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I used to be a sun worshiper - 1:00 p.m. (Daylight Savings Time) on June 21st was a holy moment each year - the time when the sun was closest to the earth. I got lots of tans, but rarely burned. It all added up, however. In recent years, I have had two skin cancers removed in operations, and many pre-cancerous growths burned off. I now am checked by a dermatologist every 6 months - I highly recommend it for all my readers.

Here are some statistics for skin cancers in Connecticut.

A 2004 survey found that 43.1% of white adults in Connecticut had at least one sunburn in the past year—an increase from 33.3% in 1999. Sunburns are a significant risk factor for the development of skin cancer.

■■ New Cases of Melanoma. The rate of new melanoma diagnoses—responsible for
75% of all skin cancer deaths—was 31% higher in Connecticut than the national
average from 2001-2005 and was the 8th highest in the U.S.9,10 An estimated 1,060
state residents were diagnosed with melanoma in 2008.

■■ New London County has the highest rate of melanoma diagnoses in the state,
79% above the national average.

■■ Deaths from Melanoma. Approximately 110 people in Connecticut die of melanoma
every year.11 Connecticut had the 17th highest melanoma death rate nationally from
2001-2005—7.4% higher than the U.S. average.

■■ Tolland County has the highest melanoma death rate in the state, 30% higher
than the national average.

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Kaiser Permanente Research Strengthens National Recommendations

Receiving the herpes zoster vaccine was associated with a 55 percent reduced risk of developing shingles, according to a Kaiser Permanente study of 300,000 people that appears in the current issue of the Journal of the American Medical Association.

This retrospective study observed the outcomes of the effectiveness of the herpes zoster vaccine in a large, diverse population of men and women ages 60 years and older. Researchers found a significant reduced risk of shingles across all sub-groups -- those who are healthy as well as those with chronic conditions including diabetes or heart, lung or kidney diseases.

These study findings differ from the clinical trial of the vaccine, which observed its effectiveness on 38,000 participants 60 years of age and older and found it less effective for people older than 75. This new study found a 55 percent reduced risk of shingles among both adults 60 years and older, as well as adults 75 years and older who received the vaccine.

These findings support Centers for Disease Control and Prevention recommendations to offer the vaccine to eligible patients of all ages, including those over 75. Researchers note that additional examination of the vaccine's effect in the oldest group should continue. The herpes zoster vaccine was licensed in 2006, but uptake in the United States remains low: about 10 percent in 2009 in adults 60 years and older.

"Our study shows the vaccine has the potential to prevent tens of thousands of cases of shingles, a painful, lingering disease," said study lead author Hung Fu Tseng, PhD, MPH, a research scientist with the Kaiser Permanente Department of Research & Evaluation in Pasadena, Calif. "We suggest clinicians follow the CDC's recommendations to talk to their patients about the option of vaccination against this serious condition."

There are more than 1 million episodes of shingles every year in the United States. Shingles is a painful condition that can last months or years and can seriously impact quality of life. Shingles is caused by the dormant chickenpox virus, which stays in the body after a person has recovered from chickenpox. The virus can reactivate and replicate and cause shingles and damage to the nerve system. The elderly are especially vulnerable because as we age, our immunity against the virus that causes shingles declines.

"The risk of developing shingles during a lifetime is about 30 percent. It is therefore reassuring to confirm results of the original clinical trial that herpes zoster vaccine is effective at preventing this painful disease," said study co-author Rafael Harpaz, MD, MPH, an epidemiologist with the Centers for Disease Control and Prevention's National Center for Immunization and Respiratory Diseases. "Although that trial was well done, one cannot be sure a vaccine works outside a research setting until you evaluate it in routine medical practices. In addition, our study also provided new information that the vaccine worked to prevent shingles involving the eye, which can result in very serious complications."

Researchers conducted a retrospective observational study that looked at 75,761 vaccinated and 227,283 unvaccinated male and female members of Kaiser Permanente in Southern California from 2007 to 2009, using electronic health records to compare the incidence of shingles of the vaccinated and unvaccinated populations. Results remained after taking into account differences in sex, race, chronic diseases, and prior utilization.

This is the latest in a series of published Kaiser Permanente studies undertaken to better understand vaccine effectiveness and safety. Dr. Tseng published another study in JAMA that found the pneumococcal pneumonia vaccination is not associated with a reduced risk of heart attacks or strokes. Another Kaiser Permanente study found the combination vaccine for measles, mumps, rubella and chickenpox (MMRV) is associated with double the risk of febrile seizures for 1- to 2-year-old children compared to same-day administration of the separate vaccine for MMR (measles, mumps, rubella) and the varicella (V) vaccine for chickenpox. Other recent published Kaiser Permanente studies found children of parents who refuse vaccines are nine times more likely to get chickenpox and 23 times more likely to get whooping cough compared to fully immunized children. A study published last year found that herpes zoster, also known as shingles, is very rare among children who have been vaccinated against chickenpox.

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New research suggests eating vegetables gives you a healthy tan. The study, led by Dr Ian Stephen at The University of Nottingham, showed that eating a healthy diet rich in fruit and vegetables gives you a more healthy golden glow than the sun.


The face in the middle shows the woman's natural colour. The face on the left shows the effect of sun tanning, while the face on the right shows the effect of eating more carotenoids. Participants thought the carotenoid colour looked healthier.

The research, which showed that instead of heading for the sun the best way to look good is to munch on carrots and tomatoes, has been published in the Journal Evolution and Human Behaviour.

Dr Ian Stephen, from the School of Psychology, University of Nottingham, Malaysia Campus, led the research as part of his PhD at the University of St Andrews and Bristol University. He said: “Most people think the best way to improve skin colour is to get a suntan, but our research shows that eating lots of fruit and vegetables is actually more effective.

Dr Stephen and his team in the Perception Lab found that people who eat more portions of fruit and vegetables per day have a more golden skin colour, thanks to substances called carotenoids. Carotenoids are antioxidants that help soak up damaging compounds produced by the stresses and strains of everyday living, especially when the body is combating disease. Responsible for the red colouring in fruit and vegetables such as carrots and tomatoes, carotenoids are important for our immune and reproductive systems.

Dr Stephen said: “We found that, given the choice between skin colour caused by suntan and skin colour caused by carotenoids, people preferred the carotenoid skin colour, so if you want a healthier and more attractive skin colour, you are better off eating a healthy diet with plenty of fruit and vegetables than lying in the sun.”

Dr Stephen suggests that the study is important because evolution would favour individuals who choose to form alliances or mate with healthier individuals over unhealthy individuals.

Professor David Perrett, who heads the Perception Lab, said: “This is something we share with many other species. For example, the bright yellow beaks and feathers of many birds can be thought of as adverts showing how healthy a male bird is. What’s more, females of these species prefer to mate with brighter, more coloured males. But this is the first study in which this has been demonstrated in humans.”

While this study describes work in Caucasian faces, the paper also describes a study that suggests the effect may exist cross culturally, since similar preferences for skin yellowness were found in an African population.

New Delhi researchers show that vitamin D levels may be a useful index for the assessment of hip fracture risk in elderly people.

A study in New Delhi India has revealed high rates of vitamin D deficiency among hip fracture patients, confirming the conclusions of similar international studies which point to vitamin D deficiency as a risk factor for hip fracture.

A group of 90 hip fracture patients was compared to a matched control group of similar age, sex and co-morbidity. Of the patients who had suffered hip fractures, 76.7% were shown to be vitamin D deficient as measured by serum 25(OH)D levels of less than 20 ng/ml. In addition, 68.9% had elevated PTH levels. In comparison, only 32.3% of the controls had vitamin D deficiency and 42.2% had elevated PTH levels (secondary hyperparathyroidism).

Vitamin D deficiency has been linked to the pathogenesis of osteoporosis and is increasingly thought to play a role in muscle strength, certain cancers, multiple sclerosis and diabetes. Vitamin D levels are very low in the Indian population in all age groups, and could be explained by skin pigmentation, traditional clothing and the avoidance of sunlight.

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So does heavy drinking

Previous research regarding the association between alcohol consumption and dementia or cognitive impairment in later life suggests that mild to moderate alcohol consumption might be protective of dementia. However, most of the research has been conducted on subjects already rather elderly at the start of the follow-up.

A new study published in the December issue of the Journal of Alzheimer's Disease addresses this problem with a follow-up of more than two decades.

The study, conducted at the University of Turku, University of Helsinki and National Institute for Health and Welfare in Finland based on subjects from the Finnish Twin Cohort, shows that midlife alcohol consumption is related to the risk of dementia assessed some 20 years later. The study indicates that both abstainers and subjects consuming large amounts of alcohol have a greater risk for cognitive impairment than light drinkers.

"Our finding is significant as the changes typical of Alzheimer's disease -- the most common dementia syndrome -- are thought to start appearing two to three decades before clinical manifestation and therefore identification of early risk factors is imperative," states Jyri Virta, researcher at University of Turku, Finland.

In addition to total alcohol consumption, the authors were able to assess the effects of different drinking patterns. The study suggests that drinking large amounts of alcohol (defined as a bottle of wine or the equivalent) at a single occasion at least monthly is an independent risk factor for cognitive impairment. Such binge drinking doubles the risk of cognitive impairment even when total alcohol consumption was statistically controlled for.

Similarly, passing out because of heavy drinking on one occasion was also found to increase the development of subsequent cognitive impairment. Thus, it is not only the amount of alcohol, but also the pattern by which alcohol is consumed that affects the risk of cognitive impairment. The published study is among the first to report these effects.

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Spending too much leisure time in front of a TV or computer screen appears to dramatically increase the risk for heart disease and premature death from any cause, perhaps regardless of how much exercise one gets, according to a new study published in the January 18, 2011, issue of the Journal of the American College of Cardiology. Data show that compared to people who spend less than two hours each day on screen-based entertainment like watching TV, using the computer or playing video games, those who devote more than four hours to these activities are more than twice as likely to have a major cardiac event that involves hospitalization, death or both.

The study – the first to examine the association between screen time and non-fatal as well as fatal cardiovascular events – also suggests metabolic factors and inflammation may partly explain the link between prolonged sitting and the risks to heart health.

"People who spend excessive amounts of time in front of a screen - primarily watching TV - are more likely to die of any cause and suffer heart-related problems," said Emmanuel Stamatakis, PhD, MSc, Department of Epidemiology and Public Health, University College London, United Kingdom. "Our analysis suggests that two or more hours of screen time each day may place someone at greater risk for a cardiac event."

In fact, compared with those spending less than two hours a day on screen-based entertainment, there was a 48% increased risk of all-cause mortality in those spending four or more hours a day and an approximately 125% increase in risk of cardiovascular events in those spending two or more hours a day. These associations were independent of traditional risk factors such as smoking, hypertension, BMI, social class, as well as exercise.

The findings have prompted authors to advocate for public health guidelines that expressly address recreational sitting (defined as during non-work hours), especially as a majority of working age adults spend long periods being inactive while commuting or being slouched over a desk or computer.

"It is all a matter of habit. Many of us have learned to go back home, turn the TV set on and sit down for several hours – it's convenient and easy to do. But doing so is bad for the heart and our health in general," said Dr. Stamatakis. "And according to what we know so far, these health risks may not be mitigated by exercise, a finding that underscores the urgent need for public health recommendations to include guidelines for limiting recreational sitting and other sedentary behaviors, in addition to improving physical activity."

Biological mediators also appear to play a role. Data indicate that one fourth of the association between screen time and cardiovascular events was explained collectively by C-reactive protein (CRP), body mass index, and high-density lipoprotein cholesterol suggesting that inflammation and deregulation of lipids may be one pathway through which prolonged sitting increases the risk for cardiovascular events. CRP, a well-established marker of low-grade inflammation, was approximately two times higher in people spending more than four hours of screen time per day compared to those spending less than two hours a day.

Dr. Stamatakis says the next step will be to try to uncover what prolonged sitting does to the human body in the short- and long-term, whether and how exercise can mitigate these consequences, and how to alter lifestyles to reduce sitting and increase movement and exercise.

The present study included 4,512 adults who were respondents of the 2003 Scottish Health Survey, a representative, household-based survey. A total of 325 all-cause deaths and 215 cardiac events occurred during an average of 4.3 years of follow up.

Measurement of "screen time" included self-reported TV/DVD watching, video gaming, as well as leisure-time computer use. Authors also included multiple measures to rule out the possibility that ill people spend more time in front of the screen as opposed to other way around. Authors excluded those who reported a previous cardiovascular event (before baseline) and those who died during the first two years of follow up just in case their underlying disease might have forced them to stay indoors and watch TV more often. Dr. Stamatakis and his team also adjusted analyses for indicators of poor health (e.g., diabetes, hypertension).


This confirms an earlier study, published last January:



Every hour spent sitting idle in front of the television raises the risk of premature death from heart disease by 18 percent, an Australian study found.

Researchers tracked the TV-viewing habits of 8,800 adults and followed them for six years. They found those who spent four hours daily in front of the tube had an 80 percent greater risk of dying from cardiovascular disease than those who watched the box for less than two hours. The association was independent of risks such as smoking, obesity and unhealthy diet.

Prolonged inactivity, which can raise blood-sugar and cholesterol levels, is to blame for the health effects, not the appliance itself, said David Dunstan, a study author and researcher at Baker IDI Heart & Diabetes Institute in Melbourne. The finding, published today in the medical journal Circulation, supports studies from the Rochester, Minnesota-based Mayo Clinic showing that watching too much television is one of the biggest contributors to a sedentary lifestyle and weight gain.

“Too much sitting is bad for health,” said Dunstan, a professor of health sciences. “Avoid sitting for prolonged periods and keep in mind to move more, more often.”

Australians and Britons watch television for an average of three hours a day. In the U.S., where two-thirds of all adults are overweight or obese, viewing time is as much as eight hours, Dunstan said.

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Elevated fat and cholesterol levels found in a typical American-style diet play an important role in the growth and spread of breast cancer, say researchers at the Kimmel Cancer Center at Jefferson.

The study, published in the January issue of The American Journal of Pathology, examines the role of fat and cholesterol in breast cancer development using a mouse model. The results show that mice fed a Western diet and predisposed to develop mammary tumors, can develop larger tumors that are faster growing and metastasize more easily, compared to animals eating a control diet.

The research team led by cancer biologist Philippe G. Frank, Ph.D., Assistant Professor in the Department of Stem Cell Biology and Regenerative Medicine at Thomas Jefferson University, was interested in learning about the link between diet and breast cancer. The incidence rate of this cancer is five times higher in Western countries than in other developed countries. Moreover, studies have shown an increase in breast cancer incidence in immigrant populations that relocate from a region with low incidence. "These facts suggest strong environmental influence on breast cancer development," says Dr. Frank.

Dietary fat and cholesterol have been shown to be important risk factors in the development and progression of a number of tumor types, but diet-based studies in humans have reached contradictory conclusions. This has led Dr. Frank to turn to animal models of human cancer to examine links between cholesterol, diet, and cancer.

The research team turned to the PyMT mouse model to determine the role of dietary fat and cholesterol in tumor development. This mouse model is believed to closely parallel the pathogenesis of human breast cancer. PyMT mice were placed on a diet that contained 21.2 percent fat and 0.2 percent cholesterol, reflective of a typical Western diet. A control group of PyMT mice was fed a normal chow that had only 4.5 percent fat and negligible amounts of cholesterol.

The researchers found that tumors began to develop quickly in mice fed the fat/cholesterol-enriched chow. In this group, the number of tumors was almost doubled, and they were 50 percent larger than those observed in mice that ate a normal diet. "The consumption of a Western diet resulted in accelerated tumor onset and increased tumor incidences, multiplicity, and burden, suggesting an important role for dietary cholesterol in tumor formation," Dr. Frank says. There was also a trend towards an increased number of lung metastasis in mice fed the fatty diet, he adds.

To confirm the aggressive nature of the cancer in animals fed a cholesterol-rich diet, the researchers examined the levels of several biomarkers of tumor progression and found a signature of a more advanced cancer stage, compared to tumors that developed in the control group.

The researchers also showed that plasma cholesterol levels in experimental mice that developed tumors were significantly reduced compared to a group of "wild-type" mice – animals with no predisposition to develop tumors – that was also fed a cholesterol-rich diet. "This suggests that tumor formation was responsible for the reduction in blood cholesterol levels observed in our animals," indicates Dr. Frank.

Dr. Frank explains the use of cholesterol in breast tumors this way: "In a neighborhood, if you want to build more houses, you need more bricks. In tumors, cholesterol provides the bricks that are the foundation for further growth, and this cholesterol comes from the blood. A drop in blood cholesterol may signify that some tumors are growing as cholesterol provides support for breast cancer growth."

"These data provide new evidence for an increase in cholesterol utilization by breast tumors and thus provides many new avenues for prevention, screening, and treatment," indicates Dr. Frank. These findings suggest that use of cholesterol-lowering drugs, such as statins, may both protect against breast cancer as well as treat patients carrying tumors. Since researchers also found that blood cholesterol levels dropped significantly as tumors began to develop, the study indicates measuring blood cholesterol levels may also be an effective method of screening cancer development.

This research team also discovered the same association between cholesterol and growth of prostate cancer in mice in a study published in the December issue of The American Journal of Pathology. The results of these two new studies indicate, according to Dr. Frank that, "Cholesterol does indeed seem to be an important factor in the regulation of tumor formation in several cancer types."