Aspirin & Breast Cancer Survival

March 28, 2010 by  
Filed under Weekly Health Update

 

Welcome to Weekly Health Update



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


ASPIRIN & BREAST CANCER SURVIVAL

 

Breast cancer tumors, like many other types of cancer, produce increased amounts of chemicals called prostaglandins.  As with many other types of cancer, prostaglandins are thought to play an important role in the growth and spread of breast cancer. 

Aspirin belongs to a class of drugs known as NSAIDs (non-steroidal anti-inflammatory drugs).  Like other NSAIDs, aspirin is able to block the activity of the prostaglandin-producing enzyme cyclooxygenase (COX).  Moreover, previous research has indicated that, in addition to decreasing prostaglandin production in the body, aspirin also reduces the levels of estrogen in the body (approximately 90 percent of breast cancers are stimulated to grow in the presence of estrogen).

Previous research on aspirin as a breast cancer prevention drug has resulted in contradictory findings (although aspirin and other NSAIDs have clearly been shown to reduce the incidence of colorectal polyps and colorectal cancer, and other cancers as well).  However, a newly published study, in the Journal of Clinical Oncology, adds weight to prior evidence that the regular intake of aspirin may significantly decrease the risk of breast cancer recurrence, and the risk of death due to recurrent breast cancer.

The enormous Nurses’ Health Study is a prospective public health research study that began in 1976 with more than 120,000 female nurses in the United States.  Every 2 years, this huge cohort of women completes detailed personal questionnaires regarding diet and lifestyle factors related to cardiovascular disease and cancer.  Between 1976 and 2002, more than 4,000 nurses participating in this study were newly diagnosed with breast cancer.  The researchers conducting this landmark study then analyzed the incidence of breast cancer recurrence, and the risk of death, among these 4,164 breast cancer patients as a function of their aspirin intake.  (Other cancer-associated diet and lifestyle risk factors were also analyzed, as well.)

In this huge prospective public health trial, regular aspirin intake was found to significantly reduce the risk of death due to breast cancer.  Taking aspirin 2 to 5 times per week was associated with a 71 percent reduction in the relative risk of death due to breast cancer, while 6 to 7 days of aspirin use per week was associated with a 64 percent reduction in the relative risk of cancer-associated death.  Importantly, this apparent aspirin-associated reduction in the risk of death due to breast cancer recurrence was observed in women with both early-stage and more advanced breast cancers, in both premenopausal and postmenopausal women, in both obese and non-obese women, and in women with estrogen-sensitive and estrogen-resistant tumors. 

While this study’s primary weakness is that (like most epidemiological studies) the collected data was primarily based upon patient questionnaires, the Nurses’ Health Study continues to be a carefully conducted prospective study with very stringent data quality controls in place.   

To summarize the important findings of this study:  Among women previously diagnosed with breast cancer, taking aspirin for 2 or more days per week was associated with a significant reduction in the risk of both breast cancer recurrence and death due to breast cancer.  (As always, I recommend that you discuss the potential risks and benefits of regularly taking aspirin, or any other new medication, with your doctor before making such changes.)

 

To learn more about the potential role of NSAIDs in cancer risk reduction, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the spring/summer of this year.


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 different perspective on Dr. Wascher, please click on the following YouTube link: 

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



I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 



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

http://www.redcross.org/

http://www.imcworldwide.org/haiti


 

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Obesity, Alcohol & Liver Disease

March 21, 2010 by  
Filed under Weekly Health Update

 

Welcome to Weekly Health Update



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

OBESITY, ALCOHOL & LIVER DISEASE

 

Chronic liver disease, including cirrhosis, is the 12th most common cause of death in the United States, alone, and causes nearly 30,000 deaths per year in America.  Increased alcohol intake and obesity are both known risk factors for chronic liver disease.  Moreover, recent research has suggested that the combination of alcohol intake and obesity may synergistically increase the risk of chronic liver disease above and beyond the sum of these two risk factors.  Two newly published prospective, randomized clinical research studies from the United Kingdom further suggest that increased alcohol intake in the presence of obesity significantly increases the risk of chronic liver disease, and premature death related to chronic liver disease.  Both of these studies appear in the current issue of the British Medical Journal.

In the first study, more than 1.2 million women (average age was 56 years) were recruited between 1996 and 2001.  In this Million Woman Study, after an average duration of follow-up of 6.2 years, 1,811 women were either admitted to a hospital with a new diagnosis of cirrhosis, or died of cirrhosis.  Based upon the extensive health data collected from all of the participants in this enormous public health study, both obesity and alcohol intake were proportionally linked to an increased risk of cirrhosis, as well as death due to cirrhosis.  (Note: a standard glass of wine, mixed drink, or beer contains about 0.6 ounces, or 14 grams, of alcohol.)

For every 5 units of BMI above 22.5, the relative risk of cirrhosis increased by 28 percent (BMI is a standard measure of body fat content that is adjusted for height and weight).  Among women who reported the consumption of less than 70 grams of alcohol per week (equivalent to 5 alcoholic drinks per week), the absolute risk of developing cirrhosis, over a period of 5 years, was 20 percent higher in women with a BMI of 30 or more, when compared to non-obese women with normal BMIs (“obesity” is defined as a BMI of 30, or greater; while being “overweight is defined as having a BMI of 25 or greater, but less than 30).  Among the women who reported consuming 150 grams or more of alcohol per week (which is equivalent to 11 or more alcoholic drinks per week), a normal BMI was associated with a 170 percent increase in the absolute risk of developing cirrhosis, while obese women (with a BMI of 30 or greater) who consumed 150 grams or more of alcohol per week experienced a whopping 400 percent increase in the risk of developing cirrhosis!  When this data was extrapolated to the population of the United Kingdom, as a whole, it was determined that alcohol consumption, particularly at higher levels, accounted for 42 percent of all cases of non-fatal and fatal cirrhosis in middle-aged women, while obesity caused an additional 17 percent of all non-fatal and fatal cases of cirrhosis of the liver.

 

In the second published study in the British Medical Journal, data from two prospective clinical studies was analyzed.  A total of 9,559 men participated in these prospective public health studies, with a highly impressive median follow-up of 29 years.  These nearly 10,000 male study participants were divided into separate study groups based upon their measured BMI and their self-reported alcohol intake.

During nearly 3 decades of observation, 80 (0.8 percent) of these male research volunteers died directly due to chronic liver disease, while another 146 (1.5 percent) died of multiple causes, but with liver disease as a contributing cause of death.

As with the previous study, there were significant interactions between alcohol intake, BMI, and chronic liver disease (after adjusting for other known risk factors for chronic liver disease).  In this study, the consumption of 15 or more alcoholic drinks per week in volunteers with a normal BMI more than doubled the relative risk of dying of chronic liver disease when compared to other non-obese men who consumed less than 15 drinks per week.  Among the overweight (but not obese) men who consumed 15 or more alcoholic drinks per week, the relative risk of death due to chronic liver disease was more than 7 times higher than was observed in overweight men who consumed significantly less than 15 drinks per week.  Finally, and most disconcertingly, obese men who consumed 15 or more alcoholic drinks per week experienced nearly 18 times the relative risk of dying from chronic liver disease as compared to their obese counterparts who drank significantly less alcohol.  (Even among obese men who consumed 14 or fewer alcoholic drinks per week, the relative risk of death due to chronic liver disease was still more than 4 times higher than what was observed in obese men who did not drink alcoholic drinks at all.)

Based upon this data, the researchers conducting this study were able to determine that there was a synergistic, enhanced risk of dying from liver disease when alcohol intake was present in addition to being overweight or obese.  This “relative excess risk” due to an interaction between alcohol intake and increasing BMI amounted to 4 times the relative risk of simply adding the individual liver disease risks of increased BMI and alcohol intake.

 

Taken together, these two large prospective public health studies confirm previous observations that both rising levels of excess weight and increasing levels of regular alcohol intake are associated, both separately and together, with an increased risk of chronic liver disease, and death due to chronic liver disease.  Moreover, the combination of obesity and increased alcohol intake appears to be a particularly severe risk factor for the development of chronic liver disease, and for death due to liver disease.  Therefore, in addition to the multiple other health risks associated with obesity and excessive alcohol intake, the results of these two studies should cause all of us to reexamine our lifestyle and dietary habits in our pursuit of better health and greater longevity.

 

To learn more about the role of alcohol and obesity in cancer risk, look for the publication of my new book, “A Cancer Prevention Guide for the Human Race,” in the spring of this year. 



In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in those countries to assist the injured, the ill, and the homeless.  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 different perspective on Dr. Wascher, please click on the following YouTube link: 

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



I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 

 

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Nuts, Diet & Obesity

March 14, 2010 by  
Filed under Uncategorized

 

Welcome to Weekly Health Update



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


 

NUTS, DIET & OBESITY

 

In last week’s column, I reviewed recent research suggesting a role for walnuts in reducing elevated cholesterol levels.  Based upon some of the comments that I received from readers regarding this “walnut column,” I will present some additional favorable new health research findings on nuts in this week’s column.

Hard-shelled nuts tend to be rich in inflammation-fighting omega-3 fatty acids (luckily, the majority of the fat content in hard-shelled nuts is in the form of heart-healthy unsaturated fats), and in plant sterols.  As I discussed last week, these compounds help to lower the level of LDL (the “bad cholesterol”) in the blood.

The Mediterranean Diet, which is rich in fish, whole grains, nuts, fresh fruits, and fresh vegetables (and low in red meat and highly processed foods), has repeatedly been shown to decrease the risk of the top two causes of premature death throughout the world (cardiovascular disease and cancer).  However, some health experts have expressed concerned about the relatively high fat content of nuts, and the possibility that daily nut consumption might lead to an increased risk of obesity.  Fortunately, a newly published prospective public health study suggests that the moderate intake of nuts, in combination with the Mediterranean Diet, is actually associated with a decreased risk of obesity.

The current issue of the journal Nutrition, Metabolism & Cardiovascular Diseases includes the findings of the Mediterranean “PREDIMED” prospective public health study, which enrolled 847 older men and women, with an average age of 67 years.  The diets and activity levels of these patient volunteers were carefully evaluated in this study, and all of these elderly volunteers underwent clinical examinations to determine their waist circumference, and their body mass index, or BMI (a measure of body fat content that is adjusted for both height and weight).

After correcting for other dietary and lifestyle factors associated with obesity in these patient volunteers, the data from this study revealed that increased nut intake was associated with both a decreased BMI and decreased waist circumference.  For every serving of 30 grams of nuts consumed, waist circumference decreased by 2.1 centimeters (approximately 1 inch), and BMI was reduced by 0.78 (kilograms per meter-squared) in these patient volunteers.  Increased vegetable intake was also associated with a decreased waist circumference, as well.  (Not surprisingly, meat intake was significantly associated with an increase in both BMI and waist circumference.)  Moreover, these findings were observed in both male and female study participants.

Walnuts, almonds, hazelnuts, pecans, pistachios, pecans, macadamia nuts, and peanuts (which are, technically, not nuts, but which have a nutritional profile similar to hard-shelled nuts) are all rich in omega-3 fatty acids and other heart-healthy nutrients.  Because these nuts do contain a significant number of “healthy fat” calories, however, nuts should be consumed in moderation, as with all fat-containing foods.  Currently, most experts recommend that 30 to 45 grams (1 to 1.6 ounces) of nuts be added to our daily diet to maximize the health benefits of these delicious nutritional treats!

 

To learn more about nuts and the Mediterranean Diet as part of a comprehensive, evidence-based cancer prevention lifestyle, look for the publication of my new book, in the spring of this year:

A Cancer Prevention Guide for the Human Race



In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in those countries to assist the injured, the ill, and the homeless.  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 different perspective on Dr. Wascher, please click on the following YouTube link: 

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



I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 

 

Bookmark and Share


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Walnuts, Cholesterol, LDL & Triglycerides

March 7, 2010 by  
Filed under Uncategorized

 

Welcome to Weekly Health Update



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


WALNUTS, CHOLESTEROL, LDL & TRIGLYCERIDES

Walnuts are rich in anti-inflammatory nutrients, including omega-3 fatty acids and ellagic acid.   Previous research has shown that the regular consumption of walnuts appears to improve cardiovascular function following high-fat meals.  In diabetics, who face an increased risk of cardiovascular disease, walnuts also appear to improve cardiovascular function.

A newly published prospective, randomized clinical research trial, which appears in the European Journal of Clinical Nutrition, evaluated the effects of a walnut-supplemented diet on 87 adults with normal-to-high cholesterol levels in their blood.  This study used a “crossover” approach, in which all of the patient volunteers received walnut supplements for 6 months, and were then switched to a walnut-free diet for another 6 months.  During this 12-month study, blood tests were performed at the beginning of the study, and then at 4, 6, 10 and 12 months into the study.  Because of the crossover design of this study, the researchers were able to directly compare the effects of walnut supplementation on body weight, total cholesterol, LDL cholesterol (the “bad cholesterol”), HDL cholesterol (the “good cholesterol”), and fatty acids (triglycerides).  (Together, these compounds are referred to as “lipids.”)

As has been observed in previous clinical studies of shorter duration, this study found that a 6-month period of walnut supplementation resulted in significant reductions in total cholesterol and triglyceride levels.  LDL levels were also reduced, although this finding just barely failed to reach statistical significance.  Importantly, these favorable changes in blood lipid levels were found to be more pronounced in patients with elevated total cholesterol and LDL cholesterol levels.  (I should note that significant reductions in LDL blood levels have been observed in response to adding walnuts to the diet of patients with elevated LDL levels, in other studies.)

While statins, and other lipid-lowering drugs, have revolutionized the management of elevated cholesterol and triglycerides, and have been shown to significantly reduce the risk of cardiovascular disease (and death due to cardiovascular disease), not all patients with hyperlipidemia can tolerate these drugs.  Moreover, as with all medications, these lipid-lowering drugs are not equally effective in all patients, and many patients with hyperlipidemia will continue to have elevated LDL cholesterol and/or triglyceride levels despite taking lipid-lowering drugs.

Studies such as this one suggest that the addition of walnuts to one’s diet may be a useful adjunct in lowering elevated LDL cholesterol and triglyceride levels.  (As always, I encourage everyone to check with their doctor before making any significant alterations in their diet, especially if you have one or more chronic illnesses.)


For a detailed and comprehensive evaluation of the role of nuts, omega-3 fatty acids, ellagic acid, and other dietary modifications, as part of a cancer prevention lifestyle, look for the publication of my new book, “A Cancer Prevention Guide for the Human Race,” in the spring of this year.
 


In view of the extreme devastation and human misery brought about in Haiti and Chile by the recent earthquakes, Weekly Health Update asks our tens of thousands of caring readers to give generously to established charities that are currently working in those countries to assist the injured, the ill, and the homeless.  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 different perspective on Dr. Wascher, please click on the following YouTube link: 

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



I and the staff of Weekly Health Update would like to take this opportunity to thank the nearly 120,000 new and returning readers who visited our premier global health information website last month.  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can. 

 

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Post to Twitter

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