Health Newsletter:November 2002
Related Links:From WebHealth
Contents |
New Research Shows: Coffee Drinking Is Healthy
Forget what somebody may have whispered into your ear in the past,namely that coffee drinking would be bad for you. Dr. Rob M. van Dam and Dr.Edith J. M. Feskens from the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, have recently completed a prospective study with a large number of participants.
The results were published in the Lancet 2002;360:1477-1478. The goal of the study was to see whether coffee consumption would have a positive or negative effect on the development of diabetes (type 2 or mature onset diabetes). Approximately 17,000 men and women were followed along over a period of time and 306 new cases of diabetes were detected. The average consumption of coffee was 5 cups per day. There was a striking difference between those who drank 7 cups of coffee per day and those who drank 2 cups or less per day: With 7 cups per day there was a 50 % LESSER risk of developing diabetes. The authors pointed out that it is known that some of the active ingredients in coffee are: the bioflavonoid chlorogenic acid, the minerals magnesium and potassium, and vitamin B3.
Chlorogenic acid and magnesium have been known in the past to have a stabilizing effect on glucose metabolism thus preventing diabetes.The authors were surprised though about the magnitude of the diabetes protective effect. They suggested that other authors should do further studies to confirm their findings and to attempt to pinpoint the mechanism of action. In the meantime they cautioned that it would be premature to recommend to increase coffee consumption for everybody.
Useful related link to a chapter of WebHealth: Health, Nutrition and Fitness
Nuts Cut Heart Attacks And Strokes In Half
According to Dr. Elliot M. Berry of Hebrew University Hadassah Medical School in Jerusalem and Dr. Ram B. Singh of the Medical Hospital and Research Centre, Moradabad/India, the word is out that a Mediterranean diet with walnuts and almonds, fruits and vegetables can safe lives and prevent heart attacks.
In a paper, published in the medical journal Lancet 2002;360:1455-1461, 1000 Asian patients with a high risk for heart disease and strokes were put on two diets: a "control" heart smart diet and the experimental diet,which consisted of the Mediterranean diet.
Surprisingly,not only did the high risk patients benefit from the Mediterranean diet, but also the control group that had already been on a healthy heart smart diet. Over 2 years the heart attack rates, death rates and heart disease event rates were all roughly cut into half on the Mediterranean diet. Cholesterol levels were significantly reduced,as much as would have been achieved with expensive cholesterol lowering medications. According to Dr.Berry the key to the understanding of this is found in the alpha-linoleic acid found in nuts and almonds. It is a precursor of the omega-3-fatty acids also found in fish oil, which in turn lower cholesterol, prevent blood clotting and are a natural remedy to prevent inflammation in the body.
Further investigations will be done by the research team to understand the mechanism of action of the healthy Mediterranean diet. In the meantime Dr. Berry stressed that other lifestyle changes must accompany the Mediterranean diet, namely an active exercise program and regular relaxation exercises such as yoga.
You may want to read these useful related links to chapters of WebHealth:
- Hardening of the arteries: Cardiovascular Disease
- Fitness: Health, Nutrition and Fitness
New Blood Test To Predict Breast Cancer Survival Rate
Dr. Keyomarsi, a researcher and radiation oncologist from the M.D. Anderson Cancer Institute in Houston/Texas, has published a very important piece of research in the New England Journal of Medicine (N Engl J Med 2002;347:1546-1547,1566-1575).
A group of 394 breast cancer patients were followed for 6.4 years and cyclin E was measured with a special blood test. Cyclin E is a key substance involved in cell division in general and also in breast cancer cells. Dr. Kyomarsi's research showed that cyclin E, and in particular high levels of its socalled "truncated isoforms", correlated very well with poor survival. On the other hand low cyclin E levels (truncated isoforms) were a powerful predictor for excellent survival. In the above mentioned breast cancer study 12 patients out of a group of stage 1 patients (= localized breast cancer) died after an average of 4.1 years from the point of diagnosis. All of these patients had high cyclin E levels.
In contrast, none of the other stage 1 patients had died within 5 years from the diagnosis and all of their cyclin E levels were low. Other known risk factors for poor survival are lymph gland metastases, negative estrogen receptors on the surface of the cancer cells and late-stage disease.
Each of those factors has a risk of about 1.7-fold. A high (truncated isoform) cyclin E level is associated with a 2.1-fold risk when compared to the low risk group with a low cyclin E level. There is a subgroup of breast cancer patients with high total cyclin E levels who have a risk of 13.3-fold of dying from breast cancer.
You may want to read these useful related links to chapters of WebHealth:
- A general overview regarding cancer: Cancer (General Overview)
- This chapter deals specifically with breast cancer: Breast Cancer
Heart Attack And Stroke Risk Measured With C-Reactive Protein
An old blood test that has been popular in assessing how aggressive rheumatic illnesses such as rheumatoid arthritis or lupus are, is now considered as the newest test to assess the risk of heart attacks. Up to now subfractions of cholesterol, in particular the LDL cholesterol level, has been used to assess the risk for a heart attack, but this according to a new study in the New England Journal of Medicine (Nov. 14, 2002) by Dr. Paul Ridker should be supplemented by a blood test checking for the C-reactive protein.
What is interesting about the C-reactive protein is that it originates from certain lining cells in blood vessels of liver tissue when inflammatory substances circulate in the body.
Other research has shown in the past that arteriosclerosis is in part due to an inflammatory process in the lining of the blood vessels that leads to the production of the C-reactive protein. Unfortunately other chronic illnesses and infections also lead to an elevation of the C-reactive protein as does the common cold or the flu. However, when 28,000 women of the Brigham and Women's Hospital study were followed for 8 years it turned out that the C-reactive protein was a more reliable predictor for who would eventually suffer from a stroke or a heart attack than the traditional LDL cholesterol. The investigators felt that the LDL cholesterol is predictive for who is more likely to develop fatty deposits (atheromatous plaques).
On the other hand the C-reactive protein appears to be more predictive for who is at a high risk for rupture of these atheromatous plaques. The bottom line is prevention by eating a diet with less fatty meats, by eating more fruit and vegetables and by engaging in an exercise program. Some patients need their cholesterol reduced with medication such as the statins.
You may want to browse through hese useful related links to chapters of WebHealth:
- For more details regarding the use of the C-reative protein test in rheumatoid arthritis see this link: Rheumatoid Arthritis
- Regarding arteriosclerosis, heart attacks and strokes follow this link: Cardiovascular Disease
"WAVE" Trial Failed To Show Benefits Of Estrogen/Vitamins
Dr. David D. Waters of the University of California at San Francisco reported in Chicago at the American Heart Association's Scientific Session 2002 about the WAVE trial. This stands for "Women's Angiographic Vitamin and Estrogen" trial.
The results of this study were simultaneously published in the Journal of the American Medical Association(JAMA 2002;288:2432-2440). It was a carefully designed randomized study where 423 women with established blood vessel damage to their hearts (established by angiography) were put on a therapy and then followed for an average of 2.8 years. Essentially the question was whether or not estrogen and vitamins (Vit.E and C) would have a protective effect on the blood vessels. Surprisingly the worst outcome was in the group with estrogen replacement and vitamins. The placebo group (=no estrogen, only vitamins) had the lowest death rate.
The authors felt that the beneficial effect of estrogen on heart vessels could not been verified in this study. The take home message to the physicians at the conference was that they should concentrate on lowering the known risk factors: weight reduction, blood pressure control, cholesterol lowering and increasing exercise. Estrogen should be given in low doses (0.625mg per day) only to those women who are symptomatic with hot flashes, but not to every postmenopausal woman.
NOTE: This group of postmenopausal women is a selection of women more likely suffering from hyperinsulinism with a higher rate of cardiovascular disease (and also arthritis and possibly a higher risk for cancer as well). The most logical therapy for these women is to work on weight loss, to increase exercise and to change their diet to a zone diet as this is known to lower cholesterol. Hoping to cure these women with estrogen or vitamin manipulation alone does not make "medical common sense" to me. You may want to read these useful related links to chapters of WebHealth:
- For links to arteriosclerosis, heart attacks and strokes see this link: Cardiovascular Disease
- For a link to hyperinsulinism follow this link: Diabetes
