Welcome to Weekly Health Update

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

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.

Welcome to Weekly Health Update

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

BLUBERRIES, OBESITY, DIABETES AND METABOLIC SYNDROME

Metabolic syndrome includes a constellation of health disorders that are associated with a high risk of developing diabetes and cardiovascular disease.  Specific disorders that are associated with metabolic syndrome include high blood pressure, abnormal cholesterol and triglyceride levels in the blood, obesity, and diabetes (or “pre-diabetes”).  In the United States, where obesity has become an epidemic, public health experts estimate that as much as 25 percent of the population currently meets the criteria for metabolic syndrome.

Excessive calorie intake, a sedentary lifestyle, obesity in the abdominal and waist areas (central, or visceral, obesity), genetic factors, and other adverse health risks are known to contribute to the development of metabolic syndrome.  Therefore, both the prevention and treatment of metabolic syndrome are based upon exercise, a healthy low-fat and low-sugar/low-carb diet, and weight loss.  A new prospective, randomized clinical research study suggests that consuming blueberries may also help to reduce some of the adverse health risks associated with metabolic syndrome.

In this study, which appears in the current issue of The Journal of Nutrition, 48 adults (44 females and 4 males) with metabolic syndrome were divided into two groups.  One group, the “experimental group,” consumed 50 grams of freeze-dried blueberries per day (equivalent to 350 grams of fresh blueberries per day), in the form of a beverage, for a period of 8 weeks.  The other group, the “control group,” consumed a “placebo” beverage that did not contain any blueberries (also for 8 weeks).  Blood pressure checks and multiple blood tests were performed at both 4 weeks and 8 weeks into the study.

When comparing the two groups of patient volunteers, the patients in the “blueberry group” were found to have significantly greater decreases in their high blood pressure when compared to the control group.  The level of oxidized LDL cholesterol in the blood, which is a form of the “bad” LDL cholesterol that can directly damage the lining of arteries throughout the body (atherosclerosis), was also significantly decreased in the “blueberry group” of patient volunteers.  At the same time, there were no significant differences between the two groups of patient volunteers with respect to blood glucose (sugar) levels, triglyceride levels, or the levels of HDL (the “good” cholesterol) or LDL (the “bad” cholesterol) in the blood .

Therefore, while a brief period of a diet supplemented with blueberries did not reverse all of the abnormalities associated with metabolic syndrome, the consumption of the equivalent of about 350 grams of blueberries each day did appear to significantly improve at least two of the adverse health factors associated with this syndrome (i.e., high blood pressure and blood levels of oxidized LDL cholesterol).  Based upon the intriguing findings of this small and short-duration study, patients with one or more health factors associated with metabolic syndrome might consider adding some blueberries to their daily diet, in addition to the standard treatment for this life-threatening disorder!

For more information on blueberries, and other sources of dietary polyphenols, as part of a cancer prevention lifestyle, watch for the publication of my new landmark evidence-based 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: 

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

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.

Welcome to Weekly Health Update

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

HIGH LDL CHOLESTEROL IN YOUNG ADULTS AND HEART DISEASE IN MIDDLE AGE

Most young adults look upon heart disease as an “old person’s” disease, and many young people therefore assume that they do not need to be concerned with their diet, or with their cholesterol profile, during this early stage of their adult lives.  However, a newly published prospective public health study, which appears in the current issue of the Annals of Internal Medicine, should certainly cause young adults to reconsider the relevance of these two very important health-related factors to them.

In this study, 3,258 men and women between the ages of 18 and 30 enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study between 1985 and 1986.  All of these research volunteers underwent blood tests for LDL cholesterol (the “bad cholesterol”), HDL cholesterol (the “good cholesterol”), and triglycerides (fat in the blood, which is also linked to cardiovascular disease risk).  Subsequently, these blood lipid tests were repeated throughout the 20-year course of this prospective public health research study.  Twenty years later, these now middle-aged adults underwent special scans of their hearts in order to detect and quantify calcium deposits in their coronary arteries (the “coronary calcium score” is used to predict a patient’s risk of experiencing future cardiac events like angina or heart attack).

The findings of this study are cause for considerable concern.  First of all, fully 87 percent of these volunteers were found to already have one or more abnormalities in their HDL, LDL or/and triglyceride levels, which are associated with an increased risk of cardiovascular disease.  Thus, nearly 90 percent of these young adults, who were recruited into this research study from nearby communities at 4 different locations in the United States, already had abnormal blood lipid test results at the time they entered into this clinical study!

After 20 years of observation, coronary calcium scores were obtained on each of these more than 3,000 study participants.  Once again, the results were striking (and concerning).  When the average LDL levels of these study volunteers were compared with their calcium scores, it quickly became apparent that elevation of LDL levels in the blood during young adulthood is associated with a rising and significant risk of coronary artery disease during middle age (based upon coronary calcium score results).  Among the volunteers who maintained normal LDL levels (<70 mg/dL, or <1.81 mmol/L) during their young adult years, there was an 8 percent incidence of coronary artery calcification (coronary artery atherosclerosis) 20 years later.   However, among the patients with elevated average LDL levels (160 mg/dL or higher, or 4.14 mmol/L or higher), the incidence of coronary artery disease was 44 percent. 

Even relatively mild increases in LDL levels during young adulthood were found, in this study, to be associated with an increased risk of coronary artery disease in mid-life.  When compared to patients with LDL levels <70 mg/dL (<1.81 mmol/L), patients with LDL levels of 70 to 99 mg/dL (1.81 to 2.56 mmol/L) were 50 percent more likely to have detectable coronary artery disease.  Patients with LDL levels between 100 and 129 mg/dL (2.59 to 3.34 mmol/L) were found have a 140 percent increased risk of coronary artery calcifications.  Patients with LDL levels between 130 and 159 mg/dL (3.37 to 4.12 mmol/L) experienced a 230 percent increased risk of developing coronary artery disease in middle age.  Finally, those patients with LDL levels of 160 mg/dl or higher (4.14 mmol/L or higher) had a whopping 460 percent increase in the risk of developing coronary artery disease by the time they reached middle age!

While the finding of coronary artery calcifications in these volunteers does not mean that every one of them will go on to experience heart attacks, or other serious complications of coronary artery disease, coronary artery calcium deposits (due to atherosclerosis) have been proven to significantly increase the risk of angina and heart attack, as well as other complications of cardiovascular disease.

This is a powerful public health study, because of its long-term follow-up of a relatively large group of patient volunteers.   Its findings tell us at least two very important things that we all should know regarding the risk of developing cardiovascular disease during middle age.  The first is that a strikingly large majority of young adults in the United States are already overweight, and already have abnormal blood lipid levels (and which are known to be associated with an increased lifetime risk of cardiovascular disease).  Secondly, even relatively mild increases in the level of LDL cholesterol in the blood during early adulthood are associated with a significant increase in the likelihood of having heart disease by middle age.  Moreover, significantly elevated LDL levels, over time, are associated with a huge increase in the risk of developing coronary artery disease by mid-life.

Based upon the findings of this important study, it is may be necessary to revisit the recommended age at which the routine annual testing of LDL cholesterol levels is initiated, particularly for young adults who are obese, or who have a family history of cardiovascular disease.  I also cannot stress enough the direct linkages that exist between diet and weight, on the one hand, and LDL cholesterol levels on the other had.  We are facing a true epidemic of obesity in this country, with two-thirds of the population already categorized as overweight or obese (and the proportion of the American population that is overweight or obese continues to rise every year).  The results of this study add to other prior research data regarding the lifetime health effects of poor lifestyle and diet choices, even when these poor choices are made during the very early years of our adult lives.

For a disturbing look at the links between obesity and cancer risk, watch for the publication of my new landmark evidence-based book, “A Cancer Prevention Guide for the Human Race,” in late August 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

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.

Welcome to Weekly Health Update

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

LACTOFERRIN REDUCES ABDOMINAL (VISCERAL) OBESITY

Disturbingly, two-thirds of the American population already meets the criteria for being overweight or obese, one-third meets the criteria for obesity, and at least 2 percent of Americans are now considered to be morbidly obese.  The cost of this rising epidemic of obesity is enormous (no pun intended), both to obese patients themselves, and to a nation that is struggling to pay for the skyrocketing cost of providing healthcare to its citizens. 

Obesity has been unquestionably linked to cardiovascular disease, diabetes, liver disease, gallstones, gastroesophageal reflux, arthritis, cancer, and multiple other serious illnesses.  Despite these sobering realities, however, the incidence of obesity continues to rise in the United States, and increasingly, throughout the world.

In our high-calorie, low-effort modern world, it is very easy to pack on excess weight over the course of our lives.  People, being people, are always looking for quick, easy solutions to their problems, including excess weight.  Unfortunately, other than decreasing our intake of food and increasing the amount of exercise that we regularly perform, no other cures for obesity have yet been found.

However, a newly published study in the British Journal of Nutrition has identified an unlikely new dietary supplement that may be helpful in the battle of the bulge.  Lactoferrin, which is abundant in the colostrum and milk of most mammals (including humans), is thought to primarily function as an antibacterial and antifungal agent, and may help to protect breast-fed babies from infection (in some countries, lactoferrin is routinely added to infant formula for this purpose).  Recent research has also suggested that lactoferrin may have a beneficial effect on the metabolism of fat within the body, and in particular, the so-called “visceral fat” that accumulates within the abdominal area, and which has been specifically linked to an increased risk of generalized inflammation in the body, as well as cardiovascular disease and cancer.

In this small prospective, randomized, doubled-blinded study, 26 overweight men and women with abdominal obesity were randomized to receive either daily lactoferrin supplements (300 milligrams per day) or an identical placebo (sugar) pill (none of the participating patient volunteers knew which group they were in until the study was completed).  These patient volunteers were then followed for 8 weeks.  All of these research volunteers underwent CT scans to measure the extent of their total body fat, superficial (subcutaneous) fat, and visceral (abdominal) fat. 

At the end of this 8-week study, the group that had been randomized to receive daily oral lactoferrin supplements experienced very significant decreases in visceral fat content, as well as decreased body weight, decreased BMI (a standardized measure of obesity that considers both body weight and height), and hip circumference, when compared to the group of volunteers who were assigned to take the placebo pills.  Additionally, blood tests to evaluate the impact of daily lactoferrin supplements on metabolism did not reveal any apparent adverse side effects associated with lactoferrin supplementation.

While this is a very small study (only 26 patient volunteers were included), and the length of follow-up was very short (only 8 weeks), the prospective, randomized, double-blinded, placebo-controlled design of this study, when combined with the rather striking results that were observed, are rather compelling.  Certainly, a larger study, with long-term follow-up, needs to be performed before daily lactoferrin supplements can be recommended as both a safe and effective aid to weight loss.  Moreover, such a study would need to show that the reduction in visceral fat that was observed in this small Japanese clinical study is not only reproducible over the long-term, but is also associated with a clinically significant improvement in the illnesses that have previously been linked to abdominal obesity.   Meanwhile, and until such a study is performed, I find the results from this small prospective clinical study to be very interesting, indeed.

For a detailed review of the impact of obesity, exercise, nutrition, and other important lifestyle factors on the risk of developing cancer, watch for the publication of my new landmark evidence-based 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.

Welcome to Weekly Health Update

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

PHYSICIAN ERROR

Ah ne’er so dire a Thirst of Glory boast,
Nor in the Critick let the Man be lost!
Good-Nature and Good-Sense must ever join;
To err is human, to forgive divine.

Alexander Pope (1688-1744)

According to the prestigious Institute of Medicine, between 50,000 and 100,000 patient deaths are caused each year in the United States by negligence on the part of doctors, nurses, and other health care providers.  Nearly 1,000,000 patient injuries per year are also attributed to human error in the delivery of health care.

The presumptive causes underlying negligence in patient care are multiple and varied, and continue to be the subject of much debate among patient safety experts.  However, virtually all such experts agree that largely preventable human errors account for the vast majority of patient injuries and deaths associated with negligent patient care.

In the operating room, where I spend much of my time, as a cancer surgeon, we have adopted patient safety “check lists” inspired by the airline industry, and which are designed to reduce the possibility of errors during surgery.  At our institution, the patient’s identity (and the surgical procedure to be performed) is confirmed, twice, by everyone in the operating room before an incision is made.  Towards the end of the surgical procedure, an additional “debriefing” is performed, and the surgeon reviews the procedures that he or she has just performed.  The operating room nurse also confirms that all sponges, needles, and instruments have been accounted for, in an effort to reduce the possibility that any of these foreign bodies will be left within the patient.

One important aspect of physician error is that of errors in diagnosis.  In a newly published clinical study, which appears in the current issue of the journal Pediatrics, 1,362 pediatricians at three major academic medical centers, and 109 affiliated clinics, were invited to anonymously complete an Internet-based survey regarding their self-perceived frequency of diagnostic errors.  These doctors included experienced academic pediatricians, experienced community-based pediatricians, and resident doctors who were training to become pediatricians.  Altogether, 53 percent of the queried pediatricians agreed to complete the anonymous survey. 

More than half (54 percent) of these responding doctors indicated that they made significant diagnostic errors at least one or two times per month.  Not surprisingly, the resident doctors in training acknowledged the highest number of diagnostic errors, with 77 percent of these trainees admitting to at least one or two significant diagnostic errors per month.

Based upon their anonymous responses, nearly half (45 percent) of these 726 pediatricians believed that one or more of their diagnostic errors had harmed patients at least once or twice per year. 

When asked to analyze the underlying causes for their errors, these doctors cited the following explanations:  failure to gather adequate patient history information, inadequate physical examination, inadequate review of the patient’s chart, and inadequate coordination of care and communication among the providers involved (“inadequate teamwork”). 

Specific examples of diagnostic errors cited by these pediatricians included viral illnesses being misdiagnosed as bacterial infections, misdiagnosis of medication side effects, misdiagnosis of psychiatric disorders, and misdiagnosis of appendicitis. 

When asked to offer solutions to common diagnostic errors, these pediatricians most commonly recommended the implementation of electronic health records, as well as closer patient follow-up.

(It is important to note that, in view of the human tendency to “under-report” personal failures, it is very likely that the true incidence of significant diagnostic errors is actually considerably higher than what these pediatricians have self-reported in this study.)

In a perfect world, we physicians would never make the wrong diagnosis, or miss a diagnosis altogether, or miss an adverse reaction to medications or other treatments.  We would never prescribe the wrong medication or perform the wrong operation; and we would never, through acts of either commission or omission, perform anything less than a perfect surgical operation.  Unfortunately, the practice of Medicine, as with all human endeavors, will never become a “zero error” profession.  However, all of us, both patients and physicians (and physicians are patients, as well), certainly would agree that every effort must be made to drive preventable patient care errors down as close to “zero” as is humanly possible. 

While it is unlikely that human error can ever be completely eliminated, in Medicine or in any other profession, the findings of this important study are significant, and point to areas where substantial improvements in the delivery of health care can be achieved by physicians and other health care providers (and, I might add, by patients as well). 

Look for the imminent publication of my new landmark evidence-based book, “A Cancer Prevention Guide for the Human Race,” in August 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

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 more than 100,000 new and returning readers 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.

Welcome to Weekly Health Update

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

OBESITY AND CANCER RISK

We have become the heaviest people in the history of our species, with two-thirds of Americans officially classified as overweight, and one of every three of us tipping the scales into the “obese” range.  For too many of us, day after day, we load our bodies with more fat- and calorie-packed foods than our bodies can utilize.  Surrounded by effort-saving devices that have drastically reduced the amount of food-derived energy that our bodies can reasonably metabolize, a majority of Americans are becoming progressively heavier and heavier.  Moreover, obesity now affects a shocking percentage of children and adolescents in our society, and it is no longer uncommon to see children and teenagers with obesity-related diseases, previously seen only in adults, like diabetes, arthritis, high blood pressure, gallstones, and cardiovascular disease.

In addition to chronic illnesses that have long been associated with obesity, it has become increasingly clear that the risk of multiple different types of cancer is also increased by obesity.  Now, a newly published public health study, which appears in a forthcoming issue of The Lancet Oncology, underscores the disturbing extent to which excess weight increases our risks of several different common types of cancer.

In this huge public health study, more than 400,000 patient volunteers from Asia, Australia, and New Zealand were followed for an average of 4 years.  When obese study volunteers (BMI of 30 or higher) were compared with volunteers of normal weight (BMI less than 25), the obese volunteers were found to have a 21 percent higher risk of death due to cancer.  The risk of dying of certain specific types of cancer were even higher among the obese volunteers, including a 50 percent increased risk of death due to colon cancer, a 68 percent increased risk of death due to rectal cancer, a 63 percent increased risk of death due to breast cancer (in postmenopausal women), a 162 percent increase in the risk of dying of ovarian cancer, a 321 percent increase in the risk of death due to cancer of the cervix, a 45 percent increase in the risk of death due to prostate cancer, and a 66 percent increase in the risk of dying from leukemia.

The findings of this enormous public health study are worrisome, to say the least, and reflect the very serious impact that obesity has on our risk of developing cancer, and the risk of dying from cancer.

Obesity is a growing public health problem in the United States and, increasingly, around the world; and the list of chronic, major illnesses associated with obesity continues to expand (along with our collective waistlines).  If you are overweight or obese, then please consult with your physician for advice on how best to lose your excess weight.  Meanwhile, sharply reduce your intake of high-calorie and high-fat foods, and begin a responsible and consistent exercise program, under your physician’s supervision. 

For a more detailed discussion of the scientific links between obesity and cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in August 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

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 more than 100,000 new and returning readers 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.

Welcome to Weekly Health Update

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

VITAMIN D REDUCES RISK OF COGNITIVE DECLINE & DEMENTIA

Regular readers of this column are already well aware of the preventive effects of Vitamin D with respect to falls in the elderly, certain cancers, and cardiovascular disease.  (My new book, “A Cancer Prevention Guide for the Human Race,” which is scheduled to be published in August, 2010, contains an exciting and comprehensive update on the role of Vitamin D in cancer prevention.)  Now, a newly published research study, which appears in the current issue of the Archives of Internal Medicine, has linked low Vitamin D levels in the blood with an increased risk of cognitive decline and dementia in adults over the age of 65.

A total of 858 adults at or over the age of 65 participated in this prospective public health study, which was conducted over a period of 7 years.  All of these study volunteers underwent extensive evaluation of their cognitive function, using validated, standardized tests, when they entered into the study.  All patients also underwent testing of their blood for Vitamin D levels.  This extensive evaluation and testing was then repeated every 3 years during the course of this important clinical research study.

The results of this study indicated that patient volunteers with low Vitamin D levels in the blood (less than 25 nmol/liter), when compared with volunteers with normal blood levels of Vitamin D (75 nmol/liter, or higher), experienced significant declines in their intellectual function over the course of this study.  Indeed, the patient volunteers with decreased Vitamin D levels in their blood were as much as 60 percent more likely to experience progressive cognitive decline or dementia over the relatively brief duration of this study, when compared with the patients who had normal levels of Vitamin D in their blood! 

The results of this study are very similar to the findings of a similar study, which has just been published in the journal Neurology.  In this particular study, an inadequate level of Vitamin D in the blood of elderly men and women was associated with a significantly increased risk of cognitive decline and dementia from all causes, including Alzheimer’s disease and stroke.  Moreover, abnormalities of the brain, as detected by MRI scans, were also more commonly observed in patients who were deficient in Vitamin D.

Vitamin D deficiency is very common in older men and women.  An estimated 80 percent of people over the age of 65 have inadequate levels of Vitamin D in their blood, while as many as 45 percent of older men and women also have severe Vitamin D deficiency.

The results of these two studies strongly suggest that adequate levels of Vitamin D in the blood may be associated with a significantly reduced risk of aging-associated cognitive decline and dementia in older men and women, in addition to improving muscle strength, decreasing the risk of certain cancers, and decreasing the risk of cardiovascular disease. 

Not everyone should take large doses of Vitamin D, however, as the unmonitored use of this potent hormone-like vitamin can cause dangerous elevations in the level of calcium in the blood, as well as calcifications in the soft tissues of the body, kidney failure, pancreatitis, and gastrointestinal ulcers.  (Prior to starting Vitamin D supplements, you should certainly discuss the risks and benefits of Vitamin D supplementation with your physician.)

To learn more about the critical role of Vitamin D and the risk of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the August 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

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 more than 100,000 new and returning readers 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.

Welcome to Weekly Health Update

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

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 more than 100,000 new and returning readers 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.

Welcome to Weekly Health Update

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

IRRITABLE BOWEL SYNDROME: CAUSE DISCOVERED?

Irritable bowel syndrome (IBS) is a poorly understood cluster of gastrointestinal (GI) tract symptoms that typically includes varying degrees of abdominal bloating and crampy pain, diarrhea, constipation, and the frequent discharge of mucus-like stools from the rectum.  At any one time, an estimated 10 to 20 percent of all Americans chronically experience one or more of these intestinal symptoms.  In most patients with IBS, these symptoms begin in childhood.  In the United States, and in most other Western countries, IBS is at least 3 times more common in women than in men although, interestingly, in Southeast Asia, men are 2 to 3 times more commonly afflicted with IBS.

Numerous theories about the cause(s) of IBS have been proposed, but none have been definitively proven to cause this common syndrome, thus far.  Because the precise cause(s) of IBS has not yet been determined, there is no specific medical test available to diagnose this condition.  Likewise, there is no specific treatment available for IBS, although fiber supplements and careful attention to dietary “triggers” are often helpful.  Moreover, as IBS is frequently associated with chronic depression and/or anxiety, the use of some types of antidepressant medications has also been associated with an improvement in IBS symptoms.

Among the numerous proposed causes of IBS, an excess of a powerful hormone and neurotransmitter, serotonin, within the GI tract has been the focus of considerable research, lately.  (Serotonin is also commonly known as 5-HT, which is an abbreviated form of serotonin’s chemical name.) 

Serotonin has been shown to have multiple functions within the human body.  Decreased serotonin levels in the brain have been associated with both depression and anxiety, which explains why the most commonly used antidepressant medications, the selective serotonin reuptake inhibitors (SSRIs), are used to treat both chronic depression and anxiety.  (Commonly prescribed SSRIs include Prozac, Paxil, Zoloft, Lexapro and Celexa, among others.)  Because more than 95 percent of the body’s serotonin is found in the GI tract, SSRI drugs also have a profound effect on GI tract function, in addition to their effects on brain serotonin levels.  Indeed, previous observations that certain SSRI antidepressant medications worsen cramping and diarrhea in patients with diarrhea-predominant IBS have at least suggested that serotonin in the GI tract may play an important role in this common form of IBS.

Another serotonin-related disease that is associated with severe abdominal cramping and diarrhea is carcinoid syndrome.  In this relatively rare condition, serotonin-secreting carcinoid tumors of the GI tract cause profuse, watery diarrhea in affected patients after these tumors spread to the liver.

Based upon these apparent clinical links between IBS and serotonin (and for diarrhea-predominant IBS, in particular), additional research into the metabolism of serotonin in the GI tract of IBS sufferers is sorely needed.  Fortunately, a newly published research study, which appears in the current issue of the journal Gastroenterology, sheds further light on the potential link between serotonin and at least some forms of IBS.

In this novel clinical research study, 98 children with chronic GI tract symptoms were evaluated.  Twelve of these children presented with chronic symptoms suggestive of IBS.  Endoscopic GI tract biopsies were performed on these 12 children, and the results of these biopsies were compared with similar biopsies performed on other age-matched children who were undergoing endoscopy for reasons other than IBS symptoms.

When compared with the biopsy results on the “control” children without IBS symptoms, the children with IBS symptoms were found to have significantly elevated levels of serotonin (5-HT) in the mucosal cells lining their GI tract.  At the same time, the children with IBS symptoms were also found to have lower levels of a protein that is responsible for removing serotonin from the GI tract (serotonin transporter protein, or SERT) when compared to the children without IBS symptoms.  Therefore, these two findings, in children with chronic IBS symptoms, further and strongly suggest that an excess of serotonin in the gut may be associated with classic IBS symptoms.

In view of the varying degrees of diarrhea and constipation (and other IBS-associated symptoms) observed among individual patients considered to have IBS, it is highly likely that this syndrome has more than just one cause.  However, the biopsy-proven excess of serotonin in the GI tracts of the 12 children in this study with chronic IBS symptoms is a powerful indication that the abnormal regulation and metabolism of GI tract serotonin likely plays an important (if not causative) role in many, if not most, cases of this chronic and very common GI affliction.  The data from this powerful little clinical study also supports the continued development and clinical testing of serotonin/5-HT blocking (antagonist) agents in patients with diarrhea-predominant IBS.

For additional information on IBS, please see my previous column on this topic:

Irritable Bowel Syndrome (IBS), Diet & Fiber

To learn more about the critical role of diet in the prevention of cancer, look for the publication of my new landmark book, “A Cancer Prevention Guide for the Human Race,” in the 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

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 more than 100,000 new and returning readers 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.

Welcome to Weekly Health Update

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

SOY, CURCUMIN & PROSTATE CANCER RISK

Because chronic inflammation within the prostate gland is through to be an important risk factor for prostate cancer, anti-inflammatory dietary supplements and medications may be able to reduce the risk of prostate cancer by reducing inflammation.

Isoflavones from soy-based foods are known to act as a weak form of estrogen (the dominant female sex hormone).  Based upon this estrogen-like behavior, as well as potential anti-inflammatory properties, soy isoflavones are being studied as possible prevention and treatment agents for prostate cancer, and other types of cancer. 

Curcumin, which is present in the Indian curry spice turmeric, is also known to have potent anti-inflammatory properties, and has also been the subject of considerable cancer prevention and cancer treatment research.

A newly published prospective, randomized, blinded, placebo-controlled research study, published in the current issue of the journal Prostate, suggests that the combination of soy isoflavones and curcumin may have important potential prostate cancer prevention properties.

In the first part of this study, human prostate cancer cells were treated with a combination of soy isoflavones and curcumin.  Treatment of these human cancer cells with soy isoflavones and curcumin resulted in a significant reduction of prostate-specific antigen (PSA) production by these malignant cells (PSA is a marker of both prostate gland inflammation and prostate gland cancer).

As regular readers of this column are already aware, treatments performed in the laboratory that have beneficial effects on cancer cells, or on mice or rats, do not always have the same positive effects on living, breathing human beings.  Therefore, the findings of the second part of this study are of particular interest.  A total of 85 men with elevated PSA levels, but without prostate cancer (as confirmed by prostate biopsy), were enrolled in the second phase of this intriguing small study.  These 85 men were divided into two groups, and one group received daily supplements containing both soy isoflavones and curcumin, while the second (control) group of men received placebo (sugar) pills that were identical in appearance to the supplement pills (neither the 85 men, nor the nurses who dispensed the supplement pills and placebo pills, were aware of which pills each study volunteer was receiving until after the research study had been completed).

PSA blood levels were tested at the beginning of the clinical portion of this study, and once again 6 months later.  As was observed in the prostate cancer cells during the first part of this study, men with a PSA level of 10, or higher, experienced a significant reduction in their blood PSA levels 6 months after starting daily supplementation with soy isoflavones and curcumin.

Although this brief study cannot definitively confirm that soy isoflavone and curcumin supplements reduce the risk of prostate cancer, their ability to reduce elevated PSA levels in men with chronic prostate inflammation, but without evidence of prostate cancer, at least suggests a potential role in the prevention of prostate cancer (presumably through a reduction in prostate gland inflammation).

While there are multiple human research studies underway that are evaluating the effectiveness of soy isoflavones as cancer prevention agents, currently, there are no major human studies looking at the effects of curcumin on prostate cancer risk.  Based upon the findings of this small, interesting study of soy isoflavones and curcumin, which suggest a potential additive effect on PSA reduction when both of these dietary supplements are taken together, human research trials should be developed to look at the long-term impact, if any, of combined soy isoflavone and curcumin supplementation on prostate cancer risk.

For additional research information on soy isoflavones and curcumin in cancer prevention and cancer treatment, please review the following previous columns:

Soy Foods & Stomach Cancer Risk

Cruciferous Vegetables, Soy & Breast Cancer Risk

Soy Isoflavones & Recurrent Prostate Cancer

Soy Isoflavones Decrease Breast Cancer Recurrence Risk

Genistein (Soy Isoflavone) & Prostate Cancer

Diet, Soy & Breast Cancer Risk

Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

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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