Light and moderate physical activity reduces the risk of early death

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A new study by researchers from the London School of Hygiene and Tropical Medicine (LSHTM), Cambridge University and the Karolinska Institute in Sweden has found that even light or moderate intensity physical activity, such as walking or cycling, can substantially reduced the risk of early death.

The study, which was published this week by the International Journal of Epidemiology, combined the results from the largest studies around the world on the health impact of light and moderate intensity physical activity. It showed that the largest health benefits from light or moderate activity (such as walking and cycling) were in people who do hardly any physical activity at all. Although more activity is better - the benefits of even a small amount of physical activity are very large in the least physically active.

The good news from this study is that you don't have to be an exercise freak to benefit from physical activity. Just achieving the recommended levels of physical activity (equivalent to 30 minutes daily of moderate intensity activity on 5 days a week) reduces the risk of death by 19% [95%confidence interval 15% to 24%], while 7 hours per week of moderate activity (compared with no activity) reduces the risk of death by 24% (95% CI 19% to 29%).

Lead researcher, James Woodcock said, "This research confirms that is not just exercising hard that is good for you but even moderate everyday activities, like walking and cycling, can have major health benefits. Just walking to the shops or walking the children to school can lengthen your life - as well as bringing other benefits for well-being and the environment."

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Adequate zinc eases pneumonia in elderly

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A high proportion of nursing facility residents were found to have low serum (blood) zinc concentrations during an observational study funded by the Agricultural Research Service (ARS) and the National Institute of Aging. The scientists found that those with normal blood zinc concentrations were about 50 percent less likely to develop pneumonia than those with low concentrations.

The study was led by Simin Nikbin Meydani, director of the Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University in Boston, Mass. ARS is the chief intramural scientific research agency of USDA.

HNRCA researchers have been studying immune response and respiratory infections in about 600 elderly residents in 33 nursing facilities in the Boston area. Meydani and colleagues previously reported that among the facility residents, those who consumed 200 international units (IU) of vitamin E daily for one year were 20 percent less likely to get upper respiratory infections, such as colds, than those who took a placebo.

The secondary analysis of data from the same clinical trial showed a high proportion of the residents had low serum (blood) zinc concentrations at baseline and after one year of follow-up. All participants had been supplemented with half of the recommended dietary allowance of essential vitamins and minerals, including zinc, during the trial.

Those with normal zinc status were not only less likely to develop pneumonia, they also had fewer new prescriptions for antibiotics, a shorter duration of pneumonia, and fewer days of antibiotic use compared with residents who had low zinc levels. In addition, mortality was lower in those with adequate blood zinc levels.

The study suggests that supplementation of zinc-deficient elderly may result in reduced risk of pneumonia. Still, the authors note that controlled clinical trials are needed to test efficacy of zinc supplementation as a low-cost intervention to reduce mortality due to pneumonia among vulnerable populations who already have low zinc levels.

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Jon's Health Tips - Latest Health Research

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I’ve pretty much given up two of my favorites: hot dogs and salami:

Certain meat components may increase bladder cancer risk

I need to eat more spicy food:

Chili peppers come with blood pressure benefits

New evidence that chili pepper ingredient fights fat

I’ve been choosing orange juice with calcium added, and my wife takes calcium supplements:

Calcium Supplements = Increased Risk of Heart Attack

Calcium supplements were associated with about a 30% increased risk of heart attack and smaller, non-significant, increases in the risk of stroke and mortality. Previous studies have found no increased cardiovascular risks with higher dietary calcium intake, suggesting that the risks are restricted to supplements. Given the modest benefits of calcium supplements on bone density and fracture prevention, a reassessment of the role of calcium supplements in osteoporosis management is warranted.

Now I know why I have so much trouble focusing on one thing for long periods ot time - I am what I used to eat:

Western diet link to ADHD

A diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis for an adolescent compared with a diet low in the Western pattern, after adjusting for numerous other social and family influences. A “healthy” pattern is a diet high in fresh fruit and vegetables, whole grains and fish. It tends to be higher in omega-3 fatty acids, folate and fibre. A “Western” pattern is a diet with a trend towards takeaway foods, confectionary, processed, fried and refined foods. These diets tend to be higher in total fat, saturated fat, refined sugar and sodium. Having an ADHD diagnosis was associated with a diet high in take out foods, processed meats, red meat, high fat dairy products and pastry. We suggest that a Western dietary pattern may indicate the adolescent has a less optimal fatty acid profile, whereas a diet higher in omega-3 fatty acids is thought to hold benefits for mental health and optimal brain function.
It also may be that the Western dietary pattern doesn't provide enough essential micronutrients that are needed for brain function, particularly attention and concentration, or that a Western diet might contain more colours, flavours and additives that have been linked to an increase in ADHD symptoms. It may also be that impulsivity, which is a characteristic of ADHD, leads to poor dietary choices such as quick snacks when hungry.

I’ve started taking reserveratrol as a supplement again as well as trying to keep up my consumption of new red wine:

Resveratrol Shown to Suppress Inflammation, Free Radicals, in Humans

I took CPR quite a while ago, but this makes it a lot easier:

CPR Without Mouth-to-Mouth Rescue Breathing May Be Better for Many Victims of Cardiac Arrest; Chest Compressions Alone Save More Lives

Two new studies support the case for dropping mouth-to-mouth, or rescue breathing by bystanders and using "hands-only" chest compressions during the life-saving practice, better known as CPR.The findings concur with the latest science advisory statement from the American Heart Association (AHA), published in 2008, recommending hands-only (or compression-only) CPR by bystanders who are not adequately trained or who feel uncomfortable with performing rescue breathing on other adults who collapse from sudden cardiac arrest.

A third of the estimated 300,000 Americans each year whose heart suddenly stops beating outside of a hospital receive CPR to keep blood and oxygen flowing to the body's vital organs in the torso until emergency services personnel arrive. CPR performed by good Samaritans is known to nearly double the survival chances of people who suffer sudden cardiac arrest.

Does it matter how fast you drink?

Stroke risk temporarily increases for an hour after drinking alcohol

Call it the not-so-happy hour. The risk of stroke appears to double in the hour after consuming just one drink — be it wine, beer or hard liquor .

Compared with times when alcohol wasn’t being used, the relative risk of stroke after alcohol consumption was:

* 2.3 times higher in the first hour;
* 1.6 times higher in the second hour; and
* 30 percent lower than baseline after 24 hours.

The patterns remained the same whether participants had consumed wine, beer or distilled spirits. When the researchers eliminated patients who had been exposed to other potential triggers (such as exercising vigorously or drinking a caffeinated beverage) just prior to their strokes, the alcohol connection didn’t change

Just after drinking, blood pressure rises and blood platelets become stickier, which may increase the possibility of a clot forming. However, consistent use of small amounts of alcohol is associated with beneficial changes in blood lipids and more flexible blood vessels, which may reduce risk overall.

The American Heart Association recommends that if you drink alcohol, do so in moderation. This means no more than two drinks per day for men and one drink per day for women. (A drink is one 12-ounce beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits.) High intakes can be associated with serious adverse effects and may increase alcoholism, high blood pressure, obesity, stroke, breast cancer, suicide and accidents. Consult your doctor on the benefits and risks of consuming alcohol in moderation.

I’ve stated taking niacin again, inspired by my new prescription for a statin, even though this study says there is no need for me to do so:

Although measurement of HDL–cholesterol concentration is useful as part of initial cardiovascular risk assessment, HDL-cholesterol concentrations are not predictive of residual vascular risk among patients treated with potent statin therapy who attain very low concentrations of LDL cholesterol.

And the flushing hasn’t been as bad as before so far:

Raising HDL Still Beneficial?

In the Lancet study, Paul Ridker and colleagues, from Brigham and Women’s Hospital (Boston, MA, USA), undertook a retrospective post-hoc analysis of the JUPITER trial. The results show that if a normal, healthy individual has level of low density lipoprotein (LDL), known as “bad cholesterol”, substantially lowered with a potent statin, then the level of HDL “good cholesterol” in that person no longer bears any relation to the remaining cardiovascular risk.

Cholesterol influences the health of our hearts and blood vessels. Conventional treatment attempts to reduce the level of "bad" cholesterol, LDL cholesterol, in the blood plasma. The opposite approach, which involves increasing the concentration of "good" HDL cholesterol using nicotinic acid, has proven unpopular among patients up to now. The reason for this is that treatment with nicotinic acid (niacin) has an unpleasant but harmless side-effect: the drug makes patients turn quite red in the face.

In addition to a healthy lifestyle, the treatment of lipid metabolic disorders is one of the important measures used in the prevention of cardio-vascular disease. Cholesterol is the key molecule here and LDL cholesterol is the type of cholesterol most widely discussed in this context. This "bad" cholesterol is one of the most important risk factors for the emergence of cardio-vascular diseases. The higher the blood-plasma concentration of LDL cholesterol, the higher an individual's risk of suffering cardiac arrest, stroke or peripheral vascular disease. The opposite applies to the "good" HDL cholesterol: in other words, the higher an individual's level of HDL cholesterol, the lower his or her risk of contracting these diseases. For this reason, the strategy of increasing HDL plasma concentration through medication has become more prevalent of late. The drug on which most hopes are pinned here is nicotinic acid.

I’m sitting here typing this when I should be up and walking around:

More time spent sitting = higher risk of death

A new study from American Cancer Society researchers finds it's not just how much physical activity you get, but how much time you spend sitting that can affect your risk of death. Researchers say time spent sitting was independently associated with total mortality, regardless of physical activity level. They conclude that public health messages should promote both being physically active and reducing time spent sitting.

This poses a very serious threat to my wife’s health:

Women who report greater use of cleaning products may be at higher breast cancer risk than those who say they use them sparingly.

I was shocked by how much sodium was in a can of beans, but I still ate it-and felt guilty:

Less Salt

I now eat an occasional egg, some soy and a more than a few peanuts - do I need another supplement?

Only 10 percent or less of older children, men, women and pregnant women in America are meeting the Adequate Intake (AI) levels for choline

Eggs, soy, peanuts and almonds are good sources of choline.

I’m eating lots of broccoli

Light has been cast on the interaction between broccoli consumption and reduced prostate cancer risk.

And taking Vitamin D supplements religiously:

New evidence shows low vitamin D levels lead to Parkinson's disease

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Laser may reduce prostate surgery's sexual side effects

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One of the challenges of prostate cancer surgery is removing the cancer-affected gland without side effects. The procedure is estimated to cause long-term sexual dysfunction in half of men.

Now, new published research by urologic surgeons at NewYork-Presbyterian Hospital/Columbia University Medical Center presents evidence that a new laser technology used with robotic prostate cancer surgery may reduce the risk of damaging the crucial nerves necessary for erections and urinary continence.

Published in the July online issue of the Journal of Endourology, the pilot study is the first to evaluate the CO2 laser for prostate cancer. The research was also presented recently at the American Urological Association annual meeting in San Francisco.

"The precision of movement available through robotic surgery is already helping reduce the risk of sexual side effects, and the early evidence is that CO2 lasers will help us be even more accurate -- especially when preserving the sensitive nerve areas necessary for sexual function and urinary continence," says Dr. Ketan Badani, director of robotic urologic surgery at NewYork-Presbyterian Hospital/Columbia University Medical Center and assistant professor of urology at Columbia University College of Physicians and Surgeons.

CO2 lasers are widely used to treat cancer in the head and neck. A new, flexible, fiber-based delivery system is now making the treatment approach possible with robotic prostate cancer surgery.

In the procedure, Dr. Badani uses the robotic instrumentation to remove the patient's prostate. This process is aided by the laser, which is used to dissect the plane between the nerves and the prostate, freeing the nerves and preserving them.

"Traditionally, we cut, clip or cauterize the tissue around the prostate nerves. However, these techniques can cause irreversible damage due to traction or heat injury," explains Dr. Badani. "The CO2 laser may reduce this risk because it is low-heat and doesn't require much manipulation of the nerves."

The new study describes the use of the laser in 10 cases. It reports that the technology is easy to manipulate and very accurate. Patients experienced a return of urinary continence better than the norm, something the researchers found "extremely encouraging." Future research will determine if the technology can improve outcomes with regard to the ability of men to sustain an erection, and its long-term ability to prevent cancer recurrence.

The laser technology, known as BeamPath, was provided by OmniGuide of Cambridge, Mass. OmniGuide BeamPath CO2 laser fibers are cleared for use by the FDA across a variety of open, endoscopic and laparoscopic soft-tissue cutting applications, including urology.

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Surgery better than radiation, hormone treatments for some prostate cancer, study shows

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Surgery for localized prostate cancer offers a significantly higher survival rate than either external-beam radiation or hormonal therapies, according to a new study led by researchers at UCSF.

The differences among therapies were more prominent at higher levels of cancer risk, and suggest, the researchers say, that in many cases surgery should play a greater role in treatment strategies for patients with prostate cancer that is likely to recur or spread.

The study is available online in the journal “Cancer,” the journal of the American Cancer Society, at http://www3.interscience.wiley.com/cgi-bin/fulltext/123630095/HTMLSTART.

Most previous reports comparing treatment outcomes among different treatment options have looked only at PSA responses to treatment, rather than at the more important long-term survival outcomes, according to the researchers. Measuring levels of PSA, or prostate-specific antigen, in the blood, is intended to help determine whether prostate cancer has recurred or spread, although in many cases a rising PSA level does not necessarily mean the cancer will progress.

Roughly one man in six will be diagnosed with prostate cancer, which is the second leading cause of cancer death in American men, according to the American Cancer Society.

“Despite the high incidence of prostate cancer, there is relatively little high-quality evidence on which to base current treatments for localized disease,” said Matthew R. Cooperberg, MD, MPH, lead investigator of the study and a prostate cancer specialist in the UCSF Department of Urology and the UCSF Helen Diller Family Comprehensive Cancer Center.

“These therapies can all have significant side effects, so it’s important to understand which treatment alternatives are most effective. In current practice, likelihood of undergoing surgery falls progressively with increasing levels of risk, which may be exactly contrary to what the treatment pattern should be,” he said.

Researchers found that the risk for cancer-specific mortality was more than three times higher in patients who received hormone therapy versus radical prostatectomy (surgical removal of the prostate) and more than twice as high in patients who received external-beam radiation therapy versus prostatectomy.

For men at low levels of risk, prostate cancer mortality was very uncommon, and differences among the treatment options were small. The survival differences increased substantially for men at intermediate and high risk, according to the analysis, with the greatest relative benefit for surgery seen for men at higher levels of risk.

The American Urological Association’s clinical practice guidelines for localized prostate cancer treatments include active surveillance, radical prostatectomy, external-beam radiation therapy, and brachytherapy (radiotherapy delivered via radioactive seeds), but draw no conclusions about the relative efficacy of each.

Androgen-deprivation therapy, which suppresses the production of male sex hormones, is not endorsed by the American Urological Association clinical practice guidelines for localized prostate cancer, due to inadequate evidence regarding outcomes, yet it is commonly used in practice, the researchers state.

“This is a clear signal to the physician community that prostatectomy should be considered for men with higher-risk prostate cancer. In many cases, surgery would be part of a multimodal treatment approach, including adjuvant radiation or systemic treatments based on the pathology and early PSA response,” added Peter R. Carroll, MD, MPH, chair of the UCSF Department of Urology and leader of the Prostate Program at the UCSF Helen Diller Family Comprehensive Cancer Center. Carroll is senior author on the paper.

Because no adequate randomized trials have compared active treatments for localized prostate cancer, the authors analyzed risk-adjusted, cancer-specific mortality outcomes among men who underwent radical prostatectomy, external-beam radiation therapy, or primary androgen deprivation.

The research team analyzed data from 7,538 men with localized disease from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) registry, a national disease registry comprising men from 40 urologic practice sites from across the country. The team then compared outcomes across treatments after adjusting for risk and age. In total, 266 men died of prostate cancer during follow-up.

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Calcium supplements play an important role in maintaining bone health

A broad range of scientific research has demonstrated that an adequate intake of calcium plays an important role in building and maintaining optimum bone mass, and a recent meta-analysis published online in the British Medical Journal should not cause consumers to doubt the value of calcium supplements for maintaining bone health.

"Adequate calcium intake is vital to building and maintaining healthy bones, and to preventing osteoporosis—which is caused by a failure to build adequate bone mass or by bone loss that occurs as we age. Most people do not get enough calcium from diet alone, and this is where a calcium supplement can be important to consumers of all ages," said Andrew Shao, Ph.D., senior vice president, scientific & regulatory affairs, Council for Responsible Nutrition. "The results from this meta-analysis does not undermine the value calcium supplements offer to those concerned with maintaining or increasing bone density, as years of research shows these products do."

The authors of the meta-analysis examined the effects of calcium supplements on the risk of cardiovascular events, concluding there is an increased risk, and calling for a reassessment of the role of calcium supplements for osteoporosis. According to CRN, these conclusions are dramatically overstated, considering the limitations of meta-analysis, in general, and this meta-analysis, specifically.

For example, the analysis could have potentially included over 300 scientific studies on calcium supplementation's effect on bone, but only 15 randomized clinical trials were deemed "eligible for analysis."

Further, seven of the 15 trials evaluated had no, or incomplete, data on cardiovascular outcomes, and only five of the 15 studies accounted for almost all of the cardiovascular outcomes. Further, because the researchers chose to exclude any trials administering calcium plus vitamin D, many large, important trials—including the Women's Health Initiative, which found calcium plus vitamin D had no effect on the risk of coronary heart disease or stroke—were not included.

"The authors characterize these findings as though all of the selected studies suggest increased risk. In fact, the opposite is true: most of the studies do not suggest increased risk," says Dr. Shao. "Bone health is one of the most common reasons why healthcare professionals recommend calcium supplements; there are other health benefits that may be associated with calcium supplementation, such as reduction of colon cancer risk. This is not even considered by the authors. It's unfortunate that these researchers are making sweeping judgments about the value of calcium supplements by only assessing a handful of handpicked studies."

Dr. Shao also pointed out that none of the original studies included in the meta-analysis were designed to evaluate cardiovascular outcomes. Additionally, the data on cardiovascular events was never previously published, so the meta-analysts had to track the information down separately, in some cases, 10 even 20 years after the original study was published.

"Meta-analysis can be a useful tool for scientific evaluation, but we have to recognize its limitations, and keep in mind that its findings are based on a collection of past studies that may have different designs, doses and study populations," says Dr. Shao. "This analysis should not dissuade consumers, particularly young women, from taking calcium supplements. They should talk with their doctors about their current and long-term needs and determine how much calcium they are getting from their diets, and supplement accordingly—likely in combination with vitamin D."

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Certain meat components may increase bladder cancer risk

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A new study suggests that consuming specific compounds in meat related to processing methods may be associated with an increased risk of developing bladder cancer. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings may be relevant for understanding the role of dietary exposures in cancer risk.

Eating red and processed meats has been linked to an increased risk of developing several different types of cancer. Animal studies have identified a number of compounds in meat that might account for this association. These include heterocyclic amines, polycyclic aromatic hydrocarbons, and N-nitroso compounds. Nitrate and nitrite are added to processed meats and are known precursors to N-nitroso compounds.

Amanda J. Cross, PhD, of the National Cancer Institute in Rockville and colleagues conducted one of the first prospective studies – the NIH-AARP Diet and Health Study—to assess the relationship between intake of these meat-related compounds and the risk of developing bladder cancer. They used information gathered through questionnaires to assess the types of meat consumed as well as how meat was prepared and cooked to estimate the intake of these meat-related compounds.

The investigators had information from approximately 300,000 men and women aged 50 to 71 years from eight US states. At the start of the study (1995 to 1996), all participants completed lifestyle and dietary questionnaires about their usual consumption of foods and drinks. The participants were followed for up to eight years, during which time 854 people were diagnosed with bladder cancer.

People whose diets had the highest amount of total dietary nitrite (from all sources and not just from meat), as well as those whose diets had the highest amount of nitrate plus nitrite from processed meats had a 28 percent to 29 percent increased risk of developing bladder cancer compared with those who consumed the lowest amount of these compounds. This association between nitrate/nitrite consumption and bladder cancer risk may explain why other studies have observed an association between processed meats and increased bladder cancer risk.

"Our findings highlight the importance of studying meat-related compounds to better understand the association between meat and cancer risk," said Dr. Cross. "Comprehensive epidemiologic data on meat-related exposures and bladder cancer are lacking; our findings should be followed up in other prospective studies," she added.

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