Monday, April 9, 2012

New evidence could tip the balance in aspirin cancer prevention care

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A new report by American Cancer Society scientists says new data showing aspirin's potential role in reducing the risk of cancer death bring us considerably closer to the time when cancer prevention can be included in clinical guidelines for the use of aspirin in preventive care. The report, published early online in Nature Reviews Clinical Oncology, says even a 10% reduction in overall cancer incidence beginning during the first 10 years of treatment could tip the balance of benefits and risks favorably in average-risk populations.

Current guidelines for the use of aspirin in disease prevention consider only its cardiovascular benefits, weighed against the potential harm from aspirin-induced bleeding. While daily aspirin use has also been convincingly shown to reduce the risk of colorectal cancer and recurrence of adenomatous polyps, these benefits alone do not outweigh harms from aspirin-induced bleeding in average-risk populations. But recently published secondary analyses of cardiovascular trials have provided the first randomized evidence that daily aspirin use may also reduce the incidence of all cancers combined, even at low doses (75-100 mg daily).

The current review, led by Michael J. Thun, M.D., vice president emeritus of epidemiology and surveillance research for the American Cancer Society was not designed as a comprehensive review of the literature, but instead is a focused discussion of the key outstanding issues in using aspirin as a cancer prevention tool.

The report says recently published meta-analyses of results from randomized trials of daily aspirin treatment to prevent vascular events have provided provocative evidence that daily aspirin at doses of 75 mg and above might lower both overall cancer incidence and overall cancer mortality.

In six primary prevention trials of daily low-dose aspirin, randomization to aspirin treatment was associated with an approximately 20% reduction in overall cancer incidence between 3 and 5 years after initiation of the intervention (metaodds ratio [OR] = 0.81; 95% CI 0.67-0.98) and a 30% reduction during follow up more than 5 years after randomization (meta-OR = 0.70; 95% CI 0.56-0.88). Cancer mortality was also reduced during study follow up that happened more than 5 years after the start of aspirin use (meta-OR = 0.63; 95% CI 0.49-0.82) in analyses that included 34 trials of daily aspirin at various doses. Surprisingly, the size of the observed benefit did not increase with daily doses of aspirin above 75-100 mg. Notably, these meta-analyses excluded results from the Women's Health Study (WHS), a large 10-year-long trial of 100 mg of aspirin taken every other day, which reported no reduction in cancer incidence or mortality.

"The accumulating data from randomized clinical trials provide an exciting opportunity to reconsider the potential role of aspirin in cancer prevention," write the authors. They say several important questions remain unanswered, such as the exact magnitude of the overall cancer benefit and which individual cancer sites contribute to this benefit. "However, these new data bring us considerably closer to the time when cancer prevention can be integrated into the clinical guidelines for prophylactic treatment following regulatory review by the FDA and the European Medicines Agency."

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Thursday, April 5, 2012

Eating flavonoids protects men against Parkinson's disease

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Men who eat flavonoid-rich foods such as berries, tea, apples and red wine significantly reduce their risk of developing Parkinson's disease, according to new research by Harvard University and the University of East Anglia (UEA).

Published today in the journal Neurology ®, the findings add to the growing body of evidence that regular consumption of some flavonoids can have a marked effect on human health. Recent studies have shown that these compounds can offer protection against a wide range of diseases including heart disease, hypertension, some cancers and dementia.

This latest study is the first study in humans to show that flavonoids can protect neurons against diseases of the brain such as Parkinson's.

Around 130,000 men and women took part in the research. More than 800 had developed Parkinson's disease within 20 years of follow-up. After a detailed analysis of their diets and adjusting for age and lifestyle, male participants who ate the most flavonoids were shown to be 40 per cent less likely to develop the disease than those who ate the least. No similar link was found for total flavonoid intake in women.

The research was led by Dr Xiang Gao of Harvard School of Public Health in collaboration with Prof Aedin Cassidy of the Department of Nutrition, Norwich Medical School at UEA.

"These exciting findings provide further confirmation that regular consumption of flavonoids can have potential health benefits," said Prof Cassidy.

"This is the first study in humans to look at the associations between the range of flavonoids in the diet and the risk of developing Parkinson's disease and our findings suggest that a sub-class of flavonoids called anthocyanins may have neuroprotective effects."

Prof Gao said: "Interestingly, anthocyanins and berry fruits, which are rich in anthocyanins, seem to be associated with a lower risk of Parkinson's disease in pooled analyses. Participants who consumed one or more portions of berry fruits each week were around 25 per cent less likely to develop Parkinson's disease, relative to those who did not eat berry fruits. Given the other potential health effects of berry fruits, such as lowering risk of hypertension as reported in our previous studies, it is good to regularly add these fruits to your diet."

Flavonoids are a group of naturally occurring, bioactive compunds found in many plant-based foods and drinks. In this study the main protective effect was from higher intake of anthocyanins, which are present in berries and other fruits and vegetables including aubergines, blackcurrants and blackberries. Those who consumed the most anthocyanins had a 24 per cent reduction in risk of developing Parkinson's disease and strawberries and blueberries were the top two sources in the US diet.

The findings must now be confirmed by other large epidemiological studies and clinical trials.

Parkinson's disease is a progresssive neurological condition affecting one in 500 people, which equates to 127,000 people in the UK. There are few effective drug therapies available.

Dr Kieran Breen, director of research at Parkinson's UK said: "This study raises lots of interesting questions about how diet may influence our risk of Parkinson's and we welcome any new research that could potentially lead to prevention.

"While these new results look interesting there are still a lot of questions to answer and much more research to do before we really know how important diet might be for people with Parkinson's."

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Keeping mentally fit through board games or reading may be the best way to preserve memory during late life.

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This study, which focused on mental activities, involved 1,076 people with an average age of 80 who were free of dementia. Participants underwent yearly memory exams for about five years. They reported how often they read the newspaper, wrote letters, visited a library and played board games such as chess or checkers. Frequency of these mental activities was rated on a scale of one to five, one meaning once a year or less and five representing every day or almost every day.

"The results suggest a cause and effect relationship: that being mentally active leads to better cognitive health in old age," said Wilson.

The results showed that people's participation in mentally stimulating activities and their mental functioning declined at similar rates over the years. The researchers also found that they could predict participants' level of cognitive functioning by looking at their level of mental activity the year before but that level of cognitive functioning did not predict later mental activity.

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Why Don't More Women Take a Daily Aspirin to Prevent Heart Disease?

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Heart disease is the leading cause of death among women, and evidence-based national guidelines promote the use of daily aspirin for women at increased risk for cardiovascular disease. However, less than half of the women who could benefit from aspirin are taking it, according to an article in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc. The article is available free online at the Journal of Women’s Health website.

“Based on this survey, it is evident that the majority of women for whom aspirin is recommended for prevention of cardiovascular disease are not following national guidelines,” says Editor-in-Chief Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women’s Health and Executive Director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, VA.

Among more than 200,000 women participating in a web-based survey to assess their risk for cardiovascular disease, only 41%-48% of women for whom aspirin is recommended reported that they took an aspirin daily, according to the study authors, Cathleen Rivera, MD and Texas-based colleagues from Scott and White Healthcare, Navigant Healthcare Consultants, and Texas A&M Health Science Center. The women were more likely to use aspirin if they had a family history of cardiovascular disease or had high cholesterol, as reported in the article “Underuse of Aspirin for Primary and Secondary Prevention of Cardiovascular Disease Events in Women.” The authors conclude that improved educational programs are needed to increase awareness of the benefits of aspirin use to prevent heart disease among women.

Soy may alleviate hot flashes in menopause

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In the most comprehensive study to date to examine the effects of soy on menopause, researchers have found that two daily servings of soy can reduce the frequency and severity of hot flashes by up to 26 percent, compared to a placebo.

The findings, published in Menopause: The Journal of the North American Menopause Association, reviewed 19 previous studies that examined more than 1,200 women.

Although the effectiveness of soy in alleviating hot flashes has been inconclusive, with some studies suggesting soy to be beneficial and others suggesting otherwise, much of the discrepancy is due to small sample sizes and inconsistent methodology, according to the authors.

"When you combine them all, we've found the overall effect is still positive," said Melissa Melby, a medical anthropology professor at the University of Delaware and co-author of the study.

Examining the impact of soy isoflavones, chemicals found in soy that exert a mild estrogen-like effect, Melby and her colleagues found:

- Ingesting at least 54 milligrams of soy isoflavones daily for six weeks to a year reduces menopause hot flash frequency by 20.6 percent and severity by 26 percent, compared to a placebo.
- The total reduction in frequency and severity might be even greater due to the placebo effect.
- In longer duration studies (where women consumed soy isoflavones for 12 weeks or more), the decrease in hot flash frequency was approximately threefold greater than in shorter-duration trials.
- Isoflavone supplements with higher levels (at least 19 milligrams) of genistein, one of the two main types of isoflavones, were more than twice as effective at reducing hot flash frequency than lower amounts.

Melby called the genistein result particularly notable because the compound is the primary isoflavone in soybeans and soy foods, suggesting that, "Eating soy foods, or using supplements derived from whole soybeans, may work better for women."

Each gram of soy protein in soybeans and traditional soyfoods provides approximately 3.5 mg of isoflavones. Two glasses (16 oz) of soymilk or seven ounces of tofu provide approximately 50 mg of isoflavones.

The interest in soy and menopause stems from observational evidence in Japan, where researchers have found the low frequency of hot flashes in Japanese women might be attributed to the high soy consumption that often begins in utero and continues throughout their lifespan.

"Soy is probably more effective in these women," Melby said. "But if you're 50 and you've never touched soy, it's not too late. We've found that it still helps."

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Warning: Farm-Raised Salmon Is a Serious Health Hazard

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Posted by Kevin Passero, ND

For years, salmon has been touted as a health food and as a result, its consumption in the United States has surged. Fifty-two million Americans consume salmon once per month and 23 million Americans eat salmon once weekly. As of 2003, salmon had surpassed fish sticks as the third most commonly consumed fish product behind only shrimp and tuna fish.

The meteoric rise in consumption of this fish was made possible by the innovation of mass farming operations that raise salmon in open water caged environments or in closed tank settings. This dramatically reduced the price by significantly increasing volume.

Most people have heard that they should eat wild salmon over farm-raised salmon, but do you actually know the risks associated with eating the farm-raised variety? Let’s take a closer look.

The primary health concern stems from nasty chemicals called polychlorinated biphenyls (PCBs). These pesticide chemicals were banned in the U.S. in 1976 due to their cancer-causing potential and other negative health effects. Unfortunately, PCBs are persistent organic pollutants, which means that they take a very long time to leave our environment. They still exist in our oceans and waterways and are detectable in the flesh and fat of wild fish.

The high levels of PCBs found in farm-raised salmon come from their food supply. The salmon are fed a high-protein diet derived from smaller feeder fish. This process concentrates the PCBs to dangerously high amounts. How high?

The FDA Fails to Protect American Consumers

According to a study done by the Environmental Working Group, levels of PCBs in farm-raised salmon were 4.5 times higher than the upper limit set forth by the FDA for weekly consumption of fish. According to EPA standards, farm-raised salmon should have a warning label advising people not to eat it more than 1x per month due to the toxic levels of PCBs it contains. So why hasn’t there been a warning issued? Well, the EPA only sets standards for wild-caught salmon. It is the FDA’s job to set the standard for commercially raised fish, and their standard is 500x less protective when it comes to PCB levels. No surprise that, once again, the FDA has failed to protect Americans from harm in favor of giving big business a break.

So besides the possible cancer risk, why are PCBs so harmful?

PCBs Increase Risk of Type II Diabetes

New research based on population analysis and PCB intake from fish has been surfacing directly linking PCB exposure to type II diabetes. Studies on human and animal cells show that certain types of PCBs alter key genes and proteins that effect insulin activity and inflammation, which is a critical part of the development of metabolic syndrome and type II diabetes. This association is new and further research is needed to fully understand the connection, but the preliminary data is alarming. Considering that type II diabetes represents the fastest growing health threat to our country, this is a correlation worth looking into.

The bottom line: If you are going to eat salmon and cannot be absolutely sure that it is wild-caught, restrict it to one time per month. Pregnant women need to be even more careful about consuming farm-raised salmon because the effects of PCBs are more detrimental to a developing baby.

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Caffeine and Exercise May Be Protective Against Skin Cancer

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The combined effects of exercise plus caffeine consumption may be able to ward off skin cancer and also prevent inflammation related to other obesity-linked cancers.

"We found that this combination treatment can decrease sunlight-caused skin cancer formation in a mouse model," said Yao-Ping Lu, Ph.D., associate research professor of chemical biology and director of skin cancer prevention at the Rutgers Ernest Mario School of Pharmacy in Piscataway, N.J. He presented these findings at the AACR Annual Meeting 2012, held in Chicago March 31 -- April 4.

"I believe we may extrapolate these findings to humans and anticipate that we would benefit from these combination treatments as well," Lu added.

The researchers evaluated the effects of caffeine and exercise on mice at high risk for developing skin cancer. Results showed that mice that took a dose of caffeine and exercised with a running wheel experienced 62 percent fewer skin tumors. The volume of tumors also decreased by 85 percent compared with the mice that did not consume caffeine or exercise.

Positive effects were found with either caffeine or exercise alone, but to a lesser extent. Researchers observed a 27 percent reduction in tumors in caffeine-only mice and a 61 percent reduction in tumor size. In the exercise-only mice, researchers found that tumor activity decreased by 35 percent and tumor volume decreased by 70 percent.

The researchers also found that exercise and caffeine reduced weight and inflammation. They fed mice a high-fat diet of omega-6 fatty acid-rich foods and measured the volume of the parametrial fat pad (the largest fat pad in a mouse) after two weeks of exercise and/or caffeine treatment.

Mice that had caffeine and exercised had a fat pad weight decrease of 63 percent. Caffeine-only mice had a 30 percent decrease, and exercise-only mice had a 56 percent decrease. Development and size of cancer decreased as well. The link, Lu believes, is inflammation, which dropped as much as 92 percent in mice that exercised and consumed caffeine.

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