Regular smear tests boost chances of cure from 66 percent to 92 percent

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Women can boost their chances of surviving cervical cancer substantially through regular cervical screening, claims a research paper published today on bmj.com.

The authors from the Centre for Research and Development in Gävle and the Karolinska Institutet, Stockholm, Sweden, studied all 1230 women diagnosed with cervical cancer nationwide between 1999 and 2001.

In the study, which is the first to estimate chances of surviving cervical cancer, both screen-detected cancers (those with an abnormal smear result one to six months before cancer diagnosis) and symptomatic cancers (all remaining cases) were tested. The objective of the paper was to see if the detection of cervical cancer by screening resulted in better prognosis or just resulted in earlier diagnosis, without postponing the time of death.

For women of screening age there was a 92% cure rate after a screen-detected diagnosis, which decreased to 66% for symptomatic diagnosis. This result shows a substantial increase in chances of cure for women who attended cervical screening compared to those who did not. The chances of cure were also higher for women who attended screening following an invitation, compared to those who were overdue for an examination.

Furthermore, three quarters of the 373 women who died from cervical cancer had not had a cervical smear in the recommended time frame.

The authors conclude that screening both reduces the risk of cervical cancer and is associated with improved cure. They state that "detection of invasive cancer by screening implies a very favourable prognosis compared to cases detected by symptoms". The authors recommend that the effect on the cure for cervical cancer should be included when evaluating screening programmes.

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Diabetes risk from sitting around

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A new study has found that women who stay seated for long periods of time every day are more prone to developing type 2 diabetes, but that a similar link wasn't found in men.

Researchers from the University of Leicester Departments of Health Sciences and Cardiovascular Sciences revealed that women who are sedentary for most of the day were at a greater risk from exhibiting the early metabolic defects that act as a precursor to developing type 2 diabetes than people who tend to sit less.

The team assessed over 500 men and women of the age of 40 or more about the amount of time spent sitting over the course of a week, helped out by tests on the level of specific chemicals in their bloodstream that are linked to diabetes and metabolic dysfunction. It was found that the women who spent the longest time sitting had higher levels of insulin, as well as higher amounts of C-reactive protein and chemicals released by fatty tissue in the abdomen, leptin, and interleukin6, and which indicate problematic inflammation.

The study, published in the American Journal of Preventive Medicine, revealed that the link between sitting time and diabetes risk was much stronger in women than men, but could not pinpoint why there was a gender difference, although it was suggested that women might snack more often than men during sedentary behaviour, or because men tend to take part in more robust activity when they do get up and about.

Dr Thomas Yates who led the study said: "This study provides important new evidence that higher levels of sitting time have a deleterious impact on insulin resistance and chronic low-grade inflammation in women but not men and that this effect is seen regardless of how much exercise is undertaken. This suggests that women who meet the national recommendations of 30 minutes of exercise a day may still be compromising their health if they are seated for the rest of the day.

'It therefore suggests that enabling women to spend less time sitting may be an important factor in preventing chronic disease.' The paper calls for further experimental research investigating the effect of reduced sitting time on human volunteers

Dr Yates added: "If these results are replicated, they have implications for lifestyle recommendations, public health policy, and health behaviour change interventions, as they suggest that enabling women to spend less time sitting is an important factor in preventing chronic disease."

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Heart Healthy Choices Early On Pay Off Later

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Maintaining a healthy lifestyle from young adulthood into your 40s is strongly associated with low cardiovascular disease risk in middle age, according to a new Northwestern Medicine study.

“The problem is few adults can maintain ideal cardiovascular health factors as they age,” said Kiang Liu, first author of the study. “Many middle-aged adults develop unhealthy diets, gain weight and aren’t as physically active. Such lifestyles, of course, lead to high blood pressure and cholesterol, diabetes and elevated cardiovascular risk.”

Liu is a professor and the associate chair for research in the department of preventive medicine at Northwestern University Feinberg School of Medicine.

“In this study, even people with a family history of heart problems were able to have a low cardiovascular disease risk profile if they started living a healthy lifestyle when they were young,” Liu said. “This supports the notion that lifestyle may play a more prominent role than genetics.”

Published Feb. 28 in the journal Circulation, this is the first study to show the association of a healthy lifestyle maintained throughout young adulthood and middle age with low cardiovascular disease risk in middle age.

The majority of people who maintained five healthy lifestyle factors from young adulthood (including a lean body mass index (BMI), no excess alcohol intake, no smoking, a healthy diet and regular physical activity) were able to remain in this low-risk category in their middle-aged years.

In the first year of the study, when the participants’ average age was 24 years old, nearly 44 percent had a low cardiovascular disease risk profile. Twenty years later, overall, only 24.5 percent fell into the category of a low cardiovascular disease risk profile.

Sixty percent of those who maintained all five healthy lifestyles reached middle age with the low cardiovascular risk profile, compared with fewer than 5 percent who followed none of the healthy lifestyles.

Researchers used data collected over 20 years from the Coronary Artery Risk Development in (Young) Adults (CARDIA) study. It began in 1985 and 1986 with several thousand 18 to 30 year-olds and has since followed the same group of participants.

For this study, the researchers analyzed data such as blood pressure, cholesterol, blood sugar, BMI, alcohol intake, tobacco use, diet and exercise from more than 3,000 of the CARDIA participants to define a low cardiovascular disease risk profile and healthy lifestyle factors.

If the next generation of young people adopt and maintain healthy lifestyles, they will gain more than heart health, Liu stressed.

“Many studies suggest that people who have low cardiovascular risk in middle age will have a better quality of life, will live longer and will have lower Medicare costs in their older age,” he said. “There are a lot of benefits to maintaining a low-risk profile.”

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Cocoa may enhance skeletal muscle function

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A small clinical trial led by researchers at UC San Diego School of Medicine and VA San Diego Healthcare System (VASDHS) found that patients with advanced heart failure and type 2 diabetes showed improved mitochondrial structure after three months of treatment with epicatechin-enriched cocoa. Epicatechin is a flavonoid found in dark chocolate.

The results of this initial study has led to the implementation of larger, placebo-controlled clinical trial at UC San Diego School of Medicine and VASDHS to assess if patients with heart failure and diabetes show improvement in their exercise capacity when treated with epicatechin-rich cocoa.

The study published this week by the journal Clinical and Translational Science looked at five profoundly ill patients with major damage to skeletal muscle mitochondria. Mitochondria are structures responsible for most of the energy produced in cells. These "fuel cells" are dysfunctional as a result of both type 2 diabetes and heart failure, leading to abnormalities in skeletal muscle. In patients with heart failure and diabetes abnormalities in both the heart and skeletal muscle result in impaired functional capacity. These patients often complain of shortness of breath, lack of energy and have difficulty walking even short distances.

The trial participants consumed dark chocolate bars and a beverage with a total epicatechin content of approximately 100 mg per day for three months. Biopsies of skeletal muscle were conducted before and after treatment. After the three-month treatment, the researchers looked at changes in mitochondria volume and the abundance of cristae, which are internal compartments of mitochondria that are necessary for efficient function of the mitochondria, and measurable by electron microscopy.

"The cristae had been severely damaged and decreased in quantity in these patients," said one of the senior investigators, Francisco J. Villarreal, MD, PhD of UC San Diego's Department of Medicine's Division of Cardiology. "After three months, we saw recovery – cristae numbers back toward normal levels, and increases in several molecular indicators involved in new mitochondria production."

The results, which mimicked earlier studies showing improvement in skeletal and heart muscle function in animal models after treatment with epicatechin, were promising enough to prompt the larger study.

The principal investigator of this trial was Pam R. Taub, MD, assistant professor of medicine at UC San Diego and the VA San Diego Healthcare System. Taub will be leading the new clinical trial at UC San Diego that will enroll normal sedentary subjects as well as patients with heart failure/diabetes who will be treated with placebo, or epicatechin-rich chocolate.

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Are Selenium Supplements Good For You? Yes And No

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If you lack selenium, supplements are good for you, if you have enough they could raise your risk of developing diabetes type 2, says a study published Online First in The Lancet. The authors explain that the number of people taking selenium supplements has grown considerably over the last few years

Study author, Margaret Rayman from the University of Surrey, Guilford, UK, said:

"The intake of selenium varies hugely worldwide. Intakes are high in Venezuela, Canada, the USA, and Japan, but lower in Europe. Selenium-containing supplements add to these intakes, especially in the USA where 50% of the population takes dietary supplements."



Selenium is a trace mineral that is essential to good health in small amounts. Higher selenium intake or status (levels in the blood) have been demonstrated to improve male fertility, provide some protection against bladder, lung, colorectal system, and prostate cancers, and have antiviral effects. Low selenium intake or status as been associated with increased risk of poor immune function, cognitive decline, and death.

However, evidence indicates that this mineral has a limited therapeutic range and that high levels of selenium may have detrimental effects, such increasing the risk of type 2 diabetes.

The use of selenium supplements has become extensive over the last decade, primarily due to the theory that it can decrease the risk of developing cancer and other diseases. Based on the results of observational studies, selenium supplements have been marketed for numerous conditions. Although, results from human trials to confirm the effectiveness of these supplements has differed.

These differing results are because the studies were conducted in different populations with different genetic backgrounds and selenium status, according to Rayman.

Rayman states that the differing results can be explained by the fact that selenium supplements, as for many nutrients, only benefits individuals when they lack certain nutrients.

According to Rayman, individuals with low blood selenium levels are most likely to receive the greatest benefit from selenium supplementation. However, to date, the largest trials have been conducted in countries like the USA, were selenium status is good. More trials are required in populations with low selenium status.

In addition, the study indicates that the interaction between genetic background and selenium intake or status could be vital - individuals could be either less genetically receptive to the benefits of selenium-containing proteins (selenoproteins) in the body or to selenium supplements, or more receptive:

Rayman said:

"Since polymorphisms is selenoproteins affect both selenium status and disease risk or prognosis, future studies must genotype participants."



Rayman concludes:

"The crucial factor that needs to be emphasized is that people whose blood plasma selenium is already 122 µg/L or higher - a large proportion of the US population (the average level in American men is 134 µg/L) - should not take selenium supplements. However, there are various health benefits, and no extra risk, for people of lower selenium status (plasma level less than 122 µg/L), who could benefit from raising their status to 130-150 µg/L - a level associated with low mortality."

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Aspirin may counteract potential trans fat-related stroke risk in older women

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Older women whose diets include a substantial amount of trans fats are more likely than their counterparts to suffer an ischemic stroke, a new study shows.

However, the risk of stroke associated with trans fat intake was lower among women taking aspirin, according to the findings from University of North Carolina at Chapel Hill researchers.

The study, "Trans Fat Intake, Aspirin and Ischemic Stroke Among Postmenopausal Women," was published Thursday (March 1, 2012) online in the journal Annals of Neurology.

The study of 87,025 generally healthy postmenopausal women aged 50 to 79 found that those whose diets contained the largest amounts of trans fats were 39 percent more likely to have an ischemic stroke (clots in vessels supplying blood to the brain) than women who ate the least amount of trans fat. The risk was even more pronounced among non-users of aspirin: those who ate the most trans fat were 66 percent more likely to have an ischemic stroke than females who ate the least trans fat.

However, among women who took aspirin over an extended period of time, researchers found no association between trans fat consumption and stroke risk – suggesting that regular aspirin use may counteract trans fat intake's adverse effect on stroke risk among women.

Trans fat is generally created in the food production process and is found in commercially prepared foods, including many shortenings, cake mixes, fried fast foods, commercially baked products (such as doughnuts, cakes and pies), chips, cookies and cereals.

Researchers from the UNC Gillings School of Global Public Health studied women who were enrolled in the Women's Health Initiative Observational Study. From 1994 to 2005, 1,049 new cases of ischemic stroke were documented.

Women who consumed the highest amount of trans fat also were more likely to be smokers, have diabetes, be physically inactive and have lower socioeconomic status than those who consumed the least trans fat, the study showed.

"Our findings were contrary to at least two other large studies of ischemic stroke," said Ka He, Sc.D., M.D., associate professor of nutrition and epidemiology at the UNC public health school. "However, ours was a larger study and included twice as many cases of ischemic stroke. Our unique study base of older women may have increased our ability to detect the association between trans fat intake and ischemic stroke among non-users of aspirin."

He said aspirin may lower the risk of ischemic stroke because of its anti-inflammatory and anti-platelet clumping properties.

The UNC researchers did not find any association between eating other kinds of fat (including saturated, monounsaturated or polyunsaturated fat) and ischemic strokes.

"Our findings highlight the importance of limiting the amount of dietary trans fat intake and using aspirin for primary ischemic stroke prevention among women, especially among postmenopausal women who have elevated risk of ischemic stroke," said lead author Sirin Yaemsiri, a doctoral student in the school's epidemiology department.

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Nutrient found in dark meat of poultry, some seafood, may have cardiovascular benefits

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A nutrient found in the dark meat of poultry may provide protection against coronary heart disease (CHD) in women with high cholesterol, according to a study by researchers at NYU Langone Medical Center.

The study, published online in the European Journal of Nutrition, evaluated the effects of taurine, a naturally-occurring nutrient found in the dark meat of turkey and chicken, as well as in some fish and shellfish, on CHD. It revealed that higher taurine intake was associated with significantly lower CHD risk among women with high total cholesterol levels. The same association was not seen in women with low cholesterol levels, however.

There is very little information available about taurine, said principal investigator Yu Chen, PhD, MPH, associate professor of epidemiology at NYU School of Medicine, part of NYU Langone Medical Center. While there have been some animal studies that indicate taurine may be beneficial to cardiovascular disease, this is the first published prospective study to look at serum taurine and CHD in humans, she explained. "Our findings were very interesting. Taurine, at least in its natural form, does seem to have a significant protective effect in women with high cholesterol."

Coronary heart disease is the leading killer of American men and women, causing one in five deaths. Also known as coronary artery disease, it is caused by the buildup of plaque in the arteries to the heart. Large prospective epidemiologic studies have provided evidence that nutritional factors are important modifiable risk factors for CHD.

Dr. Chen and colleagues conducted their study using data and samples from the NYU Women's Health Study. The original study enrolled more than 14,000 women, 34 to 65 years of age, between 1985 and 1991 at a breast cancer screening center in New York City. Upon enrollment, a wide range of medical, personal and lifestyle information was recorded and the data and samples continue to be utilized for a variety of medical studies.

For the serum taurine study, funded by the American Heart Association, the researchers measured taurine levels in serum samples collected in 1985 – before disease occurrence – for 223 NYUWHS participants who developed or died from CHD during the study follow up period between 1986 and 2006. The researchers then compared those samples to the taurine levels in serum samples collected at the same time for 223 participants who had no history of cardiovascular disease.

The comparison revealed serum taurine was not protective of CHD overall. However, among women with high cholesterol, those with high levels of serum taurine were 60 percent less likely to develop or die from CHD in the study, compared to women with lower serum taurine levels. If future studies are able to replicate the findings, taurine supplementation or dietary recommendations may one day be considered for women with high cholesterol at risk for CHD.

"It is an interesting possibility," she said. "If these findings are confirmed, one day we might be able to suggest that someone with high cholesterol eat more poultry, specifically dark meat."

Dr. Chen explained that Caucasian women comprised more than 80 percent of the study population and, therefore, the results may not at this time be generalized to men or other races, but suggested that future studies should be conducted in these populations. In addition, she explained, it is unclear whether synthetic taurine as an additive in food and drink products will have the same benefit observed in this study, and health effects of these products should be investigated separately. "We studied taurine found in the blood that originated from natural sources," Dr. Chen said. "The nutrient being added to energy drinks or supplements is man-made and is added in unstudied amounts. These products also often contain not only very high amounts of taurine, but a multitude of other ingredients as well – such as caffeine and ginseng – that may influence CHD risk."

The researchers are currently using NYUWHS data to evaluate the effect of taurine on the occurrence of stroke in another study funded by the National Heart, Lung, and Blood Institute (NHLBI).

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