Miscellaneous Health Benefits of Coffee

Drinking coffee = lower risk of developing multiple sclerosis

Drinking coffee may be associated with a lower risk of developing multiple sclerosis (MS), according to a study released today that will be presented at the American Academy of Neurology's 67th Annual Meeting in Washington, DC, April 18 to 25, 2015.

"Caffeine intake has been associated with a reduced risk of Parkinson's and Alzheimer's diseases, and our study shows that coffee intake may also protect against MS, supporting the idea that the drug may have protective effects for the brain," said study author Ellen Mowry, MD, MCR, with Johns Hopkins University School of Medicine in Baltimore and a member of the American Academy of Neurology.

For the study, researchers looked at a Swedish study of 1,629 people with MS and 2,807 healthy people, and a U.S. study of 1,159 people with MS and 1,172 healthy people. The studies characterized coffee consumption among persons with MS one and five years before MS symptoms began (as well as 10 years before MS symptoms began in the Swedish study) and compared it to coffee consumption of people who did not have MS at similar time periods. The study also accounted for other factors such as age, sex, smoking, body mass index, and sun exposure habits.

The Swedish study found that compared to people who drank at least six cups of coffee per day during the year before symptoms appeared, those who did not drink coffee had about a one and a half times increased risk of developing MS. Drinking large amounts of coffee five or 10 years before symptoms started was similarly protective.

In the US study, people who didn't drink coffee were also about one and a half times more likely to develop the disease than those who drank four or more cups of coffee per day in the year before symptoms started to develop the disease.\

"Caffeine should be studied for its impact on relapses and long-term disability in MS as well," said Mowry.


Increased Caffeinated Coffee Consumption Associated With Decreased Risk of Depression in Women

The risk of depression appears to decrease for women with increasing consumption of caffeinated coffee, according to a report in the September 26, 2011 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Caffeine is the most frequently used central nervous system stimulant in the world, and approximately 80 percent of consumption is in the form of coffee, according to background information in the article. Previous research, including one prospective study among men, has suggested an association between coffee consumption and depression risk. Because depression is a chronic and recurrent condition that affects twice as many women as men, including approximately one of every five U.S. women during their lifetime, “identification of risk factors for depression among women and the development of new preventive strategies are, therefore, a public health priority,” write the authors. They sought to examine whether, in women, consumption of caffeine or certain caffeinated beverages is associated with the risk of depression.

Michel Lucas, Ph.D., R.D., from the Harvard School of Public Health, Boston, and colleagues studied 50,739 U.S. women who participated in the Nurses’ Health Study. Participants, who had a mean (average) age of 63, had no depression at the start of the study in 1996 and were prospectively followed up with through June 2006. Researchers measured caffeine consumption through questionnaires completed from May 1980 through April 2004, including the frequency that caffeinated and noncaffeinated coffee, nonherbal tea, caffeinated soft drinks (sugared or low-calorie colas), caffeine-free soft drinks (sugared or low-calorie caffeine-free colas or other carbonated beverages) and chocolate were usually consumed in the previous 12 months. The authors defined depression as reporting a new diagnosis of clinical depression and beginning regular use of antidepressants in the previous two years.

Analysis of the cumulative mean consumption included a two-year latency period; for example, data on caffeine consumption from 1980 through 1994 were used to predict episodes of clinical depression from 1996 through 1998; consumption from 1980 through 1998 were used for the 1998 through 2000 follow-up period; and so on. During the 10-year follow-up period from 1996 to 2006, researchers identified 2,607 incident (new-onset) cases of depression. When compared with women who consumed one cup of caffeinated coffee or less per week, those who consumed two to three cups per day had a 15 percent decrease in relative risk for depression, and those consuming four cups or more per day had a 20 percent decrease in relative risk. Compared with women in the lowest (less than 100 milligrams [mg] per day) categories of caffeine consumption, those in the highest category (550 mg per day or more) had a 20 percent decrease in relative risk of depression. No association was found between intake of decaffeinated coffee and depression risk.

“In this large prospective cohort of older women free of clinical depression or severe depressive symptoms at baseline, risk of depression decreased in a dose-dependent manner with increasing consumption of caffeinated coffee,” write the authors. They note that this observational study “cannot prove that caffeine or caffeinated coffee reduces the risk of depression but only suggests the possibility of such a protective effect.” The authors call for further investigations to confirm their results and to determine whether usual caffeinated coffee consumption could contribute to prevention or treatment of depression.

Coffee W/O Milk Fights Bad Breath

We all know why Starbucks puts boxes of breath mints close to the cash register. Your morning latte can create a startling aroma in your mouth, strong enough to startle your co-workers too.

But intriguing research from Tel Aviv University by renowned breath specialist Prof. Mel Rosenberg of TAU's Sackler Faculty of Medicine finds that a coffee extract can inhibit the bacteria that lead to bad breath. laboratory tests have shown that the extract prevents malodorous bacteria from making their presence felt — or smelt.

"Everybody thinks that coffee causes bad breath," says Prof. Rosenberg, "and it's often true, because coffee, which has a dehydrating effect in the mouth, becomes potent when mixed with milk, and can ferment into smelly substances."

But not always. "Contrary to our expectations, we found some components in coffee that actually inhibit bad breath," explains Prof. Rosenberg.

In the laboratory, the team monitored the bacterial odor production of coffee in saliva. In the study, three different brands of coffee were tested: the Israeli brand Elite coffee, Landwer Turkish coffee, and Taster's Choice. Prof. Rosenberg expected to demonstrate the malodor-causing effect of coffee in an in vitro saliva assay developed by Dr. Sarit Levitan in his laboratory. To his surprise, the extracts had the opposite effect.

"The lesson we learned here is one of humility," says Prof. Rosenberg. "We expected coffee would cause bad breath, but there is something inside this magic brew that has the opposite effect."

Prof. Rosenberg would love to isolate the bacterial-inhibiting molecule in order to reap the biggest anti-bacterial benefits from coffee. "It's not the raw extract we will use, he says, "but an active material within it." His latest discovery could be the foundation for an entirely class of mouthwash, breath mints and gum. Purified coffee extract can be added to a breath mint to stop bacteria from forming, stopping bad breath at its source, instead of masking the smell with a mint flavor.

Prof. Rosenberg is a successful scientist and inventor who has already developed a popular mouthwash sold widely in Europe, a pocket-based breath test, and an anti-odor chewing gum.

Coffee consumption may lower blood uric acid levels

High uric acid levels in the blood are a precursor of gout, the most common inflammatory arthritis in adult men. It is believed that coffee and tea consumption may affect uric acid levels but only one study has been conducted to date. A large-scale study published in the June 2007 issue of Arthritis Care & Research examined the relationship between coffee, tea, caffeine intake, and uric acid levels and found that coffee consumption is associated with lower uric acid levels but that this appears to be due to components other than caffeine.

Coffee is one of the most widely consumed beverages in the world; more than 50 percent of Americans drink it at the average rate of 2 cups per day. Because of this widespread consumption, its potential effects have important implications for public and individual health. Led by Hyon K. Choi, of the University of British Columbia in Vancouver, Canada, the current study was based on the U.S. Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. It included over 14,000 men and women at least 20 years old who consented to a medical exam in which blood and urine specimens were obtained. Coffee and tea consumption were determined based on responses to a food questionnaire that assessed intake over the previous month. Researchers estimated the amount of caffeine per cup of coffee or tea using data from the U.S. Department of Agriculture.

The results showed that levels of uric acid in the blood significantly decreased with increasing coffee intake, but not with tea intake. In addition, there was no association between total caffeine intake from beverages and uric acid levels. These results were similar to those found in the only previous study on the topic, which was conducted in Japan. Interestingly, there was an association between decaffeinated coffee consumption and uric acid levels. "These findings suggest that components of coffee other than caffeine contribute to the observed inverse association between coffee intake and uric acid levels," the researchers state.

A recent study found that coffee was associated lower C peptide levels (a marker of insulin levels). The researchers in the current study suggest that because there is a strong relationship between insulin resistance and elevated uric acid levels, the decreased insulin levels associated with coffee consumption may lead to lower uric acid levels. Coffee is also a major source of chlorogenic acid, a strong antioxidant, which may improve insulin sensitivity. Chlorogenic acid also helps inhibit glucose absorption in the intestine; in another study decaffeinated coffee seemed to delay intestinal absorption of glucose and increase concentrations of glucagon-like peptide 1, which is well known for its beneficial effects on insulin secretion and action. The researchers note further that their results could be due to an effect of non-caffeine components found in coffee, which would also explain why coffee affected uric acid levels but tea did not.

To examine how coffee consumption might aggravate or protect against this common and excruciatingly painful condition, researchers at the Arthritis Research Centre of Canada, University of British Columbia in Canada, Brigham and Women’s Hospital, Harvard Medical School, and Harvard School of Public Health in Boston conducted a prospective study on 45,869 men over age 40 with no history of gout at baseline. Over 12 years of follow-up, Hyon K. Choi, MD, DrPH, and his associates evaluated the relationship between the intake of coffee and the incidence of gout in this high risk population. Their findings, featured in the June 2007 issue of Arthritis & Rheumatism provide compelling evidence that drinking 4 or more cups of coffee a day dramatically reduces the risk of gout for men.

Subjects were drawn from an ongoing study of some 50,000 male health professionals, 91 percent white, who were between 40 and 75 years of age in 1986 when the project was initiated. To assess coffee and total caffeine intake, Dr. Choi and his team used a food-frequency questionnaire, updated every 4 years. Participants chose from 9 frequency responses – ranging from never to 2 to 4 cups per week to 6 or more per day – to record their average consumption of coffee, decaffeinated coffee, tea, and other caffeine-containing comestibles, such as cola and chocolate.

Through another questionnaire, the researchers documented 757 newly diagnosed cases meeting the American College of Rheumatology criteria for gout during the follow-up period. Then, they determined the relative risk of incident gout for long-term coffee drinkers divided into 4 groups – less than 1 cup per day, 1 to 3 cups per day, 4 to 5 cups per day, and 6 or more cups per day – as well as for regular drinkers of decaffeinated coffee, tea, and other caffeinated beverages. They also evaluated the impact of other risk factors for gout – body mass index, history of hypertension, alcohol use, and a diet high in red meat and high-fat dairy foods among them – on the association between coffee consumption and gout among the study participants.

Most significantly, the data revealed that the risk for developing gout decreased with increasing coffee consumption. The risk of gout was 40 percent lower for men who drank 4 to 5 cups a day and 59 percent lower for men who drank 6 or more cups a day than for men who never drank coffee. There was also a modest inverse association with decaffeinated coffee consumption. These findings were independent of all other risk factors for gout. Tea drinking and total caffeine intake were both shown to have no effect on the incidence of gout among the subjects. On the mechanism of these findings, Dr. Choi speculates that components of coffee other than caffeine may be responsible for the beverage’s gout-prevention benefits. Among the possibilities, coffee contains the phenol chlorogenic acid, a strong antioxidant.

While not prescribing 4 or more cups a day, this study can help individuals make an informed choice regarding coffee consumption. "Our findings are most directly generalizable to men age 40 years and older, the most gout-prevalent population, with no history of gout," Dr. Choi notes. "Given the potential influence of female hormones on the risk of gout in women and an increased role of dietary impact on uric acid levels among patients with existing gout, prospective studies of these populations would be valuable."

A cup of coffee a day may keep retinal damage away

Coffee drinkers, rejoice! Aside from java’s energy jolt, food scientists say you may reap another health benefit from a daily cup of joe: prevention of deteriorating eyesight and possible blindness from retinal degeneration due to glaucoma, aging and diabetes.

Raw coffee is, on average, just 1 percent caffeine, but it contains 7 to 9 percent chlorogenic acid (CLA), a strong antioxidant that prevents retinal degeneration in mice, according to a Cornell study published in the Journal of Agricultural and Food Chemistry (December 2013).

The retina is a thin tissue layer on the inside, back wall of the eye with millions of light-sensitive cells and other nerve cells that receive and organize visual information. It is also one of the most metabolically active tissues, demanding high levels of oxygen and making it prone to oxidative stress. The lack of oxygen and production of free radicals leads to tissue damage and loss of sight.

In the study, mice eyes were treated with nitric oxide, which creates oxidative stress and free radicals, leading to retinal degeneration, but mice pretreated with CLA developed no retinal damage.

The study is “important in understanding functional foods, that is, natural foods that provide beneficial health effects,” said Chang Y. Lee, professor of food science and the study’s senior author. Holim Jang, a graduate student in Lee’s lab, is the paper’s lead author. Lee’s lab has been working with Sang Hoon Jung, a researcher at the Functional Food Center of the Korea Institute of Science and Technology in South Korea. “Coffee is the most popular drink in the world, and we are understanding what benefit we can get from that,” Lee said.

Previous studies have shown that coffee also cuts the risk of such chronic diseases as Parkinson’s, prostate cancer, diabetes, Alzheimer’s and age-related cognitive declines.

Since scientists know that CLA and its metabolites are absorbed in the human digestive system, the next step for this research is to determine whether drinking coffee facilitates CLA to cross a membrane known as the blood-retinal barrier. If drinking coffee proves to deliver CLA directly into the retina, doctors may one day recommend an appropriate brew to prevent retinal damage. Also, if future studies further prove CLA’s efficacy, then synthetic compounds could also be developed and delivered with eye drops.

How coffee protects against Parkinson's

A specific genetic variation discovered by researchers at Linköping University in Sweden protects against Parkinson's Disease -- especially for those who drink a lot of coffee.

The study is published in the scientific journal PLOS One.

Hereditary and environmental factors interact with one another in the emergence of diseases, and research is often focused on identifying genes and exposures that increase the risk for contracting diseases. But there are also genetic variations -- mutations -- and environmental factors that protect against the emergence of certain diseases.

Neurodegenerative diseases such as Parkinson's have a complicated background where both genetic factors and exposure to environmental factors are involved. In a study of a million genetic malformations, the research team identified a variant of the GRIN2A gene as a protective factor against Parkinson's. The corresponding protein is part of a complex that is thought to play a role in several neurodegenerative diseases.

An epidemiological study of Parkinson's patients from two counties in south east Sweden examined a combination of a previously known protective factor -- caffeine -- and the genetic variant in GRIN2A. The findings show that individuals with this combination run a significantly lower risk of developing the disease.

The study gives a molecular explanation to the protective effects that increased caffeine intake has on the development of Parkinson's. Caffeine integrates with a dopamine receptor that regulates the flow of calcium into the cell. As dopamine is part of the human reward system, and the interaction of caffeine with it, it has been speculated that individuals with certain genetic variations are not "rewarded" to the same extent by a cup of coffee, and therefore would not enjoy the same protective effect as others. The newly published study shows that GRIN2A can be a part of such a genetic predisposition.

Chemical in coffee may help prevent obesity-related disease

Researchers at the University of Georgia have discovered that a chemical compound commonly found in coffee may help prevent some of the damaging effects of obesity.

In a paper published recently (September 2014) in Pharmaceutical Research, scientists found that chlorogenic acid, or CGA, significantly reduced insulin resistance and accumulation of fat in the livers of mice who were fed a high-fat diet.

"Previous studies have shown that coffee consumption may lower the risk for chronic diseases like Type 2 diabetes and cardiovascular disease," said Yongjie Ma, a postdoctoral research associate in UGA's College of Pharmacy and lead author of the paper. "Our study expands on this research by looking at the benefits associated with this specific compound, which is found in great abundance in coffee, but also in other fruits and vegetables like apples, pears, tomatoes and blueberries."

During the past 20 years, there has been a dramatic increase in obesity in the United States. More than one-third of U.S. adults and approximately 17 percent of children are obese, according to the Centers for Disease Control and Prevention, and the annual medical cost of obesity is more than $147 billion.

Aside from weight gain, two common side effects of obesity are increased insulin resistance and the accumulation of fat in the liver. Left untreated, these disorders can lead to diabetes and poor liver function.

To test the therapeutic effects of CGA, researchers fed a group of mice a high-fat diet for 15 weeks while also injecting them with a CGA solution twice per week.

They found that CGA was not only effective in preventing weight gain, but it also helped maintain normal blood sugar levels and healthy liver composition.

"CGA is a powerful antioxidant that reduces inflammation," said Ma, who works in the laboratory of professor Dexi Liu in the department of pharmaceutical and biomedical sciences. "A lot of evidence suggests that obesity-related diseases are caused by chronic inflammation, so if we can control that, we can hopefully offset some of the negative effects of excessive weight gain."

But the authors are quick to point out that CGA is not a cure-all. Proper diet and regular exercise are still the best methods to reduce the risks associated with obesity.

The mice in this study received a high dose of CGA, much higher than what a human would absorb through regular coffee consumption or a diet rich in fruits and vegetables.

However, the researchers do believe that CGA may form the foundation of a treatment for those who need extra help. They plan to conduct more research to develop an improved CGA formulation specifically for human consumption.

"We're not suggesting that people start drinking a lot of coffee to protect themselves from an unhealthy lifestyle," said Ma, who is also a member of UGA's Obesity Initiative. "But we do think that we might be able to create a useful therapeutic using CGA that will help those at risk for obesity-related disease as they make positive lifestyle changes."

Caffeine intake associated with reduced levels of erectile dysfunction
 
Men who drink the equivalent caffeine level of two to three cups of coffee a day are less likely to have erectile dysfunction (ED), according to researchers from The University of Texas Health Science Center at Houston (UTHealth).

The results of a study published (May 2015) in PLOS ONE found that men who consumed between 85 and 170 milligrams of caffeine a day were 42 percent less likely to report ED, while those who drank between 171 and 303 milligrams of caffeine a day were 39 percent less likely to report ED compared to those who drank zero to seven milligrams a day. This trend was also true among overweight, obese and hypertensive men.

"Even though we saw a reduction in the prevalence of ED with men who were obese, overweight and hypertensive, that was not true of men with diabetes. Diabetes is one of the strongest risk factors for ED, so this was not surprising," said David S. Lopez, Dr.P.H., M.P.H., lead author and assistant professor at UTHealth School of Public Health.

According to the journal article, the suggested biological mechanism is that caffeine triggers a series of pharmacological effects that lead to the relaxation of the penile helicine arteries and the cavernous smooth muscle that lines cavernosal spaces, thus increasing penile blood flow.

In the United States, 18.4 percent of men 20 years and older have ED, suggesting that more than 18 million men are affected. Caffeine is consumed by more than 85 percent of adults, according to previous research.

Data for the study came from the National Health and Nutrition Examination Survey and ED was assessed by a single question during a computer-assisted interview. Caffeine sources in the study included coffee, tea, soda and sports drinks.

Resveratrol has an anti-inflammatory effect in cardiovascular diseases

A natural substance present in red wine, resveratrol, inhibits the formation of inflammatory factors that trigger cardiovascular diseases. This has been established by a research team at the Department of Pharmacology of the University Medical Center of Johannes Gutenberg University of Mainz (JGU) working in collaboration with researchers of the Friedrich Schiller University in Jena and the University of Vienna. Their results have recently been published in the scientific journal Nucleic Acids Research.

Despite the fact that they eat more fatty foods, the French tend to less frequently develop cardiac diseases than Germans. This so-called French Paradox is attributed to the higher consumption of red wine in France and it has already been the subject of various studies in the past. A number of research projects have actually demonstrated that the natural product resveratrol, present in red wine, has a protective effect against cardiovascular diseases. 

But what exactly is the reason for this? It seems that at least part of the protective effect can be explained by the fact that resveratrol inhibits the formation of inflammatory factors, a conclusion reached by the research team of Junior Professor Andrea Pautz and Professor Hartmut Kleinert of the Mainz University Medical Center following collaboration in a joint project with Professor Oliver Werz of the Friedrich Schiller University in Jena and Professor Verena Dirsch of the University of Vienna. In fact, the researchers discovered that the natural substance binds to the regulator protein KSRP and activates it. KSRP reduces the stability of messenger RNA (mRNA) in connection with a number of inflammatory mediators and thus inhibits their synthesis.

"We now know more precisely how resveratrol inhibits the formation of the inflammatory factors that trigger cardiovascular diseases. This is an important finding in view of the fact that more recent research has shown that cardiovascular diseases are significantly promoted by inflammatory processes in the body," said Pautz. Cardiovascular disorders, such as myocardial infarction and strokes, frequently occur in association with chronic inflammatory diseases, such as arthritis. The natural substance resveratrol thus has major therapeutic potential, particularly when it comes to the treatment of inflammatory diseases that can cause serious damage to the cardiovascular system.

Mediterranean diet linked to improved CV function in erectile dysfunction patients

The Mediterranean diet is linked to improved cardiovascular performance in patients with erectile dysfunction, according to research presented at EuroEcho-Imaging 2014 by Dr Athanasios Angelis from Greece. Patients with erectile dysfunction who had poor adherence to the Mediterranean diet had more vascular and cardiac damage.

EuroEcho-Imaging is the annual meeting of the European Association of Cardiovascular Imaging (EACVI), a branch of the European Society of Cardiology (ESC), and is held 3-6 December in Vienna, Austria.

Dr Angelis said: "Erectile dysfunction is not a symptom of ageing, it is a bad sign from the body that something is wrong with the vasculature. In 80% of cases erectile dysfunction is caused by vascular problems and is a warning that patients are at increased risk of a heart attack or stroke."

He added: "The Mediterranean diet is associated with lower cardiovascular events and could be a way to help erectile dysfunction patients lower their risk. We wanted to investigate whether patients with erectile dysfunction who follow this diet have less vascular and cardiac damage."

The study included 75 men with erectile dysfunction, aged 56 years on average, who attended the Department of Cardiology at Hippokration Hospital in Athens, Greece. Adherence to the Mediterranean diet was assessed with the Med-Diet Score1 which ranks patients as high (30-55), intermediate (21-29) or low (0-20) according to consumption of cereals, fruit, vegetables, meat, fish, dairy products, wine and olive oil.
Vascular function was assessed by measuring two aspects of atherosclerosis, namely atheromatosis and arteriosclerosis. Atheromatosis refers to the development of atheroma (plaque), a fatty deposit in the intima (inner lining) of the artery, and was measured by the intima-media thickness (IMT) of the common carotid artery. Arteriosclerosis refers to the stiffening of the arteries and was evaluated with carotid-femoral pulse wave velocity (PWV). Heart involvement was based on diastolic function and left ventricular mass.

The researchers found that a lower Med-Diet Score correlated with significantly worse vascular and heart function. These patients had greater IMT and aortic stiffness as well as higher left ventricular mass and more profound diastolic dysfunction.

Dr Angelis said: "Patients with erectile dysfunction who had unhealthy diets had more vascular and cardiac damage than those who followed the Mediterranean diet. Previous studies have shown that patients with erectile dysfunction have vascular damage but we found that the heart is also damaged. This may help to further explain why these patients are more prone to cardiovascular events. The formation of atheroma, the stiffening of the arteries, and the poor functioning of the heart can eventually lead to a cardiac event."

He added: "Our findings suggest that adopting the Mediterranean diet can improve the cardiovascular risk profile of patients with erectile dysfunction and may reduce their chances of having a heart attack or stroke. This needs to be tested in a larger study."

The Mediterranean diet is characterised by daily consumption of fruit, vegetables, unrefined cereals and pasta, olive oil and nuts. Dairy products are eaten in modest amounts, in the form of yogurt and cheese. Consumption of meat is low, with red meat once a week and poultry once a week considered a healthy level. A modest amount of wine can be consumed, and refined sugar should be avoided in favour of natural desserts like fruit.

Dr Angelis said: "Really simple changes in our diet may help a lot, for example using olive oil which contains monounsaturated fat. If someone doesn't have the money to buy some of the foods they can substitute them with others, for example nuts are a good source of monounsaturated fat. Sometimes it's difficult to adopt something if you consider that it's part of a prescription, but the Mediterranean diet is not a prescription, it's a lifestyle. It's about having an awareness of what foods are healthy or unhealthy."

He concluded: "Patients who have erectile dysfunction and don't adhere to the Mediterranean diet have vascular and cardiac damage and are at increased risk of heart attack and stroke. Our findings suggest that adopting a healthy diet can reduce that risk. We also advise patients to stop smoking, exercise and ensure that they have healthy levels of blood pressure and lipids."

Study: How Red Wine Prevents Cancer

Alcohol use is a major risk factor for head and neck cancer. But an article published in the November issue of the journal Advances in Experimental Medicine and Biology shows that the chemical resveratrol found in grape skins and in red wine may prevent cancer as well.

“Alcohol bombards your genes. Your body has ways to repair this damage, but with enough alcohol eventually some damage isn’t fixed. That’s why excessive alcohol use is a factor in head and neck cancer. Now, resveratrol challenges these cells – the ones with unrepaired DNA damage are killed, so they can’t go on to cause cancer. Alcohol damages cells and resveratrol kills damaged cells,” says Robert Sclafani, PhD, investigator at the University of Colorado Cancer Center and professor of biochemistry and molecular genetics at the CU School of Medicine.

Some of what we know about the ability of alcohol to cause cancer comes from the study of another disease, namely Fanconi anemia, a rare genetic disorder that affects about 1 in every 350,000 babies. DNA naturally accumulates tangles called “cross links” and healthy genes can repair and disentangle cross-linked DNA. In Fanconi anemia, people are born without the ability to repair DNA cross links and so DNA damage accumulates. Accordingly, patients with Fanconi anemia are at greatly increased risk of developing cancers including leukemias and also head and neck cancer.

“We learn a lot from genetic disorders because you can put a finger on a gene and say, hey, we know what that does!” says Sclafani, who has presented at and regularly attends the annual meeting of the Fanconi Anemia Research Foundation.

In fact, it turns out that a genetic accelerator of cancer in Fanconi anemia is the same as the cancer-causing mechanism of alcohol. In both cases, the cause is partially metabolized alcohol. The body metabolizes alcohol by converting it first to acetyl aldehyde and then the body uses aldehyde dehydrogenase (ALDH) to further convert it to acetic acid, which is excreted. The partially processed state of alcohol, acetyl aldehyde, is a carcinogen and produces “cross links” in DNA.

Because Fanconi anemia patients cannot repair the DNA damage produced by acetyl aldehyde, they are at even higher risk for cancer if they also lack ALDH.

“With enough alcohol, the body can get behind and end up with a backlog of acetyl aldehyde,” Sclafani says. “Increased exposure to alcohol, loss of the ALDH gene that helps the body process alcohol, and loss of the ability to repair DNA cross links all result in increased cancer risk.”

With hard alcohol that’s the end of the story: increased risk for head and neck cancer due to increased production of acetyl aldehyde.

“But when you look at epidemiological studies of head and neck cancer, alcohol is a factor, but by alcohol source, the lowest cancer incidence is in people who drank red wine,” Sclafani says. “In red wine, there’s something that’s blocking the cancer-causing effect of alcohol.”

The recent article points to resveratrol as Sclafani’s “something”.

Sclafani describes the effects of resveratrol in terms of probability: “The more you drink, the more you accumulate DNA damage, and the more chance that one or more cells will accumulate the specific type of DNA damage that can cause cancer. Now, resveratrol takes out the cells with the most damage – the cells that have the highest probability of being able to cause cancer.”

According to Sclafani, the resveratrol in red wine (and other chemopreventive chemicals found in grape seed extract) isn’t a magic bullet that can completely undo the cancer-causing effects of alcohol, but by killing the most dangerous cells it may decrease the probability that alcohol use will cause cancer.

“Because alcohol-related head and neck cancer has a high rate of recurrence, after a cancer has been treated once, you’ve still got a very high-risk population,” Sclafani says.

Ongoing clinical trials are testing the ability of resveratrol to prevent colon and liver cancer. Dr. Sclafani and his colleague Dr. Rajesh Agarwal plan to test resveratrol in the prevention and possibly treatment of head and neck and other cancer types.

Antacids linked to better survival in head and neck cancer

Patients with head and neck cancer who used antacid medicines to control acid reflux had better overall survival, according to a new study from the University of Michigan Comprehensive Cancer Center.

Reflux can be a common side effect of chemotherapy or radiation treatment for head and neck cancer. Doctors at the University of Michigan frequently prescribe two types of antacids - proton pump inhibitors or histamine 2 blockers - to help treat this side effect.

The researchers looked at 596 patients who were treated for head and neck cancer. More than two-thirds of the patients took one or both types of antacid medication after their diagnosis.

Patients who were taking antacids had significantly better overall survival than those who did not take them. Proton pump inhibitors, which include drugs such as Prilosec, Nexium and Prevacid, had the biggest effect: a 45 percent decreased risk of death, compared to patients who did not take antacids. Patients taking histamine 2 blockers, such as Tagamet, Zantac or Pepcid, saw a 33 percent decreased risk of death.

"We had suspicions that these medications somehow had a favorable impact on patient outcomes. This led us to review our large cohort of patients and screen them for common medications, focusing on antacids. In fact, our study did show that people taking antacids are doing better," says lead study author Silvana Papagerakis, M.D., Ph.D., research assistant professor of otolaryngology--head and neck surgery at the University of Michigan Medical School and an adjunct clinical assistant professor at the U-M School of Dentistry.

Results of the study are published in the December issue of Cancer Prevention Research.

The researchers are not clear why these medications affect the cancer, although they have begun additional work to understand the mechanisms involved.

"Currently, patients might be on and off of this medication according to their symptoms of acid reflux. We believe this medication can also be beneficial at stopping cancer progression. Perhaps longer duration of treatments may have significant effect in terms of outcome survival," Papagerakis says.

In addition, the researchers would like to understand if using antacids in people with reflux disease or people with precancerous lesions might reduce their risk of developing head and neck cancer.

Antacids are seen as relatively safe and typically have little or no adverse side effects. More importantly, Papagerakis notes, head and neck cancer patients are already taking these medications.

"What this study makes clear is these medications may be more beneficial to the patients than just controlling side effects," she says.

Vitamin D deficiency, depression linked

Vitamin D deficiency is not just harmful to physical health—it also might impact mental health, according to a team of researchers that has found a link between seasonal affective disorder, or SAD, and a lack of sunlight.

"Rather than being one of many factors, vitamin D could have a regulative role in the development of SAD," said Alan Stewart of the University of Georgia College of Education.

An international research partnership between UGA, the University of Pittsburgh and the Queensland University of Technology in Australia reported the finding in the November 2014 issue of the journal Medical Hypotheses.

Stewart and Michael Kimlin from QUT's School of Public Health and Social Work conducted a review of more than 100 leading articles and found a relationship between vitamin D and seasonal depression.

"Seasonal affective disorder is believed to affect up to 10 percent of the population, depending upon geographical location, and is a type of depression related to changes in season," said Stewart, an associate professor in the department of counseling and human development services.

"People with SAD have the same symptoms every year, starting in fall and continuing through the winter months."

Stewart said, based on the team's investigations, vitamin D was likely to be a contributing factor in seasonal depression.

"We believe there are several reasons for this, including that vitamin D levels fluctuate in the body seasonally, in direct relation to seasonally available sunlight," he said. "For example, studies show there is a lag of about eight weeks between the peak in intensity of ultraviolet radiation and the onset of SAD, and this correlates with the time it takes for UV radiation to be processed by the body into vitamin D.

Vitamin D is also involved in the synthesis of serotonin and dopamine within the brain, both chemicals linked to depression, according to the researchers.

"Evidence exists that low levels of dopamine and serotonin are linked to depression, therefore it is logical that there may be a relationship between low levels of vitamin D and depressive symptoms," said Kimlin, a Cancer Council Queensland Professor of Cancer Prevention Research.

"Studies have also found depressed patients commonly had lower levels of vitamin D."

Vitamin D levels varied according to the pigmentation of the skin. People with dark skin often record lower levels of vitamin D, according to the researchers.

"Therefore it is suggested that persons with greater skin pigmentation may experience not only higher risks of vitamin D deficiency, but also be at greater risk of psychological and psychiatric conditions," he said.

Kimlin, who heads QUT's National Health and Medical Research Council Centre for Research Excellence in Sun and Health, said adequate levels of vitamin D were essential in maintaining bone health, with deficiency causing osteomalacia in adults and rickets in children. Vitamin D levels of more than 50 nanomoles per liter are recommended by the U.S. Institute of Medicine.

"What we know now is that there are strong indications that maintaining adequate levels of vitamin D are also important for good mental health," Kimlin said. "A few minutes of sunlight exposure each day should be enough for most people to maintain an adequate vitamin D status."

"Queensland is known as the Sunshine State in Australia but that doesn't mean all Queenslanders get enough vitamin D," Kimlin said. "This research is of international importance because no matter where you live, low levels of vitamin D can be a health concern."

Risk of cataracts as a result of statin use

 Few classes of drugs have had such a transformative effect on the prevention of cardiovascular disease (CVD) as have statins, prescribed to reduce total cholesterol and low-density lipoprotein cholesterol. However, some clinicians have ongoing concerns regarding the potential for lens opacities (cataracts) as a result of statin use.

In an article in the Canadian Journal of Cardiology, researchers report increased risk for cataracts in patients treated with statins. An accompanying editorial discusses the history of statins and positions this new study in the context of conflicting results from previous analyses of purported adverse effects due to statin use.

In previous studies the association between statin use and cataracts has been inconsistent and controversial. The current study used data from the British Columbia (BC) Ministry of Health databases from 2000-2007 and the IMS LifeLink U.S. database from 2001-2011 to form two patient cohorts. The BC cohort was composed of female and male patients; 162,501 cases were matched with 650,004 controls. The IMS LifeLink cohort was comprised of males only, aged 40-85; 45,065 cases were matched with 450,650 controls. Patients using statins for more than a year prior to initial ophthalmology examination were identified. Diagnosis and surgical management of cataracts were followed.

In the BC cohort, there was about a 27% increased risk of developing cataracts requiring surgical intervention (Adjusted Risk Ratio, RR =1.27). In the IMS cohort, the increased risk was only 7%, but still statistically significant.

The adjusted RRs for long-term regular use of specific statins in the BC cohort ranged from 1.14 to 1.42. In the IMS cohort, the adjusted RRs for individual statins varied within a narrow range from 1.03 to 1.14. The investigators did not determine whether certain statins were worse than others, but most confidence intervals overlapped suggesting a class effect.

Lead investigator G.B. John Mancini, MD, of the Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada, states that, "Further assessment of the clinical impact of this relationship is recommended, especially given increased statin use for primary prevention of CVD and the importance of acceptable vision in old age where CVD is common. Future studies addressing the possible underlying mechanisms to explain this association are also warranted. However, because the RR is low and because cataract surgery is both effective and well tolerated, this association should be disclosed but not be considered a deterrent to use of statins when warranted for CV risk reduction."

In an accompanying editorial, Steven Gryn, MD, FRCPC, and Robert A. Hegele, MD, FRCPC, of the Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada, echo the need for balance.

They write, "Any medication that has beneficial effects has potential adverse effects; weighing the benefits against the risks is an integral part of the informed consent process, and is central to any decision to initiate treatment. Among patients who are at high CVD risk, like most of those seen by cardiologists...the prevention of CVD, stroke, and their associated morbidity and mortality vastly outweighs the risk of cataracts. Even among lower risk patients, for whom the benefit-risk ratio is less dramatic, most patients would still probably prefer having to undergo earlier non-life-threatening cataract surgery over suffering a major vascular event."

In any observational study, there can be unknown confounders that could introduce bias. Both the study itself and the commentary note this weakness, but both agree that this study, while not putting the issue to rest, does add significantly to the accumulated knowledge about the statin-cataract connection. However, as Dr. Hegele notes, "A randomized double-blinded placebo-controlled clinical trial is the best way to mitigate confounding, and such studies so far have shown no association of statins with cataracts."