Concord Grape Juice Improves Memory

January 24, 2010 by Robert Wascher  
Filed under dementia

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

 

CONCORD GRAPE JUICE IMPROVES MEMORY

 

Polyphenols are plant-based dietary compounds with known antioxidant and anti-inflammatory properties.  These biological properties of polyphenols reduce the ongoing damage to the DNA in our cells that results from the toxic byproducts of metabolism, including free radicals.  Polyphenols have, therefore, been the subject of intense research as potential prevention agents for a variety of human ailments, including cardiovascular disease, dementia, and cancer.  (The evidence-based role of dietary polyphenols in cancer prevention is discussed in great detail in my soon-to-be-published book, “A Cancer Prevention Guide for the Human Race.”)

Foods that are naturally rich in polyphenols include most blue and red berries, grapes (including red wine), pomegranates, walnuts, peanuts, olive oil, green tea, dark chocolate and cocoa, coffee, and beer (as well as other fruits and vegetables). 

Recent animal research has suggested that polyphenols derived from grape seeds can reduce the development of plaques in the brain (at least in mice) that are associated with the development of Alzheimer’s disease.  Now, a newly published prospective, randomized, double-blind clinical research study suggests that Concord grape juice, which is rich in polyphenols, may be able to improve early memory decline in older adults.

In this small study, which has been published in the British Journal of Nutrition, 12 elderly adults with declining memory were divided into two groups.  The “experimental group” received daily Concord grape juice supplements for a period of 12 weeks.  The second group, the “control group,” received placebo supplements that were identical in appearance to Concord grape juice, but which contained no juice.  Neither the 12 patient volunteers nor the research assistants were aware of which patients received grape juice and which patients received the placebo while the study was being conducted.

Standardized, validated tests of memory, and other aspects of cognitive function, were administered to all 12 patient volunteers participating in this study.  These cognitive function tests revealed statistically significant improvements in verbal learning skills among the patients who received 12 weeks of Concord grape juice (when compared to the placebo group).  Although not statistically significant, improvements were also noted in both verbal and spatial recall among the patient volunteers who received the grape juice supplements in this small clinical study with a brief duration of patient follow-up.

While larger studies, with a longer duration of follow-up, will be required to confirm the findings of this small pilot study, the prospective, randomized, placebo-controlled, double-blind nature of this small study does give it considerably more predictive power than the much larger dietary survey-based epidemiological studies that are more commonly used in disease prevention research. 



In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author



For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg



 

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Mozart, Music, Babies & Health

January 24, 2010 by Robert Wascher  
Filed under Uncategorized

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

 

 

MOZART, MUSIC, BABIES & HEALTH

 

Wolfgang Amadeus Mozart, born in Salzburg on January 27, 1756, was a prolific and gifted composer, and is credited with over 600 original compositions prior to his death in 1791 at the age of 35.  A child prodigy, Mozart is said to have written his first composition by the age of 5.  Although Mozart composed music in a wide variety of styles, music scholars have noted that Mozart’s compositions tend to reflect a high degree of “periodicity,” involving extensive repetition of major melodic themes, when compared to the other enduring master classical music composers of Mozart’s era.  This aspect of Mozart’s music may be clinically important as, for example, clinical research studies in adults with epilepsy have compared Mozart’s music with that of Beethoven, Wagner, Bach, Chopin, Hayden, and Liszt, among others, and found that Mozart’s music was more effective in reducing seizure activity than that of the other titans of Classical music.  Thus, some experts in brain physiology have concluded that Mozart’s compositions may particularly resonate with the human brain’s circuitry, and may potentially affect brain function in clinically significant ways.

An entire commercial industry has emerged from a phenomenon that is often referred to as the “Mozart Effect.”  Clinical research in the early 1990s with infants suggested that listening to music by Mozart could at least temporarily improve spatial reasoning, or “spatial-temporal intelligence” in babies.  The rather narrowly focused findings of these studies have subsequently been grossly over-generalized, primarily by companies marketing Mozart recordings to hopeful new parents, as evidence that regularly listening to Mozart can enhance the IQ of infants and toddlers. 

Putting aside the debate over the potential impact of Mozart on the IQ of babies and toddlers, other recent research data has suggested that exposure to Mozart’s music might be associated with improved weight gain in underweight babies and children.  A newly published prospective clinical research study, which appears in the current issue of the journal Pediatrics, suggests a mechanism whereby underweight premature infants may be stimulated to gain weight following exposure to the music of Mozart. 

In this prospective, randomized study, 20 hospitalized premature infants receiving liquid nutrition through feeding tubes were randomly assigned to two different groups.  In the experimental group, the pre-term babies were exposed to a 30-minute period of Mozart’s music each day, for two consecutive days.   The control group of infants, however, was not exposed to any music on these two consecutive days.  This study included a crossover design, wherein all of these infants were then “crossed-over” into the opposite group, such that each baby participated in both the experimental group and the control group.  Measurements of these babies’ rate of energy metabolism were then performed during each 30-minute period of Mozart music exposure in the experimental group, and for equal 30-minute periods in the babies that were randomized to the control group.

Interestingly, the metabolic rates of the babies exposed to Mozart’s music decreased by 10 to 13 percent within 10 minutes of starting the Great Composer’s music (compared to the infants in the control group).  This innovative little study’s finding that the rate of energy metabolism in premature infants decreases following exposure to Mozart’s music is interesting, and may explain, at least in part, the findings of previous studies that underweight children gain weight after being exposed to recordings of Mozart’s music. 

Research studies such as this one raise the question of whether or not Mozart’s music, or that of other Classical composers, should be routinely used in hospital nurseries and neonatal intensive care units.  Meanwhile, if your baby or toddler is underweight, but otherwise healthy, a trial of “Mozart therapy” might just be in order.



In view of the extreme devastation and human misery brought about in Haiti by the recent earthquake, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in that country to assist the injured, the ill, and the homeless there.  There are many such legitimate charities, including the following two:

http://www.redcross.org/

http://www.imcworldwide.org/haiti



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

 

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Breast Cancer, Physical Therapy & Lymphedema

January 17, 2010 by Robert Wascher  
Filed under Breast Cancer

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

 

BREAST CANCER, PHYSICAL THERAPY &

 

LYMPHEDEMA

 

 

Arm lymphedema, or chronic swelling of the arm, occurs in 10 to 30 percent of women following treatment for breast cancer.  When the lymphatic drainage network in the arm and hand has been disrupted by the surgical removal of axillary (armpit) lymph nodes, or by radiation therapy to the axilla (or, sometimes, following both types of treatment), the delicate network of lymphatic vessels that return excess tissue fluid back to the heart can become obstructed. This lymphatic obstruction can then result in chronic swelling of the hand and arm.  Patients with significant lymphedema of the arm following breast cancer treatment may experience considerable swelling (edema), heaviness, stiffness and discomfort of the affected hand and arm.

Unfortunately, there are no known effective methods available to prevent lymphedema, and once significant lymphedema does develop, compression sleeves and soft tissue massage are the primary treatment modalities currently available.  Unfortunately, currently available lymphedema treatments are often not highly effective for many patients, and there is no known cure for lymphedema once it develops.

Now, a newly published research study, in the British Medical Journal, suggests that physical therapy, when initiated early after breast cancer surgery, can significantly decrease the risk of arm and hand lymphedema.  In this prospective randomized clinical research study, 120 women who underwent removal of their axillary lymph nodes for breast cancer were randomized to one of two groups.  Women assigned to the experimental group underwent physical therapy 3 times per week, for a total of 3 weeks.  Physical therapy techniques used in this group included manual lymph drainage and soft tissue massage techniques, as well as progressive shoulder exercises.  Both groups of women also underwent the same lymphedema management educational course, but the control group of women did not receive any physical therapy interventions.

Among the 116 women who completed at least one year of follow-up, 18 women (16 percent) went on to develop lymphedema.  Fourteen of the women who developed lymphedema were in the control group, while the remaining 4 women were in the experimental group.  Thus, in this clinical study, early physical therapy following axillary lymph node dissection (ALND) was associated with a very significant 72 percent reduction in the risk of developing lymphedema, at least within the first year following breast cancer surgery.

Whether or not the use of early postoperative physical therapy can reduce the incidence of arm lymphedema over periods longer than one year is unknown at this time, and additional follow-up of the patients who participated in this clinical research study will be required to answer this very important question.  However, this is one of the very few studies available that suggests a role for physical therapy in the actual prevention of arm and hand lymphedema following ALND for breast cancer.  If additional, mature follow-up of these patients confirms a long-term benefit from early postoperative physical therapy in preventing arm lymphedema, then a strong case could be made for the routine use of early physical therapy in women who undergo ALND, and perhaps, as well, women who undergo sentinel lymph node biopsy with subsequent radiation therapy to the breast and armpit (axilla) area.

 

For additional information and resources related to cancer-associated lymphedema, please click on the links below:

http://www.cancersupportivecare.com/Abstracts/asbdpbtps.html

http://meeting.ascopubs.org/cgi/content/abstract/23/16_suppl/8185

http://www.annalssurgicaloncology.org/cgi/content/abstract/15/7/1996

http://www.cancerlynx.com/sln.html

http://doctorwascher.com/Archives/11-23-08.htm

http://doctorwascher.com/Archives/8-16-09.htm

 



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

 

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Prevention of Surgical Site Infections (SSIs) after Surgery

January 10, 2010 by Robert Wascher  
Filed under Infection, surgery

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”

PREVENTION OF SURGICAL SITE INFECTIONS

 

(SSIs) AFTER SURGERY

 

 

Infections following surgery in the United States occur in approximately 3 to 5 percent of all cases, and in more than 10 percent of certain types of operations.  In view of these statistics, surgical site infections (SSIs) are a major public health problem throughout the world.  On average, patients in the United States who develop an SSI will remain in the hospital for an additional week, resulting in an average of more than $25,000 in additional healthcare costs per affected patient.  Patients who develop SSIs are also 60 percent more likely to be admitted to the ICU, and are twice as likely to die, when compared to patients who do not develop SSIs following surgery.   Moreover, at a time when profound changes in the United State’s health care system are being proposed to control skyrocketing health care costs, SSIs are estimated to add an additional $10 billion in national health care costs, annually.   In addition to the economic costs associated with SSIs, serious infections following surgery often cause considerable suffering among affected patients; and in severe cases, SSIs can also result in permanent disability or death.

 

The known causes of SSIs are complex and multiple and, therefore, no single or simple solution is capable of eliminating all cases of SSIs.  However, there is ample research data available suggesting that a number of opportunities exist whereby the risk of SSIs can be further reduced.  For example, one major (and preventable) cause of potentially life-threatening SSIs is the increasing prevalence of antibiotic-resistant strains of bacteria that have developed following decades of excessive and inappropriate antibiotic use.  Among these resistant bacteria, few have raised more concern than methicillin-resistant Staphylococcus aureus (more commonly known by its acronym, MRSA).  MRSA is capable of causing limb- and life-threatening infections, particularly in very ill patients, and in the very young and very old.  When I began my medical career, more than 20 years ago, MRSA was an exceedingly rare cause of bacterial infections.  When MRSA first began to appear, this bacterium primarily caused infections among seriously ill hospitalized patients, and was rarely a source of infection among generally healthy nonhospitalized patients.

 

In a landmark study by the Centers for Disease Control, and published in the Journal of the American Medical Association in 2007, a remarkable 58 percent of invasive infections caused by MRSA in 2004 and 2005 occurred in nonhospitalized patients, while 27 percent of MRSA infections arose among hospitalized patients.  This tectonic shift in the epidemiology of MRSA (and other emerging strains of antibiotic-resistant bacteria and fungi, as well) has grave implications for preventing SSIs, as the majority of SSIs are known to arise from the surgical patient’s own native bacteria.

 

 

Two important new studies related to SSI prevention, and just published in The New England Journal of Medicine, offer important new ammunition in the ongoing fight against potentially deadly SSIs.

 

In the first study, from the Netherlands, patients being admitted to the hospital for elective surgery were tested for the presence of Staphylococcus aureus bacteria in their nasal passages.  In this prospective, randomized, placebo-controlled, double-blind, multi-center clinical research trial, 6,771 patients were screened for the presence of nasal Staphylococcus aureus, and 1,251 of these patients were confirmed to be nasal carriers of this bacterium.  A total of 917 of these patients were subsequently enrolled into this clinical research trial. These 917 patients were then divided into an “experimental” group and a “control” group, although neither the patients nor the research assistants in this double-blind study were permitted to know which group any patient was assigned to until after the study had been completed.  Patients randomized to the “experimental” group were treated, before surgery, with antibacterial ointment (mupirocin) applied to their nasal passages, and with showers using antibacterial soap (chlorhexidine), in an effort to eradicate surface bacteria (including Staphylococcus aureus) from their noses and skin.  The “control group” of patients received identical-appearing nasal ointment and skin soap, but without mupirocin or chlorhexidine.

 

All study patients were tracked following surgery, and the incidence of SSIs was then analyzed.  In this highly-powered randomized, controlled clinical research trial, there was a 58 percent overall reduction in the relative risk of SSIs among the “experimental group” of patients when compared to the patients who received only placebo ointment and placebo soap.  The benefit of preoperative treatment with mupirocin ointment and chlorhexidine soap was even more pronounced for SSIs involving deep body spaces, in this study: the relative risk of deep body space SSIs was reduced by 79 percent in the “experimental group” of patients.  Therefore, the results of this powerful prospective clinical trial suggest that SSIs following elective surgery can be significantly reduced by, first, testing patients for evidence of colonization with Staphylococcus aureus bacteria and, secondly, by “decolonizing” the nasal passages and skin of already-colonized patients with antibacterial ointment and soap, respectively.  Many hospitals already selectively apply nasal cavity testing for MRSA (either before or following surgery), and recommend a shower with chlorhexidine soap prior to surgery.  The results of this important public health study suggest that the incidence of SSIs can probably be further lowered by more rigorous and more universal preoperative screening programs for nasal Staphylococcus aureus (including both MRSA and non-MRSA Staphylococcus aureus) directed at all patients who are undergoing elective surgery.

 

 

The second, and related, study evaluated the impact of two different preoperative skin prep solutions on the incidence of SSIs.

 

For decades, now, iodine-based skin cleansing solutions have been applied to skin surfaces just prior to the start of surgery, in an effort to kill skin-surface bacteria that can lead to SSIs.  While these traditional iodine-based antibacterial skin prep solutions are active against many bacteria and fungi that are known to cause SSIs, their antibacterial and antifungal activity rapidly dissipates after being applied.  Newer surgical skin prep agents that contain alcohol and chlorhexidine have been shown by recent research studies to not only have a wider spectrum of activity against skin bacteria and fungi than traditional iodine-based prep solutions, but these newer surgical prep solutions also sustain their antibacterial and antifungal activity over a much longer duration than their iodine-based counterparts.  In this new prospective, randomized clinical research study, 849 patients undergoing elective surgery were randomized to one of two groups.  One group of patient volunteers underwent preoperative skin preparation with a commercially available chlorhexidine-alcohol solution, while the second group was randomized to undergo skin preparation with the traditional povidone-iodine solution.

 

Following surgery, 16 percent of the patients who had their skin prepped with povidone-iodine solution developed SSIs within 30 days of surgery, while just under 10 percent of the patients who received the chlorhexidine-alcohol skin prep solution subsequently developed SSIs.  (This 41 percent reduction in the relative risk of SSIs was found to be highly statistically significant.)    Although use of the chlorhexidine-alcohol skin prep, alone, did not appear to protect against deep organ-space infections (when compared with the use of povidone-iodine skin prep solutions) in this study, both superficial and deep SSIs of the surgical incision were significantly reduced following use of the chlorhexidine-alcohol skin prep solution.  In this study, the use of a chlorhexidine-alcohol prep solution cut the risk of superficial incisional infection by one-half, while deep incisional infections were reduced threefold.  Thus, the use of chlorhexidine-alcohol skin prep solutions, just prior to making the incision, was associated with a highly significant reduction in the incidence of both superficial and deep infections of surgical incisions when compared to traditional iodine-based prep solutions.

 

 

Taken together, these two very important prospective randomized clinical research trials offer clinically valuable lessons for patients, physicians, and hospitals in our crucial quest to drive down the incidence of SSIs to the lowest achievable level.  In view of the recent and ongoing emergence of highly virulent strains of bacteria and fungi that have become resistant to many of our most powerful antibiotic and antifungal drugs, respectively, it is imperative that we find new ways to reduce the risk of SSIs, and particularly new methods that do not involve the continued inappropriate or excessive utilization of broad spectrum antibiotic drugs.

 

If you are scheduled to undergo elective surgery in the near future, I would advocate that you share the findings of these two clinically important research studies with your surgeon (if they are not already aware of them).



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link: 

http://www.youtube.com/watch?v=7-Tdv7XW0qg

 

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Ginkgo Biloba, Memory & Cognitive Health

Welcome to Weekly Health Update



 

“A critical weekly review of important new research findings for health-conscious readers”


GINKGO BILOBA, MEMORY & COGNITIVE HEALTH

 

 

Regular readers of this column know that I have a strong interest in lifestyle- and diet-based approaches to disease prevention, but that I insist on rigorous, high-quality research-based data before I can recommend a particular lifestyle or dietary modification to my readers (or to myself).  Many past columns have reviewed the findings of research studies with favorable results associated with specific nutritional or other lifestyle approaches to disease prevention.  However, this week’s column will report on a newly published prospective clinical research trial that calls into question the supposed clinical value of the traditional Chinese medicine herb Ginkgo biloba in reducing the cognitive decline associated with aging and Alzheimer’s disease.

 

Previously published public health research data, based upon low-powered research methods, have suggested that dietary supplementation with Ginkgo biloba might be able to improve memory and cognition, particularly in older adults.  However, more recent data, based upon more robust types of clinical research, have called this assumption into question (as well as previous claims that Gingko biloba can delay or reverse the cognitive decline associated with Alzheimer’s disease).  Now, a newly published prospective, randomized, double-blind, placebo-controlled clinical trial of Gingko biloba supplementation in older adults in the United States appears to have definitively resolved the controversy about the value of Gingko biloba in maintaining memory, and other high level cognitive functions, in older adults. 

 

 

Ginkgo biloba trees are often referred to as living fossils, as they are known to survive for 1,500 years or more, and their presence has been documented within fossil-bearing rocks more than 270 million years old.  Although ancient fossils containing the distinctive bilobed leaves of Ginkgo biloba trees have been found on multiple continents, modern day Gingko trees now grow naturally only in China (although they have been widely cultivated, over a period of centuries, throughout Asia, and particularly in Japan and Korea).    

 

A new highly-powered prospective clinical research trial evaluating Ginkgo biloba supplementation appears in this week’s issue of the Journal of the American Medical Association.  More than 3,000 adults between the ages of 72 and 96 years participated in this placebo-controlled research trial, with an impressive average patient follow-up duration of more than 6 years.  These patient volunteers were secretly randomized to one of two groups.  The patients in the “experimental group” received 120 mg of Ginkgo biloba extract twice daily during the course of this study, while the “control group” of patients received an identical-appearing placebo (“sugar pills) twice daily.  (As this was a double-blind study, neither the patient volunteers nor the researchers knew which patients were receiving Gingko pills and which were receiving the placebo pills until after the research study was completed.) 

 

Multiple validated cognitive screening exams were given to all of these older patient volunteers during each year of the study, and the rate of annual decline in cognitive function was then compared between the two groups of patient volunteers.  Areas of cognitive function that were specifically tested for in this high-powered prospective clinical research trial included memory, attention, visual-spatial abilities, language function, and overall executive brain function.  (Note: these same cognitive function tests are also routinely utilized to assess cognitive function in patients with Alzheimer’s disease.)

 

Unfortunately, there was absolutely no difference observed or measured in the rate of decline in cognitive function between the two groups of older patient volunteers, indicating the lack of any clinically detectable benefit in age-related cognitive decline associated with high-dose supplementation with Ginkgo biloba.

 

(As an editorial aside, the Journal of the American Medical Association (JAMA) is to be commended for publishing this rigorously performed clinical research trial and its Level One research findings, as there is a well-known bias against publishing clinical research studies with “negative findings,” such as this study, among prestigious medical journals.)

 

 

Although this is the second recent high-level prospective clinical research trial that has found absolutely no clinical benefit in preserving or improving cognitive function in older adults associated with Ginkgo biloba supplements, there may still be potential clinical applications for this ancient herbal remedy in view of its known ability to improve blood flow through networks of small blood vessels in the body.  There is also some research evidence available suggesting that Ginkgo biloba may have potentially important anti-inflammatory properties, and that these properties might be clinically useful in some chronic inflammatory diseases, such as ulcerative colitis (Ginkgo biloba, ulcerative colitis & colorectal cancer).  For now, however, the overwhelming available clinical research evidence indicates that Ginkgo biloba appears to offer no benefit to older patients in terms of either preserving or improving memory, or in improving other areas of higher cognitive function.

 


Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, a professor of surgery, a cancer researcher, an oncology consultant, and a widely published author


 

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