Health Newsletter:May 2004
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From WebHealth
Contents |
Sugar And Starchy Foods Cause Colorectal Cancer
A study from the Harvard University involving 38,000 women and having been started in 1993 has surprised the researchers. They wanted to find out whether there were certain foods that may cause colon and rectal cancer. So they administered a "food-frequency" questionnaire with 131 questions to women 45 years or older who entered into the study. Such factors as low-dose aspirin, vitamin E and beta-carotene were included in the questionnaire as was the exact food composition for the year prior to enrolment into the study.
A sugar load (glycemic load) was calculated. This way the impact of various sugar and starch containing foods could be assessed and compared among different subgroups regarding the later development of cancer in the colon and rectum. When Dr. Susan Higginbotham and Dr. Simin Liu analyzed the diets of the 174 patients who did develop cancer (26 rectal cancers, 148 colon cancers) they found that the women with the highest sugar and starch load were 3 times more likely to develop cancer than the controls with a low glycemic load. High glycemic load foods are candy, cakes, cookies; any other refined flour products including white bread, pasta, French fries and baked potatoes. Together with other literature in this field the authors of this study concluded that the high glycemic food load leads to increased insulin levels in the blood as well as insulin-like growth factors. This in turn leads to cell division in normal and cancerous cells including the lining of the colon and rectum. In addition it is known that the C-reactive protein promotes an inflammatory response that will lead to heart attacks and to cancer.
Dr. Bob Bruce from the University of Toronto has shown in his research on colon cancer that insulin and related factors are important in the promotion of this cancer. He commented regarding the Harvard study reviewed here that more research is required before the exact cause of cancer of the colon and rectum would be understood. This knowledge is required before more effective preventative measures can be found other than a simple reduction of sugar and starch in the foods we eat.
Based on the Feb.4 edition of the Journal of the National Cancer Institute (U.S.) and the National Review of Medicine (Canada) March 15, 2004.
Chronic Inflammation Causes Cancer, Heart Attacks And More
When the Time Magazine devotes 7 full pages in the March 22, 2004 issue to the topic of inflammation as the source of most of the diseases of the Western World, you know that something important is happening in medicine. Christine Gorman and Alice Park have summarized some of the groundbreaking research of the past few years in this article. I will report about this article here, but also include direct links regarding some of the relevant research the authors have mentioned including some of the key links regarding the metabolic syndrome, which was not mentioned in the article.
Since the beginning of the obesity wave in North America it has become obvious that a cluster of diseases such as heart attacks, strokes, Alzheimer disease, cancer of the colon, multiple sclerosis, arthritis and others have also become more frequent. Dr. Paul Ridker, a cardiologist at Brigham and Women’s Hospital, was one of the pioneers of investigating inflammation as a possible cause and the common denominator of these diverse illnesses. He noticed that certain patients got heart attacks although their blood LDL cholesterol levels (the “bad” cholesterol) were normal. The theory at that time was that all patients who would develop heart attacks would come from a high-risk group of patients with elevated LDL cholesterol. The problem was that 50% of patients with heart attacks had normal LDL cholesterol levels. Dr. Ridker suspected that the C-reactive protein (CRP), which is found to be elevated in the blood of rheumatoid patients, would be somehow involved in the disease process of hardening of the arteries before a heart attack would occur. CRP is produced by the liver cells and by the lining cells of arteries in response to a general inflammatory reaction in the body. Examples of this would be rheumatoid arthritis patients and patients with autoimmune diseases, where CRP levels can be readily measured with a blood test. Dr. Ridker found that there was a very good correlation between the CRP level and the degree of inflammation as well as the risk for developing heart attacks and strokes. Further investigation by others confirmed that CRP levels were perhaps more important than LDL levels in predicting impending heart attacks. This is so, because CRP is the body’s substance in the blood stream that would be responsible for breaking up LDL containing deposits (plaques) in the walls of the arteries, which leads to heart attacks in the heart and to strokes in the brain.
Other investigators found that CRP was only one link in a complex chain of events that includes inflammatory substances (cytokines) from the fat cells as well as insulin and insulin-like growth factors from the metabolic syndrome. Leptins are also a factor as has been discussed under this link. Dr. Steve Shoelsen from the Joslin Diabetes Center in Boston has developed a mouse model for the metabolic syndrome. These mice will produce huge amounts of inflammatory substances in their fatty tissue in response to any inflammatory process that is started in them. Anti-inflammatory drugs such as the statins or metformin, it is hoped, will be shown conclusively to dampen the inflammatory process and prevent heart attacks, strokes and diabetes as well as cancer, Alzheimers disease and arthritis. Heart disease has already been shown to be improved by anti-inflammatory drugs. Asthma is an inflammatory disease of the small bronchial tubes, which can be stabilized with the anti-inflammatory drug Avastin.
What can we do as consumers to prevent some of those life-threatening diseases? By reducing our weight through calorie restriction on a low-glycemic diet we can help to reduce the insulin-like hormone substances of the fatty tissue. Regular exercise of at least 30 minutes of a brisk walk daily or the equivalent of other sports activities will half our risk for colon cancer and many other cancers. A diet rich in fruits and vegetables as well as fish and fish oils will reduce the amount of free radicals in our system cutting down on the circulating inflammatory substances. This prolongs life, prevents all of the major diseases of modern civilization and leads to longevity as the study of the Okinawa diet has shown.
Based on an article in the Time Magazine, March 22, 2004 edition, page 54 to 60.
Pneumonia: Should It Always Be Treated With Antibiotics?
Increasingly resistant strains of bacteria have developed because of over treatment with antibiotics for various infectious conditions.This is partially due to the cautious physicians who do not want to miss a bacterial pneumonia, partially due to fears of being sued, and partially because of pressure from patients who demand an antibiotic prescription even when it is known that a viral infection will not respond to it. In the past there was no test that would help physicians to distinguish whether a shadow on a lung X-ray would be due to a viral or a bacterial pneumonia.
But this is changed now since a study from the University Hospital in Basle/Switzerland by Dr. Beat Muller. This study was done involving 243 patients who had been admitted to hospital for pneumonia and were investigated for the presence of procalcitonin. This is a precursor to calcitonin, the bone mass regulating hormone. Procalcitonin is elevated with bacterial pneumonia and other bacterial infections, but is normal in the case of viral infections. The German firm Brahms GmbH has developed a test, called Kryptor PCT that was utilized by this research group and was found to be both sensitive and fast in detecting procalcitonin levels. The study divided the patients into two groups. Group 1 was the control and the physicians would treat them according to the standard protocol based on clinical judgment. Group 2 was the test group that was treated with the input of the procalcitonin level before the physician decided whether or not to treat with antibiotics. The results were quite remarkable: the control group (83%) received about twice as often antibiotic therapy than the test group (44%).
Dr. Muller said that this was an important reduction of antibiotic usage in view of the recent data of an increase in antibiotic-resistant bacteria. Follow-up on all of the patients of the study revealed that in both groups the patients had a good recovery in 97%. Dr. Muller also said that age made a big difference in the control group as physicians tended to err on the cautious side and treated older patients more with antibiotics. For every additional year of age there was a 6.5% increase in the odds that the patient would be treated with antibiotics. In the test group (the procalcitonin group) this did not occur. With this new blood test physicians have now an important tool to help them decide wether antibiotics are necessary in the case of a fever.
Based on an article in The Medical Post, Vol.40, No14, April 6, 2004: page 46.
Physicians Use New Technology (GCFP) To Study Blood Flow
Researchers at the Duke University Medical Center have developed a new non-invasive method of visualizing blood flow through blood vessels of patients. It is a modification of the well-known MRI scan technology where a magnetic field realigns the center of hydrogen atoms (protons) during the time of the examination and the differences of the tissue and fluid qualities are reflected in the images created by this technology. This new application depicting moving blood in blood vessels is called “global coherent free procession” (GCFP).
The principle is that the investigator can focus on an area of a blood vessel upstream of the area to be examined and tag a portion of the blood flowing through with an energy pulse. As the blood continues to flow through the area of interest, the protons give off the energy again without any changes to the body fluids or the blood cells and the MRI scanner picks up the images of the blood flow through the blood vessel. The advantage of this technique is that it is done without any catheters (it is non-invasive), there is no need for any contrast material to be injected and there are no X-rays needed. At the present time this is the only diagnostic technology available for examining a patient's blood flow through the heart and its vessels in real time, which is very valuable for physicians (cardiologists). Here is a link to the Duke University site with images of blood flow.
Based on an article in the April 13, 2004 issue of The Medical Post , Vol.40, No. 15, p.5.
Age-Related Macular Degeneration Can Be Postponed
In a well-controlled study that was published earlier in 2004 Dr. Johanna M. Seddon has shown that age-related blindness (AMD) is caused from an inflammation in the blood vessels, which is associated with an elevated blood marker, called C-reactive protein (CRP). The authors of this study also showed that the dry form of AMD would tend to deteriorate with age and/or from smoking cigarettes into the more serious wet form, a common cause of blindness.
The inflammatory component of cardiovascular disease is known to be controlled by the use of aspirin (ASA) or the statins, medication that is known to lower the bad LDL cholesterol. It is with this background that the author of the study that I am reviewing here, Dr. Jacque L. Duncan from the University of California at San Francisco, has examined the effects of ASA and of statins on AMD. 326 patients with AMD (204 with dry AMD, 104 with wet AMD from blood vessels forming underneath the retina and 18 with geographic atrophy) were followed between January 1990 and March 2003. Patients were at least 60 years old or older and followed at the San Francisco VA Hospital Eye Clinic. Dr. Duncan found that patients with blindness due to wet AMD used ASA or statins significantly less than patients with stable AMD. Moreover, he found that patients who had AMD and took statins were 49% less likely to develop wet AMD and 37% less likely to develop wet AMD, if they took ASA. The study also suggests that there is a link between the inflammatory process that leads to heart attacks and strokes on the one hand and the further deterioration to blindness when AMD is not treated on the other hand. The notion that inflammation is the missing link in both of these processes is a relatively new finding.
Based on article by Dr. Jacque L. Duncan in the American Journal of Ophthalmology 2004;137: 615-624.
