Archives for December 2015

Dec
26
2015

Coffee Could Be A Lifesaver

Coffee has long been a subject of heated discussions. It has been praised or condemned. Many studies have been done in the past; some showed health benefits, some did not. A new, larger study was done by the Department of Nutrition, Harvard School of Public Health in Boston, MA to re-examine this issue for both caffeinated and decaffeinated coffee.

Mortality was determined among 74,890 women in the Nurses’ Health Study (NHS), 93,054 women in the NHS 2, and 40,557 men in the Health Professionals Follow-up Study after a medium follow-up of 22.5 years. 19,524 women and 12,432 men died during that time period. Ming Ding is a doctoral student in the Harvard School of Public Health department of nutrition and was the lead author of the study that was published in the medical journal “Circulation”. She pointed out that in the past there were confounding problems: although many studies had shown that both caffeinated and decaffeinated coffee consumption lowered the risk of cardiovascular disease, the results in many studies were blurred. Studies often did not distinguish between smokers and nonsmokers; so a beneficial effect from coffee drinking was wiped out by the cardiovascular risk from smoking.

Ding’s studies took this into account and also other confounding factors like how much sugary soda pop people were drinking and whether or not they were eating well. In addition they normalized for other factors that could interfere like drinking alcohol and eating red meat.

Without normalizing for the factors mentioned above the study results were as follows. Study participants had less than a cup of coffee and three cups a day had a 5% to 9% lower risk of dying than those who drank no coffee. Those who drank more than three cups a day did not see any benefit.

However, when all the confounding factors were removed and the various groups were compared again the following emerged:

  • Less than 1 cup of coffee per day: 6% lower death rates than non-coffee drinkers.
  • 1 cup to 3 cups of coffee per day: 8% lower death rates.
  • 3 to 5 cups of coffee per day: 15% lower death rates.
  • More than 5 cups of coffee per day: 12% lower death rates.

Ming Ding was associated with another research paper that had shown that coffee drinkers have a lower risk of developing type 2 diabetes and heart disease. She found that both caffeinated and decaffeinated coffee reduced the risk of getting diabetes later in life.

When asked about what would be responsible for the reduced death rates with coffee consumption, Ding explained: “There are at least two known chemicals in coffee, namely lignans and chlorogenic acid that could reduce inflammation and help control blood sugar, both of which could help reduce the risk of heart disease”.

Although there seems to be a linear response up to 5 cups of coffee consumption, above 5 cups this linear relationship disappeared. It was not explained whether there was a saturation point reached, whether there was yet another hidden confounding factor or whether there were detrimental effects on the adrenal glands with too much coffee consumption.

Another finding was that it did not matter whether the coffee was regular (caffeinated) coffee or decaffeinated coffee. The results were identical.

Many other studies did not have the large numbers to show whether or not decaffeinated coffee was as effective in preventing heart disease.

Finally, there was another peculiar finding; suicides were down by 20% to 36%, if a person drank at least one cup of coffee per day. But if a person consumed less than 1 cup of coffee per day the suicide rate was 36% higher than the control group with no coffee consumption. This is a rather peculiar finding, particularly for the consumption of less than 1 cup of coffee. But other studies have also shown a decrease in suicide rates with coffee consumption.

Although previous studies had shown a reduction in liver and prostate cancer, after the removal of confounding factors this study did not show any effects on cancer causation or cancer death rates with coffee consumption.

Discussion

The Department of Nutrition, Harvard School of Public Health in Boston, MA has excelled in high quality nutritional studies for decades. But this study is particularly important, because it is so large giving it more statistical power; secondly, the observation time of an average of 22.5 years is longer than most coffee studies in the past. Add to this the removal of the noise (called confounding factors) that interfered with the objective of the study and you end up with a very meaningful result.

The important findings were that both caffeinated and decaffeinated coffee have the same effect of saving lives. Perhaps you want to drink not more than 5 cups of coffee per day. That lowers your risk of premature death by 15%. It is most likely that it is the effect of lowering the rate of diabetes and heart attack rates that is responsible for the risk reduction. At least this was the opinion of the chief investigator. Cancer rates were not lowered by coffee consumption.

I sleep better when I drink decaffeinated coffee, so for me the notion that decaffeinated coffee had the same effect as regular coffee was important.

Coffee Could Be A Lifesaver

Coffee Could Be A Lifesaver

Conclusion

Here is a study that is large enough, went long enough, and showed decisively that both caffeinated and decaffeinated coffee will reduce the death rate by 15% up to 5 cups of coffee per day. This finding was true for both males and females. Coffee seems to also reduce the suicide risk by a mechanism that has not yet been determined. If you want to live 15% longer than your previous life expectancy would have been without coffee, you may now have your coffee and enjoy it!

Dec
19
2015

Beer Belly Bad News

You heard the expression “beer belly”. It is an unflattering term for increased abdominal girth, especially in males. It is quite often that this picture is found in middle-aged men who consume more beer than what is good for them, but they may also mill around the hot dog stands at the ball game instead of being physically active. Any leftover calories are stored as belly fat, which protrudes their stomach as if they were pregnant.

There is a big difference between belly fat and body fat. Belly fat is metabolically much more active. Body fat is more sessile. So, it is the belly fat we need to do something about as this has been shown to be associated with heart attacks, strokes and diabetes.

Originally it was thought that excessive weight would best be measured with the body mass index (BMI). But subsequently it was shown that athletes with well-developed muscles could have BMI’s that were in the overweight (between 25.0 and 30.0) or even obese category (more than 30.0). Also, some people with heavy bones can have excessive BMI values despite them being normal based on other measurements. The new measurement is the old fashioned abdominal girth to hip ratio.

You measure the abdominal girth, the hip girth and divide the abdominal girth by the hip girth. Normally this should be 80% (=0.8) or less for women and 90% (=0.9) or less for men. But a person with a beer belly will have ratios of 1.2 or 1.5. This is where it shows that there is a problem. If you take blood tests of that person you would also find elevated triglycerides, lowered HDL cholesterol (the protective cholesterol) and elevated LDL cholesterol (the bad cholesterol). But it does not stop there. We know from studies that often the insulin level is elevated in the sense of hyperinsulinism. In fact that person has often the metabolic syndrome, which is a characteristic change of the metabolism in an obese person. The blood is thicker with clotting factors floating around, there are inflammatory kinins that circulate and these factors work together on causing hardening of the arteries.

Why is a beer belly dangerous?

There are not only cardiovascular risk on the long-term causing heart attacks and strokes down the road. There is a danger of fat deposits in the liver, called fatty liver disease.

In time this can turn into liver cirrhosis and in some cases develop into liver cancer. Because belly fat causes inflammation in the system including in the lining of the blood vessels, this can in time also affect the immune system, weakening it and eventually allowing cancer to develop. Common cancers that are associated with obesity are breast cancer, ovarian cancer and uterine cancer in women, prostate cancer in men and pancreas and colon cancer in both sexes.

In men beer bellies produce a lot of estrogen, the female hormone. This is so because fat tissue contains the enzyme aromatase that metabolizes male hormones into estrogen. Estrogen in men is only good in traces, but when it is massively produced it will counter testosterone production and will cause heart attacks and strokes.

What can be done about a beer belly?

We need to understand how beer bellies develop. One of the sources of fat from beer bellies is the consumption of foods that contain a lot of fructose. Food manufacturers have been diligent in mixing high fructose corn syrup into sugary drinks and into a myriad of processed foods.

Sugar itself can only be processed and stored until the glycogen stores in the liver and the muscles are filled. The liver metabolizes a surplus of sugar into triglycerides and LDL cholesterol. This is also the case for any fructose that comes from metabolized sucrose (table sugar) and from the high fructose corn syrup popular with the food processing industry. One problem is that fructose can only be processed by the liver, while glucose gests directly taken up by cells with the help of insulin.

The surplus of fructose is mostly used to metabolize into triglycerides and LDL cholesterol before it is stored as fat in fat cells. Unfortunately a lot of the fat will end up between your guts, in the liver as fatty liver and in the beer belly, a metabolically more active form of fat.

The sad part is that in the 1960’s I have seen the German economic wonder (“Wirtschaftswunder”) where many mid fifty to mid sixty business men died as a result of obesity and subsequent heart attacks and strokes. At that time it was thought that Germans having been starved during World War II lived it up in the late fifties and 1960’s to the point where they ate what they could get hold of: cakes, fatty cheeses, whipped cream, fatty foods like pork roasts and beef. They also consumed loads of bread, buns, pasta and sugar. Margarine also became popular with its hydrogenated fatty acids that also contained free radicals. The end result was that they gained weight, did not exercise and developed their beer bellies.

Since the 1980’s when low fat/high carbs became popular to replace saturated fatty acids that were supposed to be responsible for heart attacks, strokes and obesity, obesity continued to steadily increase. Sure, the hydrogenated fatty acids did not help and should be cut out. But the bigger problem was the consumption of high fructose corn syrup and over-consuming high glycemic-index carbohydrates.

Here is the solution of what to do get rid of the beer belly.

  1. Remove sugar and high fructose corn syrup from your diet.
  2. The second effective step is to cut out as many empty starches that you can cut out like white rice, bread, sweets, cookies, cakes, ice cream and pasta. The reason for this is that these starchy foods get metabolized in the gut into sugar, which causes an insulin response. The extra insulin is responsible for developing inflammation in the arteries, which eventually leads to heart attacks and strokes.
  3. Exercise on a regular basis. This will produce HDL cholesterol, the protective cholesterol, which balances LDL cholesterol.
  4. Perhaps the most important step is to rebalance your food intake. With this I mean that you replace high glycemic-index carbs with low glycemic-index carbs. This means you will eat a lot of salads, steamed vegetables, and fruit. This gives you a lot of extra fiber, which your system needs to slow down the rate of sugar absorption, helps you to lower LDL cholesterol and helps you to detoxify your body in the gut where toxins are bound to fiber.
  5. If you are heavily into alcoholic drinks there is another source of refined carbohydrates that gets metabolized into LDL cholesterol, triglycerides and can cause fatty liver disease and liver cirrhosis. A moderate consumption of alcohol (one drink for women per day and two drinks for men per day) lowers the risk of heart attacks and strokes, while excessive alcohol intake increases the risk.
  6. Bioidentical hormone replacement may be something you have not heard about. But if you are a woman above the age of 40 or a man above the age of 50 chances are that your natural hormone production from your testicles or adrenal glands (in a man) or from the ovaries or adrenal glands (in a woman) are no longer keeping up with the demand of regular life. Part of the aging process is that is that the production of our sex hormones slows down shortly before menopause in women and shortly before andropause in men. This will not only manifest itself in hot flashes and sleep disturbance in women or in erectile dysfunction and grumpiness in men; it will eventually lead to a lack of energy metabolism in the heart, the brain and other organ systems that have sex hormone receptors. A lack of hormones translates into yet another cause of heart attacks, strokes and certain cancers. This is an area where conventional medicine disagrees with anti-aging medicine. But it is my experience from years in general practice that heart attacks, strokes, colorectal cancer and pancreatic cancer in both sexes, cancer of the breasts, uterus and ovaries in women and prostate cancer in men are indeed more common when natural hormone production has declined.

On the other hand, when bioidentical hormone replacement is given, the metabolism of all cells will return to normal and the likelihood of not developing all these illnesses at an earlier time is diminishing as well. It is not a panacea for eternal life, but it will add significant longevity without premature disabilities, which is what we all need.

Beer Belly Bad News

Beer Belly Bad News

Conclusion

Although weight gain around the waistline is common these days and increased mortality due to heart attacks, strokes and cancer is common, we do not have to accept this as the new norm. We need to assess our food intake habits, cut out the items that contribute to the beer belly and ask ourselves what other change in lifestyle we need to do to improve our body shape and our energy metabolism. Life is too precious to just throw away years of fruitful living in our golden retirement years. Work on these factors in midlife or even in younger years and you will enjoy disease-free aging.

Dec
12
2015

Thyroid Cancer In Children

Children normally do not get thyroid cancer. It is usually older people who get thyroid cancer. If children in one area are getting a lot of thyroid cancer, epidemiologists ask whether there was radioactive iodine poisoning in the area. The Fukushima disaster in March 2011 was in effect such radioactive iodine poisoning in this region of Japan.

An area extending about 20 kilometers from the nuclear plant has been declared an exclusion zone. It is not surprising that now there are reports of thyroid cancers in the area of Fukushima. The most recent statistics released in August 2015 showed that 137 of those children monitored in the Fukushima area came down with thyroid cancer while the year before there were only 112 such cases (25 cases less). Elsewhere, the disease occurs in only about one or two of every million children per year. Overall the amount of thyroid cancers in the Fukushima area is 20 to 50 times of what would normally be expected in a population.

Experience from Chernobyl nuclear accident

We learnt from the Chernobyl nuclear accident in April 1986 that the latency period (time elapsed between exposure to radiation and the first cancer observations) was about 4 years. The most dominant type of thyroid cancer was papillary carcinoma, which is a more benign type of cancer. Genetic examination of the tumors showed chromosomal rearrangements.

It is interesting to note that in Belarus, which is quite a distance from Chernobyl (Ukraine) there was a wave of thyroid cancers that stemmed from the Chernobyl disaster.

In the period of 1987-2000 there were about 4,400 radiation-induced thyroid cancers that appeared in Belarus; of these 692 cancers were among children and 3,709 cancers were among adolescents and adults.

How is thyroid cancer diagnosed?

Thyroid nodules can easily be detected by ultrasound examination. Normally in children there are no nodules in the thyroid gland, but it is out of nodules in the thyroid that thyroid cancer develops. If a thyroid nodule is detected in a child, the child needs to be referred to a specialist for further examinations and tests.

Treatment of thyroid cancer

If there is a local nodule within the thyroid gland, usually the pediatric surgeon will remove this surgically. Depending on the stage of the disease radiotherapy may or may not be included.

What can be done to minimize the impact of thyroid cancer?

When the Fukushima disaster occurred, a lot of people and children were offered potassium iodide pills to take. The iodide saturates the body’s iodine receptors with non-radioactive iodine so that radioactive iodine from inhaled air would not enter the thyroid and lead to mutations of the thyroid tissue. We know from the atom bomb in Nagasaki that this type of prevention has helped to prevent the development of some thyroid cancers. Unfortunately not everyone after the Fukushima disaster took these iodide pills or they stopped taking them after a while, which allowed radioactive iodine to enter the thyroid glands of those exposed to the substance.

Screening program

An unprecedented ongoing screening program of almost the entire children population in the Fukushima area is diagnosing thyroid follicles early. This has helped the medical teams to diagnose the thyroid cancers early and continue to follow these children. In the case of thyroid cancer treatment could be administered early before the cancer metastasized. If hypothyroidism occurs, this is treated right away with thyroid medication.

Long-term follow up after Hiroshima and Nagasaki

Previous experience with patients affected by the atom bombs in Hiroshima and Nagasaki, Japan in 1945 has shown interesting findings 55 to 58 years later. A total of 4091 (1352 men and 2739 women) people were followed. 14.6% of them had solid thyroid nodules; 2.2% of them had malignant thyroid tumors; 4.9% of them had benign thyroid nodules, and 7.7% had thyroid cysts.

Thyroid antibodies in the blood were also determined: 28.2% had positive thyroid antibodies, 3.2% had antithyroid antibody-positive hypothyroidism and 1.2% had Graves disease (=hyperthyroidism with enlarged thyroid). There was a significant linear dose-response curve between exposure to radiation and the amount of solid nodules, malignant tumors, benign nodules and cysts that had developed over the years in the 4091 men and women.

These types of long-term follow-ups help to know how important it is to follow all of the exposed individuals from the Fukushima disaster in a similar fashion.

Thyroid Cancer In Children

Thyroid Cancer In Children

Conclusion

A massive screening program is going on in children who were exposed to radioactive iodine in the Fukushima region. Nodules in the thyroid that are precursors to thyroid cancer are being evaluated. As a result early biopsies and, if necessary, resection of suspicious thyroid gland areas can be done before thyroid cancer or metastases develop. Physicians now build on the experience of prior nuclear disasters like the atom bombs in Hiroshima and Nagasaki and the nuclear accident in Chernobyl. Apart from radioactive iodine there were other nuclear isotopes that were released in these nuclear incidences. They may have been responsible for other malignancies that have developed in children, men and women in these areas.

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Dec
05
2015

Processed Meat Causes Cancer

A report from the World Health Organization (WHO) has stated that processed foods are cancer producing. The report also stated that to a lesser degree red meat is also cancer causing. Overall there are 34,000 people per year worldwide who die from cancers that are related to the consumption of processed foods. They are mainly colorectal cancers, pancreatic cancer and prostate cancer.

Seeing deaths from processed meat in perspective

When you relate the 34,000 processed food related cancers to all of the 8.2 million cancer deaths per year worldwide, the cancer numbers related to processed food amount to only 0.41 % of all the cancer deaths in the world, which is a very small percentage. In comparison to these numbers smoking as a cause of cancer is responsible for the death of 1 million people per year. Furthermore, there are 600,000 deaths due to drinking alcohol, and 200,000 deaths due to breathing polluted air. Of course it has to be emphasized that it is important to avoid cancer causes wherever possible!

Nevertheless we are talking about preventative deaths and the public should be informed about what the risks are due to consuming processed meats, cigarette smoking, drinking alcohol and breathing polluted air.

Pancreatic cancer study

A large multi-ethnic study analyzed data from 190,545 men and women at the Cancer Research Center at the University of Hawaii. In an average follow-up time of 7 years there were 482 incidents of pancreatic cancer, and it became obvious that processed meats play a role in the increase of pancreatic cancer. After taking other risk factors into consideration like a positive family history, age, smoking and diabetes mellitus, those patients who consumed the largest amount of processed meats had a 67% increased risk for pancreatic cancer as opposed to those who had the lowest intake of these foods. A diet rich in red meats increased the pancreatic cancer risk by about 50%.

Poultry, fish, dairy products and egg intake showed no pancreatic cancer risk factor, nor did it matter how much fat, saturated fat or cholesterol was consumed over the 7 year observation period.

The lead investigator of the study, Dr. Ute Noethlings, observed that the risk increase is a consequence of meat processing. The main culprit would very likely be carcinogenic substances which are used in processed meat production.

Too much red meat

Grain fed or corn fed and antibiotic treated regular beef changes the gut bacteria and can cause superbugs. The change of the gut flora can lead to inflammation in the gut lining and a condition called “leaky gut syndrome”. We carry almost 2 pounds of gut bacteria in us at any given time. Residual antibiotics from regular beef and chicken reduce that amount and change the composition of our gut flora.

The changes taking place from consuming regular beef changes your liver metabolism and leads to accelerated hardening of the arteries, which in turn causes deadly heart attacks and strokes. On the other hand, grass fed beef or organic beef do not have the same effect. To prevent leaky gut syndrome, heart attacks and strokes from developing you can also take probiotics every day, which should include these two species: Lactobacillus acidophilus and Bifidobacterium bifidus. This keeps your gut flora stable and does not allow your food to undermine your health. But this does not mean that you pop a supplement, and you can blissfully ignore sensible nutrition!

Red meat can cause heart attacks in diabetics

Red meat is one of the sources of protein, but doctors from the Harvard School of Public Health reported in the January edition of Diabetes Care, that a type 2 diabetes diet should go easy on red meat.

Type 2 diabetics are at risk for subsequent coronary heart disease (CHD), and intake of iron rich food was significantly associated with a greater risk of fatal CHD. The results come from a prospective study of 6,161 women from the Nurses’ Health Study.

All of these patients reported a diagnosis of adult onset diabetes, and they were followed between 1980 through 2000, which amounts to an impressive 54,455 person-years follow-up. Attention was paid to the food questionnaires, which were monitored for the consumption of iron and red meat such as beef, pork or lamb as a main dish, also for the use of beef in roast beef sandwiches and mixed dishes, hamburger, hot dog, processed meat and bacon. Note was also taken of other nutrients such as seafood and poultry.
Women with diabetes who ate the most iron in the form of heme found in red meats had a 50% increased risk of total coronary heart disease as compared to those with the lowest intake. The risk ratio with women was more obvious for postmenopausal women when compared with premenopausal women .

While lean beef may be a good protein food to the average population, type 2 diabetics might choose to cut back on red meat and processed red meat sources and replace it with a heart-friendlier choice. Fresh seafood, rich in omega -3 fatty acids, would rank high on the list of a healthy eating plan.

Another prospective study of 72,113 women over 18 years found a definitive relationship between dietary patterns and cancer and heart attacks. A prudent diet with high intakes of vegetables, fruit, legumes, fish, poultry, and whole grains had a very low cancer and heart attack rate. Conversely a Western diet consisting of high intakes of red meat, processed meat, refined grains, French fries, and sweets/desserts led to a higher cardiovascular mortality risk of 22% and a higher cancer mortality risk of 16%.

Processed Meat Causes Cancer

Processed Meat Causes Cancer

Conclusion

Although the World Health Organization has now announced that processed food is carcinogenic, this piece of news is not entirely new. Hopefully it will work its way into the consciousness of the population at large. Meat processors producing sausages, ham and other processed meat varieties will not stop advertising their products in a way to make them sound tasty and delicious for the consumer. Colorful images are geared to make the prospective buyer drool, but this is a make-believe world in the art of commercials. In the end it is the consumer who has to make a decision which food is tasty and also beneficial. Only when the customer makes the choice for health and stops buying foods that border to being nutritionally hazardous products, we will see a true change in health statistics. But while you are thinking about changes, do not forget to quit smoking, cut down your alcohol consumption and perhaps, if possible move to a less polluted area. All of that will help to reduce mortality rates!

More info about pancreatic cancer: Causes of cancer of the pancreas.

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