Older adults who 'train' for a major operation spend less time in the hospital

Older adults who "train" for a major operation by exercising, eating a healthy diet, and practicing stress reduction techniques preoperatively have shorter hospital stays and are more likely to return to their own homes afterward rather than another facility, compared with similar patients who do not participate in preoperative rehabilitation, according to research findings. The new study, which appears as an "article in press" on the Journal of the American College of Surgeons website in advance of print, evaluated a home-based program of preoperative rehabilitation--called prehabilitation--for Michigan Medicare beneficiaries.

The researchers also reported an association between prehabilitation and lower total insurance payments for all phases of care.

"Prehabilitation is good for patients, providers, and payers," said study coauthor Michael J. Englesbe, MD, FACS, a liver transplant surgeon at the University of Michigan, Ann Arbor. "We believe every patient should train for a major operation. It's like running a 5K race: You have to prepare."

Involving physical and lifestyle changes, prehabilitation, or "prehab," optimizes a patient's well-being and ability to withstand the stress of undergoing an operation, Dr. Englesbe said. Past studies show that prehabilitation lowers the rate of postoperative complications and speeds the patient's return to their normal functioning, among other advantages.*

"Prehab has been gaining momentum over the past 10 years. More surgeons and other clinicians are appreciating its benefits," Dr. Englesbe said. "However, the feasibility and value of broad implementation of prehabilitation outside the research environment were unknown."

For this new study researchers tested the real-world effectiveness and cost savings of prehabilitation. Patients underwent diverse cardiothoracic (chest/heart) and abdominal operations at 21 hospitals in Michigan that participated in a statewide prehabilitation program called the Michigan Surgical & Health Optimization Program (MSHOP). Patients' surgeons referred them to MSHOP if they were at high risk of postoperative complications, Dr. Englesbe, program co-developer and director, said.

Physical and psychological preparation
MSHOP involved a home-based walking program in which surgical patients tracked their steps using a pedometer and received daily reminders and feedback through phone, email, or text messages. Program participants received educational materials on nutrition, relaxation techniques, and smoking cessation as well. They also practiced using an incentive spirometer, a medical device that helps patients keep their lungs healthy after an operation.

Included in the study were 523 Medicare patients who participated in MSHOP for at least one week before an inpatient operation and filed Medicare claims between 2014 and 2017, according to the article. For comparison, the researchers used Medicare claims data during the same period to identify 1,046 matched controls: patients with similar demographic characteristics and coexisting illnesses who had the same operation at the same hospital but did not take part in prehabilitation. The average age of patients and controls was 70 years.

Participation in MSHOP ranged from 11 to 33 days, the researchers reported. Of the participants, 62 percent were reportedly "engaged" in the prehabilitation program, defined as recording step counts three or more times per week for most of the program. Thirty-nine patients (7.5 percent) asked to be removed from the program, but they remained in the statistical data analysis. For both groups, the study authors analyzed data for the hospitalization and 90 days afterward.

Prehabilitation leads to better outcomes
Participation in prehabilitation was significantly associated with several improved outcomes that are important to patients or insurers, according to the researchers:

• The hospital length of stay was shorter by one day, with a median (middle value) of six days for participating patients versus seven days for controls, who received no prehabilitation.
• Program participants were more likely to be discharged from the hospital to home: 65.6 percent versus 57 percent of controls.
• Medicare paid nearly $3,200 less in total payments for both hospital and posthospital care (what Medicare calls an "episode of care") for patients who underwent prehabilitation than for controls: $31,641 versus $34,837.
• Insurance payments were especially lower among patients for posthospital care, including skilled nursing facility ($941 versus $1,566 for controls) and home health care ($829 versus $960 for controls).

"Every patient scheduled for a major operation--not just those at high risk--should ask their surgeon for a prehabilitation program," Dr. Englesbe recommended.

Although the study did not evaluate patient satisfaction with prehabilitation, Dr. Englesbe said patients at his medical center who completed MSHOP described their surgical experience positively, using words such as "empowering." Some patients requested MSHOP when they required another operation, he said.

Dr. Englesbe said he hopes that prehabilitation will become the standard of surgical care in Michigan.

Nationwide, prehabilitation is an area of focus for the American College of Surgeons' Strong for Surgery program, which promotes evidence-based practices to boost preoperative health. Prehab also is part of the College's new Geriatric Surgery Verification Program standards, developed to optimize surgical care for older adults, and now enrolling hospitals nationally.

A strong link between non-HDL cholesterol levels and long-term risk for cardiovascular disease in people aged under 45 years

• Study is the most comprehensive analysis of long-term risk for cardiovascular disease related to non-high-density lipoprotein (non-HDL) cholesterol - including almost 400,000 people from 19 countries who were followed for up to 43.5 years (median 13.5 years follow-up) between 1970 to 2013.
• This longer-term evidence may be particularly important in people aged under 45 years.
• Depending on cholesterol level and number of cardiovascular risk factors, men and women aged under 45 years have a 12-43% or 6-24% risk (respectively) of having fatal or non-fatal heart disease or stroke by the age of 75 years.
• If non-HDL cholesterol levels were halved, women and men younger than 45 years with starting levels of non-HDL cholesterol between 3.7-4.8 mmol/litre and who had two additional cardiovascular risk factors could reduce their risk from around 16% to 4%, and from around 29% to 6%, respectively.

The most comprehensive analysis of its kind suggests that there is a strong link between non-HDL cholesterol levels and long-term risk for cardiovascular disease in people aged under 45 years, not just at older ages.
The observational and modelling study which used individual-level data from almost 400,000 people, published in The Lancet, extends existing research because it suggests that increasing levels of non-HDL cholesterol may predict long-term cardiovascular risk by the age of 75 years. Past risk estimates of this kind are based on 10-year follow-up data.
For example, women with non-HDL cholesterol levels between 3.7-4.8 mmol/litre, who were younger than 45 years, and had at least two additional cardiovascular risk factors, had a 16% probability of experiencing a cardiovascular disease event by the age of 75 years (ie, 16 in 100 women with these characteristics were predicted to have a cardiovascular event by the age of 75 years). For women aged 60 or over with the same characteristics, the estimated risk was 12%.
For men with the same characteristics, the estimated risk for those aged under 45 years was 29%, and was 21% for those aged 60 years or more.
"This increased risk in younger people could be due to the longer exposure to harmful lipids in the blood. The risk may also appear larger compared to older ages because people aged 60 years and older in our study had not developed cardiovascular disease up to this age, so they may be healthier than others of their age who were excluded from the study because they had had cardiovascular disease," says Professor Barbara Thorand, German Research Center for Environmental Health, Germany. [1]
The amount of non-HDL cholesterol [2] and low-density lipoproteins (LDL) in the blood are accepted as causal risk factors for cardiovascular disease, and play a significant part in predicting a person's risk of developing cardiovascular disease.
The authors say that intervening early and intensively to reduce non-HDL cholesterol levels during the lifespan could potentially reverse early signs of atherosclerosis. However, considerable uncertainty exists about the extent to which slightly increased or apparently normal cholesterol levels affect lifetime cardiovascular risk, and about which levels should be used to make treatment recommendations, particularly in young people.
In the study, the authors used individual-level data from almost 400,000 people from 38 studies from Europe, Australia and North America. The participants had no cardiovascular disease at the start of the study and were followed for up to 43.5 years (median 13.5 years follow-up) for the occurrence of a fatal or non-fatal coronary heart disease event or ischaemic stroke.
Using their data, the authors assessed and confirmed the long-term association between cholesterol levels and cardiovascular event risk. They then used this data in a model to estimate the probability of a cardiovascular event by the age of 75 years for people aged 35-70 years, according to a person's gender, non-HDL cholesterol levels, age, and cardiovascular disease risk factors (such as smoking status, diabetes, BMI, systolic blood pressure, and antihypertensive medication). The model also estimated how much risk could be reduced if non-HDL cholesterol levels were halved (the authors note that the 50% reduction was hypothetical and not based on specific estimates or treatments).
During follow-up, there were 54,542 fatal or non-fatal cases of heart disease and stroke.
Looking at data for all age groups and both sexes, the authors found that the risk for a cardiovascular event decreased continuously with decreasing non-HDL levels and the risk was lowest for those individuals with the lowest non-HDL levels (classified as below 2.6 mmol non-HDL cholesterol per litre in the study). [3]
Using the model to estimate the risk of a cardiovascular event by the age of 75 years for different age groups, the authors found that the highest long-term risks of cardiovascular disease were seen in individuals younger than 45 years of age.
For example, women with non-HDL cholesterol levels between 3.7-4.8 mmol/litre, who were younger than 45 years, and had at least two additional cardiovascular risk factors, had an estimated 16% probability of experiencing a cardiovascular disease event by the age of 75 years (ie, 16 in 100 women with these characteristics were predicted to have a cardiovascular event by the age of 75 years). For women aged 60 or over with the same characteristics, the estimated risk was 12%. For men with the same characteristics, the estimated risk for those aged under 45 years was 29%, and was 21% for those aged 60 years or more.
Using the model to estimate how much cardiovascular disease could be reduced if a person halved their non-HDL cholesterol levels, the authors found that for all non-HDL cholesterol levels, the greatest reductions were seen in the youngest age group compared with older age groups.
For example, in people younger than 45 years with levels of 3.7-4.8 mmol/litre and with at least two risk factors, they estimated that the long-term risk of cardiovascular disease could hypothetically be reduced from 16% to 4% in women, and from 29% to 6% in men. For people with the same characteristics aged 60 years or over, risk could potentially be reduced from 12% to 6% in women and from 21% to 10% in men.
"Our estimates suggest that halving non-HDL cholesterol levels may be associated with reduced risk of cardiovascular events by the age of 75 years, and that this reduction in risk is larger the sooner cholesterol levels are reduced. The risk scores currently used in the clinic to decide whether a person should have lipid-lowering treatment only assess the risk of cardiovascular disease over 10 years, and so may underestimate lifetime risk, particularly in young people," says Professor Stefan Blankenberg, German Center for Cardiovascular Research, Germany. [1]
"In lieu of needed clinical trial results investigating the benefits of long-term lipid-lowering therapy in people younger than 45, this study may provide helpful insights on the benefits of lipid-lowering therapy as primary prevention from an earlier age. However, future research is needed to understand whether intervention in young people with a high lifetime risk, but low 10-year risk, would have more benefits than later intervention," he concludes. [1]
Professor Frank Kee, Queens University Belfast, UK, adds: "Further research is also needed on how useful lifetime absolute risk estimates are for motivating behaviour change among otherwise healthy young people, and whether titrating any intervention dose according to a non-HDL target would be more effective than to a target of overall life-time risk." [1]
The authors note some limitations within their study, including that their study results may not be generalisable to other regions or racial and ethnic groups as the study was based on data from people of European ancestry from high-income countries.
The authors used data about the participants' non-HDL cholesterol levels when they entered the study only, and so could not account for changes in cholesterol levels. However, they note that non-HDL cholesterol levels in young people are generally stable over the 30-year life course. They also could not account for participants beginning to take lipid-lowering therapy during the study, but adjusted cholesterol levels for people who were already taking lipid-lowering therapy at the start of the study.
Lastly, they note that their modelled 50% reduction posits that the effects of treatment apply over a longer period (30 years) than has been studied in clinical trials (around seven years), and note that real-world benefits of lipid-lowering therapies like statins are probably lower than the cholesterol reductions seen in trials because of sub-optimal adherence and side effects.
Writing in a linked Comment, Professor Jennifer G Robinson, University of Iowa, USA, also says that the size of this reduction is the main limitation of the analysis, as only long-term lipid-lowering treatment is likely to achieve a reduction of this size, but the existing evidence for these drugs does not assess decades-long treatment, meaning that the risk of adverse events - which would alter the benefit-to-risk ratio - are unclear.
She writes: "The novelty of Brunner and colleagues' findings arises from projecting the effect of beginning cholesterol-lowering therapy early in life. Such therapy could reduce the lifetime risk of atherosclerotic cardiovascular disease in patients with increased concentrations of non-HDL and LDL cholesterol, especially when risk is further amplified by the presence of comorbid factors. These individuals could be at much lower 10-year risk thresholds of atherosclerotic cardiovascular disease than are currently recommended for consideration of statin therapy. Lowering cholesterol with more intensive therapy is also supported by findings that generic statins are cost-saving or highly cost-effective even for primary prevention in patients at low risk of cardiovascular disease."

Eating within 10-hour window may help stave off diabetes, heart disease

Metabolic syndrome is the name for a group of risk factors, such as high blood pressure and cholesterol levels, that increase the risk for adverse health issues, from heart disease and diabetes to stroke. Eating healthier, getting more exercise and taking prescribed medications when needed are common remedies but often prove insufficient to fully managing risks.
In a recent collaborative effort, researchers from University of California San Diego School of Medicine and the Salk Institute for Biological Studies reported a form of intermittent fasting, called time-restricted eating, improved the health of study participants who had been diagnosed with metabolic syndrome.
The pilot study, published online in the December 5, 2019 edition of Cell Metabolism, found that when participants restricted their eating to 10 hours or less over a period of 12 weeks, they lost weight, reduced abdominal fat, lowered blood pressure and cholesterol and enjoyed more stable blood sugar and insulin levels.
"As a cardiologist, I find it is very hard to get patients with prediabetes or metabolic syndrome to make lasting and meaningful lifestyle changes," said Pam Taub, MD, co-corresponding author and associate professor of medicine at UC San Diego School of Medicine and cardiologist at the Cardiovascular Institute at UC San Diego Health. "There is a critical window for intervention with metabolic syndrome. Once people become diabetic or are on multiple medications, such as insulin, it's very hard to reverse the disease process.
"Metabolism is closely linked with circadian rhythms, and knowing this, we were able to develop an intervention to help patients with metabolic syndrome without decreasing calories or increasing physical exercise."
Time-restricted eating (eating all calories within a consistent 10-hour window) allows individuals to eat in a manner that supports their circadian rhythms and their health. Circadian rhythms are the 24-hour cycles of biological processes that affect nearly every cell in the body. Erratic eating patterns can disrupt this system and induce symptoms of metabolic syndrome, including increased abdominal fat and abnormal cholesterol or triglycerides.
"Time-restricted eating is a simple dietary intervention to incorporate, and we found that participants were able to keep the eating schedule," said Satchin Panda, PhD, co-corresponding author and professor in Salk's Regulatory Biology Laboratory. "Eating and drinking everything (except water) during a 10-hour window allows your body to rest and restore for 14 hours at night. Your body can also anticipate when you will eat, so it can prepare the body to optimize metabolism."
The study involved 19 participants diagnosed with metabolic syndrome, with 16 taking at least one medication, like a statin. Participants used an app created by Panda called myCircadianClock to log when and what they ate during an initial two-week baseline period followed by three months of 10-hour time-restricted eating per day. They were told they could decide what time to eat and how much to eat as long as all food consumption occurred within a 10-hour window.
At the end of the 12 weeks, participants averaged a 3 percent reduction in weight and body mass index (BMI) and a 4 percent reduction in abdominal/visceral fat. Many also experienced reductions in cholesterol and blood pressure and improvements in fasting glucose. Seventy percent of participants reported an increase in sleep satisfaction or in the amount they slept. "Patients also reported that they generally had more energy, and some were able to have their medications lowered or stopped after completing the study," said Taub.
More than two-thirds of participants continued with time-restricted eating for up to a year after the study concluded -- at least part of the time. "Adapting this 10-hour time-restricted eating is also a cost-effective method for reducing symptoms of metabolic syndrome and improving health," said Panda. "By delaying the onset of diabetes by even one year in a million people with prediabetes, the intervention could save roughly $9.6 billion dollars in health care costs."
The researchers are currently conducting another clinical trial to examine the benefits of time-restricted eating in a larger group of more than 100 participants with metabolic syndrome. The study examines additional measures that will help the researchers investigate changes in body composition and muscle function.
"Knowing how to optimize circadian rhythms could lead to a new treatment option for metabolic syndrome patients with life-altering diseases," said Taub.

Scientists discover multiple mechanisms at work in widely-used diabetes drug metformin

Salk Institute

IMAGE: Computational analysis revealing targets of metformin. view more 

Credit: Salk Institute

Metformin is the most commonly prescribed type 2 diabetes drug, yet scientists still do not fully know how it works to control blood sugar levels. In a collaborative effort, researchers from the Salk Institute, The Scripps Research Institute and Weill Cornell Medical College have used a novel technology to investigate why it functions so well. The findings, which identified a surprising number of biochemical "switches" for various cellular processes, could also explain why metformin has been shown to extend health span and life span in recent studies. The work was published in Cell Reports on December 3, 2019.
"These results provide us with new avenues to explore in order to understand how metformin works as a diabetes drug, along with its health-span-extending effects," says Professor Reuben Shaw, co-corresponding author of the paper and the director of Salk's NCI-designated Cancer Center. "These are pathways that neither we, nor anyone else, would have imagined."
Previously, the only biochemical pathway that was known to be activated by metformin was the AMPK pathway, which Shaw discovered stalls cell growth and changes metabolism when nutrients are scarce, as can occur in cancer. But the scientists believed more pathways than AMPK might be involved.
The scientists developed a novel screening platform to examine kinases, the proteins that transfer phosphate groups, which are critical on/off switches in cells and can be rapidly flipped by metformin. Using this technology, the researchers were able to decode hundreds of regulatory "switch-flipping" events that could affect healthy aging.
"Being mentored by John Yates, one of the top mass spectrometry investigators in the world, and Reuben Shaw, an expert in the field of metabolism, enabled me to both develop and apply a novel technology to a critical biological question: What pathways are regulated by metformin in the liver?" says Ben Stein, first author and postdoctoral associate at Weill Cornell Medical College.
The results revealed that metformin turns on unexpected kinases and pathways, many independent of AMPK. Two of the activated kinases are called Protein Kinase D and MAPKAPK2. These kinases are poorly understood, but are known to have some relation to cellular stress, which could connect them to the health-span- and life-span-extending effects observed in other studies. In fact, metformin is currently being tested in multiple large-scale clinical trials as a health-span- and life-span-extending drug, but the mechanism for how metformin could affect health and aging has not been clear. The current study indicates that Protein Kinase D and MAPKAPK2 may be two players in providing these therapeutic effects, and identifies new targets and cellular processes regulated by AMPK that may also be critical to metformin's beneficial effects.
"We never imagined these two kinases would have anything to do with metformin," says Shaw, holder of the William R. Brody Chair. "The results broaden our understanding of how metformin induces a mild stress that triggers sensors to restore metabolic balance, explaining some of the benefits previously reported such as extended healthy aging in model organisms taking metformin. The big questions now are what targets of metformin can benefit the health of all individuals, not just type 2 diabetics."
Next, the researchers plan to examine the new signaling pathways they discovered in more detail to better understand the beneficial effects of metformin.

Aspirin can be considered a possible clinical option to other, more costly treatment and preventive options for migraines

According to a new report in The American Journal of Medicine, published by Elsevier, aspirin can be considered an effective and safe option to other, more expensive medications to treat acute migraines as well as prevent recurrent attacks. A review of randomized evidence suggests efficacy and safety of high dose aspirin in doses from 900 to 1,300 milligrams taken at the onset of acute symptoms. The data also support a lower dose of from 81 to 325 milligrams as a possible preventive option.
"Aspirin provides a possible clinical option for primary healthcare providers to relieve the debilitating symptoms of acute migraine headaches and prevent recurrent attacks. Aspirin's side effect profile and low cost may also favour its use," noted senior author Charles H. Hennekens, MD, DrPH, the first Sir Richard Doll Professor & Senior Academic Advisor to the Dean of the Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, FL, USA. The investigators reviewed the randomized evidence for high dose aspirin in treatment and low dose aspirin in prevention of migraine headaches.
Migraine headache is the third most common disease in the world affecting about one in seven people. More prevalent than diabetes, epilepsy, and asthma combined, migraine headaches are among the most common and potentially debilitating disorders encountered by primary healthcare providers. Migraines are also associated with an increased risk of stroke. There are effective prescription medications available to treat acute migraine headaches as well as to prevent recurrent attacks. Nonetheless, in the United States many patients are not adequately treated for reasons that include limited access to healthcare providers, lack of health insurance, or high co-pays, which make expensive medications of proven benefit unaffordable. The rates of uninsured (or underinsured) have been estimated to be 8.5 percent nationwide and 13 percent in Florida. Furthermore, for all patients, the prescription drugs may be poorly tolerated or contraindicated.
Professor Hennekens mused that, "If aspirin were only half as effective, 10 times more expensive, and available by prescription, then perhaps patients and, possibly some of their healthcare providers, would take it more seriously."
"Despite the fact that aspirin is an over-the-counter drug," Dr. Hennekens cautioned, "as is the case for any drug used long term, it should be prescribed by a healthcare provider."
Joseph S. Alpert, MD, Editor-in-Chief of The American Journal of Medicine and Professor of Medicine, University of Arizona Department of Medicine, Tucson, AZ, USA, commented in an accompanying editorial, "My take home message from this thoughtful and carefully researched review is that physicians should always try the simple and inexpensive high dose aspirin regimen as the initial therapeutic attempt for migraine headache control. If aspirin works to abort or ameliorate the headaches, then it should be tried as a prophylactic measure to see if it can prevent the occurrence of these debilitating headaches. Hopefully, this would lead to less disability and loss of employment time for these patients who are so common in the US and throughout the world."

Protein amounts larger than the recommended dietary allowance benefits only those who are cutting calories or strength training

Purdue University

IMAGE: A new study by Purdue University nutrition scientists show that eating more protein daily than what is recommended may only benefit a few - those who are actively losing weight... view more 

Credit: Shaw Nielsen

While some diets load up on protein and other diets dictate protein sources, it can be hard to know what to consume while managing weight or during weight loss.
A new study by Purdue University nutrition scientists shows that eating more protein daily than what is recommended may benefit only a few - those who are actively losing weight by cutting calories or those strength training to build more lean muscle mass. This study also affirms that the recommended dietary allowance, of 0.8 grams of protein per kilogram of body weight per day - or 0.36 grams per pound - is adequate for most people. For example, an adult who weighs 150 pounds should eat 54 grams of protein a day, which could be three ounces of lean meat, three cups of dairy and one ounce of seeds or nuts within a day.
"But here is the hard part for consumers: These findings support that most adults who are consuming adequate amounts of protein may only benefit from moderately higher protein intake when they are purposefully trying to change their body composition such as when dieting or strength training. The results are not meant to encourage everyone to increase their protein intake in general," said Wayne Campbell, a professor of nutrition science, whose research integrates exercise physiology, geriatrics and nutrition, especially protein.
The study was led by Joshua L. Hudson, Purdue postdoctoral research associate, and it is published in Advances in Nutrition.
"This research uniquely assesses whether adults benefit from consuming more protein than the current recommended dietary allowance," Hudson said. "This research was not designed to assess whether or not adults would benefit from consuming more protein than they usually consume. This distinction is important because the recommended dietary allowance is the standard against which to assess nutrition adequacy; however, most adults consume more protein than what is recommended."
When people are in a neutral metabolic state - not losing weight or lifting weights - eating more protein does not influence their body composition any differently, including lean mass, which is consistent with the current recommended dietary allowances being adequate for generally healthy sedentary weight-stable people. This does not include adults with Type 2 diabetes.
"And that is important because there is so much encouragement, advertising and marketing for everyone to eat higher protein diets, and this research supports that, yes, under certain conditions, including strength training and weight loss, moderately more protein may be helpful, but that doesn't mean more is needed for everybody at all times," Hudson said.
More than 1,500 nutrition articles were screened across journal databases to identify 18 studies with 22 intervention groups and 981 participants that addressed this topic. The studies were selected based on specific factors including inclusion of healthy adults, protein intake, weight loss and physical activity. The sources of protein evaluated included lean and minimally processed meats, dairy, eggs, nuts, seeds and legumes.
"This research is clinically more important for women and especially older women who are known to typically consume lower amounts of protein and should be maintaining a healthy bodyweight and regularly strength training," Campbell said.
What do these findings mean for someone watching their weight during the holidays or planning New Year's resolutions?
"If you are going to start losing weight, don't cut back across all foods you usually consume, because you'll inadvertently cut back protein. Instead, work to maintain, or even moderately increase, protein-rich foods. Then, cut back on the carbs and saturated fat-containing foods," said Campbell, who studies how sources and amounts of protein - which is critical to building muscle mass - may be a part of adopting healthy eating patterns, including the Mediterranean diet and DASH diet.
These findings are in general, and more evaluation is needed to determine effects on age and gender. This research does not apply to elite athletes or people who lost weight with bariatric surgery, nor does it relate to protein supplements.
No external funding was used for this study. Campbell's lab continues to study the influences of healthy eating patterns and diets with different amounts and sources of protein on changes in body composition and clinical health risk factors.

Aspartame Is Linked To Leukemia And Lymphoma In Landmark Study On Humans

It’s time to play Kick the Can—of soda, that is.

In a 22-year landmark study published in The American Journal of Clinical Nutrition involving over 125,000 people, significant links were found between daily intake of aspartame and the development of leukemia and lymphoma. (1) These findings are consistent with previous studies in animal models:

“A recent megaexperiment in 1800 rats tested at aspartame doses much lower than the currently acceptable daily intake (ADI) for humans reported a dose-dependent increase in lymphomas, leukemias, and transitional renal cell tumors.” (2, 3)

Broken down, here are the primary results of this mega-study.

• Consuming only one 12-ounce can of diet soda per day increased risk of lymphoma and myeloma (cancer of blood plasma), the incidence increasing in correlation with aspartame intake. The risk was much higher in men (it hasn’t been identified why that is the case).
• There is an elevated risk of lymphoma with higher consumption of non-diet soda in men than women.
• Annual consumption of aspartame in the United States is estimated at 5000-5500 tons and the most common product in which it is used is diet soda.
• Aspartame (especially in liquids) breaks down into asparitic acid, methanol, and phenylalanine; when ingested, methanol turns into formaldehyde—a known carcinogen.
• Previous studies that didn’t support a link between aspartame and cancer were limited in time and scope. This study included a large sample size and scientifically-viable time period and tested subjects at intervals throughout the study.
• Subjects’ measured aspartame intake included that added from packets (e.g., NutraSweet and Equal) and contributed to the weighting of the results.
• Subjects with a higher intake of diet soda had a higher body mass index and animal protein intake and were less likely to smoke. (This is highly significant: it is known that aspartame contributes to obesity and metabolic syndrome; the result noted here corroborates that finding. Additionally, this group of diet soda drinkers didn’t smoke cigarettes, discounting smoking as a contributing factor to the development of cancer in the study.)

This research begs the question: what will we find about the effects of aspartame on human health twenty years from now, when the generation that grew up with it is at middle age?

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If this isn’t enough to get you to kick the can to the curb for good (and then recycle it!), other studies show a direct connection between the methanol in aspartame and neurological disease.

Is anyone surprised?

Thirty years ago, a toxicologist from the Food and Drug Administration (FDA) testified before the U.S. Congress on the subject of the safety of aspartame in the food supply:

“…the cancer-causing potential of aspartame is a matter that had been established way beyond any reasonable doubt… Given the cancer-causing potential of aspartame, how would the FDA justify its position that it views a certain amount of aspartame as constituting an allowable daily intake or safe level of it? Is that position in effect not equivalent to setting a tolerance for this food additive and thus a violation of that law? And if the FDA itself elects to violate the law, who is left to protect the health of the public?” Congressional Record SID835:131 (8/1/85)

Yet aspartame is not only legal, it’s consumed at thousands of tons per year.

Aspartame poisoning, while not on most doctors’ diagnosis chart, is disturbingly real. It can manifest in symptoms similar to multiple sclerosis, digestive problems, severe muscle pain, headaches, dizziness, and blurred vision. These symptoms will subside if the artificial sweetener is discontinued. The research here discussed shows that sustained exposure has a cumulative effect and there is a point at which it becomes life-threatening.

Oh, and by the way: regular soda is just as bad as diet.

High-fructose corn syrup (the primary sweetener in most non-diet sodas) causes cancer, heart disease, obesity, and dementia, too.
If you need a sweet drink, try fruit-infused water and mixing honey or maple syrup with water or club soda (real club soda that contains only water and bicarbonate of soda). If it’s the push of caffeine you want, drink coffee, black tea, matcha, or yerba maté. But by all means, kick the killer soda habit.