Chocolate: A sweet method for stroke prevention in men?

Eating a moderate amount of chocolate each week may be associated with a lower risk of stroke in men, according to a new study published in the August 29, 2012, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"While other studies have looked at how chocolate may help cardiovascular health, this is the first of its kind study to find that chocolate, may be beneficial for reducing stroke in men," said study author Susanna C. Larsson, PhD, with the Karolinska Institute in Stockholm, Sweden.

For the study, 37,103 Swedish men ages 49 to 75 were given a food questionnaire that assessed how often they consumed various foods and drinks and were asked how often they had chocolate. Researchers then identified stroke cases through a hospital discharge registry. Over 10 years, there were 1,995 cases of first stroke.

Men in the study who ate the largest amount of chocolate, about one-third of a cup of chocolate chips (63 grams), had a lower risk of stroke compared to those who did not consume any chocolate. Those eating the highest amount of chocolate had a 17-percent lower risk of stroke, or 12 fewer strokes per 100,000 person-years compared to those who ate no chocolate. Person-years is the total number of years that each participant was under observation.

In a larger analysis of five studies that included 4,260 stroke cases, the risk of stroke for individuals in the highest category of chocolate consumption was 19 percent lower compared to non-chocolate consumers. For every increase in chocolate consumption of 50 grams per week, or about a quarter cup of chocolate chips, the risk of stroke decreased by about 14 percent.

"The beneficial effect of chocolate consumption on stroke may be related to the flavonoids in chocolate. Flavonoids appear to be protective against cardiovascular disease through antioxidant, anti-clotting and anti-inflammatory properties. It's also possible that flavonoids in chocolate may decrease blood concentrations of bad cholesterol and reduce blood pressure," said Larsson.

"Interestingly, dark chocolate has previously been associated with heart health benefits, but about 90 percent of the chocolate intake in Sweden, including what was consumed during our study, is milk chocolate," Larsson added.

Daily Aspirin May Help Fight Prostate Cancer, But Not Breast Cancer

Two new studies paint a complex portrait of aspirin's impact on cancer risk and mortality, with one suggesting the drug may lower the risk of dying from prostate cancer and the other seeing no significant drop in the risk for developing breast cancer.

"These were different types of studies," explained Dr. Stanley Liauw, author of the prostate cancer study and an associate professor in the department of radiation and cellular oncology at the University of Chicago Medical Center. "The breast cancer group was looking at how aspirin might affect new formations of cancer, while we looked at how it might inhibit cancer progression."

"And we're also talking about different disease sites," he added, "which may involve different pathways. So, it's possible that aspirin might affect these pathways differently."

"But there is some rationale, based on previous research, for why we might expect to see an aspirin benefit," Liauw added. "And for our study looking at prostate cancer death we actually saw a pretty dramatic effect."

Both findings are published online Aug. 27 in the Journal of Clinical Oncology.

The breast cancer research team, led by Dr. Xuehong Zhang, an instructor in medicine at Brigham and Women's Hospital in Boston, pointed out that the disease is the most frequently diagnosed cancer among American women.

With previous research suggesting that routine aspirin and/or nonsteroidal anti-inflammatory drug (NSAID) use reduced the risk for colon cancer (some of which was conducted by Zhang's team), the Harvard researchers set out to see whether either might have a similar impact on breast cancer.

Between 1980 and 2008, the team tracked nearly 85,000 postmenopausal women, all of whom were working as registered nurses when the study first launched.

Nearly every two years, the women completed questionnaires on their medical histories and lifestyle. All were asked about their routine use of aspirin and/or other NSAIDS.

Over the course of three decades, more than 4,700 of the women developed some form of invasive breast cancer. Yet, Zhang's team found that neither regular aspirin nor other NSAIDs had any significant impact on overall breast cancer risk, regardless of how much they were used.

Meanwhile, Liauw and his team explored the potential benefit of aspirin use among nearly 6,000 men diagnosed with, and undergoing treatment for, prostate cancer.

The men were drawn from 41 different health centers across the United States, and all had undergone either surgery (radical prostatectomy) or radiotherapy.

The team noted that 37 percent of the patients were already taking some type of anticoagulant (aspirin, warfarin (Coumadin), clopidogrel (Plavix), and/or enoxaparin). No aspirin or other anticoagulant was prescribed once the study began.

After more than 10 years of follow-up, the team found that among those taking some type of anticoagulant, the risk of dying from prostate cancer was significantly lower than it was among those not taking one.

Further analysis revealed that most of the benefit came from aspirin use, which Liauw said was responsible for a 57 percent reduction in the risk of prostate cancer death.

Because dosage information was not collected, no conclusions could be drawn about exactly how much aspirin was most beneficial. However, the team noted that the protective effect was strongest among patients with particularly "high-risk" disease.

Both study teams said that more research is needed to confirm their respective findings. And neither study proved a cause-and-effect relationship between aspirin use and its effect on cancer.

"So, at this point, this is just hypothesis-generating," Liauw said. "It may be true, but it needs to be tested more formally."

Zhang added that although aspirin showed little benefit with respect to breast cancer risk, he doesn't see any cancer-related downside to their long-term use. However, for women seeking to reduce their breast cancer risk, "the best strategies remain to maintain an ideal weight, exercise, avoid long-term use of postmenopausal hormones, and minimize alcohol intake," he noted.

Two experts who wrote an accompanying editorial in the journal suggested that aspirin might make a difference among very specific subgroups of people.

"When looking at aspirin's impact on breast cancer risk, looking at all-comers and including all sorts of people who take anti-inflammatory drugs for all sorts of reasons might miss the kernel," said editorial lead author Dr. Clifford Hudis, chief of the breast cancer medicine service at Memorial Sloan-Kettering Cancer Center, in New York City. "That is to say that there may very well be a subset of people for whom taking aspirin can be of protective benefit "

"But," he added, "the answer always is and remains that you should talk to your doctor about this before deciding to take or not take anything, including aspirin, because none of these studies prove anything definitively one way or another."

Editorial co-author Dr. Andrew Dannenberg, director of the Weill Cornell Cancer Center, agreed.

"It continues to seem to me that aspirin does have a use for reducing the risk for certain cancers," he said. "However, aspirin also has side effects -- peptic ulcer disease and hemorrhagic stroke, which are real diseases. And therefore I'm still reluctant at this time to make specific recommendations that people take aspirin for the prevention for cancer. And I believe that prospective trials that better define dose and duration are required before anyone should make definitive recommendations for the use of aspirin in this context."

Sudden death less likely in exercise related cardiac arrests

People who have a cardiac arrest during or shortly after exercise are three times more likely to survive than those who have a cardiac arrest that is not exercise related, according to research presented at the ESC Congress 2012 today, August 26. The findings from the Amsterdam Resuscitation Study (ARREST) were presented by Dr Arend Mosterd from the Netherlands.

"Although physical activity is the best way to promote cardiovascular health, exercise can also trigger an acute cardiac event leading to death," said Dr Mosterd. "These dramatic and often high profile events, for example in soccer players, invariably lead to concerns and cast a shadow over the overwhelmingly positive effects of regular exercise."

The ARREST research group maintains a prospective database of all resuscitation efforts in the greater Amsterdam area (i.e. the Dutch province of North Holland, covering approximately 2671 km2 and a population of 2.4 million). In case of a medical emergency in the Netherlands, one dials the national emergency number (112), where an operator connects the call to a regional ambulance dispatch center. If a cardiac arrest is suspected, the dispatcher sends out two ambulances of a single tier. The standard Emergency Medical System consists of ambulances manned by a team equipped with a manual defibrillator (a). Also, the dispatcher sends out a first responder – fire fighters or police officers – equipped with an automated external defibrillator (AED) (b). Many public areas like supermarkets, sport centers and office buildings have an AED onsite. Trained lay rescuers can attach this AED prior to arrival of the dispatched first responders or ambulance team.

The researchers used data from ARREST to determine the occurrence and prognosis of exercise related out of hospital cardiac arrests (OHCA) in the greater Amsterdam area from 2006 to 2009. The number of exercise related OHCAs was low at just 48 per year, which equated to 5.8% of all OHCAs.

During the 3 year study period, 145 of the 2,517 OHCAs were in people who were exercising during or within 1 hour before the arrest, predominantly bicycling (n = 49), tennis (n = 22), workouts at the gym (n = 16) and swimming (n = 13). Only 10 of the 145 exercise related OHCAs were in women. Just 7 (including 1 woman) exercise related OHCAs occurred in subjects aged 35 years or younger.

Almost half (65) of the 145 patients who had an exercise related OHCA survived the event. Patients suffering an exercise related OHCA had a much better prognosis better prognosis (45% survival) than cardiac arrests that were not exercise related (15% survival) (see table 1).

"Patients persons suffering an exercise related OHCA are three times more likely to survive the event than persons whose arrest is not exercise related," said Dr Mosterd. "None of the survivors of exercise related OHCA suffered serious neurologic damage, which was not the case for those surviving a non exercise related OHCA."

Patients who had an exercise related OHCA were younger (mean age 58.8 ± 13.6 vs 65.5 ± 15.8) and more likely to be male (93.1% vs 71.9%) than those whose arrest was not exercise related. In addition, exercise related OHCAs occurred more frequently in public places (99.3% vs 25.3%), were more frequently witnessed (89.0% vs 75.7%) and had higher rates of bystander cardiopulmonary resuscitation (CPR) (86.2% vs 64.4%) and AED (35.2% vs 22.2%) use.

Dr Mosterd said: "The remarkably good survival of victims of exercise related out of hospital cardiac arrest can partially be ascribed to the fact that they are younger and more likely to suffer the arrest in a public location, leading to bystander cardiopulmonary resuscitation, often with the use of an automated external defibrillator. Taking these factors into account exercise per se also contributes to a better outcome."

The only other prospective study of sports related OHCA and sudden death in the general population to date was conducted in France (1). "The survival rate to hospital discharge of exercise related OHCA victims was three times higher in our study group than was observed in the French study (45% vs 16%)," said Dr Mosterd. "As most exercise related events are bystander witnessed (89% in the Netherlands vs 93% in France) the most likely explanation for the remarkably better survival in the Netherlands relates to the high rate of initiation of bystander CPR (86%) compared to 31% in France. It is of note that the highest survival rates (around 50%) in France are found in two regions where bystanders initiated CPR in 90% of cases (compared to 86% in our population)."

Dr Mosterd continued: "More research is needed to determine why, after taking into account favourable factors such as age, location of the event and initiation of CPR, persons who exercise during or shortly before having a cardiac arrest still have a better prognosis than people who have a cardiac arrest that is unrelated to exercise."

He added: "The number of exercise related out of hospital cardiac arrests in the general population is low, particularly in women and in those aged 35 years or younger. We demonstrated for the first time that cardiac arrests occurring during or shortly after exercise carry a markedly better prognosis (45% survival) than cardiac arrests that are not exercise related (15% survival)."

Dr Mosterd concluded: "Prompt bystander initiation of CPR with the use of an AED is likely to be the key to improving outcome, an observation that should have direct implications for public health programmes aimed at preventing exercise related sudden death."

Midlife fitness staves off chronic disease at end of life, UT Southwestern researchers report

Being physically fit during your 30s, 40s, and 50s not only helps extend lifespan, but it also increases the chances of aging healthily, free from chronic illness, investigators at UT Southwestern Medical Center and The Cooper Institute have found.

For decades, research has shown that higher cardiorespiratory fitness levels lessen the risk of death, but it previously had been unknown just how much fitness might affect the burden of chronic disease in the most senior years – a concept known as morbidity compression.

"We've determined that being fit is not just delaying the inevitable, but it is actually lowering the onset of chronic disease in the final years of life," said Dr. Jarett Berry, assistant professor of internal medicine and senior author of the study available online in the Archives of Internal Medicine.

Researchers examined the patient data of 18,670 participants in the Cooper Center Longitudinal Study, research that contains more than 250,000 medical records maintained over a 40-year span. These data were linked with the patients' Medicare claims filed later in life from ages 70 to 85. Analyses during the latest study showed that when patients increased fitness levels by 20 percent in their midlife years, they decreased their chances of developing chronic diseases – congestive heart failure, Alzheimer's disease, and colon cancer – decades later by 20 percent.

"What sets this study apart is that it focuses on the relationship between midlife fitness and quality of life in later years. Fitter individuals aged well with fewer chronic illnesses to impact their quality of life," said Dr. Benjamin Willis of The Cooper Institute, first author on the study.

This positive effect continued until the end of life, with more-fit individuals living their final five years of life with fewer chronic diseases. The effects were the same in both men and women.

These data suggest that aerobic activities such as walking, jogging, or running translates not only into more years of life but also into higher quality years, compressing the burden of chronic illness into a shorter amount of time at the end of life, Dr. Berry said.

According to the National Heart, Lung, and Blood Institute (NHLBI), adults should get at least 2 _ hours of moderate to intense aerobic activity each week to ensure major heart and overall health benefits.

Nutrition tied to improved sperm DNA quality in older men

A new study led by scientists from the U.S. Department of Energy's Lawrence Berkeley National Laboratory (Berkeley Lab) found that a healthy intake of micronutrients is strongly associated with improved sperm DNA quality in older men. In younger men, however, a higher intake of micronutrients didn't improve their sperm DNA.

In an analysis of 80 healthy male volunteers between 22 and 80 years of age, the scientists found that men older than 44 who consumed the most vitamin C had 20 percent less sperm DNA damage compared to men older than 44 who consumed the least vitamin C. The same was true for vitamin E, zinc, and folate.

"It appears that consuming more micronutrients such as vitamin C, E, folate and zinc helps turn back the clock for older men. We found that men 44 and older who consumed at least the recommended dietary allowance of certain micronutrients had sperm with a similar amount of DNA damage as the sperm of younger men," says Andy Wyrobek of Berkeley Lab's Life Sciences Division.

"This means that men who are at increased risk of sperm DNA damage because of advancing age can do something about it. They can make sure they get enough vitamins and micronutrients in their diets or through supplements," adds Wyrobek.

Wyrobek conducted the research with a team of researchers that includes Brenda Eskenazi of the University of California at Berkeley's School of Public Health and scientists from the University of Bradford in the United Kingdom. They report their findings in the August 27 online issue of the journal Fertility and Sterility.

Their research comes as more men over 35 have children, which raises public health concerns. Previous research conducted in Wyrobek's lab found that the older a man is, the more he's likely to have increased sperm DNA fragmentation, chromosomal rearrangements, and DNA strand damage. Older men are also more likely to have increased frequencies of sperm carrying certain gene mutations, such as those leading to dwarfism. These findings help explain why aging men are less fertile and are predicted to have more chromosomally defective pregnancies and a higher proportion of offspring with genetic defects.

But until now, researchers haven't understood whether diet can protect against the detrimental effects of aging on the sperm genome.

The scientists studied a group of about 80 men between 20 and 80 years old with an average age of 44. They were recruited several years ago as part of the California Age and Genetic Effects on Sperm Study when Wyrobek was at Lawrence Livermore National Laboratory. Each man who participated in the study filled out a 100-item questionnaire that estimated their average daily vitamin intake, both from food and supplements.

In addition, their sperm DNA quality was assessed via a lab analysis in which a voltage gradient pulls broken DNA strands from intact strands within the sperm nucleus.

Each volunteer's intake of a micronutrient was classified as low, moderate, or high based on how they compared to other participants. The median daily intake, both from diet and supplements, was 162 milligrams for vitamin C, 23.7 milligrams for vitamin E, 2,586 micrograms for _-carotene, 475 grams for folate, and 12.3 milligrams for zinc. Many participants, even those who reported to be healthy, consumed much less than the recommended dietary allowance for many of the micronutrients.

The scientists analyzed the data several ways and came up with the same result each time: A diet high in antioxidants and micronutrients may decrease the risk of producing sperm with DNA damage, especially in older men.

Why this is so isn't a mystery. Antioxidants scavenge reactive molecules that cause oxidative damage to cells. Studies have shown that dietary supplementation with antioxidants and increased consumption of antioxidant-rich fruits and vegetables can decrease the amount of oxidative DNA damage.

Based on their results, the scientists believe this same protective mechanism may also be at work in the reproductive tract of older men.

"The different response of the old and young men presents new opportunities for health care, especially for older men planning families," says Wyrobek.

More research is needed, however. Although the scientists found a clear link between higher vitamin intake and improved sperm DNA quality in older men, they don't know whether this link extends to male fertility and the health of offspring.

"Our research points to a need for future studies to determine whether increased antioxidant intake in older fathers will improve fertility, reduce risks of genetically defective pregnancies, and result in healthier children," says Wyrobek. "The research also raises a broader question beyond sperm DNA: How might lifestyle factors, including higher intakes of antioxidants and micronutrients, protect somatic as well as germ cells against age-related genomic damage?"

Healthy lifestyle reduces the risk of hypertension by two thirds

Healthy behaviours regarding alcohol, physical activity, vegetable intake and body weight reduce the risk of hypertension by two thirds, according to research presented at the ESC Congress today. The findings were presented by Professor Pekka Jousilahti from National Institute for Health and Welfare.

According to the World Health Organization, hypertension is the leading cause of mortality in the world, contributing annually to over 7 million deaths (about 15% of all deaths). Therefore, prevention of hypertension is essential to improving health and preventing morbidity and mortality, both in developing and developed countries.

The purpose of this study was to examine whether five major cardiovascular disease related lifestyle factors – smoking, alcohol consumption, physical activity, obesity and consumption of vegetables – predict the future increase of blood pressure and development of clinical hypertension, and need for antihypertensive drug treatment.

This large prospective population-based cohort study included 9,637 Finnish men and 11,430 women who were 25 to 74 years of age and free of hypertension during the baseline measurements (1982-2002). Healthy lifestyle factors were defined as: (1) not smoking, (2) alcohol consumption less than 50g per week, (3) leisure time physical activity at least 3 times per week, (4) daily consumption of vegetables, and (5) normal weight (BMI<25kg/m2).

Data on the development of hypertension during the follow-up period were obtained from the Social Insurance Institution of Finland register of people entitled to special reimbursement for antihypertensive drugs. During a mean follow-up of 16 years, 709 men and 890 women developed hypertension.

Smoking was omitted from the final analysis. Professor Jousilahti said: "Even though smoking is a major risk factor for cardiovascular disease, it was not associated with the development of hypertension in our analyses, which is in accordance with previous studies."

The four remaining healthy lifestyle factors were included in the analysis. Hazard ratios for hypertension associated with adherence to 0 (the reference group), 1, 2, 3, and 4 healthy lifestyle factors were calculated after adjusting for age, year of entering the study, education, and smoking.

The hazard ratios for hypertension associated with adherence to 0, 1, 2, 3, and 4 healthy lifestyle factors were 1.00, 0.74, 0.51, 0.34, and 0.33 for men, and 1.00, 0.89, 0.68, 0.41, and 0.37 for women. "The risk of hypertension was only one third among those having all four healthy lifestyle factors compared to those having none," said Professor Jousilahti. "Even having one to three healthy lifestyle factors reduced the risk of hypertension remarkably. For example having two healthy lifestyle factors reduced the risk of hypertension by nearly 50% in men and by more than 30% in women."

"Our analysis suggests that adherence to healthy lifestyle factors may have more of an impact on risk of hypertension in men than women," he added. "This could be because of the stronger association of obesity and alcohol consumption with the risk of hypertension in men than in women."

"Four modifiable lifestyle factors: alcohol consumption, physical activity, consumption of vegetables and keeping normal weight have a remarkable effect on the development of hypertension," said Professor Jousilahti. "Lifestyle modification has a huge public health potential to prevent hypertension. While our research suggests that lifestyle modification may produce greater reductions in hypertension in men than women, it also shows large benefits in women, and adherence to all four healthy lifestyle factors had a nearly similar effect in both sexes. Both men and women should take steps towards a healthier lifestyle to decrease their risk of hypertension."

He concluded: "Our study was focused on prevention of hypertension and therefore included subjects who did not have hypertension at baseline. But the results should apply to the treatment of patients with hypertension, who can reduce their blood pressure by modifying the four lifestyle factors alone, or by making these modifications while taking blood pressure lowering medication.

People of Normal Weight With Belly Fat at Highest Death Risk

People who are of normal weight but have fat concentrated in their bellies have a higher death risk than those who are obese, according to Mayo Clinic research presented today at the European Society of Cardiology Congress in Munich. Those studied who had a normal body mass index but central obesity — a high waist-to-hip ratio — had the highest cardiovascular death risk and the highest death risk from all causes, the analysis found.

"We knew from previous research that central obesity is bad, but what is new in this research is that the distribution of the fat is very important even in people with a normal weight," says senior author Francisco Lopez-Jimenez, M.D., a cardiologist at Mayo Clinic in Rochester. "This group has the highest death rate, even higher than those who are considered obese based on body mass index. From a public health perspective, this is a significant finding."

The study included 12,785 people 18 and older from the Third National Health and Nutrition Examination Survey, a representative sample of the U.S. population. The survey recorded body measurements such as height, weight, waist circumference and hip circumference, as well as socioeconomic status, comorbidities, and physiological and laboratory measurements. Baseline data were matched to the National Death Index to assess deaths at follow-up.

Those studied were divided by body mass index into three categories (normal: 18.5–24.9 kg/m2; overweight: 25.0–29.9 kg/m2; and obese: >30 kg/m2) and two categories of waist-to-hip ratio (normal: <0.85 in women and <0.90 in men; and high: e0.85 in women and e0.90 in men). Analyses were adjusted for age, sex, race, smoking, hypertension, diabetes, dyslipidemia and baseline body mass index. People with chronic obstructive pulmonary disease and cancer were excluded.

The mean age was 44; 47.4 percent were men. The median follow-up period was 14.3 years. There were 2,562 deaths, of which 1,138 were cardiovascular related.

The risk of cardiovascular death was 2.75 times higher, and the risk of death from all causes was 2.08 times higher, in people of normal weight with central obesity, compared with those with a normal body mass index and waist-to-hip ratio.

"The high risk of death may be related to a higher visceral fat accumulation in this group, which is associated with insulin resistance and other risk factors, the limited amount of fat located on the hips and legs, which is fat with presumed protective effects, and to the relatively limited amount of muscle mass," says Karine Sahakyan, M.D., Ph.D., a cardiovascular research fellow at Mayo Clinic in Rochester.

Many people know their body mass index these days; it's also important for them to know that a normal one doesn't mean their heart disease risk is low, adds Dr. Lopez-Jimenez. Where their fat is distributed on their body can mean a lot, and that can be determined easily by getting a waist-to-hip measurement, even if their body weight is within normal limits, he says.

Lack of sleep found to be a new risk factor for aggressive breast cancers

Lack of sleep is linked to more aggressive breast cancers, according to new findings published in the August issue of Breast Cancer Research and Treatment by physician-scientists from University Hospitals Case Medical Center's Seidman Cancer Center and Case Comprehensive Cancer Center at Case Western Reserve University.

Led by Cheryl Thompson, PhD, the study is the first-of-its-kind to show an association between insufficient sleep and biologically more aggressive tumors as well as likelihood of cancer recurrence. The research team analyzed medical records and survey responses from 412 post-menopausal breast cancer patients treated at UH Case Medical Center with Oncotype DX, a widely utilized test to guide treatment in early stage breast cancer by predicting likelihood of recurrence.

All patients were recruited at diagnosis and asked about the average sleep duration in the last two years. Researchers found that women who reported six hours or less of sleep per night on average before breast cancer diagnosis had higher Oncotype DX tumor recurrence scores. The Oncotype DX test assigns a tumor a recurrence score based on the expression level of a combination of 21 genes.

"This is the first study to suggest that women who routinely sleep fewer hours may develop more aggressive breast cancers compared with women who sleep longer hours," said Dr. Thompson, who is Assistant Professor at Case Western Reserve University School of Medicine and lead author. "We found a strong correlation between fewer hours of sleep per night and worse recurrence scores, specifically in post-menopausal breast cancer patients. This suggests that lack of sufficient sleep may cause more aggressive tumors, but more research will need to be done to verify this finding and understand the causes of this association."

The authors point out that while the correlation of sleep duration and recurrence score was strong in post-menopausal women, there was no correlation in pre-menopausal women. It is well known that there are different mechanisms underlying pre-menopausal and post-menopausal breast cancers. The data suggest that sleep may affect carcinogenic pathway(s) specifically involved in the development of post-menopausal breast cancer, but not pre-menopausal cancer.

"Short sleep duration is a public health hazard leading not only to obesity, diabetes and heart disease, but also cancer," said Li Li, MD, PhD, a study co-author and family medicine physician in the Department of Family Medicine at UH Case Medical Center and Associate Professor of Family Medicine, Epidemiology and Biostatistics at Case Western Reserve University School of Medicine. "Effective intervention to increase duration of sleep and improve quality of sleep could be an under-appreciated avenue for reducing the risk of developing more aggressive breast cancers and recurrence."

Dark Chocolate, Cocoa Compounds, May Reduce Blood Pressure

Compounds in cocoa may help to reduce blood pressure, according to a new systematic review in The Cochrane Library. The researchers reviewed evidence from short-term trials in which participants were given dark chocolate or cocoa powder daily and found that their blood pressure dropped slightly compared to a control group.

Cocoa contains compounds called flavanols, thought to be responsible for the formation of nitric oxide in the body. Nitric oxide causes blood vessel walls to relax and open wider, thereby reducing blood pressure. The link between cocoa and blood pressure stems from the discovery that the indigenous people of San Blas Island in Central American, who drink flavanol-rich cocoa drinks every day, have normal blood pressure regardless of age. However, flavanol concentrations in cocoa and chocolate products vary according to cocoa processing procedures and types of chocolate, so it is difficult to establish the optimal dosage for an effect.

To investigate the effect of flavanols on blood pressure, the researchers reviewed data from trials in which people consumed dark chocolate or cocoa powder containing between 30-1080 mg of flavanols in 3-100 g of chocolate each day. Altogether, 856 people were involved in 20 trials lasting 2-8 weeks, or in one case, 18 weeks. Flavanol-rich chocolate or cocoa powder reduced blood pressure on average by 2-3 mm Hg.

“Although we don’t yet have evidence for any sustained decrease in blood pressure, the small reduction we saw over the short term might complement other treatment options and might contribute to reducing the risk of cardiovascular disease,” said lead researcher Karin Ried of the National Institute of Integrative Medicine in Melbourne, Australia, who worked with colleagues at the University of Adelaide.

In a subset of trials, when chocolate or cocoa powder was compared to flavanol-free-products as controls, the beneficial effects were more pronounced (3-4 mm Hg), whereas the researchers found no significant effect on blood pressure in the second subset with low-flavanol products as control. It is possible that low-flavanol products also have a small effect on blood pressure, so that it was harder to observe differences between high and low-flavanol products in these trials. However, results of these subsets of trials may have been influenced by trial length and blinding of participants, as trials using flavanol-free control products tended to be of shorter duration with participants knowing their allocated group.

“We’ll also need to see long term trials, including effects on the risk of stroke and cardiovascular disease, before we can come to conclusions regarding clinical outcomes and potential side effects of long-term consumption,” said Ried. “These trials should use flavanol-free products in the control groups to eliminate any potential effects of low-dose flavanol on blood pressure.”

Statin Use Tied to Possible Boost in Cataract Risk

The millions of adults who currently use prescription statins to control their cholesterol levels may be inadvertently increasing their risk for developing age-related cataracts, new research suggests.

The bump in cataract risk linked to statin use appears comparable to the elevated risk already known to exist among people with type 2 diabetes, the study team observed.

That said, the study authors cautioned that more research is needed before being able to definitively say there is a cause-and-effect relationship between statins and cataract risk.

"The bottom line is that there appears to be an increased risk among people taking statins as far as getting cataracts," said study lead author Elizabeth Irving, research chairwoman in the School of Optometry and Vision Science at the University of Waterloo in Ontario, Canada. "That was actually a surprise, because most of the previous literature had suggested the opposite. However, it doesn't mean that one is causing the other."

"I would also say we are not now suggesting that statin patients do anything except follow their doctor's advice with respect to statins," Irving added. "They're taking statins for a reason. If you're going to have a heart attack or get cataracts, what would you choose?"

Irving and her colleagues discuss their findings in the August issue of the journal Optometry and Vision Science.

The authors noted that previous animal research has already pointed to a possible link between high-dosage statin use and a bump in the risk for cataracts, which are characterized by a significant clouding of the eyes' lenses.

To explore the potential link between statins and eye health in humans, the investigators focused on nearly 6,400 cataract patients who were being treated at the University of Waterloo between 2007 and 2008.

Of those patients, more than 450 had type 2 diabetes, and both diabetes status and statin use were looked at possible risk factors for cataracts.

After accounting for factors such as gender, cigarette use and high blood pressure, the team found that statin use was associated with a 57 percent increased risk for developing cataracts.

Statin users were more likely to develop cataracts at a younger age, the study found. For patients without diabetes, the average age for which the odds of developing cataracts were at least 50 percent was 57.3 years for those not using statins compared with 54.9 years for those taking statins. Patients with diabetes had the same cataract risk at 55.1 years if not using statins and 51.7 years if taking them.

Some overlap existed between diabetes and statin use, the team noted, with 56 percent of the diabetic cataract patients regularly taking statins. The authors pointed out that patients with diabetes who also took statins were found to have developed cataracts a full 5.6 years earlier than those who neither had diabetes nor took statins.

Yet the team nevertheless determined that statin use appeared to be, by itself, an independent risk factor for cataracts.

"Again, we don't think these findings should turn the world upside down," Irving stressed. "However, we do think that it once again shows that it's good to think about what drugs do to the people who take them, and that the people who make drugs might want to consider making better drugs than statins, given the possibility that they do raise the risk for cataracts."

Dr. Alfred Sommer, professor of ophthalmology and dean emeritus of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, strongly suggested that statin users should "not be alarmed" by the current findings.

"It's not to put down this kind of exploratory study, but this simply doesn't prove anything. This only suggests that there may be some association between the two," he noted. "For now, statins are really the most important way we have to prevent heart attacks. We don't have any alternatives at this point, so this is really just a teaser for more research. Nobody should change what they're doing."

Prostate Cancer: Six Things Men Should Know About Tomatoes, Fish Oil, Vitamin Supplements, Testosterone, PSA Tests

When it comes to prostate cancer, there's a lot of confusion about how to prevent it, find it early and the best way -- or even whether -- to treat it. Below are six common prostate cancer myths along with research-based information from scientists at Fred Hutchinson Cancer Research Center to help men separate fact from fiction.

Myth 1 -- Eating tomato-based products such as ketchup and red pasta sauce prevents prostate cancer. "The vast majority of studies show no association," said Alan Kristal, Dr.Ph., associate director of the Hutchinson Center's Cancer Prevention Program and a national expert in prostate cancer prevention. Kristal and colleagues last year published results of the largest study to date that aimed to determine whether foods that contain lycopene -- the nutrient that puts the red in tomatoes -- actually protect against prostate cancer.

After examining blood levels of lycopene in nearly 3,500 men nationwide they found no association. "Scientists and the public should understand that early studies supporting an association of dietary lycopene with reduced prostate cancer risk have not been replicated in studies using serum biomarkers of lycopene intake," the authors reported in Cancer Epidemiology, Biomarkers & Prevention. "Recommendations of professional societies to the public should be modified to reflect the likelihood that increasing lycopene intake will not affect prostate cancer risk."

Myth 2 -- High testosterone levels increase the risk of prostate cancer. "This is a lovely hypothesis based on a very simplistic understanding of testosterone metabolism and its effect on prostate cancer. It is simply wrong," Kristal said. Unlike estrogen and breast cancer, where there is a very strong relationship, testosterone levels have no association with prostate cancer risk, he said. A study published in 2008 in the Journal of the National Cancer Institute, which combined data from 18 large studies, found no association between blood testosterone concentration and prostate cancer risk, and more recent studies have confirmed this conclusion.

Myth 3 -- Fish oil (omega-3 fatty acids) decrease prostate cancer risk. "This sounds reasonable, based on an association of inflammation with prostate cancer and the anti-inflammatory effects of omega-3 fatty acids," Kristal said. However, two large, well-designed studies -- including one led by Kristal that was published last year in the American Journal of Epidemiology -- have shown that high blood levels of omega-3 fatty acids increase the odds of developing high-risk prostate cancer.

Analyzing data from a nationwide study of nearly 3,500 men, they found that those with the highest blood percentages of docosahexaenoic acid, or DHA, an inflammation-lowering omega-3 fatty acid commonly found in fatty fish, have two-and-a-half times the risk of developing aggressive, high-grade prostate cancer compared to men with the lowest DHA levels. "This very sobering finding suggests that our understanding of the effects of omega-3 fatty acids is incomplete," Kristal said.

Myth 4 -- Dietary supplements can prevent prostate cancer. Several large, randomized trials that have looked at the impact of dietary supplements on the risk of various cancers, including prostate, have shown either no effect or, much more troubling, they have shown significantly increased risk. "The more we look at the effects of taking supplements, the more hazardous they appear when it comes to cancer risk," Kristal said. For example, the Selenium and Vitamin E Cancer Prevention Trial (SELECT), the largest prostate cancer prevention study to date, was stopped early because it found neither selenium nor vitamin E supplements alone or combined reduced the risk of prostate cancer. A SELECT follow-up study published last year in JAMA found that vitamin E actually increased the risk of prostate cancer among healthy men. The Hutchinson Center oversaw statistical analysis for the study, which involved nearly 35,000 men in the U.S., Canada and Puerto Rico.

Myth 5 -- We don't know which prostate cancers detected by PSA (prostate-specific antigen) screening need to be treated and which ones can be left alone. "Actually, we have a very good sense of which cancers have a very low risk of progression and which ones are highly likely to spread if left untreated," said biostatistician Ruth Etzioni, Ph.D., a member of the Hutchinson Center's Public Health Sciences Division.

In addition to blood levels of PSA, indicators of aggressive disease include tumor volume (the number of biopsy samples that contain cancer) and Gleason score (predicting the aggressiveness of cancer by how the biopsy samples look under a microscope). Gleason scores range from 2-5 (low risk) and 6-7 (medium risk) to 8-10 (high risk).

"Men with a low PSA level, a biopsy Gleason score of 6 or lower and very few biopsy samples with cancer are generally considered to be very low risk," Etzioni said. Such newly diagnosed men increasingly are being offered active surveillance -- a watchful waiting approach -- rather than therapy for their disease, particularly if they are older or have a short life expectancy.

"The chance that these men will die of their disease if they are not treated is very low, around 3 percent," she said. Similarly, such men who opt for treatment have a mortality rate of about 2 percent. "For the majority of newly diagnosed cases of prostate cancer, giving initial clinical and biopsy information, we can get a very good idea of who should be treated and who is likely to benefit from deferring treatment."

Myth 6 -- Only one in 50 men diagnosed with PSA screening benefits from treatment. "This number, which was released as a preliminary result from the European Randomized Study of Prostate Cancer Screening, is simply incorrect," Etzioni said. "It suggests a very unfavorable harm-benefit ratio for PSA screening. It implies that for every man whose life is saved by PSA screening, almost 50 are overdiagnosed and overtreated."

"Overdiagnosis" is diagnosing a disease that will never cause symptoms or death in the patient's lifetime. "Overtreatment" is treating a disease that will never progress to become symptomatic or life-threatening.

The 50-to-one ratio is based on short-term follow-up and "grossly underestimates" the lives likely to be saved by screening over the long term and overestimates the number who are overdiagnosed. "The correct ratio of men diagnosed with PSA testing who are overdiagnosed and overtreated versus men whose lives are saved by treatment long term is more likely to be 10 to one," she said.

Potency of Statins Linked to Muscle Side Effects

A study from the University of California, San Diego School of Medicine, published August 22 online by PLoS ONE, reports that muscle problems reported by patients taking statins were related to the strength or potency of the given cholesterol-lowering drugs.

Adverse effects such as muscle pain and weakness, reported to the U.S. Food and Drug Administration (FDA) were related to a statin's potency, or the degree by which it typically lowers cholesterol at commonly prescribed doses.

"These findings underscore that stronger statins bear higher risk -- and should be used with greater caution and circumspection," said investigator Beatrice Golomb, MD, PhD, professor in the Departments of Medicine and Family and Preventive Medicine at the University of California, San Diego.

Golomb teamed up with researchers from California-based AdverseEvents, Inc., using the company's software platform to conduct a detailed examination of statin side-effect data from the FDA's Adverse Event Reporting System (AERS). The study analyzed muscle-related adverse events linked to each of the major statin drugs in total of 147,789 AERS reports, gathered between July 2005 and March 2011.

Looking at the most commonly used statins -- both brand names and, when available, generic forms of the drugs -- rosuvastatin, the strongest statin, had the highest rates of reported problems. This was followed by atorvastatin, simvastatin, pravastatin, and lovastatin.

"These rankings closely match the individual potencies of each statin. Thus, the strength of the statin drug appears to be a dominant factor in determining how likely muscle problems are to occur," said Golomb, who directs the Statin Adverse Effects Study at UC San Diego.

Rates were determined for each statin by tallying reports of muscle side effects, standardized to the number of prescriptions filled for that drug. This was done for individual muscle side effects, as well as for side effects overall.

Some experts have maintained that rosuvastatin, the strongest statin, should have superior safety, because it is less fat soluble, and was thereby assumed not to penetrate into muscle cells as much as other statins. In addition, rosuvastatin is not cleared by common drug-clearance pathways that are sometimes involved in adverse drug interactions.

"The FDA AERS data analyzed in this study, however, suggests that the higher potency of rosuvastatin may more than offset any safety advantages due to such factors," Golomb said. She added that pooled analysis of statin studies in patients with stable heart disease do not indicate that higher strength statins result in a lower death rate. Therefore, "evidence showing that stronger statins may pose a greater risk of side effects is particularly important."

"Post-marketed studies utilizing AERS data are becoming increasingly important to understand the lasting side effect risks of widely used medications in disparate populations. Until recently, conducting such studies has been difficult due to the fractured and inaccessible nature of the FDA's raw data," said Brian Overstreet, CEO of AdverseEvents. The study utilized the company's unique data sourcing method called RxFilter™, which analyzed more than 140,000 AERS case reports filed with FDA over a six-year time period.

Statins are among the most widely taken prescription medications in the world, with over 30 million users in the United States alone and $19 billion in domestic sales. They are prescribed to lower cholesterol, and reduce the risk of cardiovascular disease. Their use has been linked to a variety of muscle-related side effects (together termed "statin myopathy") that occur in as many as 10 to 15 percent of all statin users. These include commonly reported problems such as pain and weakness, as well as life-threatening muscle breakdown, known as rhabdomyolysis. Statin myopathies can significantly increase pain and injury risk and affect mobility, especially in older individuals.

"Only a fraction of adverse effects are reported to the FDA, and a range of factors can influence reporting rates and accuracy of this information," Golomb said. "However, findings from this study align with -- and extend -- other forms of evidence."

For instance, an earlier study from Golomb's group at UC San Diego showed that patients with muscle problems related to statins often found relief from symptoms after stopping one statin. However, muscle pain or weakness consistently redeveloped if the patient was then placed on a higher potency statin, while patients placed on a lower potency statin had significantly lower risk of recurrence.

"Our findings suggest that individual statin potency is a critical determinant of how likely a statin is to cause problems," Golomb concluded. "This information should help guide prescribing decisions for statins by offering more information on the risk-benefit profile of the class. It should also be important for guiding decisions about statin selection and use after a patient has experienced a muscle-related adverse event."

Statin therapy associated with lower risk of pancreatitis

Although some studies have suggested that use of lipid-lowering therapies may increase the risk of pancreatitis, an analysis that involved pooling of data from previous studies and included more than 150,000 participants found that statin therapy was associated with a reduction in the risk of pancreatitis in patients with normal or mildly elevated triglyceride levels, according to an article in the August 22/29 issue of JAMA.

"Pancreatitis has a clinical spectrum ranging from a mild, self-limiting episode to a severe or fatal event. Case reports and pharmacoepidemiology studies have claimed that statins may cause pancreatitis, although few of these studies comprehensively considered confounding factors. Very few large randomized trials of statin therapy have published data on incident pancreatitis," according to background information in the article. "Although lipid guidelines recommend fibrate therapy to reduce pancreatitis risk in persons with hypertriglyceridemia, fibrates may lead to the development of gallstones, a risk factor for pancreatitis."

David Preiss, M.D., Ph.D., of the University of Glasgow, United Kingdom, and colleagues examined the associations between use of a statin or a fibrate and the incidence of pancreatitis by conducting collaborative meta-analyses of published and unpublished data from large randomized clinical trials. The authors conducted a search of the medical literature to identify relevant studies for inclusion in the analysis.

In 16 placebo- and standard care-controlled statin trials with 113,800 participants conducted over 4.1 years, 309 participants (0.27 percent) developed pancreatitis (134 assigned to statin, 175 assigned to control; a 23 percent lower risk of pancreatitis for those assigned to statin therapy). In 5 dose-comparison statin trials with 39,614 participants conducted over 4.8 years, 156 participants (0.39 percent) developed pancreatitis (70 assigned to intensive dose, 86 assigned to moderate dose; an 18 percent lower risk for the intensive dose group).

In the combined data set of 21 trials, 465 participants (0.30 percent) developed pancreatitis (of whom 204 were assigned to statin therapy or intensive-dose statin therapy and 261 were assigned to placebo, standard care, or moderate-dose statin therapy, respectively), a 21 percent lower risk.

Seven randomized clinical trials of fibrate therapy (4 with published data and 3 with unpublished data regarding incident pancreatitis) provided data on 40,162 participants over a weighted average follow-up period of 5.3 years. Baseline average triglyceride levels in the trials varied from 145 mg/dL to 184 mg/dL. During this time, 144 participants (0.36 percent) developed pancreatitis (84 assigned to fibrate therapy, 60 assigned to placebo), but the risk difference was not statistically significant.

"Although the present results for both statins and fibrates should be considered hypothesis-generating and the number of pancreatitis cases was small in this trial population at low risk of pancreatitis, the analysis raises questions regarding the choice of lipid-modifying agents in patients with hypertriglyceridemia. In those with slightly elevated triglyceride levels, statins appear better supported by the available data than fibrates for preventing pancreatitis. Lifestyle modifications also remain important to improve lipid profiles in such individuals. In patients with severe hypertriglyceridemia, a trial comparing fibrates and statins for preventing pancreatitis would be clinically valuable," the authors write.

Chemicals in chocolate, blueberries, raspberries, strawberries, teas and certain foods could well be mood-enhancers

New evidence reveals the possibility of mood-enhancing effects associated with some flavors, stemming at least in part from natural ingredients bearing a striking chemical similarity to valproic acid, a widely used prescription mood-stabilizing drug, scientists reported in Philadelphia. This effect joins those previously reported for chocolate, teas and some other known comfort foods.

"Molecules in chocolate, a variety of berries and foods containing omega-3 fatty acids have shown positive effects on mood. In turn, our studies show that some commonly used flavor components are structurally similar to valproic acid," said Karina Martinez-Mayorga, Ph.D., leader of a research team that has been studying the effects of flavors on mood. She described research done while working at the Torrey Pines Institute for Molecular Studies, and now is with the Chemistry Institute at the National Autonomous University of Mexico.

Sold under brand names that include Depakene, Depakote and Stavzor, valproic acid is used to smooth out the mood swings of people with manic-depressive disorder and related conditions.

"The large body of evidence that chemicals in chocolate, blueberries, raspberries, strawberries, teas and certain foods could well be mood-enhancers encourages the search for other mood modulators in food," noted Martinez-Mayorga.

Martinez-Mayorga pointed out that the need for a broad spectrum of mood modulators is fostering research not just in the pharmaceutical industry, but in the food and beverage industries as well. Food industry research, however, focuses on less-severe mood changes. People have recognized the mood-altering properties of various foods for years. Now Martinez-Mayorga's team, and other research groups, is seeking to identify the chemical compounds that moderate mood swings, help maintain cognitive health, improve mental alertness and delay the onset of memory loss.

Her study involved use of techniques of chemoinformatics _ the application of informatic methods to solve chemical problems _ to screen the chemical structures of more than 1,700 food flavor ingredients for similarities to approved antidepressants, marketed drugs and agents with reported antidepressant activity. The main result so far in the ongoing project involves valproic acid. In the future, she said that the team plans to move from the area of analyzing the database to actually begin testing the flavor/mood hypothesis experimentally. The end result may be dietary recommendations or new nutritional supplements with beneficial mood effects, she added.

"It is important to remember that just eating foods that may improve mood is not a substitute for prescribed antidepressive drugs," Martinez-Mayorga cautioned. And for people not requiring medication, she notes that eating specific foods and living a healthful lifestyle can generally boost mood.

Resveratrol might help improve mobility and prevent life-threatening falls among older people.

In a stride toward better health in later life, scientists have reported that resveratrol, the so-called "miracle molecule" found in red wine, might help improve mobility and prevent life-threatening falls among older people. The finding, believed to be the first of its kind, was presented August 19 to some 14,000 scientists and others gathered at the 244th National Meeting & Exposition of the American Chemical Society.

The researchers say this report -- based on studies of laboratory mice -- could lead to the development of natural products designed to help older Americans live safer and more productive lives.

"Our study suggests that a natural compound like resveratrol, which can be obtained either through dietary supplementation or diet itself, could actually decrease some of the motor deficiencies that are seen in our aging population," said Jane E. Cavanaugh, Ph.D., leader of the research team. "And that would, therefore, increase an aging person's quality of life and decrease their risk of hospitalization due to slips and falls."

Cavanaugh notes that falls become more common with advancing age and are the leading cause of injury-related death among people older than 65. In addition, about one in three older Americans have difficulty with balance or walking, according to the American Geriatrics Society.

These mobility problems are particularly common among older people who have Parkinson's disease and other age-related neurological disorders, Cavanagh said. She is with Duquesne University in Pittsburgh. However, while drugs can help alleviate some of the motor-related problems in Parkinson's disease, Cavanaugh points out that there are no comparable treatments for balance and walking problems in otherwise healthy older adults. She and her colleagues set out to rectify that, focusing on natural chemical compounds such as resveratrol.

Previous studies have shown that resveratrol -- an antioxidant found in red wine and dark-skinned fruits -- might help reduce inflammation, lower cholesterol, slash the risk of heart disease and certain cancers and, perhaps, have some anti-aging effects in the body. Resveratrol is available as a dietary supplement and is abundant in foods such as red grapes, blueberries and nuts.

To determine its effects on balance and mobility, Cavanaugh, Erika N. Allen and colleagues fed young and old laboratory mice a diet containing resveratrol for eight weeks. They periodically tested the rodents' ability to navigate a steel mesh balance beam, counting the number of times that each mouse took a misstep. Initially, the older mice had more difficulty maneuvering on the obstacle. But by week four, the older mice made far fewer missteps and were on par with the young mice.

While it is unclear how resveratrol works in the body, Cavanagh's team found some clues. In laboratory experiments, they exposed neural cells to a neurotransmitter called dopamine, which in large amounts can induce cell death. However, neurons treated with resveratrol before being exposed to dopamine survived. On closer examination, the researchers found that resveratrol mitigated the damage done by oxygen free radicals, generated by the breakdown of the dopamine, and activated protein signaling pathways that appeared to promote cell survival.

Although she is encouraged by the results, Cavanaugh notes that resveratrol does have some drawbacks. For instance, it is poorly absorbed by the body. In fact, she calculates that a 150-pound person would have to drink almost 700 4-ounce glasses of red wine a day to absorb enough resveratrol to get any beneficial effects. That's why she and her colleagues are investigating similar human-made compounds that mimic the effects of resveratrol and might be more bioavailable to the body. They're also trying to determine how much resveratrol actually enters the brain.

Nevertheless, the researchers suspect that even if the effects of resveratrol in the brain are minute, this small margin could potentially be enough to help older people remain steady on their feet and avoid taking serious tumbles.

Pan-fried Meat Increases Risk of Prostate Cancer

Research from the University of Southern California (USC) and Cancer Prevention Institute of California (CPIC) found that cooking red meats at high temperatures, especially pan-fried red meats, may increase the risk of advanced prostate cancer by as much as 40 percent.

Mariana Stern, associate professor of preventive medicine at the Keck School of Medicine of USC, led analyses for the study, “Red meat and poultry, cooking practices, genetic susceptibility and risk of prostate cancer: Results from the California Collaborative Prostate Cancer Study.” The study, which is available online in the journal Carcinogenesis, provides important new evidence on how red meat and its cooking practices may increase the risk for prostate cancer.

Previous studies have emphasized an association between diets high in red meat and risk of prostate cancer, but evidence is limited. Attention to cooking methods of red meat, however, shows the risk of prostate cancer may be a result of potent chemical carcinogens formed when meats are cooked at high temperatures.

Researchers examined pooled data from nearly 2,000 men who participated in the California Collaborative Prostate Cancer Study, a multiethnic, case-control study conducted in the San Francisco Bay Area by Esther John, CPIC senior research scientist, and in Los Angeles by Sue A. Ingles, associate professor of preventive medicine at the Keck School of Medicine of USC. Study participants completed a comprehensive questionnaire that evaluated amount and type of meat intake, including poultry and processed red meat. Information regarding cooking practices (e.g., pan-frying, oven-broiling and grilling) was obtained using color photographs that displayed the level of doneness. More than 1,000 of the men included in the study were diagnosed with advanced prostate cancer.

“We found that men who ate more than 1.5 servings of pan-fried red meat per week increased their risk of advanced prostate cancer by 30 percent,” Stern said. “In addition, men who ate more than 2.5 servings of red meat cooked at high temperatures were 40 percent more likely to have advanced prostate cancer.”

When considering specific types of red meats, hamburgers—but not steak—were linked to an increased risk of prostate cancer, especially among Hispanic men. “We speculate that these findings are a result of different levels of carcinogen accumulation found in hamburgers, given that they can attain higher internal and external temperatures faster than steak,” Stern added.

Researchers also found that men with diets high in baked poultry had a lower risk of advanced prostate cancer, while consumption of pan-fried poultry was associated with increased risk. Stern noted that pan-frying, regardless of meat type, consistently led to an increased risk of prostate cancer. The same pattern was evident in Stern’s previous research, which found that fish cooked at high temperatures, particularly pan-fried, increased the risk of prostate cancer.

The researchers do not know why pan-frying poses a higher risk for prostate cancer, but they suspect it is due to the formation of the DNA-damaging carcinogens—heterocyclic amines (HCAs)—during the cooking of red meat and poultry. HCAs are formed when sugars and amino acids are cooked at higher temperatures for longer periods of time. Other carcinogens, such as polycyclic aromatic hydrocarbons (PAHs) are formed during the grilling or smoking of meat. When fat from the meat drips on an open flame, the rising smoke leaves deposits of PAHs on the meat. There is strong experimental evidence that HCAs and PAHs contribute to certain cancers, including prostate cancer.

“The observations from this study alone are not enough to make any health recommendations, but given the few modifiable risk factors known for prostate cancer, the understanding of dietary factors and cooking methods are of high public health relevance,” said Stern.

Middle-aged adults help their hearts with regular leisure-time physical activities

Middle-aged adults who regularly engage in leisure-time physical activity for more than a decade may enhance their heart health, according to new research in the American Heart Association's journal Circulation.

In a new study, more than 4,200 participants (average age 49) reported the duration and frequency of their leisure-time physical activities such as brisk walking, vigorous gardening, cycling, sports, housework and home maintenance.

"It's not just vigorous exercise and sports that are important," said Mark Hamer, Ph.D., study lead author and associate professor of epidemiology and public health at University College in London, U.K. "These leisure-time activities represent moderate intensity exercise that is important to health. It is especially important for older people to be physically active because it contributes to successful aging."

At the baseline assessment in 1991-1993, researchers analyzed two key inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6). Researchers again assessed physical activity and inflammatory markers in 1997-99 and about 11 years later.

Physically active participants at baseline had lower CRP and IL6 levels. The difference remained stable over time compared to participants that rarely adhered to physical activity guidelines during 10-year follow-up.

"Inflammatory markers are important because we have shown they are a key mechanism explaining the link between physical activity and the lower risk of heart disease." Hamer said. "The people who benefited the most from this study were the ones that remained physically active."

Overall, 49.1 percent of the participants met the standard physical activity recommendations for cardiovascular health (2.5 hours per week of moderate to vigorous physical activity). The rate reached 83 percent in subsequent phases of the study.

"The percentage of exercising participants jumped quite a bit because they were entering their retirement during the last phase of the study," Hamer said. "We have shown that retirement seems to have a beneficial effect on physical activity levels."

Those who changed from inactive to active exercisers achieved lower inflammatory markers at follow-up.

"Previous studies have looked at the association between physical activity and inflammatory markers in cross-sectional and short-term studies, but none have done this using longitudinal data," Hamer said. "Our data is much stronger than the previous shorter or cross-sectional studies, adds to prior evidence and confirms the importance of physical activity for its anti-inflammatory effects."

The participants were part of the ongoing Whitehall II study, which included more than 10,000 British civil service participants in 1985 to investigate social and occupational influences on cardiovascular risk.

Should doctors treat lack of exercise as a medical condition?

A sedentary lifestyle is a common cause of obesity (http://www.mayoclinic.com/health/obesity/DS00314), and excessive body weight and fat in turn are considered catalysts for diabetes (http://www.mayoclinic.com/health/diabetes/DS01121), high blood pressure (http://www.mayoclinic.com/health/high-blood-pressure/DS00100), joint damage (http://www.mayoclinic.com/health/arthritis/DS01122/DSECTION=risk-factors) and other serious health problems. But what if lack of exercise itself were treated as a medical condition? Mayo Clinic physiologist Michael Joyner, M.D. (http://mayoresearch.mayo.edu/mayo/research/staff/joyner_mj.cfm), argues that it should be. His commentary is published this month in The Journal of Physiology (http://jp.physoc.org/).

Physical inactivity affects the health not only of many obese patients, but also people of normal weight, such as workers with desk jobs, patients immobilized for long periods after injuries or surgery, and women on extended bed rest (http://www.mayoclinic.com/health/pregnancy/PR00107) during pregnancies, among others, Dr. Joyner says. Prolonged lack of exercise can cause the body to become deconditioned, with wide-ranging structural and metabolic changes: the heart rate may rise excessively during physical activity, bones and muscles atrophy, physical endurance wane, and blood volume decline.

When deconditioned people try to exercise, they may tire quickly and experience dizziness or other discomfort, then give up trying to exercise and find the problem gets worse rather than better.

"I would argue that physical inactivity is the root cause of many of the common problems that we have," Dr. Joyner says (http://www.drmichaeljoyner.com/newsroom/). "If we were to medicalize it, we could then develop a way, just like we've done for addiction, cigarettes and other things, to give people treatments, and lifelong treatments, that focus on behavioral modifications and physical activity. And then we can take public health measures, like we did for smoking, drunken driving and other things, to limit physical inactivity and promote physical activity."

Several chronic medical conditions are associated with poor capacity to exercise, including fibromyalgia (http://www.mayoclinic.com/health/fibromyalgia/DS00079), chronic fatigue syndrome (http://www.mayoclinic.com/health/chronic-fatigue-syndrome/DS00395) and postural orthostatic tachycardia syndrome (http://www.youtube.com/watch?v=CatWlEGPqG4), better known as POTS, a syndrome marked by an excessive heart rate and flu-like symptoms when standing or a given level of exercise. Too often, medication rather than progressive exercise is prescribed, Dr. Joyner says.

Texas Health Presbyterian Hospital Dallas (http://www.texashealth.org/landing.cfm?id=115) and University of Texas Southwestern Medical Center (http://www.utsouthwestern.edu/index.html) researchers found that three months of exercise training can reverse or improve many POTS symptoms, Dr. Joyner notes. That study offers hope for such patients and shows that physicians should consider prescribing carefully monitored exercise before medication, he says.

If physical inactivity were treated as a medical condition itself rather than simply a cause or byproduct of other medical conditions, physicians may become more aware of the value of prescribing supported exercise, and more formal rehabilitation programs that include cognitive and behavioral therapy would develop, Dr. Joyner says.

For those who have been sedentary and are trying to get into exercise, Dr. Joyner advises doing it slowly and progressively.

"You just don't jump right back into it and try to train for a marathon," he says. "Start off with achievable goals and do it in small bites."

There's no need to join a gym or get a personal trainer: build as much activity as possible into daily life. Even walking just 10 minutes three times a day can go a long way toward working up to the 150 minutes a week of moderate physical activity the typical adult needs, Dr. Joyner says.

Cocoa may enhance brain function

Eating cocoa flavanols daily may improve mild cognitive impairment, according to new research in the American Heart Association's journal Hypertension.

Each year, more than six percent of people aged 70 years or older develop mild cognitive impairment, a condition involving memory loss that can progress to dementia and Alzheimer's disease.

Flavanols can be found in tea, grapes, red wine, apples and cocoa products and have been associated with a decreased risk of dementia. They may act on the brain structure and function directly by protecting neurons from injury, improving metabolism and their interaction with the molecular structure responsible for memory researchers said. Indirectly, flavanols may help by improving brain blood flow.

In this study, 90 elderly participants with mild cognitive impairment were randomized to drink daily either 990 milligrams (high), 520 mg (intermediate) or 45 mg (low) of a dairy-based cocoa flavanol drink for eight weeks. The diet was restricted to eliminate other sources of flavanols from foods and beverages other than the dairy-based cocoa drink. Cognitive function was examined by neuro-psychological tests of executive function, working memory, short-term memory, long-term episodic memory, processing speed and global cognition.

Researchers found

: • Scores significantly improved in the ability to relate visual stimuli to motor responses, working memory, task-switching and verbal memory for those drinking the high and intermediate flavanol drinks.
• Participants drinking daily higher levels of flavanol drinks had significantly higher overall cognitive scores than those participants drinking lower-levels.
• Insulin resistance, blood pressure and oxidative stress also decreased in those drinking high and intermediate levels of flavanols daily. Changes in insulin resistance explained about 40 percent of the composite scores for improvements in cognitive functioning.


"This study provides encouraging evidence that consuming cocoa flavanols, as a part of a calorie-controlled and nutritionally-balanced diet, could improve cognitive function," said Giovambattista Desideri, M.D., study lead author and director of Geriatric Division, Department of Life, Health and Environmental Sciences, University of L'Aquila in Italy. "The positive effect on cognitive function may be mainly mediated by an improvement in insulin sensitivity. It is yet unclear whether these benefits in cognition are a direct consequence of cocoa flavanols or a secondary effect of general improvements in cardiovascular function."

The study population was generally in good health without known cardiovascular disease. Thus, it would not be completely representative of all mild cognitive impairment patients. In addition, only some clinical features of mild cognitive impairment were explored in the study.

"Given the global rise in cognitive disorders, which have a true impact on an individual's quality of life, the role of cocoa flavanols in preventing or slowing the progression of mild cognitive impairment to dementia warrants further research," Desideri said. "Larger studies are needed to validate the findings, figure out how long the positive effects will last and determine the levels of cocoa flavanols required for benefit."

Alcohol consumption may decrease risk of ALS

A population-based case-control study of the rare but devastating neurological disease amyotrophic lateral sclerosis (ALS) has shown that the risk of such disease is increased among smokers, as has been shown previously. However, surprisingly, the risk of ALS was found to be markedly lower among consumers of alcohol than among abstainers.

Forum reviewers thought that this was a well-done and important paper, as it is a population-based analysis, with almost 500 cases of ALS, a very large number of cases for this rare disease. They were especially struck by the magnitude of the difference in risk of ALS between alcohol consumers and never drinkers: the risk among drinkers was about one half that of non-drinkers. Said one reviewer: "The results in this study are astonishing in this mysterious disease. One should expect that alcohol, as a toxic agent, rather should contribute to the development of ALS than to prevent it. The lower risk among drinkers compared with non-drinkers is remarkable"

Forum reviewers cautioned that the results of this paper should not be used to prompt people to consume alcohol just to prevent ALS, as it is such a rare disease. However, this paper presents important data that could help scientists understand the etiology of ALS and perhaps other more common diseases.

Atherosclerosis: Eating egg yolks as bad as smoking

Newly published research led by Dr. David Spence of Western University, Canada, shows that eating egg yolks accelerates atherosclerosis in a manner similar to smoking cigarettes. Surveying more than 1200 patients, Dr. Spence found regular consumption of egg yolks is about two-thirds as bad as smoking when it comes to increased build-up of carotid plaque, a risk factor for stroke and heart attack. The research is published online in the journal Atherosclerosis.

Atherosclerosis, also called coronary artery disease, is a disorder of the arteries where plaques, aggravated by cholesterol, form on the inner arterial wall. Plaque rupture is the usual cause of most heart attacks and many strokes. The study looked at data from 1231 men and women, with a mean age of 61.5, who were patients attending vascular prevention clinics at London Health Sciences Centre's University Hospital. Ultrasound was used to establish a measurement of total plaque area and questionnaires were filled out regarding their lifestyle and medications including pack-years of smoking (number of packs per day of cigarettes times the number of years), and the number of egg yolks consumed per week times the number of years consumed (egg yolk-years).

The researchers found carotid plaque area increased linearly with age after age 40, but increased exponentially with pack-years of smoking and egg yolk-years. In other words, compared to age, both tobacco smoking and egg yolk consumption accelerate atherosclerosis. The study also found those eating three or more yolks a week had significantly more plaque area than those who ate two or fewer yolks per week.

"The mantra 'eggs can be part of a healthy diet for healthy people' has confused the issue. It has been known for a long time that a high cholesterol intake increases the risk of cardiovascular events, and egg yolks have a very high cholesterol content. In diabetics, an egg a day increases coronary risk by two to five-fold," says Dr. Spence, a Professor of Neurology at Western's Schulich School of Medicine & Dentistry and the Director of its Stroke Prevention and Atherosclerosis Research Centre (SPARC) at the Robarts Research Institute. "What we have shown is that with aging, plaque builds up gradually in the arteries of Canadians, and egg yolks make it build up faster - about two-thirds as much as smoking. In the long haul, egg yolks are not okay for most Canadians."

Dr. Spence adds the effect of egg yolk consumption over time on increasing the amount of plaque in the arteries was independent of sex, cholesterol, blood pressure, smoking, body mass index and diabetes. And while he says more research should be done to take in possible confounders such as exercise and waist circumference, he stresses that regular consumption of egg yolk should be avoided by persons at risk of cardiovascular disease.

Cocoa compounds may reduce blood pressure

Compounds in cocoa may help to reduce blood pressure, according to a new systematic review in The Cochrane Library. The researchers reviewed evidence from short-term trials in which participants were given dark chocolate or cocoa powder daily and found that their blood pressure dropped slightly compared to a control group.

Cocoa contains compounds called flavanols, thought to be responsible for the formation of nitric oxide in the body. Nitric oxide causes blood vessel walls to relax and open wider, thereby reducing blood pressure. The link between cocoa and blood pressure stems from the discovery that the indigenous people of San Blas Island in Central American, who drink flavanol-rich cocoa drinks every day, have normal blood pressure regardless of age. However, flavanol concentrations in cocoa and chocolate products vary according to cocoa processing procedures and types of chocolate, so it is difficult to establish the optimal dosage for an effect.

To investigate the effect of flavanols on blood pressure, the researchers reviewed data from trials in which people consumed dark chocolate or cocoa powder containing between 30-1080 mg of flavanols in 3-100 g of chocolate each day. Altogether, 856 people were involved in 20 trials lasting 2-8 weeks, or in one case, 18 weeks. Flavanol-rich chocolate or cocoa powder reduced blood pressure on average by 2-3 mm Hg.

"Although we don't yet have evidence for any sustained decrease in blood pressure, the small reduction we saw over the short term might complement other treatment options and might contribute to reducing the risk of cardiovascular disease," said lead researcher Karin Ried of the National Institute of Integrative Medicine in Melbourne, Australia, who worked with colleagues at the University of Adelaide.

In a subset of trials, when chocolate or cocoa powder was compared to flavanol-free-products as controls, the beneficial effects were more pronounced (3-4 mm Hg), whereas the researchers found no significant effect on blood pressure in the second subset with low-flavanol products as control. It is possible that low-flavanol products also have a small effect on blood pressure, so that it was harder to observe differences between high and low-flavanol products in these trials. However, results of these subsets of trials may have been influenced by trial length and blinding of participants, as trials using flavanol-free control products tended to be of shorter duration with participants knowing their allocated group.

"We'll also need to see long term trials, including effects on the risk of stroke and cardiovascular disease, before we can come to conclusions regarding clinical outcomes and potential side effects of long-term consumption," said Ried. "These trials should use flavanol-free products in the control groups to eliminate any potential effects of low-dose flavanol on blood pressure."

Even minor physical activity may benefit bone health

A study to be published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) suggests that physical activity for premenopausal women is very effective in reducing sclerostin—a known inhibitor of bone formation. In addition, physical training enhances IGF-1levels, which have a very positive effect on bone formation.

Bone is a tissue that is always changing due to hormonal changes and physical activity, or lack thereof. Sclerostin is a glycoprotein produced almost exclusively by osteocytes, the most abundant cells found in human bone. Upon release, sclerostin travels to the surface of the bone where it inhibits the creation of cells that help bones develop.

"Physical activity is good for bone health and results in lowering sclerostin, a known inhibitor of bone formation and enhancing IGF-1 levels, a positive effector on bone health" said Mohammed-Salleh M. Ardawi, PhD, FRCPath, professor at the Center of Excellence for Osteoporosis Research and Faculty of Medicine at King Abdulaziz University in Saudi Arabia and lead researcher for this study. "We also found physical activity training that enhances mechanical loading in combination with anabolic therapeutic agents will have added positive effect on bone health, particularly bone formation."

A total of 1,235 randomly selected premenopausal women were involved in this cross-sectional study. Researchers followed up 58 of these women during an eight-week course of physical activity training and compared them with 62 controls. All women were medically examined and measurements were taken for bone mineral density, bone turnover markers and serum sclerostin and IGF-1.

At the conclusion of the study, it was discovered that those women who had more than two hours of physical activity per week had significantly lower levels of serum sclerostin, but had higher IGF-1 levels than those women who had less than two hours of physical activity per week.

"Physical activity training is conceptually simple, inexpensive, and can serve practical purposes including reducing the risk of low bone mass, osteoporosis, and consequently fractures," said Ardawi. "Our study found that even minor changes in physical activity were associated with clear effects on serum levels of sclerostin, IGF-1 and bone turnover markers."

Mediterranean diet + olive oil protects bones

A study to be published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) shows consumption of a Mediterranean diet enriched with olive oil for two years is associated with increased serum osteocalcin concentrations, suggesting a protective effect on bone.

Age-related bone mass loss and decreased bone strength affects women and men alike are an important determinant of osteoporosis and fracture risk. Studies have shown that the incidence of osteoporosis in Europe is lower in the Mediterranean basin. The traditional Mediterranean diet, rich in fruits and vegetables, with a high intake of olives and olive oil could be one of the environmental factors underlying this difference.

"The intake of olive oil has been related to the prevention of osteoporosis in experimental and in vitro models," said José Manuel Fernández-Real, MD, PhD, of Hospital Dr. Josep Trueta in Girona, Spain and lead author of the study. "This is the first randomized study which demonstrates that olive oil preserves bone, at least as inferred by circulating bone markers, in humans."

The participants in this study were 127 community-dwelling men aged 55 to 80 years randomly selected from one of the Prevencion con Dieta Mediterranea (PREDIMED) study centers who had at least two years of follow-up. The PREDIMED study is a large, parallel group, randomized, controlled trial aimed to assess the effect of the Mediterranean diet on the prevention of cardiovascular diseases.

For this study, subjects were elderly without prior cardiovascular disease but having a diagnosis of type 2 diabetes or harboring at least three cardiovascular risk factors, namely hypertension, dyslipidemia, or a family history of premature cardiovascular disease. Participants were randomly assigned to three intervention groups: Mediterranean diet with mixed nuts, Mediterranean diet with virgin olive oil, and a low-fat diet.

Biochemical measurements of osteocalcin, glucose, total cholesterol, HDL-cholesterol and triglycerides were performed at baseline and after two year follow-up on fasting blood samples. Researchers found that only consumption of the Mediterranean diet with olive oil was associated with a significant increase in the concentrations of total osteocalcin and other bone formation markers. There were also no significant changes in serum calcium in subjects taking olive oil whereas serum calcium decreased significantly in the other two groups.

"It's important to note that circulating osteocalcin was associated with preserved insulin secretion in subjects taking olive oil," added Fernández-Real. "Osteocalcin has also been described to increase insulin secretion in experimental models."

Eating grapes may help protect heart health

Grapes reduced blood pressure, improved blood flow and reduced inflammation

Consuming grapes may help protect heart health in people with metabolic syndrome, according to new research published in the Journal of Nutrition. Researchers observed a reduction in key risk factors for heart disease in men with metabolic syndrome: reduced blood pressure, improved blood flow and reduced inflammation. Natural components found in grapes, known as polyphenols, are thought to be responsible for these beneficial effects.

The randomized, placebo-controlled, crossover study, led by principal investigator Dr. Maria Luz Fernandez and Jacqueline Barona, a PhD student in Dr. Fernandez' lab at the Department of Nutritional Sciences of the University of Connecticut, recruited men between 30 and 70 years of age with metabolic syndrome. The study is believed to be the first to look at the impact of grapes on metabolic syndrome.

Metabolic syndrome is a cluster of conditions that occur together – increased blood pressure, a high blood sugar level, excess body fat around the waist or low HDL (the good cholesterol) and increased blood triglycerides – significantly increasing the risk for heart disease, stroke and diabetes. Metabolic syndrome is a major public health concern, and is on the rise in the U.S.

In this study, participants were randomly assigned to consume grapes, in the form of a freeze-dried whole grape powder, or a placebo powder, for four weeks. Then, following a 3-week "washout" period where neither grapes nor placebo were consumed, individuals were allocated to the alternate treatment. This powerful study design allowed investigators to compare the response of each individual to consumption of both the placebo and grapes.

The study results showed that for each of the study's subjects, grape consumption resulted in significant decreases in blood pressure, improved blood flow (greater vasodilation), and decreases in a compound associated with inflammation.

"These results suggest that consuming grapes can improve important risk factors associated with heart disease, in a population that is already at higher risk," said Fernandez. "This further supports the accumulating evidence that grapes can positively influence heart health, and extends it to men with metabolic syndrome."

Study: daily aspirin linked to lower cancer mortality

A large new observational study finds more evidence of an association between daily aspirin use and modestly lower cancer mortality, but suggests any reduction may be smaller than that observed in a recent analysis. The study, appearing early online in the Journal of the National Cancer Institute (JNCI), provides additional support for a potential benefit of daily aspirin use for cancer mortality, but the authors say important questions remain about the size of the potential benefit.

A recent analysis pooling results from existing randomized trials of daily aspirin for prevention of vascular events found an estimated 37% reduction in cancer mortality among those using aspirin for five years or more. But uncertainty remains about how much daily aspirin use may lower cancer mortality, as the size of this pooled analysis was limited and two very large randomized trials of aspirin taken every other day found no effect on overall cancer mortality.

For the current study, American Cancer Society researchers led by Eric J. Jacobs, Ph.D., analyzed information from 100,139 predominantly elderly participants in the Cancer Prevention Study II Nutrition Cohort who reported aspirin use on questionnaires, did not have cancer at the start of the study, and were followed for up to 11 years. They found daily aspirin use was associated with an estimated 16% lower overall risk of cancer mortality, both among people who reported taking aspirin daily for at least five years and among those who reported shorter term daily use. The lower overall cancer mortality was driven by about 40% lower mortality from cancers of the gastrointestinal tract (such as esophageal, stomach, and colorectal cancer) and about 12% lower mortality from cancers outside the gastrointestinal tract.

The reduction in cancer mortality observed in the current study is considerably smaller than the 37% reduction reported in the recent pooled analysis of randomized trials. The authors note that their study was observational, not randomized, and therefore could have underestimated or overestimated potential effects on cancer mortality if participants who took aspirin daily had different underlying risk factors for fatal cancer than those who did not. However, the study's large size is a strength in determining how much daily aspirin use might lower cancer mortality.

"Expert committees that develop clinical guidelines will consider the totality of evidence about aspirin's risks and benefits when guidelines for aspirin use are next updated," said Dr. Jacobs. "Although recent evidence about aspirin use and cancer is encouraging, it is still premature to recommend people start taking aspirin specifically to prevent cancer. Even low-dose aspirin can substantially increase the risk of serious gastrointestinal bleeding. Decisions about aspirin use should be made by balancing the risks against the benefits in the context of each individual's medical history. Any decision about daily aspirin use should be made only in consultation with a health care professional."

Jon's Health Tips

All articles are available here: Health News Report

Still taking a statin and glad I am

Statins' Heart Benefits Outweigh Diabetes Risk: Study

The cardiac benefits of statins outweigh any increased chances for developing diabetes, even among those who run the highest risk of developing the blood sugar disease, Harvard researchers report.

The concern that these cholesterol-lowering drugs, which include the widely prescribed medications Lipitor, Crestor and Zocor, increased the risk for diabetes prompted the U.S. Food and Drug Administration to require labeling that warns users of the risk.

Although statins did increase the risk for diabetes among those with risk factors for diabetes, these patients were 39 percent less likely to develop heart disease and 17 percent less likely to die, the researchers found.

Patients taking statins who were not at risk for diabetes had a 52 percent lower risk of developing heart disease and no increased risk of developing diabetes, the research team added.

"Among those with no risk factors for diabetes, there were 86 fewer heart attacks, stroke and other major vascular events among those who got the statin as compared to placebo, with no new cases of diabetes at all. So, for this group, there was cardiovascular benefit with no diabetes risk," Ridker said.

Not happening - but exercise is good as well

Weight training associated with reduced risk of type 2 diabetes

Men who do weight training regularly—for example, for 30 minutes per day, five days per week—may be able to reduce their risk of type 2 diabetes by up to 34%,. And if they combine weight training and aerobic exercise, such as brisk walking or running, they may be able to reduce their risk even further—up to 59%.

I'm cutting back in iced tea

Iced Tea Can Contribute to Painful Kidney Stones

Iced tea contains high concentrations of oxalate, one of the key chemicals that lead to the formation of kidney stones, a common disorder of the urinary tract that affects about 10 percent of the population in the United States.

"People are told that in the summertime they should drink more fluids," Milner said. "A lot of people choose to drink more iced tea, because it is low in calories and tastes better than water. However, in terms of kidney stones, they might be doing themselves a disservice."

Though hot tea also contains oxalate, it's hard to drink enough to cause kidney stones, Milner said. About 85 percent of tea consumed in the United States is iced.

Men are four times more likely to develop kidney stones than women, and the risk rises dramatically after age 40.

I have been worried about this, but I'm apparently in relatively good shape

Untreated Heartburn May Raise Risk for Esophageal Cancer

Here’s what they recommend:

• Engage in light physical activity after eating; exercise can help digestion. (Not happening)
• 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. (Happening)
• 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. (Done)
• Avoid caffeine, alcohol and fatty foods, which can increase the risk for acid reflux. ((1 out of 3 isn't bad (fatty foods))

This helps on the above

Aspirin reduces risk of Barrett's esophagus & esophageal cancer

Not convincing enough for me to resume taking yet

Vitamin E May Lower Liver Cancer Risk

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

Cranberry products associated with prevention of urinary tract infections



Individuals can significantly reduce their risk of developing pancreatic cancer by increasing their dietary intake of the antioxidant vitamins C, E, and selenium

I'm trying but falling behind on moderate

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

Beneficial effect of moderate alcohol consumption on osteoporosis in women

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


Want to lose weight? Keep a food journal, don't skip meals and avoid going out to lunch (1 out of 3 again - I don't skip meals!)



Not happening (is it even possible?

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

Good news!

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

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.

I'm good with these:



Cutting Salt Could Reduce Stomach Cancer

Pancreatic Cancer Risk May Be Reduced By High Dietary Antioxidant Intake

Skipping Breakfast Can Lead to Unhealthy Habits All Day Long

Dietary fiber supports gastrointestinal health

Caffeine boosts power for elderly muscles

Coffee consumption lowers risk of most common form of skin cancer

Moderate coffee consumption offers protection against heart failure

Fighting Alzheimer's Disease With Exercise

A diet high in DHA improves memory

Omega-3 fatty acid, curcumin protect an injured spinal cord

Lots of good news about the Vitamin D I take or get from the sun, but some bad news as well

Pancreatic Cancer Risk Lowered By Exposure To Sun

LOWER VITAMIN D COULD INCREASE RISK OF DYING

Vitamin D Supplementation Effective In Fracture Risk Reduction In Older Adults

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

Long-term calcium and vitamin D supplement use = increased risk of kidney stones

Calcium, Vitamin D Supplements May Pose Risks for Men With Prostate Cancer and may actually boost patients' odds for heart disease and aggressive prostate cancer


My wife won't change

Significant Cardiovascular Risk With Low Carbohydrate-High Protein Diets