Untreated Heartburn May Raise Risk for Esophageal Cancer

Rates of esophageal cancer have surged due to a lack of awareness about what causes the disease and how it can be prevented, experts say.

The esophagus is the muscular tube that carries food and liquid from the mouth to the stomach. There were six times as many cases of esophageal cancer in 2001 as there were in 1975, according to a team from the University of California, Los Angeles. The researchers noted that one key way people can reduce their risk for the disease is by managing heartburn and acid reflux, often called gastroesophageal reflux disease, or GERD.

"Obesity and poor diet have spiked the numbers suffering from acid reflux," Dr. V. Raman Muthusamy, associate clinical professor of medicine and endoscopy director at the UCLA Center for Esophageal Disorders, said in a university news release.

If left untreated, GERD can cause stomach acid to wash repeatedly into the esophagus, causing changes in the tissue lining. This condition is called Barrett's esophagus, and people diagnosed with Barrett's may be up to 40 times more likely to develop esophageal cancer, the UCLA experts explained.

Complicating matters, people with esophageal cancer may not experience any symptoms other than heartburn, which could prevent early detection of the disease, said Muthusamy and his colleague Dr. Kevin Ghassemi, clinical programs director at the UCLA Center for Esophageal Disorders.

"Early identification, treatment and management of changes in the esophageal lining are critical to catching problems early," Ghassemi said in the news release.

To help people know when to be concerned about acid reflux or heartburn and reduce the risks associated with the condition, Muthusamy and Ghassemi offered the following tips: • Anyone experiencing heartburn more than once a week should visit their doctor to manage the condition.
• Lose extra pounds. Being overweight can make acid reflux and heartburn worse.
• Avoid eating too much at one time, and keep upright after eating. Reclining with a full stomach can make symptoms worse.
• Engage in light physical activity after eating; exercise can help digestion.
• Anyone who takes medications for acid reflux -- such as Prilosec, Nexium, Prevacid, Zantac or Pepcid -- should take their medication regularly to reduce the level of acid in their stomach.
• Get screened for esophageal cancer. White men aged 50 or older who have been affected by acid reflux for more than 10 to 15 years should consider being screened for Barrett's esophagus. If caught early, the changes in the esophagus lining can be treated.
• Don't smoke.
• Avoid caffeine, alcohol and fatty foods, which can increase the risk for acid reflux.
• People taking certain heart and blood-pressure drugs, such as calcium channel blockers and nitrates, may be at greater risk for acid reflux. These patients should discuss their risk factors and treatment options with their doctor.
• Don't wear tight-fitting clothes.

The American Cancer Society estimates that there will be nearly 17,500 new cases of esophageal cancer in the United States in 2012, and more than 15,000 deaths from the disease.

Vitamin E May Lower Liver Cancer Risk

High consumption of vitamin E either from diet or vitamin supplements may lower the risk of liver cancer, according to a study published July 17 in the Journal of the National Cancer Institute.

Liver cancer is the third most common cause of cancer mortality in the world, the fifth most common cancer found in men and the seventh most common in women. Approximately 85% of liver cancers occur in developing nations, with 54% in China alone. Some epidemiological studies have been done to examine the relationship between vitamin E intake and liver cancer; however, the results have been inconsistent.

To determine the relationship between vitamin E intake and liver cancer risk, Wei Zhang, MD, MPH., of the Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine and colleagues analyzed data from a total of 132,837 individuals in China who were enrolled in the Shanghai Women's Health Study (SWHS) from 1997-2000 or the Shanghai Men's Health Study (SMHS) from 2002-2006, two population-based cohort studies jointly conducted by the Shanghai Cancer Institute and Vanderbilt University. Using validated food-frequency questionnaires, the researchers conducted in-person interviews to gather data on study participants' dietary habits. They compared liver cancer risk among participants who had high intake of vitamin E with those with low intake.

The analysis included 267 liver cancer patients (118 women and 149 men) who were diagnosed between 2 years after study enrollment and an average of 10.9 (SWHS) or 5.5 (SMHS) years of follow-up. Vitamin E intake from diet and vitamin E supplement use were both associated with a lower risk of liver cancer. This association was consistent among participants with and without self-reported liver disease or a family history of liver cancer. "We found a clear, inverse dose-response relation between vitamin E intake and liver cancer risk," the authors write, noting a small difference between men and women in the risk estimate, which is likely attributable to fewer liver cancer cases having occurred among SMHS participants due to the shorter follow-up period. Overall, the take home message is that, "high intake of vitamin E either from diet or supplements was related to lower risk of liver cancer in middle-aged or older people from China."

Boosting New Memories With Wakeful Resting

Too often our memory starts acting like a particularly porous sieve: all the important fragments that should be caught and preserved somehow just disappear. So armed with pencils and bolstered by caffeine, legions of adults, especially older adults, tackle crossword puzzles, acrostics, Sudoku and a host of other activities designed to strengthen their flagging memory muscles.

But maybe all they really need to do to cement new learning is to sit and close their eyes for a few minutes. In an article to be published in the journal Psychological Science, a publication of the Association for Psychological Science, psychological scientist Michaela Dewar and her colleagues show that memory can be boosted by taking a brief wakeful rest after learning something verbally new—so keep the pencil for phone numbers– and that memory lasts not just immediately but over a longer term.

“Our findings support the view that the formation of new memories is not completed within seconds,” says Dewar. “Indeed our work demonstrates that activities that we are engaged in for the first few minutes after learning new information really affect how well we remember this information after a week.”

In two separate experiments, a total of thirty-three normally aging adults between the ages of 61 and 87 were told two short stories and told to remember as many details as possible. Immediately afterward, they were asked to describe what happened in the story. Then they were given a 10-minute delay that consisted either of wakeful resting or playing a spot-the-difference game on the computer.

During the wakeful resting portion, participants were asked to just rest quietly with their eyes closed in a darkened room for 10 minutes while the experimenter left to “prepare for the next test.” It didn’t matter what happened while their eyes were closed, only that they were undistracted by anything else and not receiving any new information.

When participants played the spot-the-difference game, they were presented with picture pairs on a screen for 30 seconds each and were instructed to locate two subtle differences in each pair and point to them. The task was chosen because it required attention but, unlike the story, it was nonverbal.

In one study, the participants were asked to recall both stories half an hour later and then a full week later. Participants remembered much more story material when the story presentation had been followed by a period of wakeful resting.

Dewar explains that there is growing evidence to suggest that the point at which we experience new information is “just at a very early stage of memory formation and that further neural processes have to occur after this stage for us to be able to remember this information at a later point in time.”

We now live in a world where we are bombarded by new information and it crowds out recently acquired information. The process of consolidating memories takes a little time and the most important things that it needs are peace and quiet.

LOWER VITAMIN D COULD INCREASE RISK OF DYING

A new study concludes that among older adults – especially those who are frail – low levels of vitamin D can mean a much greater risk of death.

The randomized, nationally representative study found that older adults with low vitamin D levels had a 30 percent greater risk of death than people who had higher levels.

Overall, people who were frail had more than double the risk of death than those who were not frail. Frail adults with low levels of vitamin D tripled their risk of death over people who were not frail and who had higher levels of vitamin D.

“What this really means is that it is important to assess vitamin D levels in older adults, and especially among people who are frail,” said lead author Ellen Smit of Oregon State University.

Smit said past studies have separately associated frailty and low vitamin D with a greater mortality risk, but this is the first to look at the combined effect. This study, published online in the European Journal of Clinical Nutrition, examined more than 4,300 adults older than 60 using data from the Third National Health and Nutrition Examination Survey.

“Older adults need to be screened for vitamin D,” said Smit, who is a nutritional epidemiologist at OSU’s College of Public Health and Human Sciences. Her research is focused on diet, metabolism, and physical activity in relation to both chronic disease and HIV infection.

“As you age, there is an increased risk of melanoma, but older adults should try and get more activity in the sunshine,” she said. “Our study suggests that there is an opportunity for intervention with those who are in the pre-frail group, but could live longer, more independent lives if they get proper nutrition and exercise.”

Frailty is when a person experiences a decrease in physical functioning characterized by at least three of the following five criteria: muscle weakness, slow walking, exhaustion, low physical activity, and unintentional weight loss. People are considered “pre-frail” when they have one or two of the five criteria.

Because of the cross-sectional nature of the survey, researchers could not determine if low vitamin D contributed to frailty, or whether frail people became vitamin D deficient because of health problems. However, Smit said the longitudinal analysis on death showed it may not matter which came first.

“If you have both, it may not really matter which came first because you are worse off and at greater risk of dying than other older people who are frail and who don’t have low vitamin D,” she said. “This is an important finding because we already know there is a biological basis for this. Vitamin D impacts muscle function and bones, so it makes sense that it plays a big role in frailty.”

The study divided people into four groups. The low group had levels less than 50 nanomole per liter; the highest group had vitamin D of 84 or higher. In general, those who had lower vitamin D levels were more likely to be frail.

About 70 percent of Americans, and up to a billion people worldwide, have insufficient levels of vitamin D. And during the winter months in northern climates, it can be difficult to get enough just from the sun. OSU’s Linus Pauling Institute recommends adults take 2,000 IU of supplemental vitamin D daily. The current federal guidelines are 600 IU for most adults, and 800 for those older than 70.

“We want the older population to be able to live as independent for as long as possible, and those who are frail have a number of health problems as they age,” Smit said. “A balanced diet including good sources of vitamin D like milk and fish, and being physically active outdoors, will go a long way in helping older adults to stay independent and healthy for longer.”

Raisins provide same workout boost as sports chews.

New research published in the Journal of the International Society of Sports Nutrition suggests that eating raisins may provide the same workout boost as sports chews.

Conducted by researchers at the University of California-Davis, the study evaluated the effects that natural versus commercial carbohydrate supplements have on endurance running performance. Runners depleted their glycogen stores in an 80-minute 75% V02 max run followed by a 5k time trial. Runners completed three randomized trials (raisins, chews and water only) separated by seven days. Findings included:

* Those that ingested raisins or sports chews ran their 5k on average one minute faster than those that ingested only water
* Eating raisins and sports chews promoted higher carbohydrate oxidation compared to water only

"Raisins are a great alternative to sport chews as they also provide fiber and micronutrients, such as potassium and iron, and they do not have any added sugar, artificial flavor or colors," said James Painter, Ph.D., R.D., and nutrition research advisor for the California Raisin Marketing Board. "As an added bonus, raisins are the most economical dried fruit according to the United Stated Department of Agriculture, so they are cost effective and convenient for use during exercise."

Aspirin reduces risk of Barrett's esophagus & cancer

Aspirin use appears to reduce the risk of Barrett's esophagus (BE), the largest known risk factor for esophageal cancer, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

"The protective effect of aspirin use appears robust because the analyses suggests a dose-response relationship in which high-dose aspirin was significantly associated with decreased Barrett's esophagus risk," said Chin Hur, MD, MPH, of the Massachusetts General Hospital Institute for Technology Assessment and lead author of this study. "It would not be advisable at this time for patients to start taking aspirin, particularly at higher doses, if preventing Barrett's esophagus is the only goal. However, if additional data confirms our findings and an individual at high risk for development of Barrett's esophagus and esophageal cancer also could derive additional benefits, most notably cardiovascular, aspirin could be a consideration."

Dr. Hur and his team of researchers analyzed characteristics of 434 BE patients for factors that might be used in screening and management. In addition to finding that those taking aspirin were 44 percent less likely to have BE, they also found that men were more than three times more likely to develop BE than women.

The incidence of esophageal cancer has been increasing at an alarming rate during the past few decades; current attempts at targeted screening for this type of cancer focus on identifying BE. Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have been associated with reduced esophageal cancer incidence. Although there have been many studies analyzing NSAID and aspirin chemoprevention for esophageal cancer or BE progression to this cancer, few have explored NSAIDs for BE prevention.

Cutting Salt Could Reduce Stomach Cancer

If people in the UK cut the amount of salt they consumed to the recommended daily maximum, it could prevent one in seven cases of stomach cancer, said the World Cancer Research Fund (WCRF) on Tuesday, after examining the latest figures for diet and cancer incidence.

The recommended daily maximum intake of dietary salt is 6.0 g, about the same as in a level teaspoon.

But people in the UK on average eat 43% more than this: 8.6 g of salt a day.

WCRF say that although there has been a significant downward trend in levels of salt consumed in the UK, from 9.5 g a day in 2000/01, to 8.6g in 2008, the latest year for which up to date figures are available, it is still too much.

The charity bases its estimates on the latest Food Standard Agency statistics on salt intake, and on cancer incidence data from the latest Office of National Statistics (ONS), Public Health Wales Cancer Incidence, ISD Scotland Cancer Statistics and the Northern Ireland Cancer Registry.
One Traffic Light System on Food Labels
WCRF want to see one standardized "traffic light" system on the front of food and drink packaging, to help bring down salt, fat and sugar consumption in the UK.

About three quarters of the salt consumed in the UK comes from eating processed food.

A 2011 survey said one fifth of the salt consumed in the UK comes from bought bread, which contains too much salt. There is a similar pattern in the US, where a federal report shows bread and rolls contribute more salt to the American diet than salty snacks.

WCRF say the UK needs a standard system with traffic light labelling on the front of packaging showing clearly the amount of salt, sugar, fat and saturated fat.

Kate Mendoza, their Head of Health Information, told the press:

"Standardised labelling among retailers and manufacturers - rather than the different voluntary systems currently in place - would help consumers make better informed and healthy choices."

Cancer Research UK also wants to see standardized labelling as a way to help people control their salt intake:

"Improved labelling - such as traffic light labelling - could be a useful step to help consumers cut down," Lucy Boyd, an epidemiologist with Cancer Research UK, told the BBC.

She said the WCRF figures confirm a report they published recently: too much salt contributes significantly to the number of stomach cancer cases in the UK.
Salt and Sodium Confusion

One area that is confusing with different labels using different standards, is the difference between salt and sodium content.

Sometimes UK food labels don't show list salt, they list sodium content, as they do in the US. Salt is sodium chloride, and the sodium accounts for 40% of the weight.

So to work out how much salt is in the food whose label lists the sodium content, simply multiply the sodium content by 2.5: thus 0.4 g of sodium x 2.5 = 1 g of salt.
1,000 of Stomach Cancer Cases Could Be Avoided
According to the latest figures, there are 7,500 new cases of stomach in the UK a year, with nearly 5,000 deaths due to the disease.

Cutting salt intake to 6.0 g a day would prevent 1 in 7, or 1,000 cases a year, say the WCRF.

It would also lead to other benefits, because salt is linked to high blood pressure, which is a risk factor for stroke and heart disease, and is also tied to osteoporosis and kidney disease.

Mendoza explained that stomach cancer is difficult to treat because most cases are not diagnosed until the cancer is well-established.

Because it is so advanced by the time it is caught, only about 15% of patients live more than 5 years after diagnosis, making stomach cancer the 7th leading cause of cancer death in the UK.

"This places even greater emphasis on making lifestyle choices to prevent the disease occurring in the first place - such as cutting down on salt intake and eating more fruit and vegetables," said Mendoza.

Pancreatic Cancer Risk May Be Reduced By High Dietary Antioxidant Intake

Individuals can significantly reduce their risk of developing pancreatic cancer by increasing their dietary intake of the antioxidant vitamins C, E, and selenium, say researchers who are leading the Norfolk arm of the European Prospective Investigation of Cancer (EPIC) study.

The study, published in the journal Gut, states that 1 in 12 of these cancers might be prevented if the association turns out to be casual.

More than a 250,000 people die each year around the world due to pancreatic cancer. In the UK, 7,500 people are diagnosed with the disease each year.

Only 5% of patients with pancreatic cancer survive beyond 5 years, say the researchers. Risk factors of the disease include, smoking, type 2 diabetes, and diet.

The team analyzed the health of more than 23,500 adults who participated in the Norfolk arm of the EPIC study between 1993 and 1992. Patients were aged 40 to 74 years old.

All study participates filled out a food diary tracking the types and amounts of food the consumed during a 7 day period. In addition, they detailed the methods they used to prepare the food.

The team then matched each entry in the food diary to one of 11,00 food items. They then used a specially designed computer program called DINER in order to calculate the nutrient values.

According to the researchers, 49 people developed pancreatic cancer within 10 years of participating in the study, and this figure increased to 86 people by 2010. On average, they survived six months after being diagnosed with pancreatic cancer.
br> The nutrient intakes of participants diagnosed with the disease were compared with those of almost 4,000 healthy individuals in order to see if there were any differences.

According to the researchers, weekly intake of selenium in the top 25% of consumption roughly reduced their risk of developing pancreatic cancer by 50% compared with those whose intake was in the bottom 25%.

In addition, patients were 67% less likely to develop the disease if their intake of vitamins C, Em and selenium was in the top 25% of consumption.
The researchers note that antioxidants may neutralize free radicals and curb genetically programmed influences, as well as stimulating the immune system response.

They explained:

"Other trials using antioxidant supplements have not produced such encouraging results, but this may be because food sources of these nutrients may behave differently from those found in supplements. If a causal association is confirmed by reporting consistent findings from other epidemiological studies, then population based dietary recommendations may help prevent pancreatic cancer."

Moderate alcohol intake is associated with a lower risk of kidney cancer

A majority of previous epidemiologic studies have shown that moderate drinking is associated with a lower risk of kidney cancer, which may affect about 1% of the general population. In published prospective cohort studies, the risk for such cancer among moderate drinkers is usually about 25% less than the risk seen among non-drinkers.

This well-done meta-analysis supports these findings: for the more-reliable prospective cohort studies (rather than case-control studies) the current study finds a 29% lower risk for subjects in the highest category of alcohol consumption in comparison with subjects in the lowest alcohol category. The findings suggest similar effects among men and women, and for all types of alcohol beverages. The effects are seen at a level of about one drink/day, with little further reduction in risk for greater alcohol consumption.

Vitamin D may protect against lung function impairment and decline in smokers

Vitamin D deficiency is associated with worse lung function and more rapid decline in lung function over time in smokers, suggesting that vitamin D may have a protective effect against the effects of smoking on lung function, according to a new study from researchers in Boston.

"We examined the relationship between vitamin D deficiency, smoking, lung function, and the rate of lung function decline over a 20 year period in a cohort of 626 adult white men from the Normative Aging Study," said lead author Nancy E. Lange, MD, MPH, of the Channing Laboratory, Brigham and Women's Hospital. "We found that vitamin D sufficiency (defined as serum vitamin D levels of >20 ng/ml) had a protective effect on lung function and the rate of lung function decline in smokers."

The findings were published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

In the study, vitamin D levels were assessed at three different time points between 1984 and 2003, and lung function was assessed concurrently with spirometry.

In vitamin D deficient subjects, for each one unit increase in pack-years of smoking, mean forced expiratory volume in one second (FEV1) was 12 ml lower, compared with a mean reduction of 6.5 ml among subjects who were not vitamin D deficient. In longitudinal models, vitamin D deficiency exacerbated the effect of pack years of smoking on the decline in FEV1 over time.

No significant effect of vitamin D levels on lung function or lung function decline were observed in the overall study cohort, which included both smokers and non-smokers.

"Our results suggest that vitamin D might modify the damaging effects of smoking on lung function," said Dr. Lange. "These effects might be due to vitamin D's anti-inflammatory and anti-oxidant properties."

The study has some limitations, including that the data is observational only and not a trial, that vitamin D levels fluctuate over time, and that the study has limited generalizability due to the cohort being all elderly men.

"If these results can be replicated in other studies, they could be of great public health importance," said Dr. Lange. "Future research should also examine whether vitamin D protects against lung damage from other sources, such as air pollution."

"While these results are intriguing, the health hazards associated with smoking far outweigh any protective effect that vitamin D may have on lung function ," said Alexander C. White MS, MD, chair of the American Thoracic Society's Tobacco Action Committee. "First and foremost, patients who smoke should be fully informed about the health consequences of smoking and in addition be given all possible assistance to help them quit smoking."

Study suggests moderate drinking lowers risk of developing rheumatoid arthritis in women

A follow-up study of more than 34,000 women in Sweden has shown that moderate drinkers, in comparison with abstainers, were at significantly lower risk of developing rheumatoid arthritis (RA), an often serious and disabling type of arthritis. RA is known to relate to inflammation, and it is thought that this inflammation is blocked to some degree by the consumption of alcohol. In this study, women who consumed at least 4 drinks per week (with a drink being defined as containing 15 grams of alcohol) had 37% lower risk of developing RA than subjects reporting never drinking or consuming less than 1 drink/week.

This large study is important as few prospective studies are of adequate size to have sufficient cases of RA to evaluate factors related to its development. The study supports previous research showing a lower risk of developing RA, or milder severity of the disease, among moderate drinkers than among abstainers.

INCREASE IN RDA FOR VITAMIN C COULD HELP REDUCE HEART DISEASE, STROKE, CANCER

he recommended dietary allowance, or RDA, of vitamin C is less than half what it should be, scientists argue in a recent report, because medical experts insist on evaluating this natural, but critical nutrient in the same way they do pharmaceutical drugs and reach faulty conclusions as a result.

The researchers, in Critical Reviews in Food Science and Nutrition, say there’s compelling evidence that the RDA of vitamin C should be raised to 200 milligrams per day for adults, up from its current levels in the United States of 75 milligrams for women and 90 for men.

Rather than just prevent the vitamin C deficiency disease of scurvy, they say, it’s appropriate to seek optimum levels that will saturate cells and tissues, pose no risk, and may have significant effects on public health at almost no expense – about a penny a day if taken as a dietary supplement.

“It’s time to bring some common sense to this issue, look at the totality of the scientific evidence, and go beyond some clinical trials that are inherently flawed,” said Balz Frei, professor and director of the Linus Pauling Institute at Oregon State University, and one of the world’s leading experts on the role of vitamin C in optimum health.

“Significant numbers of people in the U.S. and around the world are deficient in vitamin C, and there’s growing evidence that more of this vitamin could help prevent chronic disease,” Frei said. “The way clinical researchers study micronutrients right now, with the same type of so-called ‘phase three randomized placebo-controlled trials’ used to test pharmaceutical drugs, almost ensures they will find no beneficial effect. We need to get past that.”

Unlike testing the safety or function of a prescription drug, the researchers said, such trials are ill suited to demonstrate the disease prevention capabilities of substances that are already present in the human body and required for normal metabolism. Some benefits of micronutrients in lowering chronic disease risk also show up only after many years or even decades of optimal consumption of vitamin C – a factor often not captured in shorter-term clinical studies.

A wider body of metabolic, pharmacokinetic, laboratory and demographic studies suggests just the opposite, that higher levels of vitamin C could help reduce the chronic diseases that today kill most people in the developed world – heart disease, stroke, cancer, and the underlying issues that lead to them, such as high blood pressure, chronic inflammation, poor immune response and atherosclerosis.

“We believe solid research shows the RDA should be increased,” Frei said. “And the benefit-to-risk ratio is very high. A 200 milligram intake of vitamin C on a daily basis poses absolutely no risk, but there is strong evidence it would provide multiple, substantial health benefits.”

An excellent diet with the recommended five to nine daily servings of fruits and raw or steam-cooked vegetables, together with a six-ounce glass of orange juice, could provide 200 milligrams of vitamin C a day. But most Americans and people around the world do not have an excellent diet.

Even at the current low RDAs, various studies in the U.S. and Canada have found that about a quarter to a third of people are marginally deficient in vitamin C, and up to 20 percent in some populations are severely deficient – including college students, who often have less-than-perfect diets. Smokers and older adults are also at significant risk.

Even marginal deficiency can lead to malaise, fatigue, and lethargy, researchers note. Healthier levels of vitamin C can enhance immune function, reduce inflammatory conditions such as atherosclerosis, and significantly lower blood pressure.
• A recent analysis of 29 human studies concluded that daily supplements of 500 milligrams of vitamin C significantly reduced blood pressure, both systolic and diastolic. High blood pressure is a major risk factor for heart disease and stroke, and directly attributes to an estimated 400,000 deaths annually in the U.S.
• A study in Europe of almost 20,000 men and women found that mortality from cardiovascular disease was 60 percent lower when comparing the blood plasma concentration of vitamin C in the highest 20 percent of people to the lowest 20 percent.
• Another research effort found that men with the lowest serum vitamin C levels had a 62 percent higher risk of cancer-related death after a 12-16 year period, compared to those with the highest vitamin C levels.

Laboratory studies with animals – which may be more accurate than human studies because they can be done in controlled conditions and with animals of identical genetic makeup - can document reasons that could explain all of these findings, Frei said.

Critics have suggested that some of these differences are simply due to better overall diet, not vitamin C levels, but the scientists noted in this report that some health benefits correlate even more strongly to vitamin C plasma levels than fruit and vegetable consumption.

Scientists in France and Denmark collaborated on this report. Research at OSU on these issues has been supported by the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health.

Want to lose weight? Keep a food journal, don't skip meals and avoid going out to lunch

Women who want to lose weight should faithfully keep a food journal, and avoid skipping meals and eating in restaurants – especially at lunch – suggests new research from Fred Hutchinson Cancer Research Center.

The findings by Anne McTiernan, M.D., Ph.D., and colleagues – from the first study to look at the impact of a wide range of self-monitoring and diet-related behaviors and meal patterns on weight change among overweight and obese postmenopausal women – are published online in the Journal of the Academy of Nutrition and Dietetics (formerly the Journal of the American Dietetic Association).

"When it comes to weight loss, evidence from randomized, controlled trials comparing different diets finds that restricting total calories is more important than diet composition such as low-fat versus low-carbohydrate. Therefore, the specific aim of our study was to identify behaviors that supported the global goal of calorie reduction," McTiernan said.

Specifically, McTiernan and colleagues found that:

• Women who kept food journals consistently lost about 6 pounds more than those who did not
• Women who reported skipping meals lost almost 8 fewer pounds than women who did not
• Women who ate out for lunch at least weekly lost on average 5 fewer pounds than those who ate out less frequently (eating out often at all meal times was associated with less weight loss, but the strongest association was observed with lunch)

"For individuals who are trying to lose weight, the No. 1 piece of advice based on these study results would be to keep a food journal to help meet daily calorie goals. It is difficult to make changes to your diet when you are not paying close attention to what you are eating," said McTiernan, director of the Hutchinson Center's Prevention Center and a member of its Public Health Sciences Division.

Study participants were given the following tips for keeping a food journal:

• Be honest – record everything you eat
• Be accurate – measure portions, read labels
• Be complete – include details such as how the food was prepared, and the addition of any toppings or condiments
• Be consistent – always carry your food diary with you or use a diet-tracking application on your smart phone

"While the study provided a printed booklet for the women to record their food and beverage consumption, a food journal doesn't have to be anything fancy," McTiernan said. "Any notebook or pad of paper that is easily carried or an online program that can be accessed any time through a smart phone or tablet should work fine."

In addition to documenting every morsel that passes one's lips, another good weight-loss strategy is to eat at regular intervals and avoid skipping meals. "The mechanism is not completely clear, but we think that skipping meals or fasting might cause you to respond more favorably to high-calorie foods and therefore take in more calories overall," she said. "We also think skipping meals might cluster together with other behaviors. For instance, the lack of time and effort spent on planning and preparing meals may lead a person to skip meals and/or eat out more."

Eating out frequently, another factor associated with less weight loss, may be a barrier for making healthful dietary choices. "Eating in restaurants usually means less individual control over ingredients and cooking methods, as well as larger portion sizes," the authors wrote.

The analysis was based on data from 123 overweight-to-obese, sedentary, Seattle-area women, ages 50 to 75, who were randomly assigned to two arms of a controlled, randomized year-long dietary weight-loss intervention study: diet only and exercise plus diet. Study participants filled out a series of questionnaires to assess dietary intake, eating-related weight-control strategies, self-monitoring behaviors and meal patterns. They were also asked to complete a 120-item food-frequency questionnaire to assess dietary change from the beginning to the end of the study.

At the end of the study, participants in both arms lost an average of 10 percent of their starting weight, which was the goal of the intervention.

"We think our findings are promising because it shows that basic strategies such as maintaining food journals, eating out less often and eating at regular intervals are simple tools that postmenopausal women – a group commonly at greater risk for weight gain – can use to help them lose weight successfully," McTiernan said.

Moderate alcohol consumption helps prevent bone loss

Drinking a moderate amount of alcohol as part of a healthy lifestyle may benefit women's bone health, lowering their risk of developing osteoporosis.

A new study assessed the effects of alcohol withdrawal on bone turnover in postmenopausal women who drank one or two drinks per day several times a week. Researchers at Oregon State University measured a significant increase in blood markers of bone turnover in women after they stopped drinking for just two weeks.

Bones are in a constant state of remodeling with old bone being removed and replaced. In people with osteoporosis, more bone is lost than reformed resulting in porous, weak bones. About 80 percent of all people with osteoporosis are women, and postmenopausal women face an even greater risk because estrogen, a hormone that helps keep bone remodeling in balance, decreases after menopause.

Past studies have shown that moderate drinkers have a higher bone density than non-drinkers or heavy drinkers, but these studies have provided no explanation for the differences in bone density. Alcohol appears to behave similarly to estrogen in that it reduces bone turnover, the researchers said.

In the current study, published online July 11 in the journal Menopause, researchers in OSU's Skeletal Biology Laboratory studied 40 early postmenopausal women who regularly had one or two drinks a day, were not on any hormone replacement therapies, and had no history of osteoporosis-related fractures.

The researchers found evidence for increased bone turnover – a risk factor for osteoporotic fractures – during the two week period when the participants stopped drinking. Even more surprising: the researchers found that less than a day after the women resumed their normal drinking, their bone turnover rates returned to previous levels.

"Drinking moderately as part of a healthy lifestyle that includes a good diet and exercise may be beneficial for bone health, especially in postmenopausal women," said Urszula Iwaniec, associate professor in the College of Public Health and Human Sciences at OSU and one of the study's authors. "After less than 24 hours to see such a measurable effect was really unexpected."

Iwaniec, OSU's Skeletal Biology Laboratory director Russell Turner, and researcher Gianni Maddalozzo assisted OSU alumna Jill Marrone with the study, which was Marrone's master's thesis.

This study is important because it suggests a cellular mechanism for the increased bone density often observed in postmenopausal women who are moderate drinkers, Turner said.

The researchers said many of the medications to help prevent bone loss are not only expensive, but can have unwanted side effects. While excessive drinking has a negative impact on health, drinking a glass of wine or beer regularly as part of a healthy lifestyle may be helpful for postmenopausal women.

"Everyone loses bone as they age, but not everyone develops osteoporosis," Turner said. "Being able to identify factors, such as moderate alcohol intake, that influence bone health will help people make informed lifestyle choices."

Pancreatic Cancer Risk Lowered By Exposure To Sun

According to a study presented by Rachel Neale, Ph.D. at the American Association for Cancer Research's Pancreatic Cancer: Progress and Challenges conference in June, the risk of pancreatic cancer is decreased in individuals with a history of skin cancer, as well as in those born in a location with high levels of ultraviolet radiation and in people whose skin is sensitive to sun.

Rachel Neale, Ph.D., from Australia's Queensland Institute of Medical Research led the population-based, case-control study, which adds to existing conflicting data about sun exposure, vitamin D gained from sun exposure and the risk of cancer. Neale's study results support existing ecological data, which suggests that sun exposure has a protective effect against pancreatic cancer.

Neale commented:

"Several ecological studies, including one conducted in Australia, have suggested that people living in areas with high sun exposure have lower risk for pancreatic cancer. However, some studies of circulating vitamin D indicate that people with high vitamin D are at increased risk, and one study of vitamin D intake supports this increased risk."



The study was conducted between 2007 and 2011 and involved 714 Australians from Queensland, who were matched to 709 controls in terms of age and sex. The team questioned all participants regarding their socio-demographic information and medical history, as well as about their birth location, history of skin cancer and skin type in terms of skin color, risk of sunburn sunburn and tanning ability.

The team then assigned the appropriate ultraviolet radiation level to each birth location using NASA's Total Ozone Mapping Spectrometer, and divided them into three categories based on the level of radiation.

They found that the risk for pancreatic cancer was 24% lower in those born in areas with the highest levels of ultraviolet radiation as compared with those born in areas of low ultraviolet radiation.

Despite the fact that all skin types have a considerable link of being at risk for pancreatic cancer, they discovered that those with the most sun-sensitive skin had a 49% lower risk than those with the least sun-sensitive skin. In addition, the risk of pancreatic cancer was 40% lower in participants with a history of skin cancer or other sun-related skin lesions compared with those who had not reported skin lesions.

Neale declared:

"There is increasing interest in the role of sun exposure, which has been largely attributed to the effect of vitamin D, on cancer incidence and mortality. It is important that we understand the risks and benefits of sun exposure because it has implications for public health messages about sun exposure, and possibly about policy related to vitamin D supplementation or food fortification."

Neale suggests that large cohort studies are needed in the future, which measure sun exposure and vitamin D levels more comprehensively. She concludes: "There are several trials of vitamin D that are either under way or planned, and pooling data from these might give some clue about vitamin D and pancreatic cancer."

Cranberry products associated with prevention of urinary tract infections

Use of cranberry-containing products appears to be associated with prevention of urinary tract infections in some individuals, according to a study that reviewed the available medical literature and was published by Archives of Internal Medicine, a JAMA Network publication.

Urinary tract infections (UTIs) are common bacterial infections and adult women are particularly susceptible. Cranberry-containing products have long been used as a "folk remedy" to prevent the condition, according to the study background.

Chih-Hung Wang, M.D., of National Taiwan University Hospital and National Taiwan University College of Medicine, and colleagues reviewed the available medical literature to reevaluate cranberry-containing products for the prevention of UTI.

"Cranberry-containing products tend to be more effective in women with recurrent UTIs, female populations, children, cranberry juice drinkers, and people using cranberry-containing products more than twice daily," the authors note.

The authors identified 13 trials, including 1,616 individuals, for qualitative analysis and 10 of these trials, including 1,494 individuals, were included in quantitative analysis. The random-effects pooled risk ratio for cranberry users vs. nonusers was 0.62, according to the study results.

"In conclusion, the results of the present meta-analysis support that consumption of cranberry-containing products may protect against UTIs in certain populations. However, because of the substantial heterogeneity across trials, this conclusion should be interpreted with great caution," the authors conclude.

Cutting daily sitting time to under 3 hours might extend life by 2 years

And watching TV for less than 2 hours a day might add extra 1.4 years

Restricting the amount of time spent seated every day to less than 3 hours might boost the life expectancy of US adults by an extra 2 years, indicates an analysis of published research in the online journal BMJ Open.

And cutting down TV viewing to less than 2 hours every day might extend life by almost 1.4 years, the findings suggest.

Several previous studies have linked extended periods spent sitting down and/or watching TV to poor health, such as diabetes and death from heart disease/stroke.

The researchers used data collected for the National Health and Nutrition Examination Survey (NHANES) for 2005/6 and 2009/10, to calculate the amount of time US adults spent watching TV and sitting down on a daily basis.

NHANES regularly surveys a large representative sample of the US population on various aspects of their health and lifestyle.

They trawled the research database MEDLINE, looking for published studies on sitting time and deaths from all causes, and pooled the different relative risk data from the five relevant studies, involving almost 167,000 adults. The database was then reanalysed, taking account of age and sex.

They combined these data and the NHANES figures to come up with a population attributable fraction (PAF) - an estimate of the theoretical effects of a risk factor at a population, rather than an individual level - to calculate the number of deaths associated with time spent sitting down.

The PAFs for deaths from all causes linked to sitting time and TV viewing were 27% and 19%, respectively.

The results of life table analyses indicates that cutting the amount of time spent sitting down every day to under three hours would add an extra two years to life expectancy.

Similarly, restricting time spent watching TV to under two hours daily would extend life expectancy by an extra 1.38 years.

The authors emphasise that their analysis assumes a causal association rather than proving that there is one. But they point to the evidence showing the detrimental effect of a sedentary lifestyle on health.

And they caution that their findings should not be interpreted as meaning that someone who leads a more sedentary lifestyle can expect to live two or 1.4 years less than someone who is more active.

"The results of this study indicate that extended sitting time and TV viewing may have the potential to reduce life expectancy in the USA," they write.

"Given that the results from objective monitoring of sedentary time in NHANES has indicated that adults spend an average of 55% of their day engaged in sedentary pursuits, a significant shift in behaviour change at the population level is required to make demonstrable improvements in life expectancy," they conclude.

Further research will be required before recommendations on safe levels of sedentary behaviour can be made, they add.

Rice can be part of a healthy diet

Rice consumers concerned about reports that rice is linked to diabetes can rest assured that rice can be part of a healthy diet, with scientists finding that the glycemic index (GI) of rice varies a lot from one type of rice to another, with most varieties scoring a low to medium GI.

The findings of the research, which analyzed 235 types of rice from around the world, is good news because it not only means rice can be part of a healthy diet for the average consumer, but it also means people with diabetes, or at risk of diabetes, can select the right rice to help maintain a healthy, low-GI diet.

The study found that the GI of rice ranges from a low of 48 to a high of 92, with an average of 64.

The research team from the International Rice Research Institute (IRRI) and Australia's Commonwealth Scientific and Industrial Research Organisation (CSIRO) Food Futures Flagship also identified the key gene that determines the GI of rice, an important achievement that offers rice breeders the opportunity to develop varieties with different GI levels to meet consumer needs. Future development of low-GI rice would also enable food manufacturers to develop new, low-GI food products based on rice. Dr. Melissa Fitzgerald, who led the IRRI team, said that GI is a measure of the relative ability of carbohydrates in foods to raise blood sugar levels after eating.

"Understanding that different types of rice have different GI values allows rice consumers to make informed choices about the sort of rice they want to eat," she said. "Rice varieties such as India's most widely grown rice variety, Swarna, have a low GI and varieties such as Doongara from Australia and Basmati have a medium GI."

Dr. Tony Bird, CSIRO Food Futures Flagship researcher, said that low-GI diets offer a range of health benefits: "Low-GI diets can reduce the likelihood of developing type 2 diabetes, and are also useful for helping diabetics better manage their condition.

"This is good news for diabetics and people at risk of diabetes who are trying to control their condition through diet, as it means they can select the right rice to help maintain a healthy, low-GI diet," he added.

Low-GI foods are those measured 55 and less, medium-GI foods are those measured between 56 and 69, while high-GI foods measure 70 and above.

When food is measured to have a high GI, it means it is easily digested and absorbed by the body, which often results in fluctuations in blood sugar levels that can increase the chances of getting diabetes, and make management of type 2 diabetes difficult.

Conversely, foods with low GI are those that have slow digestion and absorption rates in the body, causing a gradual and sustained release of sugar into the blood, which has been proven beneficial to health, including reducing the chances of developing diabetes.

Eating rice with other foods can help reduce the overall GI of a meal and, when combined with regular exercise, can reduce the chances of getting diabetes. In addition, people who exercise need more carbohydrates in their diet and can take advantage of low-GI foods for sustained activity.

Rice plays a strong role in global food security. Being the staple for about 3.5 billion people, it is important to maximize the nutritional value of rice. Low-GI rice will have a particularly important role in the diets of people who derive the bulk of their calories from rice and who cannot afford to eat rice with other foods to help keep the GI of their diet low. Low-GI rice could help to keep diabetes at bay in these commu

Iron supplements can reduce fatigue in nonanemic women

Iron supplementation reduced fatigue by almost 50% in women who are low in iron but not anemic, according to the results of a clinical trial published July 9 in CMAJ (Canadian Medical Association Journal).

"We found that iron supplementation for 12 weeks decreased fatigue by almost 50% from baseline, a significant difference of 19% compared with placebo, in menstruating iron-deficient nonanemic women with unexplained fatigue and ferritin levels below 50 _g/L," writes Dr. Bernard Favrat, Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland, with coauthors.

The study, a randomized controlled trial involving 198 menstruating women between the ages of 18 and 50 years, included daily oral supplements of 80 mg of prolonged-release ferrous sulfate as well as placebo. The trial was double-blinded, meaning neither the participants nor the health care providers knew which group was receiving the supplement versus placebo.

Fatigue is common in patients in primary care practices, with 14% to 27% suffering from fatigue and 1% to 2% of visits specifically for fatigue. Women are three times more likely than men to report fatigue. Positive effects on hemoglobin, ferritin and other blood levels were evident as early as six weeks after iron supplementation.

The authors note that iron did not affect anxiety or depression scores or quality-of-life indicators such as physical and psychological performance.

"Iron deficiency may be an under-recognized cause of fatigue in women of child-bearing age," write the authors. "If fatigue is not due to secondary causes, the identification of iron deficiency as a potential cause may prevent inappropriate attribution of symptoms to putative emotional causes or life stressors, thereby reducing the unnecessary use of health care resources, including inappropriate pharmacologic treatments," conclude the authors.

Above-Normal Weight Alone Does Not Necessarily Increase Short-Term Risk of Death

An evaluation of national data by UC Davis researchers has found that extra weight is not necessarily linked with a higher risk of death.

When compared to those with normal weight, people who were overweight or obese had no increased risk of death during a follow-up period of six years. People who were severely obese did have a higher risk, but only if they also had diabetes or hypertension.

The findings, which appear in the July-August issue of The Journal of American Board of Family Medicine, call into question previous studies -- using data collected when obesity was less common -- linking higher short-term mortality with any amount of extra weight.

"There is currently a widespread belief that any degree of overweight or obesity increases the risk of death, however our findings suggest this may not be the case," said Anthony Jerant, professor of family and community medicine and lead author of the study. "In the six-year timeframe of our evaluation, we found that only severe obesity was associated with an increased risk of death, due to co-occurring diabetes and hypertension."

Based on the study, Jerant recommends that doctors' conversations with patients who are overweight or obese, but not severely obese, focus on the known negative effects of these conditions on mental and physical functioning, rather than on an increased short-term risk of death.

By contrast, Jerant added that it is important for doctors to talk with severely obese patients who also have diabetes or hypertension about their increased short-term mortality risk and treatment, including weight loss.

"Our results do not mean that being overweight or obese is not a threat to individual or public health," said Jerant. "These conditions can have a significant impact on quality of life, and for this reason alone weight loss may be advisable."

In conducting the study, Jerant used nationwide data from 2000 to 2005 of nearly 51,000 adults aged 18 to 90 years who participated in the Medical Expenditure Panel Surveys on health-care utilization and costs. The surveys include information on health conditions such as diabetes and hypertension.

Body mass index (BMI), or weight adjusted for height, was calculated for each respondent. The study categorized people as underweight (BMI < 20), normal weight (BMI 20 to < 25), overweight (BMI 25 to < 30), obese (BMI 30 to 35) or severely obese (BMI > 35).

Mortality was assessed using the National Death Index. Of the 50,994 people included in the UC Davis analysis, just over 3 percent (1,683) died during the six years of follow-up.

The investigators found that severely obese people were 1.26 times more likely to die during follow-up than people in the normal weight group. However, if people with diabetes or hypertension were eliminated from the data, those who were overweight, obese or even severely obese had similar or even lower death rates than people of normal weight. Consistent with a number of prior studies, underweight people were nearly twice as likely to die than people with normal weight, regardless of whether diabetes or hypertension was present.

The prevalence of overweight and obesity has increased dramatically in recent decades. An estimated one-third of all U.S. adults over age 20 are obese and another one-third are overweight. In addition to diabetes and hypertension, health problems associated with these conditions include heart disease, osteoarthritis and sleep apnea.

The relationship between weight and mortality is a controversial topic in public health. Although studies based on data collected 30 years ago showed that mortality risk rose as weight increased, analyses of more recently collected data, including the current one, call this assumption into question.

"Our findings indicate that the risk of having an above-normal BMI may be lower than in the past," said Jerant. "While this study cannot explain the reasons, it is possible that as overweight and obesity have become more common, physicians have become more aware of associated health issues like high blood pressure, cholesterol and blood sugar, and are more aggressive about early detection and treatment of these conditions."

Jerant said that the six-year period of his investigation limits the ability to make assumptions about the link between unhealthy weight and the risk of death over a longer timeframe.

"We hope our findings will trigger studies that re-examine the relationship of being overweight or obese with long-term mortality," said Jerant.

Vitamin D Supplementation Effective In Fracture Risk Reduction In Older Adults

Based on the results of a pooled analysis of 11 unrelated randomized clinical trials investigating vitamin D supplementation and fracture risk in more than 31,000 older adults, Bess Dawson-Hughes, MD, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University, says higher doses of Vitamin D may be the most beneficial in reducing bone fractures in this age group.

As part of the study, published in The New England Journal of Medicine, Dawson-Hughes and colleagues divided the subjects into quartiles ranging from 0 to 2,000 International Units (IUs) of daily vitamin D intake. The top quartile sustained 30% fewer hip fractures and 14% fewer fractures of other bones compared to the control groups.

"Taking between 800 IUs and 2,000 IUs of vitamin D per day significantly reduced the risk of most fractures, including hip, wrist and forearm in both men and women age 65 and older," said Dawson-Hughes, the study's senior author. "Importantly, we saw there was no benefit to taking Vitamin D supplements in doses below 800 IUs per day for fracture prevention."

Dawson-Hughes and colleagues analyzed each participant's vitamin D supplementation within and independent of the study protocol, controlling for age, vitamin D blood levels at baseline, additional calcium supplementation and whether the person lived independently or under medical care.

"Evaluation of individual-level data is the gold-standard of meta-analysis," said lead author Heike Bischoff-Ferrari, MD, D.Ph., director of the Centre on Aging and Mobility at the University of Zurich and Waid City Hospital and a visiting scientist in the Bone Metabolism Laboratory at the USDA HNRCA. "Our results make a compelling contribution to the existing data on Vitamin D and fracture risk in men and women age 65 and older, whose vulnerability to bone density loss and osteoporosis leave them prone to fractures resulting from thinning bones."

The current Dietary Reference Intake (DRI) for vitamin D in older adults set by the Institute of Medicine (IOM) is a minimum of 600 IUs per day for adults between 51 and 70 years-old and 800 IUs in adults over 70.

"Vitamin D supplementation is an efficient intervention for a costly injury that affects thousands of older adults each year," said Dawson-Hughes, who is also a professor at Tufts University School of Medicine. "The average recovery is long and painful and deeply impacts quality of life. After a fracture, older patients may only regain partial mobility, resulting in a loss of independence that is personally demoralizing and that can place added stress on family members and caregivers"

Financially, Vitamin D supplements cost pennies a day, Dawson-Hughes said, whereas the American Academy of Orthopaedic Surgeons estimated the cost of treating a hip fracture was $26,912 in 2007.

Dawson-Hughes adds that older adults, unless they are exposed to bright, year-round sunlight, require supplementation to meet their vitamin D needs. Typically, adults consume 150 IUs per day from food sources such as tuna or salmon or fortified milk. On average, multivitamins contain 400 IUs of vitamin D and there are individual vitamin D supplements with 400, 800 or 1,000 IUs. While vitamin D toxicity is rare, the IOM suggests capping intake at 4,000 IUs per day.

Dawson-Hughes said the results of the current study would be strengthened by large interventional trials investigating the impact of vitamin D supplementation on fracture risk. She and the authors also call for further investigation of the impact of combining calcium supplementation with high doses of vitamin D, as their data was inconclusive.

Vitamin D's Potential to Reduce the Risk of Hospital-Acquired Infections

A paper recently published in Dermato-Endocrinology [Youssef et al., 2012] indicates that raising vitamin D concentrations among hospital patients has the potential to greatly reduce the risk of hospital-acquired infections. Hospital-acquired infections (HAIs) are a leading cause of death in the US health care arena, with an overall estimated annual incidence of 1.7 million cases and 100,000 deaths. HAIs in US hospitals generate an estimated $28.4 billion–$45 billion in excess health care costs annually. Patients are often vitamin D deficient since many diseases such as cancer, cardiovascular disease, and respiratory infections are linked to low vitamin D concentrations.

Pneumonia is the most likely HAI, followed by bacteremias, urinary tract infections, surgical site infections, sepsis, and others.

Vitamin D plays an important antimicrobial role. Among the antimicrobial actions are reducing local and systemic inflammatory responses as a result of modulating cytokine responses and reducing Toll-like receptor activation and stimulating the expression of potent antimicrobial peptides, such as cathelicidin and _-defensin 2. Cathelicidins are a family of peptides thought to provide an innate defensive barrier against a variety of potential microbial pathogens, such as gram-positive and gram-negative bacteria, fungi, and mycobacteria, at multiple entry sites, including skin and mucosal linings of the respiratory and gastrointestinal systems, as well as some viruses.

One of the advantages of vitamin D in combating HAIs is that it strengthens the innate immune response, thus overcoming the antibiotic resistance of many bacteria encountered in hospitals.

Optimal vitamin D concentrations are at least 30-40 ng/ml (75-100 nmol/l). The average white American has a concentration of 26 ng/ml, while the average African-American has only 16 ng/ml. Vitamin D concentrations have fallen in the past 20 years, in part due to spending less time out-of-doors. About half of those admitted to hospitals have concentrations below 20 ng/ml, thus making them more susceptible to HAIs. Raising vitamin D concentrations would reduce the rate of diseases such as many types of cancer, cardiovascular disease, hip fractures, and respiratory infections, thereby reducing the rate of hospital admissions as well as HAIs once admitted.

In an accompanying editorial, David McCarthy, M.D. outlined what hospitals could do to overcome vitamin D deficiency among hospital patients. Among these recommendations is making high-dose vitamin D3 (5,000 and 50,000 IU) capsules available to the patients.

Coffee consumption lowers risk of most common form of skin cancer

Increasing the number of cups of caffeinated coffee you drink could lower your risk of developing the most common form of skin cancer, basal cell carcinoma, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.

"Our data indicate that the more caffeinated coffee you consume, the lower your risk of developing basal cell carcinoma," said Jiali Han, Ph.D., associate professor at Brigham and Women's Hospital, Harvard Medical School in Boston and Harvard School of Public Health.

"I would not recommend increasing your coffee intake based on these data alone," said Han. "However, our results add basal cell carcinoma to a list of conditions for which risk is decreased with increasing coffee consumption. This list includes conditions with serious negative health consequences such as type 2 diabetes and Parkinson's disease."

Basal cell carcinoma is the form of skin cancer most commonly diagnosed in the United States. Even though it is slow-growing, it causes considerable morbidity and places a burden on health care systems.

"Given the large number of newly diagnosed cases, daily dietary changes having any protective effect may have an impact on public health," said Han.

Han and his colleagues generated their results by conducting a prospective analysis of data from the Nurses' Health Study, a large and long-running study to aid in the investigation of factors influencing women's health, and the Health Professionals Follow-up Study, an analogous study for men.

Of the 112,897 participants included in the analyses, 22,786 developed basal cell carcinoma during the more than 20 years of follow-up in the two studies. An inverse association was observed between all coffee consumption and risk of basal cell carcinoma. Similarly, an inverse association was seen between intake of caffeine from all dietary sources (coffee, tea, cola and chocolate) and risk of basal cell carcinoma. However, consumption of decaffeinated coffee was not associated with a decreased risk of basal cell carcinoma.