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Exercise and B vitamins can help cure a hangover, but coffee won't help.

These are among the tips that Loyola University Health System family physician Dr. Aaron Michelfelder offers to avoid the misery of a New Year's hangover.

Before the party:

-- Plan to drink moderately -- a maximum of five drinks for men and three drinks for women during a minimum three-hour period.
-- To prevent inflammation, take an anti-inflammatory drug such as ibuprofen or Aleve.
During the party:
-- Eat first, and then drink, not the other way around. Food slows the absorption of alcohol.
-- Drink slowly.
-- To prevent dehydration, drink a glass of water after each alcoholic drink.
-- Take a B vitamin supplement.

After the party:

-- Do not drink and drive.
-- Get as much sleep as possible.

The morning after:

-- Take another B vitamin.
-- Drink lots of water.
-- Exercise (if you can stand it). During vigorous exercise, blood circulates three times as fast as it does when you are sitting on the couch. And the faster you circulate blood through your liver and kidneys, the faster your body will remove the toxins.

What doesn't work:

-- Coffee will make you more alert, but it won't prevent or help a hangover.
-- Forget "hair of the dog" -- the notion that having a drink can relieve a hangover. It will only make you feel worse.

I started the blog on which these reports are based largely to motivate myself to keep informed and to adapt healthier ways of life. Due to the fact that I was somewhat overweight, and that my father and grandfather had both died at the age of 65, I felt extra precautions were necessary. Ironically, none of the health measures I adopted protected me from my own major health crisis at the age of 65, although I have survived and a full recovery is expected. But as a result of this health crisis, I have fallen off the wagon on many of my health practices, some out of necessity, some out of an understandable need, or at least, desire, for self-indulgence, and some out of sheer indifference.

But now I'm ready to try to resume as much as I can of healthy behaviors. Ironically as well, one of my principal motivations, weight, is no longer much of an issue, because as a result of the health crisis I have lost over 30 pounds, at least temporarily. I hope I've faced this crisis with the right attitude - because if I have, apparently I can live to 100.

Here's my report on one month's worth of new health research (but see last note):

1. I have to start taking Vitamin D again, (despite the inconclusive report e. below) and within the limits of my slow recovery, get more exercise, although I probably still won't be lifting weights, although I should:

a. "Exercise and Vitamin D supplements are the best ways to reduce the risk of falling in people aged 65 and over."

b. "A one-year follow-up study on seniors who participated in a strength training exercise program shows sustained cognitive benefits as well as savings for the healthcare system."

c. "Impairments to health and physical performance are not primarily a result of aging but of unfavorable lifestyle habits and lack of exercise. Sporty elderly people have a life expectancy that is almost 4 years higher and are often faster than younger athletes."

d. "New research from Tel Aviv University has found that "endurance exercises," like a Central Park jog or a spinning class, can make us look younger. The key, exercise, unlocks the stem cells of our muscles."

e. "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."

f. "Walking may slow cognitive decline in adults with mild cognitive impairment (MCI) and Alzheimer's disease, as well as in healthy adults."

2. One thing I have kept up, and am very happy I have, is my statin intake:

"Statin therapy is associated with reduced postoperative mortality. Preoperative uses of statins have demonstrated major cardiac and non-cardiac protective effects, including in this study. "

3. I have to be more careful about what I eat again ( although my wife still doesn't let me eat garlic):

a. Fats vs. Carbs: Debate Continues on the Sources of America’s Dietary Ills

b. "Eating a Southern staple, fried fish, could be one reason people in Alabama and across the "stroke belt" states are more likely than other Americans to die of a stroke."

c. "A new study provides some of the strongest evidence yet that those with healthy diets really do to live longer and feel better...Older adults who follow current dietary guidelines to consume relatively high amounts of vegetables, fruit, whole grains, low-fat dairy products, poultry and fish are more likely to have better nutritional status, higher quality of life and better survival than those who do not follow these guidelines."

d. High Dietary Fat, Cholesterol Linked to Increase Risk of Prostate Cancer

e. Garlic, onions and leeks, protect against hip osteoarthritis

4. I'm not ready to drink three glasses of milk a day or drink beetroot juice ( I almost threw up last time I tried it) but I do plan to eat more beets:

a. "Drinking three glasses of milk per day may lead to an 18% decreased risk of cardiovascular disease."

b. "New research into the health benefits of beetroot juice suggests it's not only athletes who can benefit from its performance enhancing properties – its physiological effects could help the elderly .. enjoy more active lives. Beetroot juice has been one of the biggest stories in sports science over the past year after researchers ...found it enables people to exercise for up to 16% longer. The startling results have led to a host of athletes – from Premiership footballers to professional cyclists – looking into its potential uses."

5. I don't take echinea, nor do I plan to, but if I did this report would not stop me:

Echinea may reduce common-cold duration by only half a day

6. No more overripe bananas or grapes? I'll miss them! This link is well worth reading:

" With a diet that is high in proteins with more lean meat, low-fat dairy products and beans and fewer finely refined starch calories such as white bread and white rice, most people can eat until they are full without counting calories and without gaining weight." But there are some provisos -

Some types of fruit may be consumed ad libitum, (freely) such as apples, pears, oranges, raspberries and strawberries. Other types should be eaten in only very limited amounts, including bananas (especially overripe bananas), grapes, kiwi, pineapple and melon. Nearly all vegetables are permitted, with the exception of corn, which should be limited. Carrots, beets and parsnip should preferably be eaten raw.

With regard to cereal-based foods (bread, grain, corn, hulled grains and breakfast products), the goal is to eat as many coarse and wholegrain foods as possible, i.e. wholegrain breads with many kernels, wholegrain pasta, whole oats and the special varieties of wholegrain cornflakes

Potatoes should be cooked as little as possible. Try to stick to new potatoes, and it is a good idea to eat them cold. Avoid mashed potatoes and baked potatoes.

Pasta should be cooked al dente and is best eaten cold.

I'll certainly be eating my parsnips raw from now on!

7. I'm going to resume drinking lots of green tea despite one inconclusive report. One of my readers has suggested frozen blueberries out of season - I need to check into that:

a. "Tea has long been regarded as an aid to good health, and many believe it can help reduce the risk of cancer. Most studies of tea and cancer prevention have focused on green tea. Although tea and/or tea polyphenols have been found in animal studies to inhibit tumorigenesis at different organ sites, including the skin, lung, oral cavity, esophagus, stomach, small intestine, colon, liver, pancreas, and mammary gland, the results of human studies—both epidemiologic and clinical studies—have been inconclusive."

b. "Eating purple fruits such as blueberries and drinking green tea can help ward off diseases including Alzheimer's, multiple sclerosis and Parkinson's."

8. I won't resume drinking cranberry juice:

"Drinking cranberry juice has been recommended to decrease the incidence of urinary tract infections, based on observational studies and a few small clinical trials. However, a new study published in the January 1 issue of Clinical Infectious Diseases, and now available online, suggests otherwise."

9. I'm going to try to check ingredient lists for amounts of sugar and high fructose corn syrup:

"Science shows us there is a potentially negative impact of excessive amounts of sugar and high fructose corn syrup on cardiovascular and kidney health."

10. I need to check with my doctor before I can resume taking aspirin:

a. "A daily low dose of aspirin significantly reduces the number of deaths from a whole range of common cancers, an Oxford University study has found."

b. How Aspirin Works To Prevent Heart Attacks

11. I have started drinking red wine again, but not yet daily:

a. "A fascinating study shows that although the French drink more than the Northern Irish each week, as they drink daily, rather than more on less occasions, the French suffered from considerably less coronary heart disease than the Northern Irish."

b. Moderate alcohol consumption lowers the risk of metabolic diseases

12. I need to start eating more fish and taking fish oil again:

Omega-3s in fish, seafood may protect seniors' eyes

Tell me this isn't depressing news:

In an effort to pinpoint potential triggers leading to inflammatory responses that eventually contribute to depression, researchers are taking a close look at the immune system of people living in today's cleaner modern society.

Rates of depression in younger people have steadily grown to outnumber rates of depression in the older populations and researchers think it may be because of a loss of healthy bacteria.

In an article published in the December issue of Archives of General Psychiatry, Emory neuroscientist Charles Raison, MD, and colleagues say there is mounting evidence that disruptions in ancient relationships with microorganisms in soil, food and the gut may contribute to the increasing rates of depression.

According to the authors, the modern world has become so clean, we are deprived of the bacteria our immune systems came to rely on over long ages to keep inflammation at bay.

Have you noticed that some reputed health benefits do not stand up after additional scrutiny?

This disturbing report in the New Yorker may explain the reason:

The test of replicability, as it’s known, is the foundation of modern research. It’s a safeguard for the creep of subjectivity. But now all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain. It’s as if our facts are losing their truth...

The disturbing implication of this study is that a lot of extraordinary scientific data is nothing but noise. This suggests that the decline effect is actually a decline of illusion...The decline effect is troubling because it reminds us how difficult it is to prove anything

So take everything I say here, and I'm only reporting on current research, with a grain of salt (but no more - salt isn't good for your blood pressure - or is it?)

Ω

A systematic review of over 50 clinical trials finds that exercise and Vitamin D supplements are the best ways to reduce the risk of falling in people aged 65 and over. The review is published in the December 21 issue of Annals of Internal Medicine and was commissioned by the US Preventive Services Task Force. A researcher at the Drexel University School of Public Health worked with colleagues at the Kaiser Permanente Center for Health Research, which is part of the Oregon Evidenced-based Practice Center, to conduct the study.

“Our evidence review shows that exercise and Vitamin D supplementation are the most effective primary care interventions to prevent falls,” said Yvonne L. Michael, ScD, MS, an associate professor at the Drexel University School of Public Health and lead review author of the report. “This is important news because falls are extremely common in this population and they are the leading cause of death and injury for the elderly. We need to help primary care clinicians find better ways to prevent falls, and this review will help to do that.”

Michael and her colleagues evaluated 18 clinical trials of exercise and physical therapy involving nearly 4,000 people who were aged 65 or older. Some of the trials involved group exercise or Thai Chi classes; others involved individualized exercise instruction at home. There were a variety of exercises included but most were aimed at improving gait, balance, strength and flexibility needed to do everyday activities. The interventions ranged from six weeks to 12 months or longer and the evaluation periods lasted up to 18 months after the programs ended. When taken individually most of these trials showed no statistical difference, but when the results were pooled together the exercisers had a 13 percent lower risk of falling compared to those who did not exercise.

For the review of Vitamin D supplementation researchers evaluated nine clinical trials involving nearly 6,000 participants who received daily oral doses of Vitamin D with or without calcium. The dosage ranged from 10 to 1,000 IU’s per day, in one trial participants received a larger single intramuscular injection of 600,000 IU’s of Vitamin D. The trials lasted from eight weeks to three years. Follow up periods ranged from six to 36 months. Participants who received Vitamin D had a 17 percent reduced risk of falling, compared to participants who did not receive Vitamin D.

Other interventions that addressed single risk factors including vision correction, medication assessment, home hazard modification, and education and behavioral counseling did not significantly reduce the risk of falling in the elderly. Interventions that provided comprehensive risk assessment and management did reduce the risk of falling by 11 percent. In these trials—called multifactorial assessment and management interventions—healthcare providers evaluated and managed multiple risk factors including medication use, visual problems, home environment and gait and balance issues. In many of the successful trials, home health nurses or case managers developed an individual tailored approach specifically for that participant. For example, the nurse might conduct a home visit to remove obstacles, help the patient enroll in an exercise class to improve balance, and help the patient get in to see an ophthalmologist to address a vision problem.

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Statin drugs were first introduced to lower blood cholesterol concentrations; however, research is now discovering other benefits. A new study from France, published in the January 2011 issue of Anesthesiology, is the first to analyze the impact of preoperative chronic statin therapy on postoperative adverse events in surgical patients. Findings from the study suggest that statin therapy is associated with reduced postoperative mortality.

“Preoperative uses of statins have demonstrated major cardiac and non-cardiac protective effects, including in this study. Since we are now able to also understand the postoperative effects of statin therapy, it should be considered as a global protection for patients,” said study author, Bruno Riou, M.D., Ph.D.

The observational study analyzed 1,674 patients undergoing aortic reconstruction surgeries from January 2001 to December 2009. Researchers from the Université Pierre et Marie Curie (UPMC) and the Assistance Publique-Hôpitaux de Paris in Paris, France, compared the outcomes between patients who received chronic statin therapy with those who did not. Results showed statins were associated with the following:_•An almost threefold reduction in the risk of death in patients undergoing major vascular surgery._•An almost twofold reduction in the risk of postoperative heart attack._•A reduced risk of postoperative stroke and kidney failure.

While statins did not reduce the risk of pneumonia, multiple organ dysfunction syndrome, and surgical complications, they did reduce mortality in patients with postoperative multiple organ dysfunction syndrome and in those developing postoperative surgical complications.

Lead study author Yannick Le Manach, M.D. added that his research team believes the way statins are currently administered to patients remains a limitation. He supports the development of intravenous formulations of statins in order to administer the drugs during and immediately after surgery. This could improve postoperative outcomes by maintaining optimal blood concentrations and avoiding low plasma levels.

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A growing number of top nutritional scientists are pointing to excessive carbohydrates, rather than fat, as the source of America’s dietary woes. As reported in the Los Angeles Times on December 20, some researchers are saying that cutting carbohydrates is the key to reversing obesity, heart disease, Type 2 diabetes and hypertension.

Dietary fat has traditionally played the role of “public enemy No. 1,” and consumption of carbohydrates has increased over the years with the help of a 30-year-old, government-mandated message to cut fat. Today Americans, on average, eat 250 to 300 grams of carbs a day, accounting for about 55% of their caloric intake; the most conservative recommendations say they should eat half that amount.
At the same time, some others are urging the public not to paint all carbohydrates with the same negative brush. “You just cannot lump all carbs into a single category,” says Tom Griesel, coauthor (with his sister Dian) of the forthcoming book TurboCharged, which outlines a fresh approach to reducing body fat as the key to weight loss.

“Fruits and vegetables are in a class all by themselves,” says Mr. Griesel. “This is because they are truly unrefined and contain fiber along with a high moisture content in their raw or lightly cooked state, and contain many readily available and usable nutrients. Because of this, they do not have the same insulin effect of any other refined or “complex” carb. Eliminating them or reducing them from the diet will always be a big mistake, because most people will then resort to eating other inferior types of carbs.”

“Other types of carbs are the problem,” says Dian Griesel, “and they are what should be eliminated or severely restricted in one’s diet. Other than calories, they contain almost no nutritional value. This is why they are almost always fortified. This group includes all sugar, particularly high fructose corn syrup; refined foods and drinks; including anything packaged; as well as all grain products, refined or unrefined. All these are concentrated carbohydrates—the most densely caloric of any “foods”—and even small quantities will cause blood sugar levels to rise to problematic levels and subsequently result in unhealthy insulin spikes. People do not realize that consuming even a small amount will have this effect.”

Both Dian and Tom note that our bodies cannot store much glycogen, and so this excess sugar is almost all stored as body fat. This happens even if we have way too much body fat already. The presence of insulin makes fat burning, using fat for energy, impossible. So even small amounts of these “other carbs” at the very least keep people fat, and most likely fatter. Reducing the amount consumed is not the answer; eliminating them is.

“So we do not have a carbohydrate problem; we have a wrong kind of carbohydrate problem,” Tom says. “This is a critical point to understand.”

A separate problem, observes Dian, concerns the substitution of proteins and fats for the restricted or eliminated carbohydrates. Although not as obvious, she says, too much protein is just as bad as not enough. “You only need enough to take care of repair and maintenance of existing lean body mass (LBM) and possibly building new LBM,” she says. “Excess protein in the diet will sometimes be used for fuel—a very inefficient process—or end up being stored as body fat. Processing excess protein puts unnecessary stress on the body. There is an optimal amount of protein that is based on an individual’s current LBM and activity levels which is generally about 10% of daily calories.”

The Griesels go on to say that fat is our body’s preferred energy source, drawn either from our diet or available existing body fat. However, choosing the correct dietary fat is of utmost importance. Most refined fats, vegetable oils, are problematic in anything other than small quantities. Trans-fats, they say, are very bad and should be avoided entirely, because they cause major metabolic problems and may remain in the body for more than two years. Trans-fats are in almost all processed foods, including vegetable oils. “The only healthy fats are the ones that come naturally in animal products like organic, wild or grass-fed meats; fish and eggs; and even dairy, along with nuts, olives, avocados,” says Tom. “There are no natural oils; they are all refined.”

Clearly, when assessing the relative effects of fats vs. carbohydrates, it pays to carefully study what dieticians know about their effects on the body—and choose our foods accordingly.

Ω

Eating a Southern staple, fried fish, could be one reason people in Alabama and across the "stroke belt" states are more likely than other Americans to die of a stroke, according to a study published in the December 22, 2010, online issue of Neurology, the medical journal of the American Academy of Neurology (AAN).

In the stroke belt states – Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee – the risk of dying from stroke is higher than in other parts of the country. In Alabama, the stroke death rate is 125 per every 100,000 people, against a national average of just 98 per 100,000.

The study was part of the long-running REGARDS (Reasons for Geographic And Racial Differences in Stroke) trial, led by George Howard, Dr. PH, at the University of Alabama at Birmingham. REGARDS enrolled 21,675 people over the age of 45 between January 2003 and October 2007, and continues to follow them for health events.

Studies have shown that the omega-3 fatty acids in fish, especially fatty fish, may reduce the risk of stroke, but other research has shown that frying fish leads to the loss of the natural fatty acids, the AAN said in a press release.

The American Heart Association recommends that people eat fish at least twice a week, with an emphasis on fatty fish. In the entire study, fewer than 1 in 4 participants consumed two or more servings of non-fried fish per week; people in the stroke buckle were 17 percent less likely to meet the recommendations than those in the rest of the country, the AAN said.

Moreover, the study showed that people in the stroke belt were 30 percent more likely to eat two or more servings of fried fish than those in the rest of the country.

"These differences in fish consumption may be one of the potential reasons for the racial and geographic differences in stroke incidence and mortality," Fadi Nahab, M.D., of Emory University, author of the current paper, said in an AAN press release.

"Our study showed that stroke belt residents, especially African-Americans, eat more fried fish than Caucasians and people living in the rest of the country," said Howard, professor and chair of the Department of Biostatistics in the School of Public Health at UAB.

The study found that blacks were more than three and a half times more likely to eat fried fish per week than whites, with an overall average of about one serving per week of fried fish for blacks compared to half of a serving for whites.

"One of the next steps in this research will be to determine if people who eat higher amounts of non-fried fish have less risk of stroke than people who don't eat a lot of fish or eat more fried fish," says Suzanne Judd, Ph.D., assistant professor of biostatistics at UAB and a study co-author.

Ω

New research into the health benefits of beetroot juice suggests it's not only athletes who can benefit from its performance enhancing properties – its physiological effects could help the elderly or people with heart or lung-conditions enjoy more active lives.

Beetroot juice has been one of the biggest stories in sports science over the past year after researchers at the University of Exeter found it enables people to exercise for up to 16% longer. The startling results have led to a host of athletes – from Premiership footballers to professional cyclists – looking into its potential uses.

A new piece of research by the university in conjunction with the Peninsula College of Medicine and Dentistry has revealed the physiological effects of drinking beetroot juice could help a much wider range of people.

In the latest study, published in the Journal of Applied Physiology, the researchers looked at low intensity exercise and found that test subjects used less oxygen while walking – effectively reducing the effort it took to walk by 12%.

Katie Lansley, a PhD student from the university's Sport and Health Sciences department and lead author of the study, said: "As you get older, or if you have conditions which affect your cardiovascular system, the amount of oxygen you can take in to use during exercise drops considerably. This means that, for some people, even simple tasks like walking may not be manageable.

"What we've seen in this study is that beetroot juice can actually reduce the amount of oxygen you need to perform even low-intensity exercise. In principle, this effect could help people do things they wouldn't otherwise be able to do."

When consumed, beetroot juice has two marked physiological effects. Firstly, it widens blood vessels, reducing blood pressure and allowing more blood flow. Secondly, it affects muscle tissue, reducing the amount of oxygen needed by muscles during activity. The combined effects have a significant impact on performing physical tasks, whether it involves low-intensity or high-intensity effort.

So far the research on the impacts of beetroot juice has only been carried out on younger people who are in good health, but the researchers believe there is no reason why the effects of beetroot juice wouldn't help others.

"While we haven't yet measured the effects on the elderly or those with heart or lung conditions, there is the potential for a positive impact in these populations which we intend to go on and investigate further," Katie Lansley added.

Beetroot juice contains high levels of nitrate. The latest study has proved that this is the key ingredient which causes the increase in performance, rather than any other component of the beetroot juice.

Professor Andy Jones, the senior scientist on the study and a pioneer of research into beetroot juice, said: "In this study, we were able to use - for the first time - both normal beetroot juice and beetroot juice with the nitrate filtered out. Test subjects didn't know which one they were getting. The drinks both looked and tasted exactly the same. Each time the normal, nitrate-rich juice was used, we saw a marked improvement in performance which wasn't there with the filtered juice – so we know the nitrate is the active ingredient."

###
The research paper Dietary nitrate supplementation reduces the O₂ cost of walking and running: a placebo controlled study is available to view online as an article in press in the Journal of Applied Physiology here: http://jap.physiology.org/cgi/reprint/japplphysiol.01070.2010v1

Ω

An over-the-counter herbal treatment believed to have medicinal benefits has minimal impact in relieving the common cold, according to research by the University of Wisconsin-Madison School of Medicine and Public Health.

The study, published in this month's Annals of Internal Medicine, involved echinacea, a wild flower (also known as the purple coneflower) found in meadows and prairies of the Midwestern plains. The supplement is sold in capsule form in drug and retail stores. Dried echinacea root has been used in homemade remedies such as teas, dried herb and liquid extracts.

The randomized trial involved more than 700 people between 12 and 80 years old. The subjects, all of whom had very early symptoms of a cold, were divided into four groups. One group received no pills, a second group received what they knew was echinacea, and a third group was given either echinacea or a placebo, but they did not know which. Participants recorded their symptoms twice a day for the duration of the cold, up to two weeks.

According to Bruce Barrett, the lead researcher and an associate professor of family medicine, patients receiving echinacea saw the duration of their cold reduced by seven to 10 hours. But he says this was not considered a significant decrease.

"Trends were in the direction of benefit, amounting to an average half-day reduction in the duration of a weeklong cold or an approximate 10 percent reduction in overall severity," he says. "However, this dose regimen did not make a large impact on the course of the common cold, compared either to blinded placebo or to no pills."

Barrett says a larger trial involving people who have found echinacea useful may help provide more answers. He adds that there were no side effects seen, so there is no reason that cold sufferers should stop using echinacea if they think it helps them.

"Adults who have found echinacea to be beneficial should not discontinue use based on the results of this trial, as there are no proven effective treatments and no side effects were seen," says Barrett.

Ω

Medical and dietary experts have long recommended healthy eating habits. Now, on the eve of one of our most calorically indulgent holidays, a new study provides some of the strongest evidence yet that those with healthy diets really do to live longer and feel better.

In a study published in the January 2011 issue of the Journal of the American Dietetic Association, researchers from the University of Maryland and five other institutions found that diets favoring "healthier foods" were associated with significantly reduced mortality when compared to diets high in fat and sugar. Their study investigated the associations of dietary patterns with mortality through analysis of the eating patterns of over 2,500 adults between the ages of 70 and 79 over a ten-year period.

According to lead author Amy L. Anderson, and senior author Nadine R. Sahyoun, both of the Department of Nutrition and Food Science at the University of Maryland, the results of this study suggest that older adults who follow current dietary guidelines to consume relatively high amounts of vegetables, fruit, whole grains, low-fat dairy products, poultry and fish are more likely to have better nutritional status, higher quality of life and better survival than those who do not follow these guidelines.

"Surprisingly few studies have investigated the associations of empirical dietary patterns with mortality," said Anderson. "Our study is the first to examine the dietary patterns of a relatively large and diverse U.S. cohort of adults aged 70 and over, and explore associations of these dietary patterns with survival. This study also is unique in that we also evaluated participants' quality of life and their nutritional status through detailed biochemical measures."

Shifts in Causes of Death & Population Age

The researchers note that the leading causes of death have shifted from infectious diseases to chronic, age-related diseases such as cardiovascular disease and cancer. These chronic illnesses can be affected by diet. Research has repeatedly linked excess weight and obesity to chronic, age-related illnesses such as heart disease, type-2 diabetes, certain cancers and stroke, all of which may be influenced by diet. Between 2000 and 2030, the number of adults worldwide aged 65 years and older is projected to more than double from approximately 420 million to 973 million.

This study examined the dietary patterns of a large and diverse group of older adults and explored associations of these dietary patterns with survival over a 10-year period. A secondary goal was to evaluate participants' quality of life and nutritional status according to their dietary patterns.

To do this, the researchers determined for the study participants the consumption frequency of 108 different food items and then grouped the participants into six different clusters according to their predominant food choices: "Healthy foods" (374 participants); "High-fat dairy products" (332); "Meat, fried foods, and alcohol" (693); "Breakfast cereal" (386); "Refined grains" (458); "Sweets and desserts" (339).

The "Healthy foods" cluster was characterized by relatively higher intake of low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables, and by lower consumption of meat, fried foods, sweets, high-calorie drinks, and added fat. The "High fat dairy products" cluster had higher intake of foods such as ice cream, cheese, and 2 percent and whole milk and yogurt, and lower intake of poultry, low-fat dairy products, rice, and pasta.

After controlling for gender, age, race, clinical site, education, physical activity, smoking, and total calorie intake, the "High-fat dairy products" cluster had a 40 percent higher risk of mortality than the "Healthy foods" cluster. The "Sweets and desserts" cluster had a 37 percent higher risk. No significant differences in risk of mortality were seen between the "Healthy foods" cluster and the "Breakfast cereal" or "Refined grains" clusters.

The study also evaluated participants' quality of life and nutritional status. Quality of life measures were based on self-assessments of health by the participants. Nutritional status was determined through detailed biochemical measures.

"Because a substantial percentage of older adults in this study followed the 'Healthy foods' dietary pattern, adherence to such a diet appears a feasible and realistic recommendation for potentially improved survival and quality of life in the growing older adult population," said Anderson.

"Our study supports the current recommendations for healthy eating," said Sahyoun," and if people see the direct association provided by this study with living longer and having a better quality of life, then maybe more people will recognize the importance of adopting these recommendations even at older ages, as part of a healthy lifestyle."

Ω

Researchers at King's College London and the University of East Anglia have discovered that women who consume a diet high in allium vegetables, such as garlic, onions and leeks, have lower levels of hip osteoarthritis.

The findings, published in the BMC Musculoskeletal Disorders journal, not only highlight the possible effects of diet in protecting against osteoarthritis, but also show the potential for using compounds found in garlic to develop treatments for the condition.

A relationship between body weight and osteoarthritis was previously recognised, although it is not yet completely understood. This study is the first of its kind to delve deeper into the dietary patterns and influences that could impact on development and prevention of the condition.

Osteoarthritis is the most common form of arthritis in adults, affecting around 8 million people in the UK, and women are more likely to develop it than men. It causes pain and disability by affecting the hip, knees and spine in the middle-aged and elderly population. Currently there is no effective treatment other than pain relief and, ultimately, joint replacement.

The study, funded by Arthritis Research UK, the Wellcome Trust and Dunhill Medical Trust, looked at over 1,000 healthy female twins, many of whom had no symptoms of arthritis.

The team carried out a detailed assessment of the diet patterns of the twins and analysed these alongside x-ray images, which captured the extent of early osteoarthritis in the participants' hips, knees and spine.

They found that in those who consumed a healthy diet with a high intake of fruit and vegetables, particularly alliums such as garlic, there was less evidence of early osteoarthritis in the hip joint.

To investigate the potential protective effect of alliums further, researchers studied the compounds found in garlic. They found that that a compound called diallyl disulphide limits the amount of cartilage-damaging enzymes when introduced to a human cartilage cell-line in the laboratory.

Dr Frances Williams, lead author from the Department of Twin Research at King's College London, says: "While we don't yet know if eating garlic will lead to high levels of this component in the joint, these findings may point the way towards future treatments and prevention of hip osteoarthritis.

"It has been known for a long time that there is a link between body weight and osteoarthritis. Many researchers have tried to find dietary components influencing the condition, but this is the first large scale study of diet in twins. If our results are confirmed by follow-up studies, this will point the way towards dietary intervention or targeted drug therapy for people with osteoarthritis."

Professor Ian Clark of the University of East Anglia said: "Osteoarthritis is a major health issue and this exciting study shows the potential for diet to influence the course of the disease. With further work to confirm and extend these early findings, this may open up the possibility of using diet or dietary supplements in the future treatment osteoarthritis."

Ω

A one-year follow-up study on seniors who participated in a strength training exercise program shows sustained cognitive benefits as well as savings for the healthcare system. The research, conducted at the Centre for Hip Health and Mobility at Vancouver Coastal Health and the University of British Columbia, is published today in the Archives of Internal Medicine.

The study is the first to examine whether both cognitive and economic benefits are sustained after formal cessation of a tailored exercise program. It builds on the Brain Power Study, published in the January 2010 issue of Archives of Internal Medicine, which demonstrated that 12 months of once-weekly or twice-weekly progressive strength training improved executive cognitive function in women aged 65- to 75- years- old. Executive cognitive functions are cognitive abilities necessary for independent living.

Both studies were led by Teresa Liu-Ambrose, principal investigator at the Centre for Hip Health and Mobility and Brain Research Centre at Vancouver Coastal Health and UBC, and assistant professor in the Department of Physical Therapy at UBC's Faculty of Medicine. The one year follow-up study found the cognitive benefits of strength training persisted, and with two critical findings.

"We were very surprised to discover the group that sustained cognitive benefits was the once-weekly strength training group rather than the twice-weekly training group," says Liu-Ambrose, who's also a Michael Smith Foundation for Health Research scholar. "What we realized was that this group was more successful at being able to maintain the same level of physical activity achieved in the original study."

In fact, the researchers found that while both the once-weekly strength training group and the control group – which performed twice-weekly balancing and toning exercises – were able to maintain higher levels of activity than when they first began the original study, individuals in the twice per week strength training group showed a reduction in physical activity. This reduction may be due community factors, both a lack of strength or weigh training programs tailored for older adults and the perception from seniors that they may need to undertake an activity program multiple times per week to receive any benefit.

The second important finding relates to the economic benefits of once-weekly strength training. Using the data from the Brain Power Study and the one-year follow-up study, health economists Jennifer Davis and Carlo Marra, research scientists with the Collaboration for Outcomes Research and Evaluation at St. Paul's Hospital and UBC Faculty of Medicine, were able to show that the economic benefits of once-weekly strength training were sustained 12 months after its formal cessation. Specifically, the researchers found the once-weekly strength group incurred fewer health care resource utilization costs and had fewer falls than the twice-weekly balance and tone group.

"This suggests that once-weekly resistance training is cost saving, and the right type of exercise for seniors to achieve maximum economic and health benefits," says Davis.

Cognitive decline among seniors is a pressing health care issue and a key risk factor for falls. Approximately 30 per cent of B.C. seniors experience a fall each year and fall-related hip fractures account for more than 4,000 injures each year at a cost of $75 million to the healthcare system.

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If you're unsure about what foods to eat to maintain a healthy diet, you're not alone. Increasing evidence continues to point people back to basics – and reach for the milk. A study to be published in the January edition of American Journal of Clinical Nutrition reveals that drinking three glasses of milk per day may lead to an 18% decreased risk of cardiovascular disease.

The research conducted at Wageningen and Harvard Universities, examined 17 studies from Europe, USA and Japan, also found no link between the consumption of regular or low-fat dairy and any increased risk of heart disease, stroke or total mortality.

"Milk and dairy are the most nutritious and healthy foods available and loaded with naturally occurring nutrients, such as calcium, potassium and protein, to name a few," said Dr. Cindy Schweitzer, Technical Director, Global Dairy Platform. "It's about going back to the basics; maintaining a healthy lifestyle doesn't have to be a scientific equation."

According to Dr. Schweitzer, during the past three decades as research sought to understand influencers of cardiovascular disease, simplified dietary advice including consuming only low fat dairy products emerged. However, in 2010 alone, a significant amount of new research was published from all over the world, supporting the health benefits of dairy.

From dispelling the myth that dairy causes heart disease, to revealing dairy's weight loss benefits, below is a 2010 roundup of select dairy research:

• US researchers examined 21 studies that included data from nearly 350,000 and concluded that dietary intakes of saturated fats are not associated with increases in the risk of either coronary heart disease or cardiovascular disease. The study was published in the January edition of the American Journal of Clinical Nutrition.

• A study published in the February American Journal of Epidemiology examined 23,366 Swedish men and revealed that intakes of calcium above the recommended daily levels may reduce the risk of mortality from heart disease and cancer by 25%.

• An Australian study published in the April European Journal of Clinical Nutrition concluded that overall intake of dairy products was not associated with mortality. The 16-year prospective study of 1,529 Australian adults found that people who ate the most full-fat dairy had a 69% lower risk of cardiovascular death than those who ate the least.

• A Danish study published in the April edition of Physiology & Behavior concluded that an inadequate calcium intake during an energy restricted weight loss program may trigger hunger and impair compliance to the diet.

• In September, an Israeli study published in the American Journal of Clinical Nutrition showed that a higher dairy calcium intake is related to greater diet-induced weight loss. The study, which sampled more than 300 overweight men and women during two years, revealed that those with the highest dairy calcium intake lost 38% more weight than those with the lowest dairy calcium intake.

The amount of dairy recommended per day varies by country and is generally based on nutrition needs and food availability. "In the US and some European countries, three servings of dairy foods are recommended daily, said Dr. Schweitzer."

This disturbing report in the New Yorker may expain the reason:

Before the effectiveness of a drug can be confirmed, it must be tested again and again. The test of replicability, as it’s known, is the foundation of modern research. It’s a safeguard for the creep of subjectivity. But now all sorts of well-established, multiply confirmed findings have started to look increasingly uncertain. It’s as if our facts are losing their truth...

The disturbing implication of this study is that a lot of extraordinary scientific data is nothing but noise. This suggests that the decline effect is actually a decline of illusion. Many scientific theories continue to be considered true even after failing numerous experimental tests. The decline effect is troubling because it reminds us how difficult it is to prove anything.

Read more http://www.newyorker.com/reporting/2010/12/13/101213fa_fact_lehrer#ixzz1882gDP9D

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Researchers at the University of California, Riverside (UCR), have identified components in pomegranate juice that seem to inhibit the movement of cancer cells and weaken their attraction to a chemical signal that has been shown to promote the metastasis of prostate cancer to the bone, according to a presentation today at the American Society for Cell Biology's 50th Annual Meeting in Philadelphia.

The researchers in the UCR laboratory of Manuela Martins-Green, Ph.D., plan additional testing in an in vivo model for prostate cancer to determine dose-dependent effects and side effects of the two components.

The effect, if any, of pomegranate juice on the progression of prostate cancer is controversial.

In a 2006 study of prostate cancer patients who daily drank an eight-ounce glass of pomegranate juice, UCLA researchers detected a decline in prostate-specific antigen (PSA) levels that suggested a potential slowing of cancer progression.

The UCLA researchers did not try to define the potential biological mechanism behind pomegranate juice's effects in the study.

In Sept. 2010, the Federal Trade Commission (FTC) filed suit against Pom Wonderful, the natural foods company that provided the pomegranate juice for the UCLA research and has supported other research on pomegranate juice. The FTC charged the company with making false and misleading claims about the juice's effects on health.

In previous studies, Martins-Green and her research team used a standardized concentration of pomegranate juice on two types of laboratory-cultured prostate cancer cells that were resistant to testosterone.

Resistance to the hormone indicates a potentially strong metastatic potential. The researchers noted not only increased cell death among the pomegranate juice-treated tumor cells but also increased cell adhesion and decreased cell migration in those cancer cells that had not died.

The Martins-Green lab next analyzed the fruit juice to identify the active ingredients that had a molecular impact on cell adhesion and migration in metastatic prostate cancer cells. Martins-Green, graduate student Lei Wang and undergraduate student Jeffrey Ho identified phenylpropanoids, hydrobenzoic acids, flavones and conjugated fatty acids.

"This is particularly exciting because we can now modify these naturally occurring components of the juice to improve their functions and make them more effective in preventing prostate cancer metastasis," said Martins-Green.

"Because the genes and proteins involved in movement of prostate cancer cells are essentially the same as those involved in movement of other types of cancer cells, the same modified components of the juice could have a much broader impact in cancer treatment," she said.

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The combination of caffeine and glucose can improve the efficiency of brain activity, according to a recent study in which functional magnetic resonance imaging was used to identify the neural substrate for the combined effects of these two substances.

The study, which was published in the journal Human Psychopharmacology: Clinical and Experimental, is led by the researchers Josep M. Serra Grabulosa, from the Department of Psychiatry and Clinical Psychobiology at the UB and a member of the August Pi i Sunyer Biomedical Research Institute (IDIBAPS); Ana Adan, a lecturer from the same department and a member of the UB's Institute of Brain, Cognition and Behaviour (IR3C); and Carles Falcón, a member of the Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN).

"Our main finding is that the combination of the two substances improves cognitive performance in terms of sustained attention and working memory by increasing the efficiency of the areas of the brain responsible for these two functions," explains Josep M. Serra Grabulosa. This supports the idea of a synergistic effect between two substances, in which each one boosts the effect of the other.

Specifically, the team found that individuals who consumed caffeine and glucose in combination showed reduced brain activation associated with the task in the bilateral parietal cortex and the left prefrontal cortex -- two regions that actively participate in attention and working memory processes. The reduced activity and the fact that no drop in behavioural performance was observed during the task suggests that the brain is more efficient under the combined effect of the two substances, since it needs fewer resources to produce the same level of performance than required by those subjects who were administered the placebo or who took only caffeine or glucose.

For the study, the team of researchers from the UB used functional MRI to analyse brain activity during the n-back task, which evaluates sustained attention and working memory -- basic capacities in improving everyday cognitive tasks. In a double-blind randomized design, participants were tested after drinking a study beverage containing either caffeine, glucose or the two combined or a placebo consisting only of water. Tests were conducted with a sample of 40 healthy volunteers at the Diagnostic Imaging Centre of the Hospital Clínic de Barcelona.

An earlier study by the same research team on the effects of caffeine and glucose consumption revealed improvements in attention span and declarative memory without significant alteration of the participants' subjective state. The conclusions suggested that a combination of caffeine and glucose has beneficial effects on attention (sequential reaction time tasks) and learning and on the consolidation of verbal memory, none of which were observed when the substances were consumed separately.

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Researchers at the Faculty of Life Sciences (LIFE), University of Copenhagen, can now unveil the results of the world's largest diet study: If you want to lose weight, you should maintain a diet that is high in proteins with more lean meat, low-fat dairy products and beans and fewer finely refined starch calories such as white bread and white rice. With this diet, most people can also eat until they are full without counting calories and without gaining weight.

Finally, the extensive study concludes that the official dietary recommendations are not sufficient for preventing obesity.

The large-scale random study called Diogenes has investigated the optimum diet composition for preventing and treating obesity. The results were recently published in the New England Journal of Medicine.

The objective of the Diogenes study has been to compare the official dietary recommendations in Europe, including the Danish recommendations, with a diet based on the latest knowledge about the importance of proteins and carbohydrates for appetite regulation. A total of 772 European families participated, comprising 938 adult family members and 827 children. The overweight adults initially followed an 800 kcal/day diet for eight weeks, losing an average of 11 kg. They were then randomly assigned to one of five different low-fat diet types which they followed for six months in order to test which diet was most effective at preventing weight regain. Throughout the project, the families received expert guidance from dieticians and were asked to provide blood and urine samples.

The five diet types

The design comprised the following five diet types:

* A low-protein diet (13% of energy consumed) with a high glycemic index (GI)*
* A low-protein, low-GI diet
* A high-protein (25% of energy consumed), low-GI diet
* A high-protein, high-GI diet
* A control group which followed the current dietary recommendations without special instructions regarding glycemic index levels

A high-protein, low-GI diet works best

A total of 938 overweight adults with a mean body mass index (BMI) of 34 kg/sq m were initially placed on an 800-kcal-per-day diet for eight weeks before the actual diet intervention was initiated. A total of 773 adult participants completed this initial weight-loss phase and were then randomly assigned to one of five different diet types, where 548 participants completed the six-month diet intervention (completion rate of 71%).

Fewer participants in the high-protein, low-GI groups dropped out of the project than in the low-protein, high-GI group (26.4% and 25.6%, respectively, vs. 37.4%; P = 0.02 and P = 0.01 for the two comparisons, respectively). The initial weight loss on the 800-kcal diet was an average of 11.0 kg.

The average weight regain among all participants was 0.5 kg, but among the participants who completed the study, those in the low-protein/high-GI group showed the poorest results with a significant weight gain of 1.67 kg. The weight regain was 0.93 kg less for participants on a high-protein diet than for those on a low-protein diet and 0.95 kg less in the groups on a low-GI diet compared to those on a high-GI diet.

The children's study

The results of the children's study have been published in a separate article in the American medical journal Pediatrics. In the families, there were 827 children who only participated in the diet intervention. Thus, they were never required to go on a diet or count calories -- they simply followed the same diet as their parents. Approx. 45% of the children in these families were overweight. The results of the children's study were remarkable: In the group of children who maintained a high-protein, low-GI diet the prevalence of overweight dropped spontaneously from approx. 46% to 39% -- a decrease of approx. 15%.

Proteins and low-GI foods ad libitum -- the way ahead

The Diogenes study shows that the current dietary recommendations are not optimal for preventing weight gain among overweight people. A diet consisting of a slightly higher protein content and low-GI foods ad libitum appears to be easier to observe and has been documented to ensure that overweight people who have lost weight maintain their weight loss. Furthermore, the diet results in a spontaneous drop in the prevalence of overweight among their children.

About glycemic index

The glycemic index is a measure of the ability of carbohydrates to increase blood glucose levels when absorbed in the body. Food with a low-glycemic index (LGI) causes blood glucose levels to increase more slowly and to lower levels compared to high-carbohydrate foods with a high glycemic index

Drastic increases in blood glucose levels give rise to several potentially undesirable effects that can influence the body's metabolism as well as our ability to perform mentally. It is therefore most appropriate to maintain a diet that results in slow digestion and thus more stable blood glucose levels and greater satiety.

A diet with a high protein content contains many protein-rich foods such as lean meat, poultry, fish, eggs and low-fat dairy products. Legumes also contain high levels of protein, as do nuts and almonds. Proteins are significantly more filling than both carbohydrates and fat.

Special requirements for a low-glycemic diet

The glycemic index applies to carbohydrate-containing foods. The recommendations are that some types of fruit may be consumed ad libitum, such as apples, pears, oranges, raspberries and strawberries. Other types should be eaten in only very limited amounts, including bananas (especially overripe bananas), grapes, kiwi, pineapple and melon. Nearly all vegetables are permitted, with the exception of corn, which should be limited. Carrots, beets and parsnip should preferably be eaten raw.

With regard to cereal-based foods (bread, grain, corn, hulled grains and breakfast products), the goal is to eat as many coarse and wholegrain foods as possible, i.e. wholegrain breads with many kernels, wholegrain pasta, whole oats and the special varieties of wholegrain cornflakes

Potatoes should be cooked as little as possible. Try to stick to new potatoes, and it is a good idea to eat them cold. Avoid mashed potatoes and baked potatoes.

Pasta should be cooked al dente and is best eaten cold.

Choose rice varieties such as brown rice, parboiled rice or basmati.

White bread without kernels, white rice and sugary breakfast products should be avoided. In general, sugar intake should be limited, not so much because of its GI but to avoid all those 'empty calories'.

Recommended GI values:

Over 70 -- high GI 55-70 -- medium GI Under 55 -- low GI

High-GI foods can still be healthy and vice versa. Carrots, for instance, have a high GI (72), while chocolate has a low GI (49). Fats help decrease the absorption of sugar in the blood, which means that carbohydrate-containing foods and fat can have a low GI.

Example of a day's menu for a high-protein, low-GI diet

If you want to maintain a high-protein, low-GI diet, daily meals could be composed as follows:

Breakfast: Low-fat A38 yogurt with muesli (without added sugar), wholegrain crispbread with low-fat cheese, an orange

Morning: Vegetable sticks and low-fat cheese sticks

Lunch: Wholegrain rye bread with lean meat or chicken cold cuts, mackerel in tomato sauce and misc. vegetables

Afternoon: Wholegrain rye bread with low-fat liver pâté and cucumber

Dinner: Stir-fried turkey with vegetables and wholegrain pasta; avocado salad with feta cheese and sugar peas

It is best to drink water or low-fat milk with meals.

To sum up, there is nothing particular about this diet with the exception of the above-mentioned limitations, special cooking instructions and the fact that certain vegetables should be eaten raw. This diet generally complies with the official dietary recommendations of eating plenty of fruit and vegetables, low-fat foods, plenty of fibre and limiting sugar intake.

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Comprehensive review by National Health Institute

Tea has long been regarded as an aid to good health, and many believe it can help reduce the risk of cancer. Most studies of tea and cancer prevention have focused on green tea (13). Although tea and/or tea polyphenols have been found in animal studies to inhibit tumorigenesis at different organ sites, including the skin, lung, oral cavity, esophagus, stomach, small intestine, colon, liver, pancreas, and mammary gland (24), the results of human studies—both epidemiologic and clinical studies—have been inconclusive.

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Drinking cranberry juice has been recommended to decrease the incidence of urinary tract infections, based on observational studies and a few small clinical trials. However, a new study published in the January 1 issue of Clinical Infectious Diseases, and now available online, suggests otherwise.

College-aged women who tested positive for having a urinary tract infection were assigned to drink eight ounces of cranberry juice or a placebo twice a day for either six months or until a recurrence of a urinary tract infection, whichever happened first. Of the participants who suffered a second urinary tract infection, the cranberry juice drinkers had a recurrence rate of almost 20 percent, while those who drank the placebo suffered only a 14 percent recurrence.

"We assumed that we would observe a 30 percent recurrence rate among the placebo group. It is possible that the placebo juice inadvertently contained the active ingredients that reduce urinary tract infection risk, since both juices contained Vitamin C," explained study author Betsy Foxman, PhD, of the University of Michigan School of Public Health in Ann Arbor.

She added, "Another possibility is that the study protocol kept participants better hydrated, leading them to urinate more frequently, therefore decreasing bacterial growth and reducing urinary tract infection symptoms."

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More and more people have become aware of the dangers of excessive fructose in diet. A new review on fructose in an upcoming issue of the Journal of the American Society of Nephrology (JASN) indicates just how dangerous this simple sugar may be.

Richard J. Johnson, MD and Takahiko Nakagawa, MD (Division of Renal Diseases and Hypertension, University of Colorado) provide a concise overview of recent clinical and experimental studies to understand how excessive amounts of fructose, present in added sugars, may play a role in high blood pressure, diabetes, obesity, and chronic kidney disease (CKD).

Dietary fructose is present primarily in added dietary sugars, honey, and fruit. Americans most frequently ingest fructose from sucrose, a disaccharide containing 50% fructose and 50% glucose bonded together, and high fructose corn syrup (HFCS), a mixture of free fructose and free glucose, usually in a 55/45 proportion. With the introduction of HFCS in the 1970s, an increased intake of fructose has occurred and obesity rates have risen simultaneously.

The link between excessive intake of fructose and metabolic syndrome is becoming increasingly established. However, in this review of the literature, the authors conclude that there is also increasing evidence that fructose may play a role in hypertension and renal disease. "Science shows us there is a potentially negative impact of excessive amounts of sugar and high fructose corn syrup on cardiovascular and kidney health," explains Dr. Johnson. He continues that "excessive fructose intake could be viewed as an increasingly risky food and beverage additive."

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A daily low dose of aspirin significantly reduces the number of deaths from a whole range of common cancers, an Oxford University study has found.

The 20% drop in all cancer deaths seen in the study adds new evidence to the debate about whether otherwise healthy people in their 40s and 50s should consider taking a low dose of aspirin each day.

Aspirin is already known to be beneficial for those at high risk of heart disease. But among healthy people, the benefit in lower chances of heart problems only marginally outweighs the small risk of stomach bleeds.

The large size of the effect now seen in preventing cancer deaths may begin to tip the balance in favour of taking aspirin, the scientists suggest, but say that it is a matter for the health bodies who write treatment guidelines.

"These results do not mean that all adults should immediately start taking aspirin," cautions Professor Peter Rothwell of the Department of Clinical Neurology at Oxford University, who led the work. "But they do demonstrate major new benefits that have not previously been factored into guideline recommendations."

"Previous guidelines have rightly cautioned that in healthy middle aged people the small risk of bleeding on aspirin partly offsets the benefit from prevention of strokes and heart attacks, but the reductions in deaths due to several common cancers will now alter this balance for many people."

However, he adds: "I don't think it's necessarily right for the person who did the research to say what guidelines should be. We can't say with absolute certainty that there won't be some unknown harm in taking aspirin for 30 years, but it looks as if there would be pretty large benefits in reducing cancer deaths. People have to accept there's some uncertainty here."

Professor Rothwell and colleagues recently established that a low dose of aspirin (75 mg per day, or a quarter of the normal dose taken for pain relief) taken for longer than five years reduces death rates from bowel cancer by more than a third.

In this new work, scientists from Oxford, Edinburgh, London and Japan used data on over 670 deaths from cancer in a range of randomised trials involving over 25,000 people. These trials compared daily use of aspirin against no aspirin and were done originally to look for any preventative effect against heart disease.

The results, published in the Lancet, showed that aspirin reduced death due to any cancer by around 20% during the trials. But the benefits of aspirin only became apparent after taking the drug for 5 years or more, suggesting aspirin works by slowing or preventing the early stages of the disease so that the effect is only seen much later.

After 5 years of taking aspirin, the data from patients in the trials showed that death rates were 34% less for all cancers and as much as 54% less for gastrointestinal cancers, such as oesophagus, stomach, bowel, pancreas and liver cancers.

The researchers also wanted to determine if the benefits from aspirin continued over time. By using cancer registries and death records, they were able to follow up what had happened to participants in three of the trials.

They showed that risk of cancer death over a period of 20 years remained 20% lower for all solid cancers among those who had taken aspirin (even though they would have been unlikely to have continued taking aspirin after the trials finished), and 35% lower for gastrointestinal cancers.

It took about 5 years to see a benefit in taking aspirin for oesophagus, pancreatic, brain, and lung cancer; about 10 years for stomach and bowel cancer; and about 15 years for prostate cancer. The 20-year risk of death was reduced by about 10% for prostate cancer, 30% for lung cancer, 40% for bowel cancer and 60% for oesophagus cancer.

As the evidence points to a delayed preventative effect against cancer, Professor Rothwell believes that it would be those who started taking aspirin in their late 40s or 50s -- ie before people's risk of cancer starts increasing -- and then continued for 20 to 30 years who might eventually see the most benefit.

Professor Rothwell estimates that in terms of cost-effectiveness, taking low-dose aspirin daily is likely to be much more cost-effective than those interventions already used for preventing cancer, such as screening for breast or prostate cancer.

He does note that more research is necessary to understand more about the effect aspirin has on cancer.

While this study looked at how aspirin affected deaths from cancer, Professor Rothwell and colleagues now aim to look at any protective effect of aspirin on the incidence or progression of cancer. The researchers also point out that more trial data are needed on breast cancer and other cancers that particularly affect women.

"Perhaps the most important finding for the longer term is the proof of principle that cancers can be prevented by simple compounds like aspirin," says Professor Rothwell.

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Use of low-dose aspirin prior to a newer type of fecal occult blood test is associated with a higher sensitivity for detecting advanced colorectal tumors, compared to no aspirin use, according to a study in the December 8 issue of JAMA.

"Screening for colorectal cancer (CRC) and its precursors by fecal occult blood tests (FOBTs), which has been shown to reduce CRC incidence and mortality in randomized trials, is widely recommended and applied in an increasing number of countries. Screening is mostly done in age groups in which use of low-dose aspirin for primary or secondary prevention of cardiovascular disease is increasingly common. Use of low-dose aspirin increases the likelihood of gastrointestinal bleeding, especially upper gastrointestinal bleeding. Because of the increased risk of bleeding from sources other than colorectal neoplasms [tumors], concerns have been raised regarding possible adverse effects on specificity of FOBT-based screening for CRC," according to background information in the article. Potential false-positive test results due to increased risk of upper gastrointestinal bleeding are expected to be of less concern for increasingly available immunochemical FOBTs (iFOBTs; a type of test to check for blood in the stool), but evidence is sparse about the performance of iFOBTs for patients who use low-dose aspirin.

Hermann Brenner, M.D., M.P.H., of the German Cancer Research Center, Heidelberg, Germany, and colleagues assessed the association of use of low-dose aspirin with performance of 2 iFOBTs in a large sample of women and men who underwent CRC screening. The study, conducted from 2005 through 2009, included 1,979 patients (average age, 62.1 years): 233 regular users of low-dose aspirin (167 men, 67 women) and 1,746 who never used low-dose aspirin (809 men, 937 women). The researchers analyzed measures of sensitivity and specificity in detecting advanced colorectal neoplasms (colorectal cancer or advanced adenoma [a tumor that is not cancer]) with 2 quantitative iFOBTs (hemoglobin test and hemoglobin-haptoglobin [a protein] test).

Advanced neoplasms were found in 24 users (10.3 percent) and 181 nonusers (10.4 percent) of low-dose aspirin. The researchers found that for the hemoglobin test, sensitivity was 70.8 percent for low-dose aspirin users compared with 35.9 percent for nonusers; specificity was 85.7 percent for users compared with 89.2 percent for nonusers. For the hemoglobin-haptoglobin test, sensitivity was 58.3 percent for users compared with 32 percent for non-users and specificity was 85.7 percent for users compared with 91.1 percent for nonusers.

"We provide a detailed comparison of the diagnostic performance of 2 quantitative iFOBTs among users and non-users of low-dose aspirin in the target population for CRC screening. For both tests, sensitivity was markedly higher, while specificity was slightly lower among users of low-dose aspirin compared with nonusers," the authors write.

"… our study strongly suggests that use of low-dose aspirin does not hamper testing for fecal occult blood by immunochemical tests. On the contrary, our findings raise the hypothesis that test performance may be enhanced by temporary use of low-dose aspirin, a hypothesis that needs replication in larger samples and followed up in further research, ideally including randomized trials and different types of FOBTs."

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In an effort to pinpoint potential triggers leading to inflammatory responses that eventually contribute to depression, researchers are taking a close look at the immune system of people living in today's cleaner modern society.

Rates of depression in younger people have steadily grown to outnumber rates of depression in the older populations and researchers think it may be because of a loss of healthy bacteria.

In an article published in the December issue of Archives of General Psychiatry, Emory neuroscientist Charles Raison, MD, and colleagues say there is mounting evidence that disruptions in ancient relationships with microorganisms in soil, food and the gut may contribute to the increasing rates of depression.

According to the authors, the modern world has become so clean, we are deprived of the bacteria our immune systems came to rely on over long ages to keep inflammation at bay.

To view a video with Dr. Raison: http://bit.ly/wearetooclean

"We have known for a long time that people with depression, even those who are not sick, have higher levels of inflammation," explains Raison.

"Since ancient times benign microorganisms, some times referred to as 'old friends,' have taught the immune system how to tolerate other harmless microorganisms, and in the process, reduce inflammatory responses that have been linked to the development of most modern illnesses, from cancer to depression."

Experiments are currently being conducted to test the efficacy of treatments that use properties of these "old friends" to improve emotional tolerance. "If the exposure to administration of the 'old friends' improves depression," the authors conclude, "the important question of whether we should encourage measured re-exposure to benign environmental microorganisms will not be far behind."

See off Alzheimer's with the color purple

Ground-breaking research from Professor Douglas Kell, published in the journal Archives of Toxicology, has found that the majority of debilitating illnesses are in part caused by poorly-bound iron which causes the production of dangerous toxins that can react with the components of living systems.

These toxins, called hydroxyl radicals, cause degenerative diseases of many kinds in different parts of the body.

In order to protect the body from these dangerous varieties of poorly-bound iron, it is vital to take on nutrients, known as iron chelators, which can bind the iron tightly.

Brightly-coloured fruits and vegetables are excellent sources of chelators, as is green tea, with purple fruits considered to have the best chance of binding the iron effectively .

However, despite conflicting reports, the widely-publicised benefits of red wine seem to work in a different way, and have no similar benefits, Professor Kell's paper noted.

This new paper is the first time the link has been made between so many different diseases and the presence of the wrong form of iron, and gives a crucial clue as to how to prevent them or at least slow them down.

Professor Kell argues that the means by which poorly-liganded iron accelerates the onset of debilitating diseases shows up areas in which current, traditional thinking is flawed and can be dangerous.

For instance, Vitamin C is thought to be of great benefit to the body's ability to defend itself against toxins and diseases.

However Professor Kell, who is Professor of Bioanalytical Science at the University, indicates that excess vitamin C can in fact have the opposite effect to that intended if unliganded iron is present.

Only when iron is suitably and safely bound ("chelated") will vitamin C work effectively.

Professor Kell said: "Much of modern biology has been concerned with the role of different genes in human disease.

"The importance of iron may have been missed because there is no gene for iron as such. What I have highlighted in this work is therefore a crucial area for further investigation, as many simple predictions follow from my analysis.

"If true they might change greatly the means by which we seek to prevent and even cure such diseases."

A 12-year breast cancer survivor, Gail Slappy was diagnosed with esophageal cancer in April 2009. Upon being diagnoses, Gail began receiving treatment at Penn Medicine's Abramson Cancer Center. When she retires from a teaching career this upcoming Spring, Gail plans on volunteering at the Abramson Cancer Center.
I’m a 12-year survivor of breast cancer. I was shocked that I was having another recurrence of cancer.

The multidisciplinary approach

Then, Dr. Ginsberg and I began to talk. I’m familiar with Dr. Ginsberg because he has been treating me over the years. He told me how he would handle my cancer treatment. Then, a team of doctors came in and discussed how I would be treated. The team consisted of Ursina Teitelbaum, MD, a hematology/oncologist; John Plastaras, MD, a radiation oncologist; and Ernest F. Rosato, MD, a surgeon. We all discussed how my case would be handled.

I felt quite relieved and confident that I was receiving the best treatment possible. There was a comprehensive team of doctors, and everyone was consulting with one another about my treatment.

Compassionate care

Throughout my experience at Penn Medicine's Abramson Cancer Center, I felt supported. Everyone was just so compassionate towards me and my care. I would receive phone calls at home asking how I was doing.

At my lowest point, I grew quite weak from the combination of radiation and chemotherapy. When I would go to receive therapy, everyone understood how I was feeling and treated me with the most compassion I could ever receive. One time, when I was receiving radiation, one of the radiation therapists talked to me so nicely. The nature of his voice and the way he spoke to me so calmly let me know I would be alright. It truly made all of the difference. He even said that I looked great even though I felt lousy and I probably looked lousy too! He was endearing and he helped me a great deal.

After I had my surgery, the nursing staff and the doctors in the hospital were so kind and gentle. They helped me through the whole process. Everyone was very concerned, very attentive, and genuinely interested in my care, my progress, and my recovery. People always asked what they could do to make me comfortable and how they could help me. That was the sentiment throughout my whole recovery at the hospital.

That’s why I like the comprehensive approach at the Abramson Cancer Center because everyone is in dialogue with one another. They are constantly updating each other on your condition, and making sure that you are okay.

Giving back
I’ve been recovering from my illness. I’m a teacher, and I plan to retire in June. Once I heal, I want to give back. I plan on volunteering at the Abramson Cancer Center. I want to help other individuals who may be diagnosed with cancer and help them get through it. I want them to know it’s not a death sentence or the end of the world. In spite of the seriousness of the illness, you can conquer it. You can be a champion.

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Impairments to health and physical performance are not primarily a result of aging but of unfavorable lifestyle habits and lack of exercise.
Sporty elderly people have a life expectancy that is almost 4 years higher and are often faster than younger athletes.

In their study, the sports scientists analyzed the stamina of more than 600 000 marathon and half marathon runners and asked participants about their lifestyle habits and their health. Marathon running is particularly suitable for studying because participants have to put in sufficient training hours for the competition, and the athletes accommodate this into their day accordingly.

Unfavorable characteristics such as obesity, smoking, and lack of physical activity are rarer in runners, and reductions in physical performance are more likely to be the result of biological aging processes. These reductions make their presence felt only after the 54th year of life and are but slight. More than 25% of 50- to 69-year-olds had taken up running only in the preceding 5 years and participated in a marathon nonetheless. Of note: older participants do not have to train any harder to maintain their fitness than their younger rivals.

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A fascinating study published in the BMJ shows that although the French drink more than the Northern Irish each week, as they drink daily, rather than more on less occasions, the French suffered from considerably less coronary heart disease than the Northern Irish. Ruidavets and colleagues compared groups of middle aged men in France and Northern Ireland, who have very different drinking cultures and rates of heart disease.The authors found that men who "binge" drink (drink =50 g of alcohol once a week) had nearly twice the risk of myocardial infarction or death from coronary disease compared with regular drinkers over 10 years of follow-up. Similarly abstainers were at higher risk. 9,778 men aged 50-59, free of ischaemic heart disease at baseline, were recruited between 1991 and 1994. A total of 2,405 men from Belfast and 7,373 men from the French centres were included in the analyses.

The investigators related weekly alcohol consumption, incidence of binge drinking (alcohol >50 g on at least one day a week), incidence of regular drinking (at least one day a week, and alcohol < 50 g if on only one occasion), volume of alcohol intake, frequency of consumption, and types of beverage consumed to risk of coronary heart disease (CHD) events over a 10 year follow-up period. Overall, 60.5% of subjects from N. Ireland and 90.6% of French reported drinking alcohol at least once a week. Among drinkers, 12% of men in Belfast drank alcohol every day compared with 75% of men in France. Mean alcohol consumption was 22.1 g/ day in Belfast and 32.8 g/day in France. Binge drinkers comprised 9.4% and 0.5% of the Belfast and France samples, respectively.

Results showed that, after multivariate adjustment, the hazard ratio for hard CHD events compared with regular drinkers was 1.97 (95% CI 1.21 - 3.22) for binge drinkers, 2.03 (95% CI 1.41 - 2.94) for never drinkers, and 1.57 (95% CI 1.11 - 2.21) for former drinkers. The hazard ratio for hard CHD events in Belfast compared with in France was 1.76 (95% CI 1.37 to 2.67) before adjustment, and 1.09 (95% CI 0.79 to 1.50) after adjustment for alcohol patterns and wine drinking, indicating that most of the differences between the rates in the two countries were related to these two factors. Irrespective of country, only wine drinking was associated with a lower risk of hard coronary events.

The authors conclude that regular and moderate alcohol intake throughout the week, the typical pattern in middle-aged men in France, is associated with a low risk of ischemic heart disease, whereas the binge drinking pattern more prevalent in Belfast confers a higher risk.

Comments: While a strong inverse association between moderate alcohol consumption and cardiovascular disease has been demonstrated for decades, more recent research has emphasized the importance of the pattern of drinking (regular moderate versus episodic or binge drinking). Further, there continues to be debate about the potential greater effect of wine versus other beverages containing alcohol. This study shows that regular moderate drinking (especially of wine) is associated with lower risk of MI, but episodic or binge drinking increases the risk. Lifetime abstinence has a similar adverse relation to CHD as does episodic or binge drinking.

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Charles H. Hennekens, M.D., DrPH, the first Sir Richard Doll Research Professor in the Charles E. Schmidt College of Medicine at Florida Atlantic University, has published the results of A Randomized Trial of Aspirin at Clinically Relevant Doses and Nitric Oxide Formation in Humans in the current issue of the Journal of Cardiovascular Pharmacology and Therapeutics. These are the first data in humans to show that all doses of aspirin used in clinical practice increase nitric oxide. Nitric oxide is released from the blood vessel wall and may decrease the development and progression of plaques leading to heart attacks and strokes.

Hennekens and his colleagues randomized patients at high risk of a first heart attack or stroke to different doses of aspirin for 12 weeks. All doses produced highly significant beneficial effects on two important and well documented markers of nitric oxide formation.

Hennekens was also the first researcher to demonstrate that aspirin prevents a first heart attack. “While the ability of aspirin to decrease the clumping of blood platelets is sufficient to explain why the drug decreases risks of heart attacks and strokes, these data suggest a new and novel mechanism,” said Hennekens.

Hennekens and his colleagues are proposing new and longer term research to the National Institutes of Health to test whether this hypothesis has clinical or public health relevance.

The American Heart Association recommends aspirin use for patients who have had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot) or transient ischemic attacks (TIAs or "little strokes"), if not contraindicated. This recommendation is based on a large body of evidence from randomized trials showing that aspirin reduces risks of heart attack, stroke and death from vascular diseases. In primary prevention, aspirin prevents a first heart attack, but the data on stroke and vascular death are not yet conclusive. The decision as to whether to use the drug should be an individual clinical judgment by the healthcare provider.

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Elevated fat and cholesterol levels found in a typical American-style diet plays an important role in the growth and spread of prostate cancer, say researchers at Thomas Jefferson University’s Kimmel Cancer Center.

Their study, the first to show such an association, is published in the December issue of The American Journal of Pathology. It demonstrates how mice eating a Western diet, and predisposed to develop prostate cancer, can develop larger tumors that are faster growing and metastasize more easily to the lungs, compared to animals eating a control diet.

In this study, a research team led by Philippe G. Frank, Ph.D., assistant professor in the Department of Stem Cell Biology and Regenerative Medicine at Jefferson, tried to understand why prostate cancer incidence is low in Asian countries, but significantly increases in Asian men who move to the United States. “Our hypothesis is that environmental factors, most likely present in the diet, may act as late stage promoters, responsible for the transformation of a prostate tumor from an early stage form into a more aggressive and clinically-apparent form,” says Dr. Frank.

Dietary fat and cholesterol have been shown to be risk factors in the development and progression of other tumor types, but diet-based studies in prostate cancer patients have reached contradictory conclusions, Dr. Frank says. For this reason, he and his colleagues turned to the TRAMP transgenic mouse model to determine the role of dietary fat and cholesterol. This mouse model is believed to closely parallel the pathogenesis of human prostate cancer.

TRAMP mice were placed on a diet that contained 21.2 percent fat and 0.2 percent cholesterol, reflective of a typical Western diet. A control group of TRAMP mice was fed a normal chow that had 4.5 percent fat and negligible amounts of cholesterol.

They found that the Western diet accelerated prostate tumor development and progression. These tumors also produced increased levels of receptors that bind to lipoproteins carriers of cholesterol, and they were more aggressive. The researchers further discovered that the TRAMP mice fed a Western diet appeared to experience greater incidence of cancer metastasis to the lungs, compared to the control group.

The research team also noted that TRAMP mice fed the high fat/high cholesterol chow had less cholesterol in their blood compared to control mice fed the same diet. “This likely reflects the fact that their tumors depend on cholesterol to grow,” explains Dr. Frank. “This study suggests that monitoring cholesterol levels in men at risk, diagnosed, or treated for prostate cancer may help limit cancer growth or even recurrence.”

Dr. Frank says the evidence involving cholesterol is strong – a finding he believes makes sense physiologically. “Cells need cholesterol to produce androgen hormones, and androgen hormones promote prostate cancer growth,” he explains. “Perhaps more importantly, we also believe that tumors feed on cholesterol, and the more blood cholesterol is accessible, the more is available for tumor growth.

“Although this is a mouse study, numerous studies have shown the health benefits of controlling blood cholesterol levels and fat intake. This research suggests the same advice may offer some benefit for men at risk of developing prostate cancer or even diagnosed with prostate cancer,” says Dr. Frank.

He adds statins that lower cellular cholesterol production may be one way to reduce prostate cancer progression – although that has yet to be demonstrated. Monitoring blood cholesterol levels of prostate cancer patients may also provide important information about cancer progression. “For example, tests showing a sudden drop in blood cholesterol is often indicative of the development of tumors,” Dr. Frank adds.

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Seniors interested in lifestyle choices that help protect vision will be encouraged by a Johns Hopkins School of Medicine study, and people concerned about glaucoma can take heart from work on early detection by the University of Miami Miller School of Medicine. Both studies are published in the December issue of Ophthalmology, the journal of the American Academy of Ophthalmology.

New Evidence for Eye-Protective Effects of Omega-3-Rich Fish, Shellfish

Researchers at Wilmer Eye Institute, Johns Hopkins School of Medicine, wanted to know how the risk of age-related macular degeneration (AMD) would be affected in a population of older people who regularly ate fish and seafood, since some varieties are good sources of omega-3 fatty acids. A diet rich in omega-3s probably protects against advanced AMD, the leading cause of blindness in whites in the United States, according to the Age-Related Eye Disease Study (AREDS) and other recent studies. High concentrations of omega-3s have been found in the eye's retina, and evidence is mounting that the nutrient may be essential to eye health. The new research, led by Sheila K. West, PhD, was part of the Salisbury Eye Evaluation (SEE) study.

Food intake information with details on fish and shellfish consumed was collected over one year using a validated questionnaire for 2,391 participants aged 65 to 84 years who lived along Maryland's Eastern Shore. After dietary assessment was complete, participants were evaluated for AMD. Those with no AMD were classified as controls (1,942 persons), 227 had early AMD, 153 had intermediate-stage disease, and 68 had advanced AMD. In the advanced AMD group, the macular area of the retina exhibited either neovascularization (abnormal blood vessel growth and bleeding) or a condition called geographic atrophy. Both conditions can result in blindness or severe vision loss.

"Our study corroborates earlier findings that eating omega-3-rich fish and shellfish may protect against advanced AMD." Dr. West said. "While participants in all groups, including controls, averaged at least one serving of fish or shellfish per week, those who had advanced AMD were significantly less likely to consume high omega-3 fish and seafood," she said.

The study also looked at whether dietary zinc from crab and oyster consumption impacted advanced AMD risk, but no significant relationship was found. Zinc is also considered protective against AMD and is included in an AMD-vitamin/nutrient supplement developed from the AREDS study. Dr. West speculated that her study found no effect because the levels of zinc obtained from seafood/fish were low compared to supplement levels.

A side note: fish and shellfish were part of the normal diet of the study population, rather than added with the intention of improving health. The links between fish consumption, omega-3s and healthy lifestyles were not widely known in the early 1990s when the dietary survey was conducted. In fact, some of the study participants who consumed the most seafood were also smokers and/or overweight, two factors usually associated with AMD and other health risks.

Retinal Nerve Function May be Key to Early Glaucoma Detection

Catching glaucoma as early as possible–before it destroys the optic nerve–is vital to preventing vision loss. Now a research team at Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, has shown that a test that measures the functionality of the eye's retinal nerve cells may be a key to early detection. Eventually, the test may also help evaluate how well glaucoma treatments are working.

The research, led by Mitra Sehi, PhD, and David Greenfield, MD, was based on the knowledge that retinal ganglion cells (RGCs) become dysfunctional as glaucoma progresses and that such changes can be measured using the pattern electroretinogram optimized for glaucoma screening (PERGLA). PERGLA measures the electrical activity of a patient's retina as he or she views an alternating pattern of black and white lines. (The retinal area in the back of the eye receives images and transmits them to the optic nerve.) Other studies had shown that abnormal changes in RGCs begin early in the glaucoma process, so PERGLA is potentially valuable as a non-invasive detection tool.

The Bascom Palmer study included 47 patients (47 eyes) in whom intraocular pressure (IOP) could not be controlled with medication and who therefore had surgery to prevent optic nerve damage. All patients had two PERGLA evaluations (as well as complete ocular exams, optic nerve assessment, and blood pressure measurement), one before surgery and one at three months post surgery. IOP and PERGLA measurements of the patients' fellow, non-glaucomatous, non-treated eyes were stable before and after surgeries. The surgeries improved fluid drainage in the eyes to reduce IOP; 34 eyes had trabeculectomy and 13 had glaucoma drainage implants.

PERGLA results showed that RGC dysfunction was reversed and IOP was reduced in all patients following surgery. The patients' central visual field tests improved, as well. Dr. Sehi says these results should be interpreted cautiously until confirmed by larger studies. She calls for longitudinal studies to clarify the relationship between reduced IOP and increased RGC response and to further investigate PERGLA assessment of RGC dysfunction as a biomarker for glaucoma.