Because Alzheimer’s dementia is a devastating and incurable illness, there has been considerable interest in preventing it. A recent study in JAMA Neurology from the University of Kentucky examined the effects of the popular anti-oxidant supplements selenium and vitamin E on the development of dementia among over 7500 asymptomatic male subjects without any initial signs of dementia, who were followed over the next 11 years. Unfortunately, supplementation did not decrease the development of dementia, nor the overall death rate, cancer, or cardiovascular disease. Furthermore, the data suggested that selenium led to a small increase in type II diabetes, and that vitamin E increased the diagnosis of prostate cancer. The take home point is that these two antioxidants do not appear to reduce the incidence of dementia in healthy elderly men.
A group of researchers from the UK recently published a meta-analysis of 141 studies examining the effects of cigarette smoking on coronary heart disease and stroke in the British Medical Journal. The authors were particularly interested in the risks of light smoking. While it was no surprise that people who smoked at least one pack per day had significantly increased risk, the authors found that the additional risk for coronary disease or stroke in men who smoked only one cigarette per day was about half that seen in men who smoked one pack per day, instead of 1/20th. For women, smoking one cigarette per day led to about one third the additional risk seen in women who smoked one pack per day, rather than 1/20th.
A recent report in CA: A Cancer Journal for Clinicians looked at US cancer incidence and death rates by analyzing data from the Centers for Disease Control (CDC) National Program of Cancer Registries, the National Cancer Institute’s Surveillance, Epidemiology, and End Results data base, and the CDC’s National Center for Health Statistics.
The authors concluded that 42% of cancers diagnosed, and 45% of cancer deaths, could be attributed to unhealthy behaviors. The most significant unhealthy behaviors include cigarette smoking, excess body weight, and alcohol intake, which by themselves accounted for 33% of cancer diagnoses and 39% of cancer deaths.
This represents one of those good news – bad news situation. The bad news is that Americans are developing and dying from cancer because of their unhealthy behaviors, but the good news is that these unhealthy behaviors are under our control, and that if Americans choose not to use tobacco, choose to maintain a healthy body weight, and choose to drink not at all or only in moderation, the incidence and death rates of cancer can be dramatically reduced.
A recent report in Cancer by investigators in Boston and Malaysia reviewed 245 patients who were followed for over 4 years from diagnosis, and found that over one in five had developed PTSD within 6 months of diagnosis. At 4 years more than 6% still had symptoms. These issues can interfere with a patient’s recovery, since patients with PTSD are less likely to keep appointments or keep on their treatment.
Physicians need to actively question cancer patients for symptoms of PTSD, and cancer patients who experience such symptoms as anxiety, depression, insomnia, nightmares, flashbacks, agitation, irritability, hostility, social isolation, loss of interest in normal activities, or other troubling emotional problems should call them to their physicians’ attention.
A recent report from the British Medical Journal identified over 200 meta-analyses of observational and interventional studies looking at the health effects of coffee drinking.
The greatest benefit was seen in people who drank 3 cups per day, who experienced a 19% reduction in the risk of death from cardiovascular disease, a 16% reduction in the risk of death from coronary heart disease, and a 30% reduction in the risk of death from stroke, but a reduction in the risk of premature death was seen with consumption of up to 7 cups per day.
Other benefits seen with coffee consumption included reductions in the risks of developing diabetes, liver disease, dementia, Parkinson’s disease, metabolic syndrome, gout, and kidney stones, as well as cancers of the uterus, prostate, liver, and skin.
The science is settled, so drink up with confidence! I take mine black. No sugar, thank you.
A publication from a Canadian group this week in The Lancet described findings from the Prospective Urban Rural Epidemiology study, which enrolled over 135,000 individuals from 18 different countries across 5 continents, including people from North and South America, Europe, the Middle East, Africa, China, and South Asia. Participants provided data about their socioeconomic situation, lifestyle, and medical issues, and were followed up for an average of 7.5 years. A higher total fat intake – providing 35% of calories – was linked with a 23% lower death rate from all causes, while a higher carbohydrate intake – providing 77% of calories – was linked with a 28% higher death rate from all causes. A separate publication from the same group found that consuming 3-4 servings of fruits, vegetables, and legumes (beans, peas, lentils, etc.) – equivalent to about 16 ounces – reduced the risk of death. There was little benefit found for a higher intake, and fruit intake was associated with a higher benefit than vegetables. Furthermore, raw vegetables were more healthful than cooked vegetables.
A report by a Spanish group presented at the European Society of Cardiology this week analyzed nearly 20,000 individuals, who completed a questionnaire regarding food consumption, demographic and lifestyle characteristics, body measurements, and other health issues, and who were followed up for an average of 10 years. The researchers found that those who consumed at least 4 cups of coffee per day had a 64% lower risk of death than those who never or almost never drank coffee. Every additional 2 cups/day consumed led to a 22% reduction in death rate. This effect appeared to be limited to those who were over 45 years of age.
I take mine black, thank you. No cream, no sugar.
Because cancer represents the second leading cause of death in the US and represents a major public health burden, there is interest in interventions which could reduce its incidence. There has been some evidence that vitamin D may protect against cancer, so a group of researchers at the University of Nebraska recently published an article in the JAMA describing the effects of calcium and vitamin D supplementation on cancer development in healthy postmenopausal women. The study enrolled over 2300 women, lasted 4 years, and examined the development of all cancer types except for skin cancers. Unfortunately, the investigators were unable to demonstrate a significant reduction in the development of cancer in the women who were prescribed calcium and vitamin D.
Even though vitamin D supplementation does not appear to reduce the risk of cancer, it remains important in the prevention of bone loss, particularly in overcast climates like we have in WV.