Jon's Health Tips - Coffee and Caffeine

Saturday, January 24, 2009

I drink lots of tea – mostly green tea. My wife drinks some tea and lots of diet Coke and even more coffee. It turns out that both coffee and tea are good for us, whether for their unique ingredients, and for their common ingredient, caffeine. Caffeine is very bad for pregnant women, and too much caffeine can be harmful for everyone. Here are the details:


Moderate coffee drinking reduces many risks

Recent advances in epidemiologic and experimental knowledge have transformed many of the negative health myths about coffee drinking into validated health benefits

Coffee is among the most widely consumed beverages in the world, and Dr. Coughlin says that the preponderance of scientific evidence - some by the panelists - suggests that moderate coffee consumption (3-5 cups per day) may be associated with reduced risk of certain disease conditions, such as Parkinson’s disease. Some research in neuropharamacology suggests that one cup of coffee can halve the risk of Parkinson’s disease. Other studies have found it reduces the risk of Alzheimer's disease, kidney stones, gallstones, depression and even suicide.

In recent epidemiological studies in the U.S., Europe and Japan, persons who were heavy coffee consumers had a lower risk of type 2 diabetes than persons who consumed little coffee. Interestingly, he says, associations were similar for caffeinated and decaffeinated coffee, suggesting that coffee components other than caffeine may be beneficial for glucose metabolism.

Coffee contains hundreds of components including substantial amounts of chlorogenic acid, caffeine, magnesium, potassium, vitamin B3, trigonelline, and lignans.

There are two areas in which there is some evidence of increased risk: leukemia and stomach cancer. The evidence for the former is intriguing, for the latter insubstantial.
Midlife Coffee And Tea Drinking May Protect Against Late-life Dementia

Midlife coffee drinking can decrease the risk of dementia/Alzheimer's disease (AD) later in life. This conclusion is made in a Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Study published in the Journal of Alzheimer's Disease.

This study has been conducted at the University of Kuopio, Finland in collaboration with Karolinska Institutet, Stockholm, Sweden, and the National Public Health Institute, Helsinki, Finland. The study included participants from the survivors of population-based cohorts previously surveyed within the North Karelia Project and the FINMONICA study in 1972, 1977, 1982 or 1987 (midlife visit). After an average follow-up of 21 years, 1409 individuals (71%) aged 65 to 79 completed the re-examination in 1998. A total of 61 cases were identified as demented (48 with AD).

"We aimed to study the association between coffee and tea consumption at midlife and dementia/AD risk in late-life, because the long-term impact of caffeine on the central nervous system was still unknown, and as the pathologic processes leading to Alzheimer's disease may start decades before the clinical manifestation of the disease," says lead researcher, associate professor Miia Kivipelto, from the University of Kuopio, Finland and Karolinska Institutet, Stockholm, Sweden.
At the midlife examination, the consumption of coffee and tea was assessed with a previously validated semi-quantitative food-frequency questionnaire. Coffee drinking was categorized into three groups: 0-2 cups (low), 3-5 cups (moderate) and >5 cups (high) per day. Further, the question concerning tea consumption was dichotomized into those not drinking tea (0 cup/day) vs. those drinking tea (≥1 cup/day).

The study found that coffee drinkers at midlife had lower risk for dementia and AD later in life compared to those drinking no or only little coffee. The lowest risk (65% decreased) was found among moderate coffee drinkers (drinking 3-5 cups of coffee/day). Adjustments for various confounders did not change the results. Tea drinking was relatively uncommon and was not associated with dementia/AD.
Kivipelto also notes that, "Given the large amount of coffee consumption globally, the results might have important implications for the prevention of or delaying the onset of dementia/AD. The finding needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. Also, identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases."

Caffeine experts at Johns Hopkins call for warning labels for energy drinks
Caffeinated energy drinks may present health risks

Johns Hopkins scientists who have spent decades researching the effects of caffeine report that a slew of caffeinated energy drinks now on the market should carry prominent labels that note caffeine doses and warn of potential health risks for consumers.

"The caffeine content of energy drinks varies over a 10-fold range, with some containing the equivalent of 14 cans of Coca-Cola, yet the caffeine amounts are often unlabeled and few include warnings about the potential health risks of caffeine intoxication," says Roland Griffiths, Ph.D., one of the authors of the article that appears in the journal Drug and Alcohol Dependence this month.
The market for these drinks stands at an estimated $5.4 billion in the United States and is expanding at a rate of 55 percent annually. Advertising campaigns, which principally target teens and young adults, promote the performance-enhancing and stimulant effects of energy drinks and appear to glorify drug use.
Without adequate, prominent labeling; consumers most likely won't realize whether they are getting a little or a lot of caffeine. "It's like drinking a serving of an alcoholic beverage and not knowing if its beer or scotch," says Griffiths.
Caffeine intoxication, a recognized clinical syndrome included in the Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases, is marked by nervousness, anxiety, restlessness, insomnia, gastrointestinal upset, tremors, rapid heartbeats (tachycardia), psychomotor agitation (restlessness and pacing) and in rare cases, death.
Reports to U.S. poison control centers of caffeine abuse showed bad reactions to the energy drinks. In a 2007 survey of 496 college students, 51 percent reported consuming at least one energy drink during the last month. Of these energy drink users, 29 percent reported "weekly jolt and crash episodes," and 19 percent reported heart palpitations from drinking energy drinks. This same survey revealed that 27 percent of the students surveyed said they mixed energy drinks and alcohol at least once in the past month. "Alcohol adds another level of danger," says Griffiths, "because caffeine in high doses can give users a false sense of alertness that provides incentive to drive a car or in other ways put themselves in danger."
A regular 12-ounce cola drink has about 35 milligrams of caffeine, and a 6-ounce cup of brewed coffee has 80 to 150 milligrams of caffeine. Because many energy drinks are marketed as "dietary supplements," the limit that the Food and Drug Administration requires on the caffeine content of soft drinks (71 milligrams per 12-ounce can) does not apply. The caffeine content of energy drinks varies from 50 to more than 500 milligrams.
"It's notable that over-the-counter caffeine-containing products require warning labels, yet energy drinks do not," says Chad Reissig, Ph.D., one of the study's authors.
Griffiths notes that most of the drinks advertise their products as performance enhancers and stimulants – a marketing strategy that may put young people at risk for abusing even stronger stimulants such as the prescription drugs amphetamine and methylphenidate (Ritalin). A 2008 study of 1,253 college students found that energy drink consumption significantly predicted subsequent non-medical prescription stimulant use, raising the concern that energy drinks might serve as "gateway" products to more serious drugs of abuse. Potentially feeding that "transition" market, Griffiths says, are other energy drinks with alluring names such as the powdered energy drink additive "Blow" (which is sold in "vials" and resembles cocaine powder) and the "Cocaine" energy drink. Both of these products use the language of the illegal drug trade.

A low dose of caffeine when pregnant may damage the heart of offspring for a lifetime
New article in the FASEB Journal shows that caffeine during pregnancy affects heart development and function
A new study published online in The FASEB Journal shows that the equivalent of one dose of caffeine (just two cups of coffee) ingested during pregnancy may be enough to affect fetal heart development and then reduce heart function over the entire lifespan of the child. In addition, the researchers also found that this relatively minimal amount of exposure may lead to higher body fat among males, when compared to those who were not exposed to caffeine. Although the study was in mice, the biological cause and effect described in the research paper is plausible in humans.
According to Scott Rivkees, Yale's Associate Chair of Pediatric Research and a senior researcher on the study, "Our studies raise potential concerns about caffeine exposure during very early pregnancy, but further studies are necessary to evaluate caffeine's safety during pregnancy."
To reach their conclusion researchers studied four groups of pregnant mice under two sets of conditions for 48 hours. The first two groups were studied in "room air," with one group having been injected with caffeine and another injected with saline solution. The second two groups were studied under conditions where ambient oxygen levels were halved, with one group receiving caffeine and the other receiving saline solution. They found that under both circumstances, mice given caffeine produced embryos with a thinner layer of tissue separating some of the heart's chambers than the group that was not given caffeine.
The researchers then examined the mice born from these groups to determine what long-term effects, if any, caffeine had on the offspring. They found that all of the adult males exposed to caffeine as fetuses had an increase in body fat of about 20 percent, and decreased cardiac function of 35__ percent when compared to mice not exposed to caffeine.
"Caffeine is everywhere: in what we drink, in what we eat, in pills that we use to relieve pain, and even in candy," said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. "This report shows that despite popular notions of safety, there's one place it probably shouldn't be: in the diet of an expectant mother."

Consuming small amounts of caffeine when pregnant may affect the growth of an unborn child
Research paper: Human maternal caffeine intake during pregnancy and the risk of fetal growth restriction: Large prospective study
Consuming caffeine at any time during pregnancy is associated with an increased risk of fetal growth restriction (low birth weight), according to research published on bmj.com today.
Although some previous studies have also shown this, this BMJ study additionally shows that any amount and type of caffeine intake—from tea, cola, chocolate, cocoa, and some prescription drugs, as well as coffee—is linked with relatively slower fetal growth.
Dr Justin Konje and colleagues from the University of Leicester as well as collaborators from the University of Leeds, examined the association of maternal caffeine intake and individual caffeine metabolism on birth weight.
From two large teaching hospitals in the UK between September 2003 and June 2006 the authors recruited 2645 low risk pregnant women of average age 30, who were between 8-12 weeks pregnant. They used a caffeine assessment tool (CAT) to record caffeine intake from all possible dietary sources in the four weeks before and throughout pregnancy, and also used a saliva sample test to calculate individual caffeine metabolism.
The researchers report that the average caffeine intake during pregnancy was 159mg/day, much lower than the limit of 300mg/day recommended by the UK government's Food Standards Agency. Interestingly, 62% of the caffeine use reported came from tea. Other sources were coffee (14%), cola (12%), chocolate (8%), and soft drinks (2%).
Most of the babies were born at full term, with an average birth weight of 3450g (which is around the UK average), while 4% were born prematurely, 0.3% were stillborn, and 0.7% were miscarried late. Overall, the results confirmed that these were low risk pregnancies. However, the authors found a 'dose-response relationship', showing that increasing caffeine intake was associated with increasing risk of fetal growth restriction (FGR).
Compared to pregnant women consuming less than 100mg/day (the equivalent of less than one cup of coffee), the risk estimates of having a lower birth weight baby increased by 20% for intakes of 100-199mg/day, by 50% for those taking between 200-299mg/day, and by 40% for over 300mg/day.
There was no level of caffeine intake at which the increased risk of FGR stopped increasing during pregnancy. Caffeine consumption of more than 100mg/day, the equivalent of one cup of coffee, was associated with a reduction in birth weight of 34-59g in the first, 24-74g in the second, and about 66-89g in the third trimesters. This effect was significant and consistent across all trimesters with consumption of over 200mg/day. The authors also noted that the link between caffeine and FGR was stronger in women who metabolised caffeine more quickly.
The authors explain that, although these reductions in birth weight may seem small given that the average birth weight is over 3kg, a drop of 60-70 g might be important for a baby that was already small and at risk. Pregnant women should make every effort to significantly reduce their caffeine consumption before and during pregnancy, they warn.
In light of this evidence, the UK Government's Food Standards Agency are altering their guidance on the recommended daily limit of caffeine consumption and reducing it from 300mg to 200mg.
These findings will reinforce the concern that caffeine is a potential fetotoxic substance, say Professor Jørn Olsen and Professor Bodil Hammer Bech, in an accompanying editorial. But the advice offered by the authors could unnecessarily frighten women who have consumed some caffeine during pregnancy.
Pregnant women should reduce their intake of caffeine, but must not replace it with unhealthy alternatives such as alcoholic drinks or soft drinks full of sugar, they add.


Caffeine may prevent heart disease death in elderly

Habitual intake of caffeinated beverages provides protection against heart disease mortality in the elderly, say researchers at SUNY Downstate Medical Center and Brooklyn College._

Using data from the first federal National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, the researchers found that survey participants 65 or more years old with higher caffeinated beverage intake exhibited lower relative risk of coronary vascular disease and heart mortality than did participants with lower caffeinated beverage intake.__

John Kassotis, MD, associate professor of medicine at SUNY Downstate, said, "The protection against death from heart disease in the elderly afforded by caffeine is likely due to caffeine's enhancement of blood pressure."_

The protective effect also was found to be dose-responsive: the higher the caffeine intake the stronger the protection. The protective effect was found only in participants who were not severely hypertensive. No significant protective effect was in patients below the age of 65.

Coffee consumption may lower blood uric acid levels

Coffee consumption may lower blood uric acid levels -- the precursor of gout
High uric acid levels in the blood are a precursor of gout, the most common inflammatory arthritis in adult men. It is believed that coffee and tea consumption may affect uric acid levels but only one study has been conducted to date. A new large-scale study published in the June 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) examined the relationship between coffee, tea, caffeine intake, and uric acid levels and found that coffee consumption is associated with lower uric acid levels but that this appears to be due to components other than caffeine.__
The results showed that levels of uric acid in the blood significantly decreased with increasing coffee intake, but not with tea intake. In addition, there was no association between total caffeine intake from beverages and uric acid levels. These results were similar to those found in the only previous study on the topic, which was conducted in Japan. Interestingly, there was an association between decaffeinated coffee consumption and uric acid levels. "These findings suggest that components of coffee other than caffeine contribute to the observed inverse association between coffee intake and uric acid levels," the researchers state.
A recent study found that coffee was associated lower C peptide levels (a marker of insulin levels). The researchers in the current study suggest that because there is a strong relationship between insulin resistance and elevated uric acid levels, the decreased insulin levels associated with coffee consumption may lead to lower uric acid levels. Coffee is also a major source of chlorogenic acid, a strong antioxidant, which may improve insulin sensitivity. Chlorogenic acid also helps inhibit glucose absorption in the intestine; in another study decaffeinated coffee seemed to delay intestinal absorption of glucose and increase concentrations of glucagon-like peptide 1, which is well known for its beneficial effects on insulin secretion and action. The researchers note further that their results could be due to an effect of non-caffeine components found in coffee, which would also explain why coffee affected uric acid levels but tea did not.

Most significantly, the data revealed that the risk for developing gout decreased with increasing coffee consumption. The risk of gout was 40 percent lower for men who drank 4 to 5 cups a day and 59 percent lower for men who drank 6 or more cups a day than for men who never drank coffee. There was also a modest inverse association with decaffeinated coffee consumption. These findings were independent of all other risk factors for gout. Tea drinking and total caffeine intake were both shown to have no effect on the incidence of gout among the subjects. On the mechanism of these findings, Dr. Choi speculates that components of coffee other than caffeine may be responsible for the beverage’s gout-prevention benefits. Among the possibilities, coffee contains the phenol chlorogenic acid, a strong antioxidant.__
Caffeine prevents multiple sclerosis-like disease in mice
Mice given caffeine equivalent to a human drinking six to eight cups of coffee a day were protected from developing experimental autoimmune encephalomyelitis (EAE), the animal model for the human disease Multiple Sclerosis (MS), according to researchers at Cornell University.
Caffeine is a well-known adenosine receptor blocker, and the researchers believe results show the importance of this molecule in permitting the infiltration of immune cells into the central nervous system of patients with MS.
Dr. Jeffrey H. Mills, a postdoctoral associate in the laboratory of Dr. Margaret S. Bynoe, presented the findings at Experimental Biology 2008 on April 7. The presentation was part of the scientific programs of the American Society of Immunologists.
Multiple sclerosis is an autoimmune disease of the central nervous system (CNS) that occurs when the body’s immune system attacks and damages nerves in the brain and spinal cord. The infiltration of immune cells into brain and other CNS tissue is rarely seen in healthy individuals without MS. What allows the immune cells to infiltrate the CNS tissue of patients with MS is unknown. In earlier work, the Bynoe laboratory became convinced that the molecule adenosine is responsible for this infiltration.
Adenosine is widely present in the body and plays an important role in many biochemical processes, such as energy transfer and the promotion of sleep and suppression of arousal. The researchers’ first studies found that mice that lacked CD73, the enzyme necessary for synthesizing extracellular adenosine, were protected from developing the mouse form of MS (experimental autoimmune encephalomyelitis or EAE).
Additional studies involving immune cells from mice that lack CD73 further convinced them that normal CD73’s ability to synthesize extracellular adenosine was what was important for development and progression of the MS-like disease. That helped explain the presence of adenosine near the cells, but how did the compound get into the CNS cells? Since adenosine must bind to its receptor in order to affect a cell, the researchers reasoned that perhaps adenosine receptor activation was what allowed for entry of immune cells into the brain and spinal cord. To test that idea in the study presented at Experimental Biology 2008, they turned to caffeine.
Caffeine’s stimulatory effects on the CNS are in large part due to its ability to bind to the same receptors as adenosine, thus blocking adenosine’s ability to affect CNS cells. Mice that consumed caffeine in their drinking water were protected from development of EAE, the MS model. Dr. Bynoe concludes that these experiments show that CD73 and adenosine receptor signaling are required for the efficient entry of immune cells into the CNS during the initiation and progression of EAE in mice and, quite possibly, during the development of MS in humans.
Dr. Bynoe adds, “These results might mark the first in a series of discoveries from our lab that could spawn the impetus for the development of adenosine-based therapies for the treatment of MS.”

Caffeine and exercise can team up to prevent skin cancer
A potential dynamic duo that may help avert sun-induced skin cancer
Regular exercise and little or no caffeine has become a popular lifestyle choice for many Americans. But a new Rutgers study has found that it may not be the best formula for preventing sun-induced skin damage that could lead to cancer. Low to moderate amounts of caffeine, in fact, along with exercise can be good for your health.
According to the National Cancer Institute, sunlight-induced skin cancer is the most prevalent cancer in the United States with more than 1 million new cases each year. A research team at Rutgers, The State University of New Jersey, showed that a combination of exercise and some caffeine protected against the destructive effects of the sun’s ultraviolet-B (UVB) radiation, known to induce skin cancer. The caffeine and exercise seemingly conspire in killing off precancerous cells whose DNA has been damaged by UVB-rays.
In women, caffeine may protect memory
Caffeine may help older women protect their thinking skills, according to a study published in the August 7, 2007, issue of Neurology, the medical journal of the American Academy of Neurology.
The study found that women age 65 and older who drank more than three cups of coffee (or the equivalent in tea) per day had less decline over time on tests of memory than women who drank one cup or less of coffee or tea per day. The results held up even after researchers adjusted for other factors that could affect memory abilities, such as age, education, disability, depression, high blood pressure, medications, cardiovascular disease, and other chronic illnesses.
“Caffeine is a psychostimulant which appears to reduce cognitive decline in women,” said study author Karen Ritchie,. “While we have some ideas as to how this works biologically, we need to have a better understanding of how caffeine affects the brain before we can start promoting caffeine intake as a way to reduce cognitive decline. But the results are interesting – caffeine use is already widespread and it has fewer side effects than other treatments for cognitive decline, and it requires a relatively small amount for a beneficial effect.”
The study involved 7,000 people whose cognitive abilities and caffeine consumption were evaluated over four years. Compared to women who drank one cup or less of coffee per day, those who drank over three cups were less likely to show as much decline in memory. Moreover, the benefits increased with age – coffee drinkers being 30 percent less likely to have memory decline at age 65 and rising to 70 percent less likely over age 80.
Caffeine consumers did not seem to have lower rates of dementia. “We really need a longer study to look at whether caffeine prevents dementia; it might be that caffeine could slow the dementia process rather than preventing it,” said Ritchie.
Ritchie said researchers aren’t sure why caffeine didn’t show the same result in men. “Women may be more sensitive to the effects of caffeine,” she said. “Their bodies may react differently to the stimulant, or they may metabolize caffeine differently.”
Coffee drinking related to reduced risk of liver cancer
After lung and stomach cancer, liver cancer is the third largest cause of cancer deaths in the world. A new study on the relationship between coffee drinking and the risk of hepatocellular carcinoma (HCC) confirmed that there is an inverse association between coffee consumption and HCC, although the reasons for this relationship are still unresolved.
The results showed a 41 percent reduction of HCC risk among coffee drinkers compared to those who never drank coffee. “Moreover, the apparent favorable effect of coffee drinking was found both in studies from southern Europe, where coffee is widely consumed, and from Japan, where coffee consumption is less frequent, and in subjects with chronic liver diseases,” the researchers state.
Certain compounds found in coffee may act as blocking agents by reacting with enzymes involved in carcinogenic detoxification. Other components, including caffeine, have been shown to have favorable effects on liver enzymes. Coffee has also been related to a reduced risk of liver diseases and cirrhosis, which can lead to liver cancer.


A coffee with your doughnut could protect against Alzheimer's disease

A daily dose of caffeine blocks the disruptive effects of high cholesterol that scientists have linked to Alzheimer's disease. A study in the open access publication, Journal of Neuroinflammation revealed that caffeine equivalent to just one cup of coffee a day could protect the blood-brain barrier (BBB) from damage that occurred with a high-fat diet.
The BBB protects the central nervous system from the rest of the body's circulation, providing the brain with its own regulated microenvironment. Previous studies have shown that high levels of cholesterol break down the BBB which can then no longer protect the central nervous system from the damage caused by blood borne contamination. BBB leakage occurs in a variety of neurological disorders such as Alzheimer's disease.
In this study, researchers from the University of North Dakota School of Medicine and Health Sciences gave rabbits 3 mg caffeine each day – the equivalent of a daily cup of coffee for an average-sized person. The rabbits were fed a cholesterol-enriched diet during this time.
After 12 weeks a number of laboratory tests showed that the BBB was significantly more intact in rabbits receiving a daily dose of caffeine.
“Caffeine appears to block several of the disruptive effects of cholesterol that make the blood-brain barrier leaky,” says Jonathan Geiger, University of North Dakota School of Medicine and Health Sciences. “High levels of cholesterol are a risk factor for Alzheimer's disease, perhaps by compromising the protective nature of the blood-brain barrier. For the first time we have shown that chronic ingestion of caffeine protects the BBB from cholesterol-induced leakage.”
Caffeine appears to protect BBB breakdown by maintaining the expression levels of tight junction proteins. These proteins bind the cells of the BBB tightly to each other to stop unwanted molecules crossing into the central nervous system.
The findings confirm and extend results from other studies showing that caffeine intake protects against memory loss in aging and in Alzheimer’s disease.
“Caffeine is a safe and readily available drug and its ability to stabilise the blood-brain barrier means it could have an important part to play in therapies against neurological disorders,” says Geiger.
New study: Coffee drinkers have slightly lower death rates than people who do not drink coffee
Drinking large amounts of coffee does not increase a person's risk for dying sooner than expected and may actually be protective

A new study published today in Annals of Internal Medicine has good news for coffee drinkers: Regular coffee drinking (up to 6 cups per day) is not associated with increased deaths in either men or women. In fact, both caffeinated and decaffeinated coffee consumption is associated with a somewhat smaller rate of death from heart disease.
"Coffee consumption has been linked to various beneficial and detrimental health effects, but data on its relation with death were lacking," says Esther Lopez-Garcia, PhD, the study's lead author. "Coffee consumption was not associated with a higher risk of mortality in middle-aged men and women. The possibility of a modest benefit of coffee consumption on heart disease, cancer, and other causes of death needs to be further investigated."
Women consuming two to three cups of caffeinated coffee per day had a 25 percent lower risk of death from heart disease during the follow-up period (which lasted from 1980 to 2004 and involved 84,214 women) as compared with non-consumers, and an 18 percent lower risk of death caused by something other than cancer or heart disease as compared with non-consumers during follow-up. For men, this level of consumption was associated with neither a higher nor a lower risk of death during the follow-up period (which lasted from 1986 to 2004 and involved 41,736 men).
The researchers analyzed data of 84,214 women who had participated in the Nurses' Health Study and 41,736 men who had participated in the Health Professionals Follow-up Study. To be in the current study, participants had to have been free of cancer and heart disease at the start of those larger studies.
The study participants completed questionnaires every two to four years that included questions about how frequently they drank coffee, other diet habits, smoking, and health conditions. The researchers then compared the frequency of death from any cause, death due to heart disease, and death due to cancer among people with different coffee-drinking habits.
Among women, 2,368 deaths were due to heart disease, 5,011 were due to cancer, and 3,716 were due to another cause. Among men, 2,049 deaths were due to heart disease, 2,491 were due to cancer, and 2,348 were due to another cause.
While accounting for other risk factors, such as body size, smoking, diet, and specific diseases, the researchers found that people who drank more coffee were less likely to die during the follow-up period. This was mainly because of lower risk for heart disease deaths among coffee drinkers.
The researchers found no association between coffee drinking and cancer deaths. These relationships did not seem to be related to caffeine because people who drank decaffeinated coffee also had lower death rates than people who did not drink coffee.
The editors of Annals of Internal Medicine caution that the design of the study does not make it certain that coffee decreases the chances of dying sooner than expected. Something else about coffee drinkers might be protecting them. And some measurement error in the assessment of coffee consumption is inevitable because estimated consumption came from self-reports.

Higher Coffee Consumption Associated with Lower Liver Cancer Risk
Liver Cancer is the Third Most Common Global Cause of Cancer Death
A new large, prospective population-based study confirms an inverse relationship between coffee consumption and liver cancer risk. The study also found that higher levels of gamma-glutamyltransferase (GGT) in the blood were associated with an increased risk of developing the disease. These findings are published in the July issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article and an accompanying editorial are also available online at Wiley Interscience (www.interscience.wiley.com).

Researchers led by Gang Hu at the University of Helsinki set out to examine the associations between coffee consumption and serum GGT with the risk of liver cancer in a large prospective cohort. Residents of Finland drink more coffee per capita than the Japanese, Americans, Italians, and other Europeans, so Hu and colleagues studied 60,323 Finnish participants ages 25 to 74 who were cancer-free at baseline. The Finns were included in seven independent cross-sectional population surveys conducted between 1972 and 2002 and followed up through June 2006.

The participants completed a mail-in questionnaire about their medical history, socioeconomic factors and dietary and lifestyle habits. For a subset of participants, clinical data was available, including serum levels of GGT. Data on subsequent cancer diagnoses was collected from the country-wide Finnish Cancer Registry.

Based on their answers to the question: “How many cups of coffee do you drink daily?” the participants were divided into five categories: 0-1 cup, 2-3 cups, 4-5 cups, 6-7 cups, and 8 or more cups per day. After a median follow-up period of 19.3 years, 128 participants were diagnosed with liver cancer.

The researchers noted a significant inverse association between coffee drinking and the risk of primary liver cancer. They found that the multivariable hazards ratio of liver cancer dropped for each group that drank more coffee. It fell from 1.00, to .66, to .44, to .38 to .32 respectively. “The biological mechanisms behind the association of coffee consumption with the risk of liver cancer are not known,” the authors point out.

They also found that high levels of serum GGT were associated with an increased risk of liver cancer. The hazard ratio of liver cancer for the highest vs. lowest quartile of serum GGT was 3.13. “Nevertheless,” they report, “the inverse association between coffee consumption and the risk of liver cancer was consistent in the subjects at any level of serum GGT.”

An accompanying editorial by Carlo La Vecchia of Milan says that Hu’s new study solidly confirms the inverse relationship between coffee drinking and liver cancer risk, though we still don’t know if it is causal. “Furthermore, the study by Hu et al. provides original and important quantitative evidence that the levels of GGT are related to subsequent incidence of liver cancer, with an overall relative risk of 2.3,” he says.

La Vecchia notes, however, that, “It remains difficult, however, to translate the inverse relation between coffee drinking and liver cancer risk observed in epidemiological studies into potential implications for prevention of liver cancer by increasing coffee consumption.”

Post-exercise caffeine helps muscles refuel
Recipe to recover more quickly from exercise: Finish workout, eat pasta, and wash down with five or six cups of strong coffee.
Glycogen, the muscle's primary fuel source during exercise, is replenished more rapidly when athletes ingest both carbohydrate and caffeine following exhaustive exercise, new research from the online edition of the Journal of Applied Physiology shows. Athletes who ingested caffeine with carbohydrate had 66% more glycogen in their muscles four hours after finishing intense, glycogen-depleting exercise, compared to when they consumed carbohydrate alone, according to the study, published by The American Physiological Society.
The study, "High rates of muscle glycogen resynthesis after exhaustive exercise when carbohydrate is co-ingested with caffeine," is by David J. Pedersen, Sarah J. Lessard, Vernon G. Coffey, Emmanuel G. Churchley, Andrew M. Wootton, They Ng, Matthew J. Watt and John A. Hawley. Dr. Pedersen is with the Garvan Institute of Medical Research in Sydney, Australia, Dr. Watt is from St. Vincent's Institute of Medical Research, Fitzroy, Victoria, Australia. All others are with the Royal Melbourne Institute of Technology University (RMIT) in Bundoora, Victoria, Australia.
A fuller audio interview with Dr. Hawley is available in Episode 11 of the APS podcast, Life Lines, at www.lifelines.tv. The show also includes an interview with Dr. Stanley Schultz, whose physiological discovery of how sugar is transported in the gut led to the development of oral rehydration therapy and sports drinks such as Gatorade.
Caffeine aids carbohydrate uptake
It is already established that consuming carbohydrate and caffeine prior to and during exercise improves a variety of athletic performances. This is the first study to show that caffeine combined with carbohydrates following exercise can help refuel the muscle faster.
"If you have 66% more fuel for the next day's training or competition, there is absolutely no question you will go farther or faster," said Dr. Hawley, the study's senior author. Caffeine is present in common foods and beverages, including coffee, tea, chocolate and cola drinks.
The study was conducted on seven well-trained endurance cyclists who participated in four sessions. The participants first rode a cycle ergometer until exhaustion, and then consumed a low-carbohydrate dinner before going home. This exercise bout was designed to reduce the athletes' muscle glycogen stores prior to the experimental trial the next day.
The athletes did not eat again until they returned to the lab the next day for the second session when they again cycled until exhaustion. They then ingested a drink that contained carbohydrate alone or carbohydrate plus caffeine and rested in the laboratory for four hours. During this post-exercise rest time, the researchers took several muscle biopsies and multiple blood samples to measure the amount of glycogen being replenished in the muscle, along with the concentrations of glucose-regulating metabolites and hormones in the blood, including glucose and insulin.
The entire two-session process was repeated 7-10 days later. The only difference was that this time, the athletes drank the beverage that they had not consumed in the previous trial. (That is, if they drank the carbohydrate alone in the first trial, they drank the carbohydrate plus caffeine in the second trial, and vice versa.)
The drinks looked, smelled and tasted the same and both contained the same amount of carbohydrate. Neither the researchers nor the cyclists knew which regimen they were receiving, making it a double-blind, placebo-controlled experiment.
Glucose and insulin levels higher with caffeine ingestion
The researchers found the following:

• one hour after exercise, muscle glycogen levels had replenished to the same extent whether or not the athlete had the drink containing carbohydrate and caffeine or carbohydrate only
• four hours after exercise, the drink containing caffeine resulted in 66% higher glycogen levels compared to the carbohydrate-only drink
• throughout the four-hour recovery period, the caffeinated drink resulted in higher levels of blood glucose and plasma insulin
• several signaling proteins believed to play a role in glucose transport into the muscle were elevated to a greater extent after the athletes ingested the carbohydrate-plus-caffeine drink, compared to the carbohydrate-only drink

Dr. Hawley said it is not yet clear how caffeine aids in facilitating glucose uptake from the blood into the muscles. However, the higher circulating blood glucose and plasma insulin levels were likely to be a factor. In addition, caffeine may increase the activity of several signaling enzymes, including the calcium-dependent protein kinase and protein kinase B (also called Akt), which have roles in muscle glucose uptake during and after exercise.
Lower dose is next step
In this study, the researchers used a high dose of caffeine to establish that it could help the muscles convert ingested carbohydrates to glycogen more rapidly. However, because caffeine can have potentially negative effects, such as disturbing sleep or causing jitteriness, the next step is to determine whether smaller doses could accomplish the same goal.
Hawley pointed out that the responses to caffeine ingestion vary widely between individuals. Indeed, while several of the athletes in the study said they had a difficult time sleeping the night after the trial in which they ingested caffeine (8 mg per kilogram of body weight, the equivalent of drinking 5-6 cups of strong coffee), several others fell asleep during the recovery period and reported no adverse effects.
Athletes who want to incorporate caffeine into their workouts should experiment during training sessions well in advance of an important competition to find out what works for them.
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Jon's Health Tips - Vitamin D Update

Thursday, January 15, 2009

It’s only been a few weeks since I reported on, and started taking, Vitamin D. But there have been several new research studies since then. The title of the first one below tells the story:

Vitamin D is the 'it' nutrient of the moment

Loyola researchers report on benefit of vitamin D in diabetes and other chronic diseases
Vitamin D is quickly becoming the "it" nutrient with health benefits for diseases, including cancer, osteoporosis, heart disease and now diabetes.
A recent review article published by researchers from Loyola University Chicago Marcella Niehoff School of Nursing concluded that adequate intake of vitamin D may prevent or delay the onset of diabetes and reduce complications for those who have already been diagnosed. These findings appeared in the latest issue of Diabetes Educator.
"Vitamin D has widespread benefits for our health and certain chronic diseases in particular," said Sue Penckofer, Ph.D., R.N., study co-author and professor, Loyola University Chicago Marcella Niehoff School of Nursing. "This article further substantiates the role of this nutrient in the prevention and management of glucose intolerance and diabetes."
Many of the 23 million Americans with diabetes have low vitamin D levels. Evidence suggests that vitamin D plays an integral role in insulin sensitivity and secretion. Vitamin D deficiency results in part from poor nutrition, which is one of the most challenging issues for people with diabetes. Another culprit is reduced exposure to sunlight, which is common during cold weather months when days are shorter and more time is spent indoors.
One study examined for this review article evaluated 3,000 people with type 1 diabetes and found a decreased risk in disease for people who took vitamin D supplements. Observational studies of people with type 2 diabetes also revealed that supplementation may be important in the prevention of this disease.
"Management of vitamin D deficiency may be a simple and cost-effective method to improve blood sugar control and prevent the serious complications associated with diabetes," said Joanne Kouba, Ph.D., R.D., L.D.N., study co-author and clinical assistant professor of dietetics, Loyola University Chicago Marcella Niehoff School of Nursing.
Diet alone may not be sufficient to manage vitamin D levels. A combination of adequate dietary intake of vitamin D, exposure to sunlight, and treatment with vitamin D2 or D3 supplements can decrease the risk of diabetes and related health concerns. The preferred range in the body is 30 - 60 ng/mL of 25(OH) vitamin D.
"People at risk for diabetes should be screened for low vitamin D levels," said Mary Ann Emanuele, M.D., F.A.C.P., study co-author and professor of medicine, division of endocrinology and metabolism, Loyola University Health System. "This will allow health care professionals to identify a nutrient deficiency early on and intervene to improve the long term health of these individuals."
Vitamin D deficiency also may be associated with hyperglycemia, insulin resistance, hypertension and heart disease. In fact, Penckofer recently published another study in Circulation that reported on the role of chronic vitamin D deficiency in heart disease.

Lack of vitamin D could spell heart trouble

Researchers issue recommendations to screen for and treat vitamin D deficiency

Vitamin D deficiency—which is traditionally associated with bone and muscle weakness—may also increase the risk of cardiovascular disease (CVD). A growing body of evidence links low 25-hydroxyvitamin D levels to common CVD risk factors such as hypertension, obesity and diabetes, as well as major cardiovascular events including stroke and congestive heart failure.
In their review article, published in the December, 9, 2008, issue of the Journal of the American College of Cardiology (JACC), the authors issue practical recommendations to screen for and treat low vitamin D levels, especially in patients with risk factors for heart disease or diabetes.
"Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated," said James H. O'Keefe, M.D., cardiologist and director of Preventive Cardiology at the Mid America Heart Institute, Kansas City, MO. "Vitamin D is easy to assess, and supplementation is simple, safe and inexpensive."
It is estimated that up to half of U.S. adults and 30 percent of children and teenagers have vitamin D deficiency, which is defined as a 25(OH)D level of <20ng/ml. Low vitamin D levels activate the renin-angiostensin-aldosterone system and, in doing so, predispose patients to hypertension and a stiffening and thickening of the heart and blood vessels. Vitamin D deficiency also alters hormone levels and immune function, which can increase the risk of diabetes, a major contributor to CVD.
Recent data from the Framingham Heart Study suggest patients with vitamin D levels below 15 ng/ml were twice as likely to experience a heart attack, stroke or other CV event within the next five years compared to those with higher levels. This risk remained even when researchers adjusted for traditional CV risk factors.
"Restoring vitamin D levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis," said Dr. O'Keefe. "We need large randomized controlled trials to determine whether or not vitamin D supplementation can actually reduce future heart disease and deaths."
Vitamin D Basics
Vitamin D deficiency is more prevalent than once thought, and greater attention to its treatment is warranted, according to Dr. O'Keefe. Although most of the body's vitamin D requirements can come from sun exposure, indoor lifestyles and use of sunscreen, which eliminates 99 percent of vitamin D synthesis by the skin, means many people aren't producing enough.
"We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight," said Dr. O'Keefe. "A little bit of sunshine is a good thing, but the use of sunscreen to guard against skin cancer is important if you plan to be outside for more than 15 to 30 of intense sunlight exposure."
Vitamin D can also be consumed through supplements and food intake. Natural food sources of vitamin D include salmon, sardines, cod liver oil, and vitamin D-fortified foods including milk and some cereals.
Major risk factors for vitamin D deficiency include: older age, darkly pigmented skin, increased distance from the equator, winter season, smoking, obesity, renal or liver disease and certain medications.
Treating Vitamin D Deficiency
In the absence of clinical guidelines, the authors outline specific recommendations for restoring and maintaining optimal vitamin D levels in CV patients. These patients should initially be treated with 50,000 IU of vitamin D2 or D3 once weekly for 8 to 12 weeks. Maintenance therapy should be continued using one of the following strategies:

• 50,000 IU vitamin D2 or D3every 2 weeks;
• 1,000 to 2,000 IU vitamin D3 daily;
• Sunlight exposure for 10 minutes for Caucasian patients (longer for people with increased skin pigmentation) between the hours of 10 a.m. to 3 p.m.

Vitamin D supplements appear to be safe. In rare cases, vitamin D toxicity (causing high calcium levels and kidney stones) is possible, but only when taking in excess of 20,000 units a day.


Lack of vitamin D causes weight gain and stunts growth in girls

Canada-US study published in Journal of Clinical Endocrinology & Metabolism recommends young people be screened for low vitamin D levels

Insufficient vitamin D can stunt growth and foster weight gain during puberty, according to a new study published in the Journal of Clinical Endocrinology & Metabolism. Even in sun-drenched California, where scientists from the McGill University Health Centre (MUHC) and the University of Southern California conducted their study, vitamin D deficiency was found to cause higher body mass and shorter stature in girls at the peak of their growing spurt.
While lack of vitamin D is common in adults and has been linked to diseases such as osteoporosis, cancer and obesity, until this study, little was known about the consequences of insufficient vitamin D in young people. The research team measured vitamin D in girls aged 16 to 22 using a simple blood test (25-hydroxy vitamin D). They also assessed body fat and height to determine how vitamin D deficiency could affect young women's health.
"The high prevalence of vitamin D insufficiency in young people living in a sun-rich area was surprising," says study lead author, Richard Kremer, co-director of the Musculoskeletal Axis of the MUHC. "We found young women with vitamin D insufficiency were significantly heavier, with a higher body mass index and increased abdominal fat, than young women with normal levels."
Vitamin D fosters growth, healthier weight
The researchers examined 90 Caucasian and Hispanic girls and discovered that young women with normal vitamin D levels were on average taller than peers deficient in vitamin D. Yet in contrast to what's been previously reported in older women, their investigation found no association between lack of vitamin D and bone strength.
"Although vitamin D is now frequently measured in older adults, due to a higher level of awareness in this population, it is rarely measured in young people – especially healthy adolescents," says Dr. Kremer.
"Clinicians need to identify vitamin D levels in younger adults who are at risk by using a simple and useful blood test," says the co-author, Dr. Vicente Gilsanz, head of musculoskeletal imaging at the Children's Hospital Los Angeles of the University of Southern California.
"Because lack of vitamin D can cause fat accumulation and increased risk for chronic disorders later in life, further investigation is needed to determine whether vitamin D supplements could have potential benefits in the healthy development of young people," added Dr. Gilsanz.
American Academy of Dermatology Issues Position Statement on Vitamin D
The American Academy of Dermatology (Academy) recently issued a position statement on vitamin D, drawing on the scientific literature to support its recommendation for safely obtaining an adequate amount of this vitamin. The Academy recommends that the public obtain vitamin D from nutritional sources and dietary supplements, and not from unprotected exposure to ultraviolet (UV) radiation from the sun or indoor tanning devices, as UV radiation is a known risk factor for the development of skin cancer.
“Vitamin D is essential for optimal health, and the medical literature supports safe ways to get it – a healthy diet which incorporates foods naturally rich in vitamin D, vitamin D-fortified foods and beverages, and vitamin D supplements,” stated dermatologist C. William Hanke, MD, MPH, FAAD, president of the American Academy of Dermatology. “And, according to the medical literature, unprotected exposure to UV radiation from sunlight (natural) or indoor tanning devices (artificial) is not safe. Individuals who intentionally expose themselves to UV radiation for vitamin D are putting their health at risk for developing skin cancer.”
The Academy further recommends that individuals who are concerned about their vitamin D levels seek a physician’s guidance about safe options to obtain vitamin D. The Academy recommends physicians use the National Academy of Sciences Institute of Medicine guidelines for vitamin D as a standard reference for advising patients on proper minimum intake levels. In addition, the Academy advises that a higher dose of supplementation for individuals with known risk factors for vitamin D deficiency should be considered.
The Academy recommends that when you are enjoying yourself outdoors, be smart by taking steps to protect yourself from UV exposure-- seek shade whenever possible, wear sunscreen and cover up with a wide-brimmed hat, long sleeves, pants and sunglasses. Also, avoid tanning beds.

Vitamin D found to fight placental infection

In a paper available at the online site of the journal Biology of Reproduction, a team of UCLA researchers reports for the first time that vitamin D induces immune responses in placental tissues by stimulating production of the antimicrobial protein cathelicidin.
The study involved exposing cultured human trophoblast cells to the active form of vitamin D, leading to production of cathelicidin and an increased antibacterial response in the trophoblast cells.
The team, headed by Dr. Martin Hewison, suspects that the ability of the placenta to synthesize cathelicidin varies widely among women. Their discovery suggests that placental innate immunity can be enhanced if pregnant women supplement their diets with vitamin D.
Induction of cathelicidin production by vitamin D may help the placenta stave off infection by a variety of pathogenic organisms, including staphylococcus, streptococcus, and E. coli bacteria. Vitamin D may also enhance and sustain this bacterial killing by protecting placental trophoblast cells from infection-associated cell death.
The significance of vitamin D in human reproduction has been recognized for the past 20 years, although its exact role has not been completely understood. This study presents a new mechanism for activation of innate immune responses in the placenta to protect it from infectious bacteria and sheds new light on the possible role of vitamin D in pregnancy and pregnancy-associated infection.

Vitamin D deficiency in infants and nursing mothers carries long-term disease risks

Once believed to be important only for bone health, vitamin D is now seen as having a critical function in maintaining the immune system throughout life. The newly recognized disease risks associated with vitamin D deficiency are clearly documented in a report in the December issue (Volume 3, Number 4) of Breastfeeding Medicine, a peer-reviewed journal published by Mary Ann Liebert, Inc. (www.liebertpub.com), and the official journal of the Academy of Breastfeeding Medicine (www.bfmed.org). The paper is available free online at www.liebertpub.com/bfm
Vitamin D deficiency is common across populations and particularly among people with darker skin. Nutritional rickets among nursing infants whose mothers have insufficient levels of vitamin D is an increasingly common, yet preventable disorder.
Carol Wagner, MD, Sarah Taylor, MD, and Bruce Hollis, PhD, from the Department of Pediatrics, Medical University of South Carolina (Charleston), emphasize the need for clinical studies to determine the dose of vitamin D needed to achieve adequate vitamin D levels in breastfeeding mothers and their infants without toxicity.
In a paper entitled, "Does Vitamin D Make the World Go 'Round'?" the authors point out that vitamin D is now viewed not simply as a vitamin with a role in promoting bone health, but as a complex hormone that helps to regulate immune system function. Long-term vitamin D deficiency has been linked to immune disorders such as multiple sclerosis, rheumatoid arthritis, type I diabetes, and cancer.
"Vitamin D is a hormone not a vitamin and it is not just for kids anymore," writes Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine, from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry, in an accompanying editorial. "Perhaps the most startling information is that adults are commonly deficit in modern society. Vitamin D is now recognized as a pivotal hormone in the human immune system, a role far beyond the prevention of rickets, as pointed out in the article by Wagner et al in this month's issue of Breastfeeding Medicine."
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Jon's Health Tips - Broccoli

Saturday, January 10, 2009

I eat lots of broccoli, mostly cooked. I need to eat more raw broccoli, and other cruciferous vegetables, such as cauliflower and cabbage, or cooked broccoli with tomato sauce, or both. Here’s why:


UCLA study finds that broccoli may help boost the aging immune system

UCLA researchers have found that a chemical in broccoli and other cruciferous vegetables may hold a key to restoring the body's immunity, which declines as we age.
Published in this week's online edition of the Journal of Allergy and Clinical Immunology, the study findings show that sulforaphane, a chemical in broccoli, switches on a set of antioxidant genes and enzymes in specific immune cells, which then combat the injurious effects of molecules known as free radicals that can damage cells and lead to disease.
Free radicals are byproducts of normal body processes, such as the metabolic conversion of food into energy, and can also enter the body through small particles present in polluted air. A supercharged form of oxygen, these molecules can cause oxidative tissue damage, leading to disease — for example, triggering the inflammation process that causes clogged arteries. Oxidative damage to body tissues and organs is thought to be one of the major causes of aging.
"The mysteries of aging have always intrigued man," said Dr. Andre Nel, the study's principal investigator and chief of nanomedicine at the David Geffen School of Medicine at UCLA. "While we have known for some time that free radicals are important in aging, most of the past attention has focused on the mechanisms that produce free radicals rather than addressing the pathways used by the body to suppress their production."
A dynamic equilibrium exists in the body between the mechanisms that lead to increased free radical production and those antioxidant pathways that help combat free radicals.
"Our study contributes to the growing understanding of the importance of these antioxidant defense pathways that the body uses to fight free radicals," said Nel, a practicing clinical allergist and immunologist at the Geffen School. "Insight into these processes points to ways in which we may be able to alleviate the effects of aging."
The delicate balance between pro-oxidant and antioxidant forces in the body could determine the outcome of many disease processes that are associated with aging, including cardiovascular disease, degenerative joint diseases and diabetes, as well as the decline in efficiency of the immune system's ability to protect against infectious agents.
"As we age, the ability of the immune system to fight disease and infections and protect against cancer wears down as a result of the impact of oxygen radicals on the immune system," Nel said.
According to the UCLA study, the ability of aged tissues to reinvigorate their antioxidant defense can play an important role in reversing much of the negative impact of free radicals on the immune system. However, until this current study, the extent to which antioxidant defense can impact the aging process in the immune system was not properly understood.
"Our defense against oxidative stress damage may determine at what rate we age, how it will manifest and how to interfere in those processes," Nel said. "In particular, our study shows that a chemical present in broccoli is capable of stimulating a wide range of antioxidant defense pathways and may be able to interfere with the age-related decline in immune function."
"Dietary antioxidants have been shown to have important effects on immune function, and with further study, we may be adding broccoli and other cruciferous vegetables to that list," Nel said.
For now, Nel suggests including these vegetables as part of a healthy diet.
Nel said that these findings offer a window into how the immune system ages.
"We may find that combating free radicals is only part of the answer. It may prove to be a more multifaceted process and interplay between pro- and antioxidant forces," he said.

More Broccoli

Women should go for the broccoli when the relish tray comes around during holiday celebrations this season.

While it has been known for some time that eating cruciferous vegetables, such as broccoli, cauliflower, and cabbage, can help prevent breast cancer, the mechanism by which the active substances in these vegetables inhibit cell proliferation was unknown - until now.

Scientists in the UC Santa Barbara laboratories of Leslie Wilson, professor of biochemistry and pharmacology, and Mary Ann Jordan, adjunct professor in the Department of Molecular, Cellular, and Developmental Biology, have shown how the healing power of these vegetables works at the cellular level. Their research is published in this month's journal Carcinogenesis.

"Breast cancer, the second leading cause of cancer deaths in women, can be protected against by eating cruciferous vegetables such as cabbage and near relatives of cabbage such as broccoli and cauliflower," said first author Olga Azarenko, who is a graduate student at UCSB. "These vegetables contain compounds called isothiocyanates which we believe to be responsible for the cancer-preventive and anti-carcinogenic activities in these vegetables. Broccoli and broccoli sprouts have the highest amount of the isothiocyanates.

"Our paper focuses on the anti-cancer activity of one of these compounds, called sulforaphane, or SFN," Azarenko added. "It has already been shown to reduce the incidence and rate of chemically induced mammary tumors in animals. It inhibits the growth of cultured human breast cancer cells, leading to cell death."

Azarenko made the surprising discovery that SFN inhibits the proliferation of human tumor cells by a mechanism similar to the way that the anticancer drugs taxol and vincristine inhibit cell division during mitosis. Mitosis is the process in which the duplicated DNA in the form of chromosomes is accurately distributed to the two daughter cells when a cell divides.

Hundreds of tiny tube-like structures, called microtubules, make up the machinery that cells use to separate the chromosomes. SFN, like the more powerful anticancer agents, interferes with microtubule functioning during mitosis in a similar manner to the more powerful anticancer drugs. However SFN is much weaker than these other plant-based drugs, and thus much less toxic.

"SFN may be an effective cancer preventive agent because it inhibits the proliferation and kills precancerous cells," said Wilson. It is also possible that it could be used as an addition to taxol and other similar drugs to increase effective killing of tumor cells without increased toxicity.


Consumption of raw, but not cooked, cruciferous vegetables and reduction of bladder cancer risk.
While researchers have long known that cruciferous vegetables are chock full of isothiocyanates (ITCs), which are a well-known class of cancer prevention agents especially promising in bladder cancer chemoprevention, they didn’t know how much one needed to eat to reap the protective benefits.
Researchers from Roswell Park Cancer Institute report that three or more servings a month of raw cruciferous vegetables like broccoli, cabbage and cauliflower, may reduce bladder cancer risk by approximately 40 percent, overall.
The Roswell Park team surveyed the dietary habits of 275 individuals with incident, primary bladder cancer and 825 individuals without cancer. The researchers surveyed patients about their pre-diagnostic intake of raw and cooked cruciferous vegetables, their smoking habits and other cancer risk factors. They observed a strong and statistically significant inverse association between bladder cancer risk and raw cruciferous vegetable consumption. When compared to smokers who ate less than three servings of raw vegetables, non-smokers who ate at least three servings a month were almost 73 percent less likely to develop bladder cancer, the researchers say.
A key factor in the research was that it’s a survey of raw cruciferous vegetables. Previous research had surveyed intake of any cruciferous vegetables – cooked or not – and results proved inconsistent. Cooking significantly reduces the availability of ITCs for absorption into the body, according to researchers.
“Cooking can reduce 60 to 90 percent of ITCs,” says Li Tang, M.D., Ph.D. of Roswell Park Cancer Institute and lead researcher on this study. “Heating destroys the enzyme that converts the precursor glucosinolates into ITCs, and also destroys ITCs already formed, which is why you need to eat raw cruciferous vegetables to receive the food’s maximum benefit.”

Broccoli, cabbage and cauliflower fight breast cancer

When your mother told you to eat your vegetables it appears that maternal wisdom had a scientific basis. Researchers have discovered a possible link between a diet rich in certain vegetables and a decreased risk for breast cancer. The study appears in the March issue of the American Journal of Clinical Nutrition.
Cruciferous vegetables contain some compounds that may have a cancer-inhibitory effect.
While there was only a small positive relationship between a diet high in these vegetables and a reduction in breast cancer risk for the overall study population, there was a striking risk reduction – 50 percent – among women with a certain genetic profile. Researchers identified three forms of the GSTP1 genotype among the cancer patients: Ille/Ile, Ile/Val and Val/Val.
“Women who consumed more of these cruciferous vegetables and who also had the Val/Val genetic polymorphism had a lower breast cancer risk. So we cautiously interpreted this as diet being a factor that may reduce the impact of genetic susceptibility in overall breast cancer risk,” said Fowke.
Studies by other researchers have suggested cruciferous vegetables may reduce the risk of lung, stomach, colorectal and bladder cancers.



Worried about prostate cancer? Tomato-broccoli combo shown to be effective

A new University of Illinois study shows that tomatoes and broccoli--two vegetables known for their cancer-fighting qualities--are better at shrinking prostate tumors when both are part of the daily diet than when they're eaten alone.__
"When tomatoes and broccoli are eaten together, we see an additive effect. We think it's because different bioactive compounds in each food work on different anti-cancer pathways," said University of Illinois food science and human nutrition professor John Erdman.__
In a study published in the January 15 issue of Cancer Research, Erdman and doctoral candidate Kirstie Canene-Adams fed a diet containing 10 percent tomato powder and 10 percent broccoli powder to laboratory rats that had been implanted with prostate cancer cells. The powders were made from whole foods so the effects of eating the entire vegetable could be compared with consuming individual parts of them as a nutritional supplement.__
Other rats in the study received either tomato or broccoli powder alone; or a supplemental dose of lycopene, the red pigment in tomatoes thought to be the effective cancer-preventive agent in tomatoes; or finasteride, a drug prescribed for men with enlarged prostates. Another group of rats was castrated.__
After 22 weeks, the tumors were weighed. The tomato/broccoli combo outperformed all other diets in shrinking prostate tumors. Biopsies of tumors were evaluated at The Ohio State University, confirming that tumor cells in the tomato/broccoli-fed rats were not proliferating as rapidly. The only treatment that approached the tomato/broccoli diet's level of effectiveness was castration, said Erdman.__
"As nutritionists, it was very exciting to compare this drastic surgery to diet and see that tumor reduction was similar. Older men with slow-growing prostate cancer who have chosen watchful waiting over chemotherapy and radiation should seriously consider altering their diets to include more tomatoes and broccoli," said Canene-Adams.
How much tomato and broccoli should a 55-year-old man concerned about prostate health eat in order to receive these benefits? The scientists did some conversions.
"To get these effects, men should consume daily 1.4 cups of raw broccoli and 2.5 cups of fresh tomato, or 1 cup of tomato sauce. I think it's very doable for a man to eat a cup and a half of broccoli per day or put broccoli on a pizza.
Erdman said the study showed that eating whole foods is better than consuming their components. "It's better to eat tomatoes than to take a lycopene supplement," he said. "And cooked tomatoes may be better than raw tomatoes. Chopping and heating make the cancer-fighting constituents of tomatoes and broccoli more bioavailable."
"When tomatoes are cooked, for example, the water is removed and the healthful parts become more concentrated. That doesn't mean you should stay away from fresh produce. The lesson here, I think, is to eat a variety of fruits and vegetables prepared in a variety of ways," Canene-Adams added.__
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Jon's Health Tips - Alcohol

Monday, January 5, 2009

My wife drinks white wine. Many of my friends don’t like red wine, either. I break down and drink beer instead of red wine from time to time myself. But there is good news. Any alcohol, especially wine, is remarkably good for you in moderation. Here’s why:


Drink For Your Health
Men who drink alcohol every day have a lower risk of heart disease than those who drink less frequently, suggests research in the British Medical Journal. It is widely known that moderate drinkers have a lower risk of coronary heart disease than those who abstain, but most research in this field has been done on men and little is known about drinking patterns and risk of heart disease among women.
Researchers in Denmark studied over 50,000 men and women aged 50-65 years who were taking part in a national health study. Details on alcohol intake and drinking frequency over the preceding year were collected, and participants were monitored for an average of 5.7 years.
Coronary heart events were recorded and results were adjusted for known risk factors, such as age, smoking, education, physical activity and diet.
A total of 28,448 women and 25,052 men took part in the study. Women consumed an average of 5.5 alcoholic drinks a week and men consumed 11.3. During the study, 749 women and 1,283 men developed coronary heart disease.
Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week.
However, risks were similar for drinking on one day a week (36% reduced risk), or seven days a week (35% reduced risk), suggesting that the amount of alcohol consumed is more important than drinking frequency among women.
In contrast, for men, risks were lowest for the most frequent drinkers. For example, men who drank on one day a week had a 7% reduced risk, while men who drank daily had a 41% reduced risk. This suggests that it doesn’t matter how much men drink, as long as they drink every day.

Moderate drinking lowers women's heart attack risk

Women who regularly enjoy an alcoholic drink or two have a significantly lower risk of having a non-fatal heart attack than women who are life-time abstainers, epidemiologists at the University at Buffalo have shown._
Moderation is the key, however. Women in the study who reported being intoxicated at least once a month were nearly three times more likely to suffer a heart attack than abstainers, results showed.
One difference in the protective pattern among drinkers involved those who drank primarily liquor. Women who preferred liquor to wine experienced a borderline increase in risk of heart attack, results showed.
The study is published in the May 2007 issue of the journal Addiction.__
"These findings have important implications, because heart disease is the leading cause of death for women," said Joan M. Dorn, Ph.D., associate professor of social and preventive medicine in the UB School of Public Health and Health Professions and first author on the study.
Women seem to have a quicker reaction to a smaller amount of alcohol, she noted: "Overdoing it is harmful, and what is too much depends on each individual. In some women, one drink can cause intoxication."__
Moderate alcohol consumption has been shown to lower the risk of heart attack, but most studies have been done with men. The current study compared alcohol drinking volume and drinking patterns of women who had been hospitalized due to a heart attack, with age-matched controls without heart problems.__

Alcohol Consumption = Lower Risk of Heart Disease

Findings from a study of healthy older adults suggest that alcohol’s effect on lipoprotein particle size may play a role in the relationship between alcohol intake and lower risk for coronary heart disease. In the study, alcohol consumption was associated with larger lipoprotein particle sizes and a lower prevalence of small LDL and HDL particles.

Light wine intake = longer life expectancy in men

Drinking a little alcohol every day, especially wine, may be associated with an increase in life expectancy. That’s the conclusion of Dutch researchers who reported the findings of their study at the American Heart Association’s 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.

The researchers found that a light intake of alcohol (on average less than one glass per day) was associated with a lower rate of cardiovascular death and death from all causes. When compared to spirits and beer, consumption of small amounts of wine, about a half a glass a day, was associated with the lowest levels of all-cause and cardiovascular deaths.

"Our study showed that long-term, light alcohol intake among middle-aged men was associated not only with lower cardiovascular and all-cause death risk, but also with longer life expectancy at age 50," said Martinette T. Streppel, lead author of the study and a Ph.D. student in the Division of Human Nutrition at Wageningen University and National Institute for Public Health and the Environment (RIVM) in Bilthoven, The Netherlands. "Furthermore, long-term light wine consumption is associated with a further protective effect when compared to that of light-to-moderate alcohol intake of other types."

Previous studies have shown that light to moderate alcohol intake is associated with a lower risk of cardiovascular death. However, it remained unclear whether a specific beverage was associated with more benefit and whether the use of long-term alcohol consumption was associated with increased life expectancy. Studies such as this cannot definitively show whether the agent being studied has a causal effect on health.

The Netherlands study — called the Zutphen Study — involved a cohort of 1,373 men born between 1900 and 1920 who were surveyed in detail about alcohol consumption seven times over 40 years. The participants, all from Zutphen, an industrial town in the eastern part of the Netherlands, were followed until death or until the final survey taken among survivors in mid-2000. The surveys included drinking habits, dietary habits, body mass index, smoking habits and the prevalence of heart attack, stroke, diabetes and cancer. The statistics on alcohol consumption were adjusted to account for other risk factors.

The researchers found that long-term, light alcohol intake of less than or equal to 20 grams per day (1 glass of alcoholic beverage contains 10 grams of alcohol, 1 ounce = ~30 mL of alcoholic beverage) compared to no alcohol intake was associated with a 36 percent lower relative risk of all-cause death and a 34 lower relative risk of cardiovascular death. The average long-term daily intake of the men throughout the 40-year study was six grams based on any alcohol intake of more than zero and up to 20 grams. The long-term average intake of six grams of alcohol is equal to one four-ounce beer, one two-ounce glass of wine or one one-ounce glass of spirits, daily.

When the researchers looked independently at wine consumption, the associated risk reduction was greater. Participants who drank on average half a glass, or 1.5 ounces, of wine per day, over a long period, had a 40 percent lower rate of all-cause death and a 48 percent lower incidence of cardiovascular death, compared to the non-wine drinkers.

Researchers said life expectancy was 3.8 years higher in those men who drank wine compared to those who did not drink alcoholic beverages. Life expectancy of wine users was more than two years longer than users of other alcoholic beverages. Men with a long-term alcohol intake less than or equal to 20 grams per day had a 1.6-year-higher life expectancy, compared to those who consumed no alcohol.

Most of the previous studies assessed alcohol intake at baseline; however, in this study researchers collected detailed information seven times over 40 years. "Consumption patterns usually change during life," Streppel said. "This enabled us to study the effects of long-term alcohol intake on mortality." Researchers found that the number of alcohol users nearly doubled from 45 percent in 1960 to 85 percent in the 2000 survey. Average alcohol consumption rose and then fell at various points during the study. Users’ consumption was eight grams a day in 1960, then survivors’ consumption was 18 grams a day in 1985, dropping to 13 grams per day in 2000. The percentage of wine users increased during follow-up from 2 percent in 1960 to more than 40 percent among the survivors in 2000. "One can speculate that a protective effect of light alcohol intake could be due to an increase in high-density lipoprotein (HDL) cholesterol, or to a reduction in blood clotting, due to an inhibition of platelet aggregation," Streppel said.

Furthermore, red wine consumption may have an additional health benefit because the polyphenolic compounds contained in wine have been seen in animal to interfere with the formation, progression and rupture of atherosclerotic plaques — the build-up of fatty tissue in the arteries that can result in stroke or heart attack.

"Those people who already consume alcoholic beverages should do so lightly (1 to 2 glasses per day) and preferably drink wine," Streppel said. "The cardio-protective effects of alcohol and wine only held up for light alcohol consumption in middle-aged men. Heavy alcohol consumption may cause accidents and diseases such as cancer and cirrhosis of the liver, even though this was not observed in our study. Since alcohol consumption can be addictive, starting to drink alcohol because of its positive health benefits is not advised."

How alcohol or wine might affect cardiovascular risk merits further research, but right now the American Heart Association does not recommend beginning to drink wine or any other form of alcohol to gain these potential benefits. The association does recommend that to reduce your risk you should talk to your doctor about lowering your cholesterol and blood pressure, controlling your weight, getting enough physical activity and following a healthy diet and quit smoking, if you smoke. There is no scientific proof that drinking wine or any other alcoholic beverage can replace these conventional measures.

Alcohol Can Benefit the Hearts of New Drinkers

A Medical University of South Carolina’s (MUSC) Department of Family Medicine study concluded that people who began moderately consuming alcohol in middle-age experience a quick benefit of lower rates of cardiovascular disease morbidity with no change in mortality after four years. In addition, the study found that those who consumed alcohol for the heart health benefits rarely drank more than recommended amounts. The study has been published in the March issue of the American Journal of Medicine, and was conducted by MUSC’s Dana E. King M.D., Arch G. Mainous III, Ph.D, and Mark E. Geesey.
“Most people are aware that moderate alcohol use can be part of a healthy lifestyle, yet current guidelines caution non-drinkers against starting to drink in middle age,” said King, lead author of the study. “We wanted to evaluate whether adopting moderate alcohol consumption in middle-age would lower cardiovascular risk. We were excited to find that moderate alcohol consumption, or one to six servings a week, lowered cardiovascular risk for our participants.”
In contrast to a recently published study in the British Public Library of Science journal, PLoS Medicine, MUSC’s study showed no increase in blood pressure for participants at moderate consumption levels (two drinks per day or fewer for men, one drink per day or fewer for women) during the four years of the study. New moderate drinkers had a 38% lower chance of developing cardiovascular disease than did their persistently non-drinking counterparts. This difference remained after adjustment for demographic and cardiovascular risk factors.

Moderate Drinkers Report Better Health

Moderate drinkers are more likely to report above-average health than lifetime abstainers, light drinkers and heavy drinkers, a new study reveals.
“Our results suggest that a moderate amount of drinking is not necessarily dangerous for most people and may actually be health-enhancing,” said study coauthor Michael French, Ph.D.
However, it is unclear whether moderate drinking leads to better health or whether moderate drinkers simply lead healthier lifestyles, he said.
This finding confirmed much of the clinical evidence on this topic. However, previous research has focused on objective health indicators such as cardiovascular disease, injuries and mortality. “We wanted to see if moderate drinkers are actually feeling better by their own assessment,” said French, professor of health economics at the University of Miami.
Regular Tipple May Curb Risk of Rheumatoid Arthritis
Alcohol cuts the risk of developing rheumatoid arthritis by up to 50%, reveals research published ahead of print in the Annals of the Rheumatic Diseases.
The Scandinavian researchers base their findings on more than 2750 people taking part in two separate studies, which assessed environmental and genetic risk factors for rheumatoid arthritis.
Over half the participants (1650) had the disease and had been matched for age, sex, and residential locality with randomly selected members of the general public.
All participants were quizzed about their lifestyle, including how much they smoked and drank. And blood samples were taken to check for genetic risk factors.
The results showed that drinking alcohol was associated with a significantly lower risk of developing rheumatoid arthritis. And the more alcohol was consumed, the lower the risk of rheumatoid arthritis.
Among those who drank regularly, the quarter with the highest consumption were up to 50% less likely to develop the disease compared with the half who drank the least.
The effect was the same for both men and women.
Among those with antibodies to a specific group of proteins involved in the development of the disease, alcohol cut the risk most in smokers with genetic risk factors for rheumatoid arthritis.
Smoking is known to be a major environmental risk factor for developing rheumatoid arthritis, and this risk is further increased in those who carry these genetic variants.
The authors conclude that their research reinforces the importance of lifestyle factors in the development of the disease, and that giving up smoking remains the single most important preventive measure.
They point to recent experimental research by other authors, which showed that alcohol protected against the development and severity of rheumatoid arthritis, although it is not clear exactly how it does this.
And they draw parallels with the links between moderate alcohol consumption and a reduced risk of other inflammatory processes, such as cardiovascular disease.
Click here to view the paper in full:_http://press.psprings.co.uk/ard/june/ar86314.pdf

Alcohol’s impact on heart and stroke risk may differ for men, women

The volume of alcohol consumption may have a significantly different effect on heart and stroke risk in men and women, according to a study of Japanese people published in Stroke: Journal of the American Heart Association.

“An amount of alcohol that may be beneficial for men is not good for women at all,” said Hiroyasu Iso, M.D., co-author of the study and professor of public health at Osaka University in Japan.

Researchers analyzed data from a survey of 34,776 men and 48,906 women (ages 40 to 79) selected from the larger Japan Collaborative Cohort Study (JACC) to determine the association of alcohol use with the risks of stroke and heart disease. Participants who had not experienced cancer, stroke or heart disease before the study completed questionnaires about their lifestyles and medical histories and provided information about their drinking of sake (rice wine), shochu (a type of brandy), beer, whiskey and/or wine.

Researchers calculated the risks and benefits of alcohol consumption after adjusting for age and several other risk factors, including smoking, weight, body mass index, the presence of high blood pressure or diabetes, exercise habits, stress, education and diet.

During a 14.2-year follow-up, 1,628 participants died from stroke and 736 died from heart disease.
Men who reported drinking heavily (at least 46 grams of alcohol per day, equivalent to four or more standard alcoholic beverages) at the time of the survey had a 19 percent lower risk of dying from coronary heart disease than nondrinking men.

In stark contrast, women who drank that much quadrupled their risk of heart disease death over that of nondrinking women. Light drinking (less than 23 grams of alcohol per day, about two drinks a day) reported on the survey was associated with a lower risk of heart disease death in women by 17 percent; while intake between 23 and 46 grams per day was associated with an increased risk of 45 percent.

“In women, we found a slightly reduced risk with light consumption but a much greater risk with heavy alcohol use,” Iso said.

In men, heavy alcohol use was associated with an increased risk of death from all types of stroke by 48 percent. The risk of hemorrhagic stroke (caused by a blood vessel bursting in the brain) was increased 67 percent. The risk of ischemic stroke (caused by a blocked blood vessel in the brain or leading to it) was higher by 35 percent.

In women, heavy alcohol use was associated with a higher risk of stroke death by 92 percent. Hemorrhagic stroke death risk was increased by 61 percent. The risk of ischemic stroke death was increased 2.43 times.

“We expected to find an increased risk of hemorrhagic stroke,” Iso said. “But since alcohol reduces the ability of the blood to clot, we didn’t expect to find the increases in ischemic stroke and coronary heart disease.”

Only 15 percent of women in JACC drank any alcohol, far less than the 45.9 percent of U.S. women who reported using alcohol in 2005, Iso said.

Before this study, evidence suggested that light-to-moderate alcohol consumption might be associated with a lower risk of cardiovascular disease in women. But data on heavy drinking was limited and the question had not been addressed in an Asian country, where both drinking and heart disease are less common.

“One limitation of the study is that, in Japanese culture, there are social restrictions against women drinking as they get older,” Iso said. “In that culture, the women who do drink may have different types of jobs or other aspects of their lifestyle that may help explain the excess risk as well as the alcohol exposure itself.”

Iso said more research could help determine how alcohol affects cardiovascular risk.

The American Heart Association does not recommend drinking wine or other forms of alcohol, since there is clear evidence that alcohol use is associated with injury to the heart in many ways. Instead, the association recommends that people talk to their doctor about lowering their cholesterol and blood pressure, controlling weight, getting enough physical activity and following a healthy diet and quitting smoking. There is no scientific proof that drinking alcoholic beverages can replace these conventional measures.

A Little Alcohol Goes a Longer Way in Women than in Men—in Good Ways and Bad

Alcohol can be a boon or a bane for health. The difference lies in the dose—a little is good, a lot is bad. But the dividing line between a little and a lot differs from person to person. It depends on many things, including sex. Women are more vulnerable than men to alcohol’s long-term effects.
Women break down alcohol more slowly than men do. If a woman and a man drink identical glasses of wine with the same meal, she will have a higher blood level of alcohol, and for a longer time. This means her tissues are exposed to more alcohol per drink than a man’s. Results from a study in Japan suggest that too much alcohol is bad for a woman’s heart and arteries, and earlier work shows it can be hazardous to breast tissue too.
What constitutes “healthy drinking”? Current guidelines say it is one to two drinks a day for men and no more than one a day for women. Keep in mind that this recommendation is for the average person. How you respond to alcohol depends on your genes, your diet, and the medications you take.
If you drink, consider taking a daily multivitamin/multimineral supplement. Alcohol blocks the absorption of folic acid and inactivates this important vitamin in the bloodstream, so drinkers need extra folic acid.

Up to 2 drinks per day not linked with higher risk of irregular heart beat for women

Women who have up to two alcoholic drinks per day do not appear to be at increased risk of atrial fibrillation (irregular heart beat), but drinking more than that amount is associated with a higher risk, according to a study in the December 3 issue of JAMA.
Studies assessing the effects of regular alcohol consumption on the risk of atrial fibrillation have provided inconsistent results, with several studies finding significant associations between moderate to high amounts of alcohol intake and increased risks of atrial fibrillation among men, but not among women. However, these studies were not of adequate size to detect significant associations among women, according to background information in the article.
David Conen, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Medical School, Boston, and University Hospital, Basel, Switzerland, and colleagues analyzed data from a completed randomized controlled trial involving 34,715 women participating in the Women's Health Study, to assess the effects of regular alcohol consumption on the risk of atrial fibrillation. The participants were older than 45 years and had no atrial fibrillation at the start of the study and underwent follow-up from 1993 to October 2006. Alcohol consumption was assessed via questionnaires at the beginning of the trial and at 48 months of follow-up and was grouped into 4 categories: 0 drinks per day, greater than 0 and less than 1, 1 or more and less than 2, and 2 or more drinks per day. Atrial fibrillation was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review.
During a median (midpoint) follow-up of 12.4 years, there were 653 confirmed cases of new atrial fibrillation. Among women consuming no alcohol (n = 15,370), there were 294 events (1.9 percent); for women consuming more than 0 and less than 1 drink per day (n = 15,758), there were 284 events (1.8 percent); for 1 to 2 drinks per day (n = 2,228), there were 35 events (1.6 percent); and for women consuming 2 or more drinks per day (n = 1,359), there were 40 atrial fibrillation events (2.9 percent).
"In the present study, alcohol consumption of up to 2 drinks per day was not associated with an increased risk of incident atrial fibrillation among initially healthy, middle-aged women. In contrast, the small group of women who consumed 2 or more alcoholic beverages per day had a 1.6-fold greater risk for atrial fibrillation relative to nondrinking women. While this finding needs to be interpreted with some caution because of the small number of women in some subgroups, it supports a possible threshold effect in the relationship between alcohol consumption and risk of atrial fibrillation among women," the authors write.


A little wine boosts omega-3 in the body: Researchers find a novel mechanism for a healthier heart

Results from the European study IMMIDIET show that moderate wine intake is associated with higher levels of omega-3 fatty acids considered as protective against coronary heart disease
Moderate alcohol intake is associated with higher levels of omega-3 fatty acids in plasma and red blood cells. This is the major finding of the European study IMMIDIET that will be published in the January issue of the American Journal of Clinical Nutrition, an official publication of the American Society for Nutrition and is already available on line (www.ajcn.org ). The study suggests that wine does better than other alcoholic drinks. This effect could be ascribed to compounds other than alcohol itself, representing a key to understand the mechanism lying behind the heart protection observed in moderate wine drinkers.
The IMMIDIET study examined 1,604 citizens from three geographical areas: south-west London in England, Limburg in Belgium and Abruzzo in Italy. Thanks to a close cooperation with General Practitioners of these areas, all participants underwent a comprehensive medical examination, including a one year recall food frequency questionnaire to assess their dietary intake, alcohol consumption included.
Omega-3 fatty acids, mainly derived from fish, are considered as protective against coronary heart disease and sudden cardiac death, thus their high blood concentration is definitely good for our health.
Now European researchers found that moderate alcohol drinking acts like a 'trigger', boosting the amount of omega-3 fatty acids in our body.
"Several studies have shown that moderate alcohol consumption, including wine, is associated with protection against coronary heart disease and ischemic stroke - says Romina di Giuseppe, lead author of the study, from the Research Laboratories at Catholic University of Campobasso - Although the mechanisms are not completely defined, there was some evidence that alcohol intake might influence the metabolism of essential polyunsaturated fatty acids, as omega-3. That is exactly what we found in our population study. People drinking moderate amounts of alcohol, one drink a day for women and two for men, had higher concentration of omega-3 fatty acids in plasma and red blood cells independently of their fish intake".
However important these results appear to be, the best is yet to come. Researchers from Catholic University of Campobasso, in Italy, and from University of Grenoble, in France, turned their attention on the variety of alcoholic beverages consumed in order to see whether the high levels of omega-3 fatty acids detected might be ascribed to alcohol itself or to other substances.
"From our previous studies we know that association between wine drinking and increased concentration of omega-3 fatty acids have been observed – says Michel de Lorgeril, from the University of Grenoble, partner of the IMMIDIET project and co-leader of the study - Nevertheless, it was not possible to separate the effects of wine from those of beer or spirits. Our study of 3 populations with different dietary habits and different consumption of alcoholic beverages types allowed us to explore this aspect.".
"Analysis carried out on different alcoholic beverages –argues Licia Iacoviello coordinator of the IMMIDIET study at Catholic University of Campobasso - showed that the association between alcohol and omega-3 fatty acids was present in both wine drinkers and beer or spirits drinkers. However, the association was stronger between wine drinking and omega-3 fatty acids levels. This suggests that components of wine other than alcohol is associated with omega-3 fatty acids concentration. We may guess this effect can be ascribed to polyphenols".
Polyphenols are naturally occurring compounds contained in a different variety of food and beverages, such as wine. Due to their strong antioxidant activity, they are able to reduce oxidation processes caused by free radicals.
"We consider these data to be a major finding - de Lorgeril concludes - opening a new window in the field of cardiovascular prevention. Beyond the alcohol issue, our results raise crucial questions regarding the effects of polyphenols on lipids (both in blood and cell membranes) and possibly of lipids on polyphenols".
The IMMIDIET study
Funded by the European Union under Key Action 1: Food, Nutrition and Health QLK1-CT-2000-00100, IMMIDIET aims to acquire fundamental knowledge in the field of cardiovascular disease, especially regarding the interaction between genetics and lifestyle.
At the core of the study there is an important episode of Italian migration: Belgium, a country that became the new home for thousands of Italians, mostly from the Abruzzo region, who came to work in the mines. Many of those emigrants didn't come back to Italy but remained in their new country. Some of them married a Belgian partner. Their genes remained the same, of course, but how much "Italy" is still there in their diet? And how much did they transmit it to their spouses? Moreover, how many Italian emigrants assimilate dietary habits of the country in which they were guests? In this framework, the role of genetic factors and lifestyle can be assessed to explore new ways in prevention of cardiovascular diseases.
To carry on the research, married couples have been recruited in three European areas: South-East London in England, Limburg in Belgium and Abruzzo in Italy. In the first phase of the study the couples involved were formed by people from the same area, Italians married with Italians (in the Abruzzo region), Belgians married with Belgians (in the Limburg area) and English married with English (in the South-East part of London)".
The second phase of IMMIDIET recruited mixed Italian–Belgian couples to understand if, acquiring dietary habits from Abruzzo, the Belgian partner changed his own risk regarding heart diseases.

Exploring the health and protective benefits of light to moderate alcohol consumption

While the physiological damage and social havoc created by alcohol abuse and dependency are well-known, it is also true that light-to-moderate drinking has certain health benefits. This mini-review summarizes a roundtable discussion held at the July 2007 annual meeting of the Research Society on Alcoholism in Chicago, Illinois.
Results will be published in the February 2009 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.
"Alcohol abuse, often in combination with poor nutrition, is responsible for a great deal of permanent organ damage, and that includes the brain," explained Michael A. Collins, professor of biochemistry at Loyola University Chicago and corresponding author for the research roundtable. "In fact, studies of alcoholics over the years sometimes indicate that brain damage can develop earlier than liver damage, but it simply is not recognized because there are common clinical lab tests for liver disease but not for subtle cognitive impairment."
Conversely, Collins added, human studies have indicated that mild or moderate social consumption of alcohol can have beneficial effects on the cardiovascular state and cognitive function. "Alcohol in low to moderate concentrations appears to promote cytoprotective cellular mechanisms," he said, "which might explain some of these epidemiological findings. It seemed important to bring researchers together in this roundtable, in part to inform the research community about these emerging mechanisms."
Some of the key points discussed were:
- Alcohol appears to have a complex relationship with cardiovascular and neurovascular diseases. These include dose-dependent associations with a lower risk of coronary heart disease (CHD), a higher risk of hemorrhagic stroke throughout a range of drinking, a higher risk of ischemic stroke with heavier drinking, and a possible lower risk of dementia or cognitive decline with aging.
"We need greater insight into how cells in the adult brain and heart, in response to moderate alcohol exposure, are able to achieve a relatively protected state with respect to certain insults or cytotoxins," said Collins. "Knowing more about these mechanisms might allow us to design 'non-addictive' molecules that trigger key cytoprotective biochemical steps, for example. This achievement, however small, potentially could have a significant impact, since – worldwide – heart disease is the major killer, and a new case of dementia from all causes is estimated to develop every seven seconds or so."
- Experimental studies with rodents and cultures indicate that moderate alcohol exposure can promote anti-inflammatory processes involving adenosine receptors, protein kinase C (PKC), nitric oxide synthase, and heat shock proteins that may underlie cardioprotection.
"Like many chemicals that we ingest, alcohol is sort of a classic double-edged sword," said Collins. "With respect to 'inflammation,' alcohol in high binge amounts, either directly or through its metabolism, appears to trigger increases in a number of inflammatory players in many cells that include free radicals and inflammatory protein molecules such as cytokines. These are probably responsible for much of the organ damage of alcoholism."
Yet alcohol in low to moderate amounts seems to do the opposite. "It increases other factors that are typically anti-inflammatory in their effects" said Collins. "After moderate alcohol exposure, we find higher levels of cellular 'heat shock' proteins which are well known to be neuroprotective. Of further relevance to the question of aging-dependent cognitive loss is how this alcohol neuroprotection is exerted against beta-amyloid, a neuroinflammatory protein abnormally increased in Alzheimer's disease and likely underlying the progressive dementia."
- Additional evidence suggests that alcohol may even help lower the risk for dementia via "preconditioning" mechanisms, that is, inducing neuronal survival pathways through its selective activation of PKC and focal adhesion kinase enzymes, the focal adhesion complex, and stabilization of the cytoskeleton.
"I want to emphasize that none of the researchers on this roundtable panel recommends moderate alcohol consumption as a tried-and-true way of reducing the risks of heart disease or cognitive decline," said Collins. "And there are situations or conditions when any drinking whatsoever should be discouraged, for example, during pregnancy, during adolescence, or prior to driving. On the other hand, if a responsible adult is doing well socially, psychologically and physically with a stable, non-binge pattern of moderate alcohol ingestion, there is no apparent reason to stop."

MODERATE DRINKING CAN REDUCE RISKS OF ALZHEIMER'S DEMENTIA AND COGNITIVE DECLINE
But Abusing Alcohol can Damage Brain, Loyola Researchers say

Moderate drinkers often have lower risks of Alzheimer's disease and other cognitive loss, according to researchers who reviewed 44 studies.
In more than half of the studies, published since the 1990s, moderate drinkers of wine, beer and liquor had lower dementia risks than nondrinkers. In only a few studies were there increased risks.
"Alcohol is a two-edged sword," said Michael Collins, Ph.D., a professor and neuroscientist at Loyola University Chicago Stritch School of Medicine and lead author of the refereed report in the journal Alcoholism: Clinical and Experimental Research. "Too much is bad. But a little might actually be helpful."
Moderate alcohol consumption generally is defined as 1 drink or less per day for women and 1-2 drinks or less per day for men.
The article will be published in the February 2009 issue of the journal, and is available on line now. The article summarizes a roundtable, organized by Collins, held at the Research Society on Alcoholism meetings in Chicago in 2007.
"The pathological damage and vast social havoc from addiction to and abuse of alcohol are well known, and of necessity should continue to receive primary attention by doctors, scientific researchers and health professionals," Collins and colleagues write. "However, light-to-moderate responsible alcohol consumption "appears to carry certain health benefits."
Long-term alcohol abuse can cause memory loss and impair cognitive function. It's unknown why moderate alcohol use appears to have the opposite effect. One theory is that the well-known cardiovascular benefits of moderate alcohol consumption also can reduce the risk of mini strokes that cause dementia.
Collins and another Loyola professor, neuroscientist Edward Neafsey, Ph.D., suggest a second possible explanation. Small amounts of alcohol might, in effect, make brain cells more fit. Alcohol in moderate levels stresses cells and thus toughens them up to cope with major stresses down the road that could cause dementia.
For most people who drink responsibly and in moderation, there's probably no reason to quit. But because of the potential for alcohol to be abused, Collins and Neafsey do not recommend that abstainers begin drinking. The researchers note there are other things besides moderate drinking that can reduce the risk of dementia, including exercise, green tea, education and a Mediterranean diet high in fruits, vegetables, cereals, beans, nuts and seeds.
Moreover, there are times when people should never drink, including adolescence, pregnancy and before driving, Collins said.
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