Welcome to Weekly Health Update

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

METFORMIN, DIABETES AND DEATH

Metformin is a diabetes medication that is of great interest to me, and to other cancer specialists, because of intriguing research data suggesting that it may reduce the risk of cancer occurrence and cancer recurrence in people with diabetes.  (Diabetes is, itself, a risk factor for certain types of cancer, including one of the most lethal of all cancers, pancreatic cancer.)

Metformin has been shown to be particularly beneficial in reducing the risk of death due to the complications of diabetes in overweight and obese patients, who are especially prone to developing diabetes.  However, there has been some concern regarding the potential safety of metformin in patients with preexisting cardiovascular disease and kidney disease, and so this first-line diabetes medication has not been extensively prescribed to diabetic patients with these diseases.  (Somewhat ironically, cardiovascular disease and kidney disease are, themselves, known complications of diabetes.)  For this reason, the clinical research study that I will be discussing in today’s column is especially important to the estimated 24 million patients in the United States, alone, who have diabetes, and to the hundreds of thousands of diabetic patients who have already developed cardiovascular disease and kidney disease in the US. 

This newly published study, which appears in the current issue of the Archives of Internal Medicine, reports on the results of the massive Reduction of Atherothrombosis for Continued Health (REACH) Study, which included 19,691 patients with documented diabetes.  (The researchers involved in the REACH Study have been following this huge number of patient volunteers since they enlisted in the study between December 2003 and December 2004.) 

The findings of this very large prospective public health study validate the findings of smaller prior clinical studies.  In this study, diabetic patients with cardiovascular disease were significantly less likely to die during the course of this study if they took metformin instead of other diabetes medications (or no diabetes medication at all).  The patients in this study who took metformin were 24 percent less likely to die when compared to the diabetic patients who did not take metformin.  Among patients with congestive heart failure, which has until recently has been considered a contraindication to taking metformin, the use of metformin was associated with a 31 percent reduction in death due to all causes.  Moreover, patients with other health conditions that have previously thought to preclude diabetes treatment with metformin also appeared to benefit from metformin in this study.  Diabetic patients with cardiovascular disease who were older than 65 years were 23 percent less likely to die if they took metformin, while patients with decreased kidney function (estimated creatinine clearance of 30 to 60 ml/minute) experienced a whopping 36 percent decrease in the risk of death if they took metformin. 

As this was an observational study (i.e., there were no randomized groups of patients, and there was no placebo-control group), it should be urgently followed with a prospective, randomized, placebo-controlled clinical research study to confirm these highly important clinical findings.  Taken together, however, the findings of this pivotal public health study are certain to eventually expand the number of patients with diabetes who will be considered eligible to receive metformin! 

For a complete discussion of metformin as a potential cancer prevention agent, as well as other important evidence-based approaches to cancer prevention, order your copy of my new book, A Cancer Prevention Guide for the Human Race, now!  For the price of a cheeseburger, fries, and a shake, you can purchase this landmark new book, and begin living an evidence-based cancer prevention lifestyle today!

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GIVE  THE  GIFT  OF  HEALTH  THIS  HOLIDAY  SEASON!  For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores! 

On Thanksgiving Day, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com Top 100 Bestseller’s List for Kindle e-books!

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 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.

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”

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” 

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.)

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.