Fruits and Vegetables Improve Memory

 

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


FRUITS AND VEGETABLES IMPROVE MEMORY

A diet rich in fruits and vegetables, and low in meat and other animal products, has been shown to significantly reduce the risk of those top two killers, cardiovascular disease and cancer.  Now, a newly published public health study, from Norway, suggests eating your fruits and veggies may also be good for your brain, as well.

In this study, which appears in the current issue of the British Journal of Nutrition, 2,013 research volunteers between the ages of 70 and 74 underwent extensive cognitive testing and evaluation of their dietary habits. 

Overall, memory and other higher cognitive functions were significantly improved among those patient volunteers who consumed the most fruits, vegetables, whole grain products, and mushrooms.  Among these foods, the frequent intake of both fruits and vegetables (up to 500 grams per day) was, specifically, linked to the highest level of cognitive function in these older men and women.

Further study of dietary preferences revealed that cruciferous vegetables (e.g., broccoli, cauliflower, cabbage, bok choy, among others), carrots, citrus fruits, and whole-grain breads were the foods most closely associated with improved cognitive function.  (On the other hand, white bread consumption was associated with decreased levels of cognitive function!)

This interesting little study, therefore, suggests that a diet rich in fruits and vegetables (and cruciferous vegetables and carrots, in particular) may help to preserve memory, and other higher cognitive functions, in the aging brain.  The findings of this study are especially interesting in view of the rapidly aging populations of many countries around the world, including the United States.           

 

For an evidence-based review of the critical importance of diet in a cancer prevention lifestyle, order your copy of my new landmark book, A Cancer Prevention Guide for the Human Race,” from Amazon or Barnes & Noble!



 

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: 

 

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I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit this premier global health information website every month.  (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!)  As always, I 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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Low-Carb Diet and Risk of Death

 

Welcome to Weekly Health Update


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


LOW-CARB DIET AND RISK OF DEATH

The debate regarding the potential health benefits of low-carbohydrate diets has gone on for over four decades now.  During this period, the pendulum has swung, repeatedly, back and forth between “low-carb” and “high-carb” diets, combined with controversies regarding low-fat versus high-fat diets, as various diet and health gurus have weighed in with their recommendations.  (Witness one of the more popular and enduring of these “have it your way” dietary fads, the now discredited Atkins Diet, which advocated a reduction in carbohydrate intake combined with a free pass on meat consumption, and other animal-based sources of fat and protein.)

Currently, there is really no meaningful controversy regarding the linkage between meat consumption and an increased risk of cardiovascular disease and cancer.  However, the impact of dietary carbohydrate intake on health continues to be the subject of some debate.   Unfortunately, as is often the case regarding debates about lifestyle- and diet-related health factors, there is very little high-level clinical research data evidence available to support the more ambitious claims made by “experts” at either spectrum of the carbohydrate debate.  Now, a newly published study, which appears in the current issue of the Annals of Internal Medicine, offers a fresh, evidence-based assessment of the impact of carbohydrate and meat intake on the risk of early death. 

In this prospectively conducted cohort study, which was funded by the National Institutes of Health, the results of two very large prospective public health studies were combined.  More than 85,000 women who participated in the vast Nurses’ Health Study, and nearly 46,000 male physicians who participated in the Health Professionals Follow-up Study, were included in this analysis.  These healthy female and male volunteers were without clinical evidence of cardiovascular disease, diabetes, or cancer when they entered into these studies.  An almost unprecedented duration of clinical follow-up was available for these two enormous groups of research volunteers, which makes this combined cohort study extremely powerful.  On average, the male study volunteers have already been followed for 20 years, while the women volunteers have been followed for an average of 26 years.  All of these 129,716 men and women completed multiple validated diet questionnaires at various time points in these two clinical studies, and the data collected from these questionnaires was then used to analyze the impact of diet on mortality (death) risk among this huge group of nurses and physicians.

Two sub-groups of volunteers were assessed, based upon their dietary preferences, and these two sub-groups of men and women were then compared with the remaining study volunteers.   The first dietary preference sub-group consisted of men and women who preferred a low-carbohydrate diet associated with the frequent intake of meat and other animal-based foods (along the lines of the Atkins Diet), while the second sub-group consisted of men and women who routinely consumed a low-carbohydrate diet that emphasized vegetable and fruit sources of protein (instead of animal sources of protein).

Over the very long duration of the two combined studies, 12,555 deaths occurred among the women (including 2,458 deaths due to cardiovascular disease).  Among the men, there were 8,678 deaths (including 2,746 deaths due to cardiovascular disease).

In the group of men and women who favored an Atkins-like diet, emphasizing a low carbohydrate intake but liberal meat consumption (and other animal-based foods, as well), the risk of premature death from any cause (when compared to a low-carb, low-meat diet) was elevated by 23 percent.  This same dietary preference was also associated with a 14 percent increase in the risk of death due to, specifically, cardiovascular disease.

In contrast, the men and women who consumed a diet low in both carbohydrates and animal products appeared to significantly reduce their risk of death due to all causes, as well as their mortality due to cardiovascular disease, specifically.  In this group of research volunteers, mortality due to any cause was reduced by 20 percent, while death due to cardiovascular disease, specifically, was reduced by 23 percent.

The findings of this very large prospective public health study, with its extremely long duration of clinical follow-up, confirms the findings of other recent (and less powerful) small clinical studies that a diet rich in vegetables, but low in both carbohydrates and animal-derived foods, confers a very significant benefit in terms of the overall risk of death, and the risk of death from cardiovascular disease, in particular.

Excessive carbohydrate intake has been previously shown to increase the risk of diabetes, obesity, cardiovascular disease, cancer, and other serious illnesses.  At the same time, increased meat intake has also been clearly shown to raise the risk of many of these same life-threatening illnesses, as well.  From this huge prospective cohort clinical study, we can see highly significant health benefits associated with long-term adherence to a healthy diet rich in vegetables and low in carbohydrates and animal-derived foods.  (And there are not many health benefits that can trump a significant reduction in your risk of premature death!)

 

For an evidence-based review of the critical importance of diet in a cancer prevention lifestyle, watch for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” later this month.



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: 

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit our premier global health information website every 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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Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death

 

Welcome to Weekly Health Update


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


NON-COMPLIANCE WITH HORMONAL THERAPY FOR BREAST CANCER AND RISK OF DEATH

The management of breast cancer today bears little resemblance to the way that we managed this most common cancer among women when I entered medical school in the early 1980s.  Back then, both early-stage and advanced breast cancers were managed with a standard “one-size-fits-all” approach that included removal of the entire breast (mastectomy) and most of the lymph nodes in the armpit area (axillary lymph node dissection).  Twenty-five years ago, most women with breast cancer also received chemotherapy, while “hormonal therapy” for many premenopausal women with breast cancer consisted of the surgical removal of both ovaries (oopherectomy). 

In 2010, 85 to 90 percent of women are eligible to undergo breast-conserving surgery (“lumpectomy”).  Radical removal of the armpit lymph nodes has also become unnecessary for the majority of women with newly diagnosed breast cancer, as approximately two-thirds of women will be found to have normal armpit lymph nodes using a high-tech lymph node mapping procedure known as sentinel lymph node biopsy.  (Sentinel lymph node biopsy is associated with one-tenth the incidence of the risks associated with more radical lymph node dissections.)  Using a recently validated genetic test (Oncotype DX), many women with early-stage, favorable breast cancers can also safely choose to avoid chemotherapy, based upon the results of individualized “molecular” testing of their breast tumors. 

Instead of undergoing surgery to remove their ovaries, premenopausal women with hormone-sensitive breast cancers can now opt to take one of several different hormone-blocking medications (selective estrogen receptor modulators, or “SERMs”) for 5 years, to further reduce their risk of developing either a recurrence of their breast cancer or a new breast cancer.  For postmenopausal women with hormone-sensitive cancers, a different class of hormone blocking medications, the aromatase inhibitors (“AIs”), are often prescribed, also for 5 years.  These medications have been shown to reduce the risk of both recurrent breast cancer and new breast cancers by as much as 50 percent, and so they have become powerful clinical tools in our breast cancer prevention and treatment armamentarium.  However, as with almost all medications, SERMs and AIs are associated with some rather significant side effects.  In the case of SERMs, these side effects can include bone pain, hot flashes, nausea, mood swings, decreased libido, and constipation, among others.  Tamoxifen, the most commonly prescribed SERM, is also associated with a small but significant increase in the risk of uterine cancer.  (Raloxifene, the newest SERM to be approved for breast cancer prevention and treatment, appears not to significantly increase the risk of uterine cancer.)  Both of these SERMS are also associated with an increased risk of blood clots in the body, as well.  On the other hand, in addition to their potent ability to reduce the risk of both recurrent and new breast cancers, tamoxifen and raloxifene also decrease the risk of osteoporosis and osteoporosis-related bone fractures.

AIs are also associated with significant side effects in some patients, including hot flashes, bone and joint pain, mood changes, rash, headache, insomnia, and a small but significant increase in the risk of osteoporosis and osteoporosis-related bone fractures, among other symptoms and complications.

In view of the side effects profiles of SERMs and AIs, it is not surprising that patient compliance with these medications is an ongoing problem in the management of breast cancer (and, especially, among premenopausal women).  A newly published clinical research study in the journal Breast Cancer Research & Treatment reveals just how serious the issue of patient compliance with hormonal therapy is among breast cancer patients, as well as the significant impact of such noncompliance on the subsequent risk of death.

In this clinical study, performed by my Northern California Kaiser Permanente colleagues, 8,769 women diagnosed with hormone-sensitive breast cancer between 1996 and 2007 were evaluated.  One of the most powerful clinical assets of Kaiser Permanente is its comprehensive electronic health records system (“Health Connect”), which allows any Kaiser Permanente health care provider to access any individual patient’s detailed medical history, including diagnoses, past and current treatments (including surgeries and medications), lab results, radiology results, and other important clinical information.  This rich source of clinical information not only improves the quality and efficiency of care provided to patients, but it also serves as a powerful tool to conduct meaningful clinical research on large numbers of patients in an effort to further improve the delivery of high-quality health care.  (Indeed, Kaiser Permanente’s computerized medical records system is often held up as an example of what the future of electronic medical records should look like in the United States.)

The results of this study revealed the true potential costs of noncompliance with hormonal therapy among patients diagnosed with relatively early-stage hormone-sensitive breast cancers.  Among the nearly 9,000 women who filled at least an initial prescription for their breast cancer hormonal therapy medications, 31 percent subsequently discontinued their SERMs or AIs, and an additional 28 percent continued with hormonal therapy, but were not fully compliant in taking their SERMs or AIs.  (This combined 59 percent incidence of overall noncompliance is consistent with the 50 to 60 percent incidence of noncompliance with hormonal therapy that has been identified in previous clinical research studies.)

During an average follow-up period of 4.4 years, 831 of these 8,769 patients died.  Based upon the observed survival data collected in this study, the women who were compliant with their SERMs or AIs had a statistically predicted 10-year survival rate of 81 percent, while the women who prematurely discontinued their hormonal therapy had a predicted 10-year survival rate of 74 percent.  (The women who continued with their hormonal therapy, but who were not compliant with their daily doses, were projected to have an intermediate 10-year survival rate of 78 percent.) 

In the final analysis of their data, the authors of this study found that early discontinuation of hormonal therapy or continuing with hormonal therapy in a noncompliant manner were associated with a significant reduction in survival among patients with hormone-sensitive breast cancers.

The results of this study say two important things, in my mind.  The first is that SERMs and AIs significantly reduce the risk of death in patients with hormone-sensitive breast cancer (as has already clearly been shown by multiple prospective, randomized, blinded, placebo-controlled clinical research studies).  As with all medications, discontinuing hormonal therapies prematurely, or taking these important breast cancer medications in a haphazard manner, deprives breast cancer patients of the full potential benefits of SERMs and AIs.  The second important observation to be derived from this study is that we need to continue to search for new hormonal therapies with improved side effect profiles, to encourage better patient compliance with this important aspect of breast cancer prevention and treatment.

If you are a breast cancer survivor who has been prescribed hormonal therapy (or a woman who is at very high risk of developing breast cancer, and who been prescribed a SERM or AI for breast cancer prevention purposes), then you should make every effort to work together with your Oncologist to help you to remain compliant with your SERM or AI prescription, including the aggressive management of any unpleasant treatment side effects that you might be experiencing.

 

To learn more about an evidence-based approach to breast cancer prevention, watch for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in September 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: 

 

Texas Blues Jam



I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit our premier global health information website every 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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