Exercise and Breast and Colon Cancer

A recent literature review published online in the Journal of the National Cancer Institute found that physical activity is associated with improved survival in people with breast and colon cancer. The study showed that exercise conferred two things: better quality of life and longevity. In breast cancer the studies show a dose response: the more you exercise, the lower your risk for all-cause or breast cancer mortality. In colon cancer there was no dose response, although exercise did reduce the mortality risk. There wasn't enough data on other cancers to make these pronouncements, although exercise seems to improve quality of life regardless. 

Fitness Can Trump Hypertension Genes

New research published in the American Heart Association's journal Hypertension, found that highly fit people who had a parent with hypertension had a 34% lower risk of developing high good pressure themselves compared to low-fitness individuals. While family history and genes are important, genes can be turned on and off by lifestyle factors such as exercise and diet, and even stress levels and sleep. Functional medicine uses all of these approaches. 

Slippery Slope Arguments

The May 12 New York Times had a wonderful article on the silliness and fallacy of slippery-slope arguments. Sadly, such sloppy thinking can also be seen on the Supreme Court (if we mandate healthcare coverage, we'll soon mandate that everyone eats broccoli). The times points out that such arguments were used in keeping women from the vote: if we allowed women to vote all our political leaders would soon be women--not necessarily a bad idea, but certainly seen as one back then. Currently only 17% of seats in Congress are held by women. I recommend that you read the whole article yourself here: http://www.nytimes.com/2012/05/13/business/economy/slippery-slope-logic-vs-health-care-law-economic-view.html?nl=health&emc=edit_hh_20120515

Tree Nuts Associated with Better Overall Health

A study published in the February issue of the Journal of the American College of Nutrition found that people consuming tree nuts tended to have lower body weight and a lower prevalence of health risks. The data from 13,292 men and women older than 19 years participating in the 1999-2004 National Health and Nutrition Examination Surveys (NHANES) were examined using 24 hour recall. Nut consumers were defined as those who consumed more than 1/4 ounce of nuts per day. That's not a lot of nuts, but on a daily basis it adds up. Those who consumed nuts tended to have lower body weight, lower BMI and waist circumference compared to non-consumers. Nut consumers also had higher levels of HDL, the good cholesterol, and lower levels of C-reactive protein, a marker for inflammation. These two markers indicated a lower risk for type 2 diabetes and heart disease. As with chocolate, you have to keep in mind that too much of a good thing is too much and can contribute to weight gain. The key is moderation.

Bans on School Junk Food Pay Off in California

The May 8 edition of the New York Times had an article on the positive effect that the modest changes in school food have had on children's calorie consumption. Since 2007 California school have not only banned soda, but many unhealthy snack foods from the vending machines and other places for sale on campuses. As a result, California children consume, on average, 158 fewer calories per day than students in other states. Apparently they are not eating more outside of school. 158 calories is about the equivalent of a small bag of potato chips. This can be enough to avoid long-term weight gain. To read more: http://well.blogs.nytimes.com/2012/05/08/bans-on-school-junk-food-pay-off-in-california/

B Vitamins and Breast Pain

Studies that show the benefits of vitamins rarely make news headlines. A recent study conducted in the Philippines and presented at the May 4th annual meeting of the American Society of Breast Surgeons in Phoenix found that vitamins E and B complex appeared to alleviate benign persistent great pain. During a 4 year period 126 outpatients with tolerable breast pain were assigned to the treatment group and 82 to the control group in an odd-even fashion. 90.2% of the women who took the vitamins were pain free after one month, compared to 9.8% in the control group. This study is interesting, although it could have been stronger if the control group had been given a placebo and if the women were evaluated over a longer period of time. Diet and exercise can also affect breast pain, but those changes take longer than a month to take effect. Also, we don't know the quality of these women's diets. 

Saturated Fat and Your Brain

A recent study found that, at least in older women, a diet high in saturated fats is associated with poorer cognitive function. Saturated fats are found primarily in animal products, such as meat and dairy products. It is not clear whether plant-based saturated fats, such as from coconut and palm oil were looked at. Diet diaries were filled out and analyzed for a subset of 6,000 women over 65 from the 40,000 women in the Women's Health Study. The women were also given three cognitive function tests that were spaced out every two years for an average of four years. Total fat intake was not correlated with a decline in cognitive scoring, only saturated fat. Women who ate higher amounts of monounsaturated fats, such as olive oil, had better scores over time.

Study FInds Lower Risk of Death Associated With Drinking Coffee

400,000 US men and women ages 50-71 who participated in the NIH-AARP Diet and Health Study were evaluated for coffee consumption, caffeinated and decaffeinated. When other factors were controlled for, such as smoking and alcohol consumption,  drinking coffee was associated with a lower risk of death from heart disease, respiratory disease, stroke, injuries and accidents, diabetes, and infections. There was no association with cancer for women, and a slightly increased risk of cancer in coffee drinkers for men. The associations were most powerful in those who drank three or more cups of coffee per day. 
I don't feel coffee is the evil drink some people make it out to be. There are some healthy aspects of coffee. I feel that three or four cups per day may disrupt the optimal function of your body's stress response by keeping you more revved up. It may also contribute to sleep disturbances. In this study that was not enough to be associated with death. I tell my patients that one cup in the morning is fine. You need to be careful about adding a lot of cream and sugar as those are empty calories. 
The study did not break out how the coffee was prepare: espresso? latte? drip coffee? boiled coffee?
This study was published in the May 17 edition of the New England Journal of Medicine. 

Of Mice and Men

A thought-provoking study recently published in the journal Cell Metabolism (May 17), showed that restricting eating to the 8 active hours of the day resulted in less weight gain than spreading the same amount of food intake throughout the day for mice. Can we infer the same for people? We don't know. The lead author of this study, Satchidananda Panda of the Salk Institute for Biological Studies, points out that every organ has a clock: there are times that our liver, intestines, muscles, and other organs work at peak efficiency and other times they are more or less sleeping. This is noticeable when traveling across different time zones. Asking the body to perform certain tasks at times that it would rather be sleeping could result in subpar function. We see this with increased incidence of serious illness in shift workers. So there are many reasons this could be similar in humans, but we just don't know. However, it is probably not a good idea to sit in front of the TV in the late evening while snacking. Mice or no mice, that can contribute to weight gain.

Rheumatoid Arthritis and Yoga

A small study conducted at UCLA and presented at the American Pain Society 31st Annual Scientific Meeting showed that a course of Iyengar yoga can help young women with RA feel better overall. However, there were no significant reductions in pain scores. These positive results were noticeable after only 6 weeks. A control group, who was wait-listed during this same period of time, noticed no change. It has long been known that movement in general can help people with RA. It is nice to know that yoga is safe and helpful at the same time. 

Don't Just Sit There

The April 28 edition of the New York Times had an interesting and amusing article by their health writer, Gretchen Reynolds, on the many ways that sitting is bad for you. She writes about how within 2 days of inactivity, genes are expressed differently in a non-exercised muscle, resulting in smaller amounts of an enzyme that disolves fat being produced. To read more, I encourage you to follow this link: http://www.nytimes.com/2012/04/29/sunday-review/stand-up-for-fitness.html?_r=2&nl=health&emc=edit_hh_20120501

Weight Training May Delay Onset of Dementia

A recent study published in the Archives of Internal Medicine found that older women with mild cognitive impairment can improve their executive function, associative memory, and other cognitive parameters within 6 months by a twice weekly resistance training routine.  This study found resistance training to be more effective than aerobic training, and far more effective than a balance and tone training class. Of interest is that that aerobic training improved balance better than the balance training. Other studies have found aerobic exercise to also help with cognitive function. 

Mild Weight Loss Reduces Inflammation in Postmenopausal Women

Overweight or obese postmenopausal women who lost at least 5% of their body weight had measurable reductions in markers of inflammation. Obesity and inflammation are both associated with different types of cancer. The women in this study used both a diet and a diet and exercise intervention. The diet and exercise intervention was a little more successful in reducing inflammatory biomarkers. This study was published in Cancer Research. 

Regular Jogging and Life Expectancy

An unpublished Danish study presented at the EuroPRevent2012 meeting found that regular, slow jogging for 1-2.5 hours per week in 2-3 sessions increased the lifespan in men by 6.2 years and in women by 5.6 years. It is unclear whether the jogging alone played a role, or if the joggers also tended to eat a healthier diet. the two often go hand in hand, in it can be rather articificial to try and separate them. 

E-mail and Stress

A new study conducted at UC Irvine with the U.S. Army researchers found that not having access to work email significantly reduces stress and allows emplyees to focus far better. Subjects in this study were outfitted with heart rate monitors. Those that had access to email, switched screens twice as often and were in a steady "high alert" statewith a more constant heart rate. Those removed from email for 5 days had a more natural, variable heart rate. Those on high alert had, not surprisingly, higher cortisol levels, a hormone linked to stress, as well as abdominal fat. 

Healthy Fats May Reduce Risk of Alzheimer's Disease

A recent paper published in Neurology found that consuming foods high in omega-3, such as fish and nuts, resulted in lower blood levels of beta-amyloid in the blood. Previous studies have suggested that blood levels of beta-amyloid correlated with brain levels of beta-amyloid that is associated with Alzheimer's disease. This is just one more reason to consume foods high in omega-3 fatty acids. Other reasons include lowering inflammation, cardiovascular benefits, improving mood disorders, improving dry skin and eczema, and decreasing joint pain. 

Can't Say Anything Good About Soda

More bad news about soda. Researchers from Cleveland Clinic's Wellness Institute and Harvard University found that greater consumption of sugar-sweetend and low-calorie sodas is associated with a higher risk of stroke. Interestingly, consumption of caffeinated or decaffeinated coffee was associated with a lower risk of stroke. The study included 43,271 men from the Health Professionals Follow-Up Study between 1986 and 2008 and 84,085 women from the Nurses' Health Study between 1980 and 2008. 

In sugar-sweetened sodas, the sugar load may lead to rapid increases in blood glucose and insulin which, over time, may lead to glucose intolerance, insulin resistance, and inflammation. These physiologic changes influence atherosclerosis, plaque stability and thrombosis – all of which are risk factors of ischemic stroke. This risk for stroke appears higher in women than in men. In addition, the study found the soda drinkers had higher blood pressure and higher levels of cholesterol and lower physical activity. Those drinking low calorie sodas had a higher incidence of chronic disease and a higher body mass index (BMI). 

In contrast, coffee contains chlorogenic acids, lignans and magnesium, all of which act as antioxidants, which in turn may reduce the risk of stroke. One serving of decaffeinated coffee was associated with a 10 percent lower risk of stroke than sugar-sweetened soda. 

This study was recently published in the American Journal of Clinical Nutrition. 

Sleep and Obesity

Adequate sleep is one of the pillars of a healthy life, along with exercise, a good diet, and good social relationships. New evidence is elucidating the connection between sleep and obesity. Inadequate sleep impacts the secretion of the signal hormones ghrelin, which then increases appetite, and leptin, which indicates when the body is satiated. This hormone dysregulation can lead to increased eating without increased energy expenditure. These effects appear to be stronger in children and adolescents. On a side note, watching television before going to sleep, can impact the quality of sleep. Practicing good sleep hygiene is important for getting a good night's sleep. 

Rosemary and Brain Performance

Intriguing research out of Northumbria University in the UK and published in the February 24 edition of Therapeutic Advances in Psychopharmacology found that inhaling rosemary boosted both speed and accuracy in brain performance. The effect was also dose related. 20 subjects who were asked to perform various tests in a room infused with the scent of rosemary, were told that the scent was left over from a previous study. After performing the tests, their blood levels of 1,8-cineole, the active ingredient in rosemary, were measured. Higher levels correlated with better performance. Previous research has shown people to perform tasks better when they were in a better mood. Interestingly, the higher levels of 1,8-cineole were correlated with being less content. Therefore the better performance was not due to being happy about smelling rosemary. Rosemary has long been known by herbalists to be good for your brain and thinking. 

Vitamin D and Severe Childhood Asthma

An research study in the December 15 edition of the American Journal of Respiratory Critical Care found that lower vitamin D levels in children with severe, therapy-resistant asthma  were associated with worse asthma control and lung function. They also found a link between vitamin D levels and airway function. They conclude that vitamin D supplementation may be useful in children with severe, therapy-resistant asthma. 

Berries and Your Brain

The April 26 edition of Annals of Neurology has a new study performed at Brigham and Women's Hospital that found that a high intake of flavonoid rich berries, such as strawberries and blueberries, can, over time, delay memory decline in older women by 2.5 years. A modest reduction in memory decline was noted in women who consumed 2 or more servings of strawberries and blueberries each week. Data was collected from the Nurses' Health Study, a cohort of 121,700 women RNs between 30 and 55. The study began in 1976. The women included in this particular study had a mean age of 74 and a body mass index of 26, so somewhat overweight but not obese. Other research has shown the benefit of berries on the brain. There is no downside to including berries in your diet. If they're out of season, frozen ones will do. 

Diet and Exercise Can Help Prevent Macular Degeneration

An article in the Archives of Ophthalmology found that regular exercise along with a very healthy diet are able to stave off age-related macular degeneration (AMD). 1325 participants in the Carotenoids in Age-Related Eye Disease Study, a subset of the Women's Health Initiative Observation Study, found that following the US Dietary Guidelines and maintaining  a regimen of daily physical activity contribute significantly to preserving vision. An interesting note on the exercise: frequency of exercise was more important than the intensity of the exercise. 

Soy Helps Reduce Blood Pressure

Recent research conducted at the Perelman School of Medicine at the University of Pennsylvania and presented at the annual meeting of the American College of Cardiology found that individuals who ingest the highest amounts of soy protein in a day lower their systolic blood pressure. Compared to those consuming the least amount of soy per day, those who consumed the most were able to lower their systolic blood pressure by 5.52 mg Hg. Although the researchers try and control for variables that might also be responsible for lowering blood pressure, it is not an exact science. Eating a diet high in soy probably means the individual is practicing a number of other healthy behaviors that would lower blood pressure. This is the trouble with looking for a silver bullet: in order to lower blood pressure you need a holistic approach that includes many healthy behaviors, such as regular exercise, adequate sleep, stress management, healthy plant-based diet, in addition to including soy and vitamin C. 

Individual Responses to High Fat Diets

Research being done in Toulouse with mice eating high-fat diets is very intriguing. Some mice on a high-fat diet get diabetes and remain thin, and others remain thin and do not get diabetes. The difference between the two genetically identical groups is the make-up of their gut flora. When the diabetic mice are fed a diet higher in fiber, their gut flora begins to resemble that of the non-diabetic mice. While this research is intriguing, you can't jump from mice to humans because their gastrointestinal systems are dissimilar. However, we can say that diet affects the gut flora, and that the gut flora does play a role in food absorption, and then possibly metabolism down the line. 

Cancer and Anxiety

Using an animal model, mice, researchers at Stanford concluded that high levels of anxiety increased the vulnerability and severity of cancer in mice. Nervous mice had higher levels of immune-suppressing cells, T-regulatory cells. Normally these cells thwart an overzealous immune response and prevent the body from attacking itself. In this case, too many T-reg cells were thwarting the immune response needed to rid the body of abnormal cells. The anxious mice also had higher levels of cortisol, a stress hormone, and were much quicker to secrete this hormone than the laid-back mice. This area of research is very important, as just the diagnosis of cancer is enough to create anxiety and stress--not the best response for combatting cancer. This research team now wants to look at the effects of ameliorating the stress response on cancer. This research was published in PLoS ONE April 25. 

Toxic Chemicals and Autism

What by some was considered fringe thinking is now gaining mainstream acceptance. The prestigious journal Environmental Health Perspectives recently published several articles and an editorial on chemicals highly likely to contribute to autism spectrum disorder (ASD) and other neurodevelopmental disorders, included Attention Deficit Hyperactivity Disorder (ADHD). The National Academy of Sciences reports that 3 percent of all neurobehavioral disorders such as ASD and ADHD are caused by toxic exposures in the environment. Another 25% are due to the interactions between the children's' genetics and environmental factors. Many of the chemicals widely used have not even undergone minimal assessment for potential toxicity. The top ten chemicals that The Children's Environmental Health Center (CEHC) at Mount Sinai School of Medicine suspect contribute to autism and learning disabilities are:
1. Lead
2. Methylmercury
3. PCBs
4. Organophosphate pesticides
5. Organochlorine pesticides
6. Endocrine disruptors
7. Automotive exhaust
8. Polycyclic aromatic hydrocarbons
9. Brominated flame retardants
10. Perfluorinated compounds


To read more: http://www.mountsinai.org/about-us/newsroom/press-releases/mount-sinai-childrens-environmental-health-center-publishes-a-list-of-the-top-ten-toxic-chemicals-suspected-to-cause-autism-and-learning-disabilities

Does Vitamin E Prevent or Promote Cancer?

It is difficult not to be confused by the research on vitamin E and cancer. Some studies say it causes cancer and others say it prevents cancer. The problem lies in the form of vitamin E used in the studies. Natural vitamin E consists of several tocopherols, with alpha-, gamma-, and delta- being the most abundant. Gamma-tocopherol is thought by many to be cancer preventative. When large doses of alpha-tocopherol are given, gamma-tocopherol is unable to be effective. An article published online in Cancer Prevention Research by Yang, et. al concluded that "Our recent results in animal models have demonstrated the cancer preventive activity of gamma- and delta-tocopherols as well as a naturally occurring mixture of tocopherols, and the lack of cancer preventive activity by alpha-tocopherol. Based on these results as well as information from the literature, we suggest that vitamin E, as ingested in the diet or in supplements that are rich in gamma-and delta-tocopherols, is cancer preventive; whereas supplementation with high doses of alpha-tocopherol is not."

Migraine Prevention

The American Academy of Neurology printed an update on their migraine prevention guidelines. Aside from various prescription drugs, they also made recommendations for specific vitamins and herbs. Petasites (butterbur) was perhaps the most effective preventative treatment with the most rigorous research behind it, even more so than NSAIDs. They considered probably effective herbal therapies including feverfew (MIG-99), vitamins riboflavin, and the mineral magnesium, as well as NSAIDs (ibuprofen and naproxen). Of course the herbs, vitamins, and minerals don't ruin your intestinal health like the NSAIDs do. Co-enzyme Q10 was possibly effective.
The full report can be read at: http://www.neurology.org/content/78/17/1346.full.pdf+html

The Difficulty of Keeping Weight Off

Since World War II in the US food has been relatively cheap and readily available. We do less physical activity because of cars, computers, and watching television. This has set us up for an environment where it is difficult to lose weight and keep weight off. James O. Hill, the director of the Colorado Nutrition Obesity Research Center was the keynote speaker at the University of Illinois' Division of Nutritional Sciences recent Nutrition Symposium, and he addressed weight loss issues. If we look at the Amish, we're looking at the world more than 100 years ago. Amish men average 18,000 steps a day, and Amish women 14,000. The average US males takes 5,940 steps. Once you become obese, it is difficult to keep weight off because your body has a metabolic drive to regain those pounds. "The more weight you lose, the more you'll have to work to keep it off. You have to be active. If you're active you eat less," he said. People who have lost at least 30 pounds and have kept it off for a year do the following:1) They consume a reduced-calorie, reduced-fat diet.2) They engage in 60 to 90 minutes of moderate physical activity a day. 3) They limit their TV viewing4) They use a high level of dietary restraint.5) They weight themselves frequently and if they gain 2 or 3 pounds, they do something about it. 6) They maintain dietary consistency. 7) They eat breakfast. 

Successful weight-loss maintainers often link their dietary behaviors to other personal values, e.g., use walking time as their spiritual time, or they walk with family or friends to connect with them. He also mentioned that little things can make a difference: using low fat milk instead of whole milk, dropping kids off at school at least 500 feet away.