Welcome to Weekly Health Update

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

COFFEE & THE RISK OF DEATH FROM HEART DISEASE & CANCER

Last month, I reviewed research showing that increased coffee consumption was associated with a decrease in inflammation and an increase in HDL cholesterol (the “good cholesterol”).  However, as I noted in that column, this small study did not address any long-term health outcomes of frequent coffee consumption (Coffee Improves HDL Cholesterol Levels).  Now, a newly published prospective public health study, from Japan, suggests that regular coffee consumption may, indeed, have long-term health benefits (at least for half of the population…).  (I should also note that, as a disclaimer, I am not a coffee drinker, despite reviewing two coffee-related health research studies in as many months!)

The results of this large Japanese research study appear in the current issue of the Journal of Nutrition.  In this prospective epidemiological study, 18,287 men and 19,455 women (between the ages of 40 and 64 years) were prospectively included in the Miyagi Cohort Study, which began in 1990.  All of these study volunteers were without any clinical history of cancer, heart disease, or stroke when they entered into the Study.  After an average of more than 10 years of follow-up, 2,454 of the volunteers died from various causes, including 426 cases of fatal cardiovascular disease and 724 fatal cases of cancer. 

These volunteers were categorized and analyzed according to their self-reported daily consumption of coffee: “never-drinkers,” “occasional-drinkers,” 1 to 2 cups per day, and 3 or more cups per day.  Other known risk factors for cardiovascular disease (including heart disease and stroke) and cancer were also factored into the analysis of the risk of death associated with coffee consumption for each volunteer.

Among the women in this study, increasing levels of daily coffee consumption were associated a decreasing risk of death, due to any cause.  (This “dose-dependent” relationship between daily coffee consumption and risk of death strongly suggests a direct clinical relationship between increased coffee consumption and a decreased risk of death.)  When compared to the women who did not drink coffee at all, the women who drank 3 or more cups of java per day were 25 percent less likely to die, from any cause, during this decade-long public health study.  The coffee-associated reduction in the risk of death from cardiovascular disease was even more powerful (and also appeared to be “dose-dependent”), as the women who downed 3 or more cups of coffee per day experienced a whopping 55 percent decrease in the risk of death due to cardiovascular causes!  Finally, there was an apparent modest decrease in the risk of dying from colorectal cancer among the female coffee drinkers, but no other reduction in the risk of dying from cancer was observed in association with regular coffee consumption among these women volunteers.

Well, I have just shared with you the good news regarding reduced death rates associated with regular coffee consumption from this large, prospective, long-term public health study; and many of you will notice that I have not yet mentioned the health impact of coffee on men!   This is because, unfortunately, this study did not identify any apparent beneficial health effects of regular coffee consumption in men.  The reason, or reasons, for this gender-related disparity is not clear, although it is well known that there are major differences in both the incidence of cardiovascular disease between men and women, and differences in the way that cardiovascular diseases (and heart disease, in particular) manifest themselves in women versus men.  It is, therefore, possible, that cardiovascular disease factors that are more unique to women are directly impacted upon by regular coffee consumption.  (At least no adverse effects of regular coffee consumption on male mortality were observed in this large public health study!)

So, ladies, keep the favorable results of this clinical research study in mind whenever you order that next cuppa Joe!

To learn more about the role of coffee, and other sources of dietary tannins, as potential cancer prevention nutrients, look for the publication of my new landmark evidence-based 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

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.

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

http://www.redcross.org/

http://www.imcworldwide.org/haiti

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. 

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

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. 

Welcome to Weekly Health Update

VITAMIN D, CARDIOVASCULAR DISEASE & DEATH

There is mounting evidence that Vitamin D plays a much more complex role in maintaining health beyond its primary function in regulating calcium absorption.  Increasingly, research data suggests that this hormone-like vitamin may also play important roles in the prevention of cardiovascular disease and cancer, as well.  (A comprehensive update on Vitamin D’s cancer prevention properties will appear in my forthcoming book, “A Cancer Prevention Guide for the Human Race.”)

The vast majority of published research studies in disease prevention have relied upon low-level research methods, including surveys of patient volunteers and retrospective medical chart reviews.  More recently, however, high-quality prospective, randomized cardiovascular disease prevention and cancer prevention clinical research trials have been performed.  These high-level studies have the potential to significantly improve lifestyle-based approaches to preventing the diseases that, together, cause the majority of all premature deaths.   

A newly published prospective clinical research study, from the Chianti region of Italy, enrolled more than 1,000 adults, aged 65 years and older.  All patient volunteers were tested for the level of Vitamin D in their blood when they joined this study, and all of these older adults were then carefully followed for an average of nearly 7 years.  During the course of this study, 228 study participants died.  The researchers then compared the levels of Vitamin D in the blood of the participants who died during the study with those of the volunteers who survived.  (This study is published in the current issue of the European Journal of Clinical Nutrition.)

The findings of this prospective clinical study were striking.  The patient volunteers with the lowest levels of Vitamin D in their blood were more than 2 times as likely to die, from any cause, when compared with the patients who had the highest levels of Vitamin D in their blood.  The patients with the lowest Vitamin D levels were also nearly 3 times as likely to die from heart attacks, and other complications related to cardiovascular disease, when compared to the patients with high levels of Vitamin D in their blood.  These dramatic findings held up even after the researchers made statistical adjustments for differences in the age, gender, education level, exercise habits, and other health-related factors among these two groups of study participants. 

As we age, our bodies become less efficient in converting sunlight into Vitamin D, and multiple research studies have shown that the majority of older adults are deficient in Vitamin D.  A growing number of high-level clinical research studies, such as this Italian study, continue to suggest that Vitamin D deficiency is associated with an increased risk of cardiovascular disease, cancer, osteoporosis, bone fractures, and decreased muscle strength in older men and women.  Therefore, the importance of this vitamin-hormone in maintaining optimal health is becoming increasingly apparent.

For additional Weekly Health Update articles on Vitamin D, please click the following links:

http://doctorwascher.com/Archives/2-3-08

http://doctorwascher.com/Archives/10-11-09.htm

http://doctorwascher.com/Archives/11-8-09.html

http://doctorwascher.com/Archives/9-20-09.htm

http://doctorwascher.com/Archives/8-9-09.htm

http://doctorwascher.com/Archives/12-28-08.htm

http://doctorwascher.com/Archives/10-5-08.htm

http://doctorwascher.com/Archives/6-29-08.htm  

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

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

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