counter to current advice to drink plenty of fluids during the day, they may often severely restrict how much they drink.

* Older men and women would rather not visit their doctor for problems with their sleep, largely because of a concern they will be prescribed some form of sleeping medication. Keeping busy and active is important to many older people and they are concerned that sleeping medication may take away that control. Women, more than men, tended to explore alternative treatments and remedies for poor sleep, such as over the counter remedies and herbal medicines.
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Healthy Lifestyle Cuts Colorectal Cancer Risk

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Almost a quarter of colorectal (bowel) cancer cases could be prevented if people followed healthy lifestyle advice in five areas including diet and exercise, says a new study published on the British Medical Journal website.

Researchers from Denmark found that following recommendations on physical activity, waist circumference, smoking, alcohol and diet could reduce the risk of developing bowel cancer considerably -- by 23%.

Bowel cancer is the third most common cancer in the UK where more than 38,600 people are diagnosed with the condition every year. It is the second most common cause of cancer death in the UK, killing more than 16,250 people each year.

There is much evidence that implicates modifiable lifestyle factors such as smoking, physical activity, body composition, alcohol and diet.

The Danish researchers wanted to study the link between following healthy lifestyle advice and risk of bowel cancer in middle-aged people. They also wanted to find out the proportion of bowel cancer cases that might be linked to lack of adherence to the advice.

They studied data on 55,487 men and women aged 50-64 (bowel cancer is rare amongst people under 40) not previously diagnosed with cancer. The people were studied over almost 10 years up to 2006.

All participants filled in a lifestyle questionnaire including questions about social factors, health status, reproductive factors and lifestyle habits as well as a food frequency questionnaire developed to assess average intake over 12 months.

The researchers created a healthy lifestyle index using internationally accepted public health recommendations from the World Health Organization, World Cancer Research Fund and the Nordic Nutrition Recommendations.

These included being physically active for at least 30 minutes a day, having no more than seven drinks a week for women and 14 drinks a week for men, being non-smoker, having a waist circumference below 88 cm for women and 102 cm for men and consuming a healthy diet.

During the follow-up period, 678 people were diagnosed with bowel cancer.

After looking at how the participants managed to keep to each of the five lifestyle recommendations, the researchers calculated that if all participants (except the healthiest) had followed even one additional recommendation, it was possible that 13% of the bowel cancer cases could have been prevented.

If all participants had followed all five recommendations, then 23% of the bowel cancer cases could have been avoided.

The researchers conclude: "Our study reveals the useful public health message that even modest differences in lifestyle might have a substantial impact on colorectal cancer risk and emphasises the importance of continuing vigorous efforts to convince people to follow the lifestyle recommendations."

A second study also published October 26 shows that adults with low education who used a decision aid when considering whether to have a bowel cancer screening test were more informed, but were less likely to have the test. Despite the lower uptake, the authors state that the decision aid improved informed choice in people with low education. They recommend that such aids should be made available for people who want to make an informed choice about screening and could be integrated within primary care.

However, an accompanying editorial says that before information interventions are adopted in practice, evidence is needed that they inform patients and meet the service need.
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Healthy Lifestyle Has Bigger Impact on Cardiovascular Health Than Genetics, Studies Show

Tuesday, November 23, 2010

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Is cardiovascular health in middle age and beyond a gift from your genes or is it earned by a healthy lifestyle and within your control?

Two large studies from Northwestern Medicine confirm a healthy lifestyle has the biggest impact on cardiovascular health. One study shows the majority of people who adopted healthy lifestyle behaviors in young adulthood maintained a low cardiovascular risk profile in middle age. The five most important healthy behaviors are not smoking, low or no alcohol intake, weight control, physical activity and a healthy diet. The other study shows cardiovascular health is due primarily to lifestyle factors and healthy behavior, not heredity.




"Health behaviors can trump a lot of your genetics," said Donald Lloyd-Jones, M.D., chair and professor of preventive medicine at Northwestern University Feinberg School of Medicine and a staff cardiologist at Northwestern Memorial Hospital. "This research shows people have control over their heart health. The earlier they start making healthy choices, the more likely they are to maintain a low-risk profile for heart disease."

Why Many Healthy Young Adults Become High Risk

The first Northwestern Medicine study investigated why most young adults, who have a low-risk profile for heart disease, often tip into the high-risk category by middle age with high blood pressure, high cholesterol and excess weight.

The unhealthy shift is the result of lifestyle, the study found. More than half of the young adults who followed the five healthy lifestyle factors for 20 years were able to maintain their low-risk profile for heart disease though middle age. (The five healthy lifestyle factors are not smoking, low or no alcohol intake, weight control, physical activity and a healthy diet.)

"This means it is very important to adopt a healthy lifestyle at a younger age, because it will impact you later on," said Kiang Liu, lead author of the study and a professor of preventive medicine at the Feinberg School.

There are big benefits to reaching middle age with a low-risk profile for heart disease. These individuals will live much longer, have a better quality of life and generate lower Medicare bills. A low-risk profile means low cholesterol, low blood pressure, no smoking, no diabetes, regular physical activity, a healthy diet and not overweight.

The study followed 2,336 black and white participants, ages 18 to 30 at baseline, for 20 years. Researchers tracked participants' diet, physical activity, alcohol consumption, smoking, weight, blood pressure and glucose levels at the baseline year, year seven and year 20. The participants are part of the CARDIA (Coronary Artery Risk Development in Young Adults) multi-center longitudinal study sponsored by the National Heart, Lung and Blood Institute.

After 20 years, the prevalence of a low-risk profile was 60 percent for participants who followed all five healthy lifestyle factors, 37 percent for four factors, 30 percent for three factors, 17 percent for two and 6 percent for one or zero. The results were similar for men only, women only, black only and white only.

"From a public health point of view, this shows we should put more emphasis on promoting a healthy lifestyle in young adulthood," Liu said. "We need to educate and encourage younger people to do this now, so they'll benefit when they get older."

Tracking Three Generations of Families for Cardiovascular Health

The second Northwestern Medicine study examined three generations of families from the Framingham Heart Study to determine the heritability of cardiovascular health. Heritability includes a combination of genetic factors and the effects of a shared environment such as the types of foods that are served in a family.

Only a small percentage of the United States population -- 8 percent -- has ideal levels of all the risk factors for cardiovascular health at middle age.

The study found that only a small proportion of cardiovascular health is passed from parent to child; instead, it appears that the majority of cardiovascular health is due to lifestyle and healthy behaviors.

"What you do and how you live is going to have a larger impact on whether you are in ideal cardiovascular health than your genes or how you were raised," said Norrina Allen, the lead study author and a postdoctoral fellow in preventive medicine at the Feinberg School.

The Northwestern Medicine study looked at three generations of families including 7,535 people at age 40 and a separate group of 8,920 people at age 50. The goal was to see who was in ideal cardiovascular health at these two critical periods in middle age.

Both Northwestern Medicine studies build on previous research from the department of preventive medicine that has provided the core for the national definition of cardiovascular health over the past decade, noted Lloyd-Jones.

"We really need to encourage individuals to improve their behavior and lifestyle and create a public health environment so people can make healthy choices," Lloyd-Jones said. "We need to make it possible for people to walk more and safely in their neighborhoods and buy fresh affordable fruit and vegetables in the local grocery store. We need physical activity back in schools, widely applied indoor smoking bans and reduced sodium content in the processed foods we eat. We also need to educate people to reduce their calorie intake. It's a partnership between individuals making behavior changes but also public health changes that will improve the environment and allow people to make those healthy choices."
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Jon's Health Tips

Irony of ironies - I have been felled by a combination of health problems (beyond my control) and while suffering through them have been forced to give up almost all my regular healthy activities including, in rough order of importance, exercise, aspirin, red wine (or beer), green tea, dark chocolate, niacin, yogurt, apples, nuts, fruits and vegetables. I have been able to, for the most part, continue eating oatmeal and taking my statin with Co-enzyme-Q. I have fallen way behind in y work and in putting out this newsletter. The most srous of my conditions was caused by extensive exposure to second-hand smoke as achild. The second most serious is a problem most men of a certain age experience. The other problems, while often painful or uncomfortable, are not serious threats to my health. In fact, in fighting these problems I have largely lost my appetite, and dropped 30 pounds in the process. I doubt I will be able to keep all or even most of it off as I recover.

Anyhow, here are a few of my health notes - more to follow:


I should try drinking pomegranate juice

Pomegranate Juice Reduces Damage to Tissues, Inflammation and Infections

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I’ll stick to red wine and apples, but do like a very occasional curry, aand will continue to avoid French fries:

Curry, Wine and Apples Fight Alzheimers


Alzheimer's Accelerated by a Chemical in Cigarette Smoke, Auto Exhaust and French Fries

I will continue to use cell phones very sparingly:

Brain Tumor Risk May Double after 10 Years of Cell Phone Use

And, in separate research, allergic reactions as well

I’m looking forward to resuming my light to moderate drinking:

Light to moderate drinking linked to fewer heart problems in male bypass patients

Regular moderate drinking among women associated with greater survival


Low dose alcohol appears to decrease risk of stroke in women.

Nothing really I can do about job strain, but until recently I mostly avoided it:

Women with high job strain have 40 percent increased risk of heart disease


I’m going to resume Vitamin D today


Vitamin D deficit doubles risk of stroke in whites, but not in blacks


I can’t wait to get back to my regular exercise (soccer) but will have to substitute until March, I’m told


Regular exercise reduces large number of health risks including dementia and some cancers

"What is clear from the research is that men and women of all ages should be encouraged to be more physically active for the sake of their long-term health."
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Pomegranate Juice Reduces Damage to Tissues, Inflammation and Infections,

Monday, November 22, 2010

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Studies in recent years have claimed multiple health benefits of pomegranate juice, including that it is a good source of antioxidants and lowers both cholesterol and blood pressure, especially in diabetic and hypertensive patients. A preliminary study now suggests that it can ward off a number of complications in kidney disease patients on dialysis, including the high morbidity rate due to infections and cardiovascular events, according to a paper being presented at the American Society of Nephrology's 43rd Annual Meeting and Scientific Exposition in Denver, CO.

PhD candidate, Lilach Shema, and colleagues studied 101 dialysis patients who received either pomegranate juice or another placebo drink at the beginning of each dialysis session, three times a week for one year.

Laboratory tests showed that patients who drank pomegranate juice experienced reduced inflammation and the damage of oxidative stress caused by free radicals, was minimized. Furthermore, pomegranate juice drinkers were less likely to be hospitalized due to infections. These findings support other studies that suggest pomegranate juice has potent antioxidant properties.

Recent analyses of data not included in this abstract, revealed that those who drank pomegranate juice also showed an improvement in cardiovascular risk factors, such as reduced blood pressure, improvement in lipid profile and fewer cardiovascular events, suggesting that they had better heart health. These results are in agreement with other studied populations and particularly important for hemodialysis patients, because most kidney disease patients die either from cardiovascular-related causes or infections.

The authors say their findings suggest that drinking a controlled amount of pomegranate juice with a safe and monitored content of potassium may help reduce the complications that often occur in dialysis patients. It is important to consider the risk involved in potassium overload, especially in chronic kidney disease (CKD) patients with dietary potassium restriction.

"Considering the expected epidemic of CKD in the next decade, further clinical trials using pomegranate juice aimed at reducing the high cardiovascular morbidity of CKD patients and their deterioration to end-stage renal disease should be conducted," said Dr. Kristal.

Study co-authors include Ronit Geron, MD, Galina Shapiro, Shifra Sela, PhD (Western Galilee Hospital), and Liora Ore (University of Haifa).

The study was supported by the Chief Scientist Office of the Ministry of Health, Israel; Jess & Midred Fisher Family Cardiology Research Fund, and the Office of the Executive Vice President for Research, Technion, Israel.

"One Year of Pomegranate Juice Consumption Decreases Oxidative Stress, Inflammation and Incidence of Infections in Hemodialysis Patients," [TH-FC059] will be presented as an oral presentation on November 18, 2010 at the Colorado Convention Center in Denver, CO.
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Curry, Wine and Apples Fight Alzheimers

Sunday, November 21, 2010

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Alzheimer's Accelerated by a Chemical in Cigarette Smoke, Auto Exhaust and French Fries

There is growing evidence that exposure to a group of chemicals known as type-2 alkenes -- which are found in the smoke inhaled from cigarettes, the exhaust of automobiles and even in French fries – can increase the chances of developing Alzheimer’s disease and other neurological conditions such as Parkinson’s disease.

“The thought process and memory deficits associated with Alzheimer’s disease appear to be due to the very early loss of function of nerve endings in the brain,” said Richard M. LoPachin, Ph.D., a neurochemist and director of research in the Department of Anesthesiology at Montefiore Medical Center and the Albert Einstein College of Medicine.

“Two years ago, we published a series of peer-review papers describing how type-2 alkenes (such as acrylamide and acrolein) damage nerve endings in the brains of animals and, since then, interest in the scientific community has grown steadily,” said Dr. LoPachin. “For example, just in the last six months there were more than a half dozen articles published in neuroscience journals that demonstrate an excess of acrolein and other type-2 alkenes in the brains of Alzheimer’s patients.”

The Perfect Neurological Storm

According to Dr. LoPachin, this excess means that these highly toxic chemicals are also being generated within nerve endings during the disease process that presumably initiates Alzheimer’s dementia. Dr. LoPachin believes that this internal production of the type-2 alkenes, along with external exposure to these chemicals (smoking, diet and other environmental factors), causes a perfect neurological storm – a doubly powerful type-2 alkene attack on brain nerve endings from outside the body and from with-in.
“This dual intoxication of nerve endings led us to conclude that daily environmental exposure to neurotoxic type-2 alkenes could increase the incidence of Alzheimer’s disease,” he said.

Can Curry, Wine and Apple Skins Offer a Cure?

As evidence for the role of type-2 alkenes in neurological disorders such as Alzheimer’s disease has grown, Dr. LoPachin and his colleague, Dr. Terrence Gavin, in the Department of Chemistry at Iona College, have discovered a possible antidote that is derived from chemical compounds found in curry spice (curcumin), wine (resveratrol) and apple skins (phloretin).

Their research, recently reported in a Journal of Neurochemistry article ( Title: β-Dicarbonyl Enolates: A New Class of Neuroprotectants), showed that a compound called 2-ACP completely protected nerve cells in culture from acrolein-induced damage by latching onto this type-2 alkene and neutralizing its toxic effects. 2-ACP could, therefore, be a treatment for neurological conditions such as Alzheimer’s and Parkinson’s disease. Drs. LoPachin and Gavin believe that 2-ACP treatment would be safe and effective in humans, because it is derived from non-toxic natural products that already have clinically demonstrated neuroprotective properties.
Dr. LoPachin says that although the 2-ACP studies are quite advanced in the world of molecular biology, they nonetheless will need to be confirmed in animal studies.
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Brain Tumor Risk May Double after 10 Years of Cell Phone Use

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Best Available Evidence Links Cell Phone Use to Brain Tumors

The highest-quality research data available suggests that long-term exposure to microwaves from cellular phones may lead to an increased risk of brain tumors, reports a paper in the November/December issue of Journal of Computer Assisted Tomography. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, and pharmacy.

Although debate continues, independent studies with long-term follow-up strongly suggest an increased risk of brain tumors related to the use of cellular or cordless phones. "We conclude that the current standard of exposure to microwave during mobile phone use is not safe for long-term exposure and needs to be revised," conclude the study authors, led by R.B. Dubey of Apeejay College of Engineering, Sohna, Gurgaon, India.

Brain Tumor Risk May Double after 10 Years of Cell Phone Use


There is increasing public concern about the potential cancer risks from microwave emissions related to wireless phones—not only cellular phones and base stations (transmission tower antennae), but also home cordless phones. Some studies have reported that long-term wireless phone users have increased rates of brain tumors, including malignant gliomas and benign acoustic neuromas. However, other studies have found no association.

To gain insight into the controversy, Dubey and colleagues performed an in-depth analysis of research on the health risks associated with microwave exposure from wireless phones. To date, only eleven published studies have provided data on the risk of developing brain tumors in long-term cell phone users—ten years or longer.
The largest data source was a series of studies called the Interphone studies, which were largely funded by the wireless communications industry. Based on data from thirteen countries, the Interphone studies concluded that cell phone exposure did not increase the risk of brain tumors. In addition to possible bias associated with industry funding, the studies had some important flaws, including relatively short durations of cell phone use.

However, an independent series of studies led by Swedish cancer specialist Dr. Lennart Hardell reached a different conclusion. Dr. Hardell's studies included more patients who had used a cell phone for ten years or longer and were performed without financial support from the wireless industry. The findings suggested that the more hours of cellular phone use over time, the higher the risk of developing brain tumors. Risk also increased along with the level of power from the wireless device, years since first use, total exposure, and younger age when starting wireless phone use.

Based on an analysis of pooled data from different studies, researchers write, "[L]ong-term cell phone usage can approximately double the risk of developing a glioma or acoustic neuroma in the more exposed brain hemisphere"—that is, on the side where the user typically holds the phone to the ear. That conclusion is consistent even with data on the long-term cell phone users from the Interphone studies.

It's unclear exactly how exposure to microwave radiation from cell phones may increase brain cancer risk. However, studies have shown that the cell signal is absorbed up to two inches in the adult skull. There is special concern about the risks in younger age groups, as cell phone signals penetrate much deeper into the brain in children.
Further studies are needed to definitively determine the risk of brain cancer and other health effects related to long-term use. Meanwhile, Dr. Dubey and coauthors suggest some steps that cell phone users can take to reduce exposure. These include limiting the number and length of calls, restricting children's cell phone use, communicating by text instead of voice, and wearing an "air tube" headset (not a regular wired headset) rather than holding the phone to the ear.

The researchers also urge adoption of newer phones and other technologies to reduce exposure, and call for government action to revise standards for microwave exposure. "The precautionary principle clearly applies in this case, since the problem is possible but not certain and low cost ameliorating actions are easily implemented by industry," Dubey and coauthors conclude. "With over 3 billion people using cell phones and with children among the heaviest users, it is time for governments to mandate precautionary measures to protect their citizens."
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Bean disease (Lima beans yellow)

Friday, November 19, 2010

Disease also known as Lima beans yellow beans is due to eating beans and broad beans or smell the smell of pollen and bean induced acute anemia, jaundice and hemoglobinuria as the main clinical manifestations of the disease. More than 90% occurring in men, and most found in children under age 5. In the southwest, south, east and north China have been found all over, in the Guangdong, Sichuan, Guangxi, Hunan, Jiangxi to the most.

Erythrocyte glucose -6-- phosphate dehydrogenase (G6PD) has a genetic defect in the consumption of fresh green beans or bean pollen exposure occurs after both acute hemolytic anemia - bean disease. Pathogenic mechanisms are not yet very clear, but the genetic defects known to have sensitive red blood cells, a factor in the case of beans, caused by acute intravascular hemolysis.

[Clinical manifestations]
Early aversion to cold, fever, dizziness, fatigue, weakness, anorexia, abdominal pain, followed by jaundice, anemia, hemoglobin in urine, urine color was soy sauce, then fever, fatigue fatigue increased, sustainable 3 days or so. And hemolytic anemia occur at the same time, vomiting, diarrhea and abdominal pain increased, hepatomegaly, abnormal liver function, approximately 50% of patients with splenomegaly. Seen severe cases coma, convulsions and acute renal failure, if the aid is often less than 1 to 2 days at death.

[Diagnostic Methods]
1. Are eating beans green beans or inhalation of pollen history.
2. Clinical features:
① incubation period of several hours to 48 hours.
② performance poisoning: early aversion to cold, fever, dizziness, fatigue, weakness, anorexia, abdominal pain, followed by jaundice, anemia, hemoglobin in urine, urine color was soy sauce, then fever, fatigue fatigue increased, sustainable 3 around June.
③ The check: methemoglobin reduction test (MHb) to restore normal rates of> 75% (colorimetric method), broad bean MHb reduction rate in patients with 31% to 74% (genetic heterozygotes), with reduction rate "30% (pure zygosity); blood corpuscles with denatured globin (He Enzi bodies) can be more than 5% (normal is 0 to 0.28%).

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Von Willebrand

VWD von Willebrand referred to is second only to the most common hemophilia hereditary hemorrhagic disease. Childhood that is characterized by hemorrhagic tendency, prolonged bleeding time and factor Ⅷ content reduced. VWD is the lack of high molecular weight factor Ⅷ part, that Ⅷ R due. 1 Ⅷ R is autosomal, and Ⅷ: C is the X chromosome inherited.

Typical VWD only factor Ⅷ related antigen (Ⅷ R: Ag) that Ⅷ R antigen part of the activity decreased, and the factor Ⅷ Rui Situo enzyme cofactor (Ⅷ R: RCOF) reduced or lack of, and Ⅷ: C also reduced, but the extent as severe hemophilia. Ⅷ R: Ag and Ⅷ R: RCOF is between platelets and vascular endothelial and platelet adhesion between the important factor, is induced platelet aggregation from Rui Situo enzyme cofactor, since the lack of von Willebrand The factors that platelet adhesion and aggregation function has obstacles, prolonged bleeding time.

Von Willebrand mode of inheritance is autosomal dominant inheritance, individual subtypes of recessive inheritance. Incidence of both men and women, parents can pass, and some parents may be no bleeding patients. Von Willebrand more bleeding tendency in childhood, adulthood, only a small number of patients to clinical symptoms. Von Willebrand typical symptoms of bleeding in hemophilia similar, but lesser extent, but there are more serious. Condition can be mitigated with age.

Von Willebrand medicine is a "hyperlipidemia" Consumption "category. Its pathogenesis and hemophilia similar.

[Clinical manifestations of von Willebrand]
1. Have a family history: in line with autosomal dominant inheritance, which both men and women to the disease, both parents can be inherited. 2. Hemorrhagic tendency: a mucous membrane, subcutaneous bleeding, or menorrhagia, severe bleeding after surgery with or without history of a small number of joint, muscle bleeding, but generally no joint deformity.

[Von Willebrand diagnosis is based on]
(A) with or without family history, have a family history consistent with autosomal dominant or recessive inheritance.
(B) clinical there mucosa, skin, visceral bleeding, or menorrhagia history of trauma, surgery with or without abnormal bleeding history, a small number of patients can the relevant section of cavity, muscle or other parts of the bleeding.
(C) of the laboratory examination can help diagnose
1. Platelet morphology and count properly.
2. Prolonged bleeding or aspirin tolerance test was positive.
3. Platelet adhesion test extended or normal.
4. Activated partial thromboplastin time prolonged or normal.
5.vWF factor antigen (vWF: Ag) to reduce or normal.
6. Ⅷ coagulation factor activity (Ⅷ: C) reduced or normal.
7. Must exclude platelet dysfunction disease.
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Light to moderate drinking linked to fewer heart problems in male bypass patients

Thursday, November 18, 2010

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Male heart bypass patients who drank light to moderate amounts of alcohol daily were less likely to require additional heart procedures or suffer a heart attack or stroke, compared to non-drinking patients.
However, bypass patients whose hearts didn’t pump blood effectively and women were more likely to require additional procedures or have a heart attack or stroke after their surgery.
CHICAGO, Nov. 14, 2010 — Light to moderate alcohol consumption (about two to three drinks daily) among male coronary artery bypass patients was associated with 25 percent fewer subsequent cardiovascular procedures, heart attacks, strokes and death compared to non-drinkers, in a study presented at the American Heart’s Association’s Scientific Sessions 2010.

However, bypass patients with left ventricular dysfunction who were moderate to heavy drinkers (more than six drinks daily) were twice as likely to have subsequent cardiovascular deaths compared to non-drinkers.

“The benefit of light amounts of alcohol consumption has been documented in healthy individuals, but our analysis showed a benefit from light alcohol intake in post-coronary bypass patients,” said Umberto Benedetto, M.D., Ph.D. at the University of Rome La Sapienza in Italy. “However, our analysis indicated that alcohol consumption is not advisable in patients with left ventricular dysfunction and heart failure. No adverse correlation was found between moderate alcohol consumption and any medication.”

Light to moderate alcohol consumption was defined as five to 30 grams of alcohol daily; moderate to heavy was defined as more than 60 grams daily.

Researchers used a standard questionnaire to compare alcohol consumption in 1,021 patients who underwent heart bypass and reviewed subsequent bypass procedures, heart attacks, strokes and cardiac deaths during the following 3 1/2 years. Patients consuming about two drinks daily had fewer cardiovascular events when compared to abstainers.

Moreover, moderate to heavy alcohol consumption (about four drinks daily) by patients with left ventricular problems was associated with significantly greater risk of dying.

Results of the study need to be confirmed over a longer follow-up period, with more patients and controls, Benedetto said.

The American Heart Association does not recommend people start consuming alcohol to prevent heart disease because too much alcohol can raise blood pressure and have other negative effects. For those who already drink alcohol, the association recommends women limit themselves to a drink a day and men limit themselves to two drinks per day.

Co-authors are: Giovanni Melina, M.D., Ph.D.; Davide Sansone, M.D.; Roberta Di Bartolomeo, M.D.; Emiliano Angeloni, M.D.; Simone Refice, M.D.; Ivan Stigliano, M.D.; Antonino Roscitano, M.D.; Tommaso Hinna Danesi, M.D.; and Riccardo Sinatra, M.D.

ALSO SEE
Abstract 18681 Regular moderate drinking among women associated with greater survival
Regular moderate alcohol consumption – two to four drinks daily – in mid-life may yield a small but significant increase of overall health status in women who survive into old age.

The researchers prospectively reviewed data from the Nurses’ Health Study in almost 14,000 individuals who survived to 70 years or older.

After adjusting for issues such as smoking, weight and physical activity, moderate alcohol use was associated with an 11 to 26 percent increase in survival odds.

The odds were also better for the nurses who drank regularly rather than those who drank sporadically or engaged in periodic binge drinking. Women who drank regularly rather than binging had a 28 percent increased survival odds if they drank three to six days a week and a 22 percent increased survival odds if they drank everyday — compared to 7 percent for those who
drank once or twice a week.

Abstract 19870 Low dose alcohol appears to decrease risk of stroke in women.
Researchers, who studied alcohol consumption and strokes in the Nurses’ Health Study database of over 84,000 nurses followed for more than 20 years, found that women who drank less than 15 grams of alcohol/day (approximately one drink/day) had a 20 percent lower risk of stroke compared to those who did not drink.
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Women with high job strain have 40 percent increased risk of heart disease

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Women who report having high job strain have a 40 percent increased risk of cardiovascular disease, including heart attacks and the need for procedures to open blocked arteries, compared to those with low job strain, according to research presented at the American Heart Association's Scientific Sessions 2010.

In addition, job insecurity – fear of losing one's job – was associated with risk factors for cardiovascular disease such as high blood pressure, increased cholesterol and excess body weight. However, it'snot directly associated with heart attacks, stroke, invasive heart procedures or cardiovascular death, researchers said.

Job strain, a form of psychological stress, is defined as having a demanding job, but little to no decision-making authority or opportunities to use one's creative or individual skills.

"Our study indicates that there are both immediate and long-term clinically documented cardiovascular health effects of job strain in women," said Michelle A. Albert, M.D., M.P.H., the study's senior author and associate physician at Brigham and Women's Hospital, Boston, Mass. "Your job can positively and negatively affect health, making it important to pay attention to the stresses of your job as part of your total health package."

Researchers analyzed job strain in 17,415 healthy women who participated in the landmark Women's Health Study. The women were primarily Caucasian health professionals, average age 57 who provided information about heart disease risk factors, job strain and job insecurity. They were followed for more than 10 years to track the development of cardiovascular disease. Researchers used a standard questionnaire to evaluate job strain and job insecurity with statements such as: "My job requires working very fast." "My job requires working very hard." "I am free from competing demands that others make."

The 40 percent higher risks for women who reported high job strain included heart attacks, ischemic strokes, coronary artery bypass surgery or balloon angioplasty and death. The increased risk of heart attack was about 88 percent, while the risk of bypass surgery or invasive procedure was about 43 percent.

"Women in jobs characterized by high demands and low control, as well as jobs with high demands but a high sense of control are at higher risk for heart disease long term," said Natalie Slopen, Sc.D., lead researcher and a postdoctoral research fellow at Harvard University Center on the Developing Child in Boston.

Previous research on the effects of job strain has focused on men and had a more restricted set of cardiovascular conditions. "From a public health perspective, it's crucial for employers, potential patients, as well as government and hospitals entities to monitor perceived employee job strain and initiate programs to alleviate job strain and perhaps positively impact prevention of heart disease," Albert said.
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Vitamin D deficit doubles risk of stroke in whites, but not in blacks

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Low levels of vitamin D, the essential nutrient obtained from milk, fortified cereals and exposure to sunlight, doubles the risk of stroke in whites, but not in blacks, according to a new report by researchers at Johns Hopkins.

Stroke is the nation's third leading cause of death, killing more than 140,000 Americans annually and temporarily or permanently disabling over half a million when there is a loss of blood flow to the brain.

Researchers say their findings, to be presented Nov. 15 at the American Heart Association's (AHA) annual Scientific Sessions in Chicago, back up evidence from earlier work at Johns Hopkins linking vitamin D deficiency to higher rates of death, heart disease and peripheral artery disease in adults.

The Hopkins team says its results fail to explain why African Americans, who are more likely to be vitamin D deficient due to their darker skin pigmentation's ability to block the sun's rays, also suffer from higher rates of stroke. Of the 176 study participants known to have died from stroke within a 14-year period, 116 were white and 60 were black. Still, African Americans had a 65 percent greater likelihood of suffering such a severe bleeding in or interruption of blood flow to the brain than whites, when age, other risk factors for stroke, and vitamin D deficiency were factored into their analysis.

"Higher numbers for hypertension and diabetes definitely explain some of the excess risk for stroke in blacks compared to whites, but not this much risk," says study co-lead investigator and preventive cardiologist Erin Michos, M.D., M.H.S., an assistant professor at the Johns Hopkins University School of Medicine and its Heart and Vascular Institute. "Something else is surely behind this problem. However, don't blame vitamin D deficits for the higher number of strokes in blacks."

Nearly 8,000 initially healthy men and women of both races were involved in the latest analysis, part of a larger, ongoing national health survey, in which the researchers compared the risk of death from stroke between those with the lowest blood levels of vitamin D to those with higher amounts. Among them, 6.6 percent of whites and 32.3 percent of blacks had severely low blood levels of vitamin D, which the experts say is less than 15 nanograms per milliliter.

"It may be that blacks have adapted over the generations to vitamin D deficiency, so we are not going to see any compounding effects with stroke," says Michos, who notes that African Americans have adapted elsewhere to low levels of the bone-strengthening vitamin, with fewer incidents of bone fracture and greater overall bone density than seen in Caucasians.

"In blacks, we may not need to raise vitamin D levels to the same level as in whites to minimize their risk of stroke" says Michos, who emphasizes that clinical trials are needed to verify that supplements actually do prevent heart attacks and stroke. In her practice, she says, she monitors her patients' levels of the key nutrient as part of routine blood work while also testing for other known risk factors for heart disease and stroke, including blood pressure, glucose and lipid levels.

Michos cautions that the number of fatal strokes recorded in blacks may not have been statistically sufficient to find a relationship with vitamin D deficits. And she points out that the study only assessed information on deaths from stroke, not the more common "brain incidents" of stroke, which are usually non-fatal, or even mini-strokes, whose symptoms typically dissipate in a day or so. She says the team's next steps will be to evaluate cognitive brain function as well as non-fatal and transient strokes and any possible tie-ins to nutrient deficiency.

Besides helping to keep bones healthy, vitamin D plays an essential role in preventing abnormal cell growth, and in bolstering the body's immune system. The hormone-like nutrient also controls blood levels of calcium and phosphorus, essential chemicals in the body. Shortages of vitamin D have also been tied to increased rates of breast cancer and depression in the elderly.

Michos recommends that people maintain good vitamin D levels by eating diets rich in such fish as salmon and tuna, consuming vitamin-D fortified dairy products, and taking vitamin D supplements. She also promotes brief exposure daily to the sun's vitamin D-producing ultraviolet light. And to those concerned about the cancer risks linked to too much time spent in the sun, she says as little as 10 to 15 minutes of daily exposure is enough during the summer months.

If vitamin supplements are used, Michos says that daily doses between 1,000 and 2,000 international units are generally safe and beneficial for most people, but that people with the severe vitamin D deficits may need higher doses under close supervision by their physician to avoid possible risk of toxicity.

The U.S. Institute of Medicine (IOM) previously suggested that an adequate daily intake of vitamin D is between 200 and 600 international units. However, Michos argues that this may be woefully inadequate for most people to raise their vitamin D blood levels to a healthy 30 nanograms per milliliter. The IOM has set up an expert panel to review its vitamin D guidelines, with new recommendations expected by the end of the year. Previous results from the same nationwide survey showed that 41 percent of men and 53 percent of women have unhealthy amounts of vitamin D, with nutrient levels below 28 nanograms per milliliter.

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Regular exercise reduces large number of health risks including dementia and some cancers

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People who take regular exercise could reduce their risk of developing around two dozen physical and mental health conditions - including some cancers and dementia - and slow down how quickly their body deteriorates as they age.

An extensive research review, published in the December issue of IJCP, the International Journal of Clinical Practice, says that apart from not smoking, being physically active is the most powerful lifestyle choice any individual can make to improve their health.

Physiotherapist and lecturer Leslie Alford from the University of East Anglia reviewed 40 papers covering the latest international research published between 2006 and 2010.

"The literature reviewed shows that how long people live and how healthy they are depends on a complex mix of factors, including their lifestyle, where they live and even luck" says Mr Alford. "Individuals have an element of control over some of these factors, including obesity, diet, smoking and physical activity.

"Although the focus of my study was on men's health, the messages on physical activity are relevant to both sexes and all age groups."

Health benefits identified by the review include:

• Regular moderate to intense physical activity is associated with decreased risk of coronary heart disease and ischaemic and haemorrhagic stroke.
• A growing body of evidence suggests that increasing physical activity can also reduce the risk of certain types of cancers, osteoporosis, type 2 diabetes, depression, obesity and high blood pressure.
• Evidence of the beneficial effects of physical activity in the primary prevention and management of cancer is growing and there is an association between higher levels of physical activity and lower cancer death rates.
• Research has found that walking or cycling for at least an half-an-hour a day is associated with a reduction in cancer and that when this is increased to an hour cancer incidence falls by 16 per cent.
• Evidence is mixed when it comes to specific cancers. Research has shown a strong relationship between increased physical activity and reduced colon cancer in both sexes. And men who are more active at work - not just sitting at a desk - have lower rates of prostate cancer.
• Other cancer studies show that physical activity after diagnosis can aid recovery and improve outcomes.
• Studies have also shown that men who are physically active are less likely to experience erection problems.
• There is growing evidence that physical activity could decrease the risk of dementia in the elderly.

Recommendations identified by the review include:

• Healthy adults aged between 18 and 65 should aim for 150 minutes of moderate intensity physical activity a week, such as 30 minutes of brisk walking, five days a week. And people who undertake more vigorous intensity exercise, such as jogging, should aim for 20 minutes three days a week.
• Healthy adults should aim for two strength-training sessions a week that work with the body's major muscle groups.
• Older people can benefit from exercise that helps to maintain their balance and flexibility.
• People who are physically active should continue to exercise even when they become middle aged or elderly and those who aren't should increase their physical activity.
• Not smoking and following a healthy diet is also important.


"Ideally, to gain maximum health benefits people should exercise, not smoke, eat a healthy diet and have a body mass index of less than 25" says Mr Alford. "The more of these healthy traits an individual has, the less likely they are to develop a range of chronic disorders. Even if people can't give up smoking and maintain a healthy weight, they can still gain health benefits from increasing the amount of regular exercise they take.

"Physical inactivity results in widespread pathophysiological changes to our bodies. It appears that our bodies have evolved to function optimally on a certain level of physically activity that many of us simply do not achieve in our modern, sedentary lifestyles.

"What is clear from the research is that men and women of all ages should be encouraged to be more physically active for the sake of their long-term health."

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