Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Saccharin, aspartame and cancer risk

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Cancer risk and consumption of arificial sweeteners especially saccharin, aspartame

 

• There has been an ongoing controversy over the health risks especially cancer risks due to consumption of artificial non-nutritive sweeteners like saccharin and aspartame. Most of the data about cancer risk has been based on animal studies. Question arises: What is the human data on cancer risk due to artificial sweeteners due to saccharin and/or aspartame.

  Gallus and colleagues from Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.provided an analysis of the integrated network of case-control studies between 1991 and 2004 in Italy on variety of cancers. The findings were published in the journal Annals of Oncology. The odds ratios for saccharin use and cancer risk are as follows:

  • Oropharynx 0.83 (95% CI 0.30-2.29)
  • Esophagus 1.58 (95% CI 0.59-4.25)
  • Colon 0.95 (95% CI 0.67-1.35)
  • Rectum 0.93 (95% CI 0.60-1.45)
  • Larynx 1.55 (95% CI 0.76-3.16)
  • Breast 1.01 (95% CI 0.77-1.33)
  • Ovaries 0.46 (95% CI 0.29-0.74) --------------Reduced risk
  • Prostate 0.91 (95% CI 0.59-1.40)
  • Kidneys 0.79 (95% CI 0.49-1.28)

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• Oral cavity and pharynx 0.77 (95% CI 0.39-1.53)
• Esophagus 0.77 (95% CI 0.34-1.75)
• Colon cancer 0.90 (95% CI 0.70-1.16)
• Rectum 0.71 (95% CI 0.50-1.02)
• Larynx 1.62 (95% CI 0.84-3.14)
• Breast cancer 0.80 (95% CI 0.65-0.97) --------Reduced risk
• Ovaries  0.75 (95% CI 0.56-1.00)
• Prostate 1.23 (95% CI 0.86-1.76)
• Kidneys 1.03 (95% CI 0.73-1.46)

 

 

In fact there was a significant less likelihood with use of total sweeteners and the risk for breast and ovarian cancer. On the other hand, there was a significant trend for total sweetener consumption and for laryngeal cancer.

Conclusion of the study: The authors concluded that there is a lack of association between saccharin, aspartame and other sweeteners and the risk of several common neoplasms.

Update of above analysis for more cancers and sweetener risk: Bosetti and colleagues examined the role of sweeteners on cancer risk especially saccharin and other artificial or low-calorie sweeteners including aspartame. They conducted an update of their analysis of an integrated network of case-control studies conducted in Italy between 1991 and 2004 including data on cancers of the stomach, pancreas, and endometrium. The findings were published in the journal Cancer Epidemio Biomarkers Prev (2009).

The invesigators found that after adjusting for confounding factors, odds ratios (indicating less or more risk; if you just want conclusions, just scroll down) ever users of sweeteners versus nonusers were as follows:

• Gastric cancer 0.80 (95% CI, 0.45-1.43)
• Pancreatic cancer 0.62 (95% CI, 0.37-1.04)
• Endometrial cancer 0.96 (95% CI, 0.67-1.40)

Conclusions of the updated cancer risk study: The authors concluded that the findings lent further support to the evidence on the absence of an adverse effect of low-calorie sweetener (including aspartame) consumption on the risk of common cancers in the Italian population.

 

What do you think about the health risks due to artificial sweetners including cancer and metabolic risks? please share your thoughts. 

 

 

 

Vitamin D deficiency: Is it a growing epidemic

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Vitamin D or calciferol is actually a group of compounds with the molecule comprised of a cholesterol backbone. 1,25(OH)2-vitamin D is the physiologically active form of vitamin D. Several of the metabolites are biologically active.

Sources of vitamin D:

Body vitamin D include is derived from production in skin as well as intestinal absorption.

Skin: Exposure of skin to sunlight leads to production of vitamin D in body.

Diet: In addition to vitamin D fortified milk, the dietary sources rich in vitamin D include fatty fish, cod-liver oil, and eggs. Vitamin D2 or ergocalciferol, a plant steroid is used for milk fortification. Other products that may be fortified include cereals, breads etc. Diet usually provides Vitamin D3.

Vitamin D homeostasis:

Factors involved in vitamin D homeostasis include parathyroid hormone, serum calcium, and phosphorus levels, estrogen, placental growth hormone, and prolactin etc.

Functional significance of vitamin D:

Vitamin D and its metabolites are intricately related to calcium homeostasis and bone metabolism. With increasingly limited exposure to sun, Vitamin D insufficiency as measured by low levels of 25-OH vitamin D is a growing epidemic across the world especially among adolescents and the elderly.

 

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Pathologic disease states with vitamin D involvement:

 

Although rickets in rare these days, subclinical vitamin D deficiency is common.

Since calcium metabolism is involved in not just in numerous metabolic functions in the body including bones, vitamin D deficiency may play a role not just in osteoporosis but also in impairment of immune function,increased risk of various malignancies including colon cancer as well as increased risk for heart disease.

Cancer: An increase of 25 nmol/L in 25-hydroxy-vitamin D levels is associated with a 17 percent decrease total cancer risk.

Bone fractures: Vitamin D and calcium supplementation reduces the risk of falls and fractures.

Vitamin D levels and mortality: Low levels of vitamin D are an increased risk of all cause mortality whereas supplementation of vitamin D results in reduced of all-cause mortality

Vitamin D levels: Best marker is the serum 25-OH vitamin D concentration. While there are considerable disagreements on the “normal” , a level below 20 to 30 ng/ml is considered abnormal. The "normals" may vary with the labs as well.

Vitamin D deficiency:

Vitamin D deficiency can be seen in 57 percent of hospitalized patients of whom 22 percent are severely deficient [Thomas 1998] Vitamin D stores decline with age, especially in the winter because of reduced sun exposure.

The deficiency or resistance may occur due to inadequate dietary intake, malabsorption, lack of sun exposure, liver or kidney dysfunction,or there may be end-organ resistence to vitamin D metabolites. Chronic use of corticosteroids results in decreased vitamin D dependent calcium absorption and hence bone disease.

 

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Dose of vitamin D:

The tolerable upper intake level for vitamin D for healthy adults is 2000 IU per day. A minimum of 200 IU per day is needed in healthy adults.  Many experts argue that the normal daily dose of vitamin D should be 1000-2000 IU per day. Some patients may even require higher doses and should be undertaken under close medical supervision.

Pregnant and lactating mothers: 400 IU/d

Infants who are exclusively breast fed: 400 IU/d. Since infant formulas are fortified with vitamin D, formula-fed infants require supplementation if they consume less than 1000 mL daily of formula.

Elderly: 800 IU/d plus atleast 1.2 g of elemental calcium per day.

Special cases:  

Patients noncompliant with daily vitamin D therapy may benefit from high dose intermittent therapy (100,000 units every four months).

Prevention and treatment of osteoporosis 800 IU (20 micrograms) per day. 

Toxic dose of vitamin D: Greater than 2000 IU per day.

 

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Toxicity of vitamin D:

Vitamin D is not innocuous and excess ingestion can lead to vitamin D intoxication. Subjects prone to this include not only those those who consume megadoses of supplements but also in patients on vitamin D replacement therapy for a variety of disorders. Manifestations of toxicity include hypercalcemia, hypercalciuria, altered mental status, polyuria, polydipsia, anorexia, vomiting, muscle weakness, and bone demineralization with pain.

Caveat:

I would like to pint out that some experts have questioned the issue of extent of prevelance of vitamin D deficiency for a variety of good reasons including in part to the paucity of reliable and reproducible blood tests and that the need for vitamin D may be different in different population sub-groups.

 

Are you taking any vitamin D supplements? If so, what dose and have you talked to your doctor about it? Have you had your vitamin D levels checked? Please share your thoughts.

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CT scan and risk of cancer

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CT or CAT scans are not risk free

Written by: Anil Minocha MD, Shreveport, La

There has been a massive increase in the use of computed tomography over recent years. Radiation dose from CT scan is significantly higher than than that from conventional radiography. CT scan is an extremely useful diagnostic modalilty, frequently superior to conventional radiography and is increasingly being used for assistance in guided invasive procedures.

Few realize that with this positive benefit comes the increased risk of cancer. Radiation exposure results in DNA damage that can usually be repaired by body's defences. Misrepair can and does occur and can result in changes leading to cancer.

A study published in the New England Journal of Medicine estimated that based on CT scan use in the 1990s, as many as 0.4% cancers may be attributed to radiation exposure due to CT scans. However, considering the significant increase in CT scan in the last decade, as many as 1.5-2 percent of cancers may be related to CT scan induced radiation exposure.

Authors recommend the following:

• Reduce the CT-related radiation dose in individual patients. The automatic exposure-control on the latest generation of scanners is helping to address this concern.
• Use more of ultrasound and MRI in lieu of CT scans as much as possible.
• Reduce the decrease the number of CT studies ordered. While benefits outweigh risks in most cases, estimates suggest that as many as one-third of CT scans may not be justified could be avoided.

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Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Testosterone and mortality, cancer screening in rural vs urban population

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Testosterone level:

Low testosterone levels can be double whammy! As if low testosterone levels are not bad enough for men for obvious reasons, they are also likely to increase risk of death. Khaw and colleagues based their conclusions about relationship between between testosterone concentrations and mortality in a case-control study of 11,606 men aged 40 to 79 years surveyed in 1993 to 1997 and followed up to 2003. Similar results have been recently reported by Haring and colleagues in European Heart Journal.

  

Pedometer for weight management:

If you are interested in weight management, use pedometer when walking rather than walking without one. Its use encourages more walking and more weight loss. Richardson and coleagues performed a meta-analysis of nine studies with a sample size ranged from 15 to 106, for a total of 307 subjects.  Subjects lost a mean 0.05 kg per week during the intervention. The authors concluded that pedometer-based walking programs result in a modest amount of weight loss. Longer programs lead to more weight loss than shorter programs.

Cancer screening:

Who do you think misses out on cancer screenings, rural or urban population? If you guessed rural, you may be wrong, so suggests a study from Dartmouth-Hitchcock Medical Center. Paquette and colleagues  performed a retrospective, descriptive analysis of cancer stage at presentation of rural versus urban patients with lung or colorectal cancer using the Surveillance, Epidemiology, and End Results database from the National Cancer Institute. 

Logistic regression analysis revealed that urban patients are more likely to present with late-stage colorectal and lung cancer when compared to their with rural counterparts.  Other studies suggest that the relationship between Socioeconomic status and the risk of late stage colorectal cancer varies among rural and urban populations.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Alcohol beverages and body weight

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Want to lose weight? I will drink to that!

According to Dennis and colleagues, evidence indicates that increased intake of water and other energy-free beverages may help you accomplish your goal of weight management. Although calorie-dense beverages acutely increase caloric consumption, jury is still out on their long term impact on body weight.

Some people avoid alcohol in order to avoid the calories that come with it. Now comes a study debunking this myth about alcohol and weight gain, at least to a limit.

Women who drink moderate amounts of alcohol are unlikely to gain as much weight in midlife as compared to women who abstain from alcohol. Investigators at Brigham and Women’s Hospital in Boston based their conclusions on analysis of data from 19,220 women enrolled in a long-standing Study. Comparison with women who do not drink revealed that those who imbibed 1.5 to 3 alcoholic drinks daily had a significantly reduced risk of becoming overweight or obese.

This study should not be interpreted as a blank check for the nearest bottle. While moderate drinking is good for heart as well, its risks for health otherwise would not be forgotten, e.g. liver, cancer etc. And of course it has potential to affect social life so drink responsibly! Because of biological differences, the generally acceptable healthy limit for women is one drink per day as compared to two drinks per day for men.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Entericoated aspirin, NSAIDs ulcers, dannon yogurt, FDA approved, medical radiation, rotavirus vaccination

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Patients concerned about side effects of aspirin especially the risk of gastrointestinal ulcers often take entericoated formulations of aspirin to avoid such complications.

Though patients often believe these pills pose a lower risk of stomach upset, they actually don’t appear to have much effect on the more serious damage that aspirin can cause.

 

“That’s a huge misunderstanding,” says David A. Johnson, a past president of the American College of Gastroenterology and a professor at Eastern Virginia Medical School. Read more here.

Dannon must pay consumers up to $45 million in damages for falsely advertising the health benefits of its yogurt, under the terms of a class action settlement reached Tuesday in federal court in Cleveland, reports Cleveland.com. The targets of the class action were two Dannon yogurt products -- Activia and DanActive -- pitched in TV ads by actress Jamie Lee Curtis. Read more at dannonsettlement.com.

 The terms "FDA approved" or "FDA registered." are reassuraing while purchasing health care products.  According to Daniel Carpenter, professor of government at Harvard University, and as published in Los Angles Times, these words "FDA approved" or "FDA registered" don't mean as much as consumers often assume. "FDA certification of a product is never a guarantee of safety or effectiveness of anything," Carpenter says.

A House subcommittee heard from various experts calling for standardization of medical radiation to enhance effectiveness and safety as reported in the New York Times, Saying that recent news reports about radiation accidents had “raised huge concerns for me,” Frank Pallone Jr. the chairman of the Energy and Commerce subcommittee on health, said he was shocked that the people who operate radiologic devices need not be licensed in many states and that “the requirements to report errors and the penalties for making errors are basically nonxistent or not enforced.”

The efficacy of the pentavalent rotavirus vaccine was assessed among infants in the United States was studied by Wang et al. from Harward University. A large, national, health insurance claim database was studied. Use of the vaccine resulted in a 66% decrease in acute gastroenteritis related hospitalization and visits to emergency rooms as well as a 74% reduction in costs.

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Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

 

Colon cancer risk prevention by colonoscopy

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Colonoscopy is considered the gold standard for screening for colon polyps and cancer. It is recommended and paid for by many third payor parties including Medicare. Few people realize that  there is paucity of randomized trials supporting the benefit of colonoscopy Few realize that there has been paucity of direct evidence in support of concept that colonoscopy would help reduce colon cancer and its resultant morbidity and mortality.

Current estimates of the effect of colonoscopy on CRC incidence—an estimated reduction of 76% to 90% reduction of incidence colon cancer as a result of colonscopy is based on data from national polyp study which lacked concurrent controls.

However, recently a few studies have cast a doubt on the presumed effectiveness of colonoscopy with respect to reducing risk of right sided colon cancers. This was supposed to be the advantage of colonoscopy over sigmoidoscopy.

Brenner and colleagues wished to determine if a prior colonoscopy compared with no colonoscopy was associated with reduced prevalence of advanced colorectal neoplasms (defined as cancers or advanced adenomas).This population based study involved a statewide cross-sectional study of 3287 subjects 55 years or older from Germany. Prevalence of advanced colorectal neoplasms was assessed by screening colonoscopy and histopathologic examination of the lesions.

 

Advanced colorectal neoplasms were found in 11.4% of the 2701 subjects without prior colonoscopy as compared 6.1% who had undergone colonoscopy within the preceding 10 years. Overall and site-specific adjusted prevalence ratios for previous colonoscopy demonstrated that the colonoscopy in the prior 10 years was associated with a reduction in prevalence of left-sided advanced colorectal neoplasms, but not right-sided advanced neoplasms.

Another study was performed by Baxter and colleagues. They conducted a population-based, case-control study to examine the effectiveness of colonoscopy for preventing deaths related to colorectal cancer in Ontario, Canada. The authors identified 10, 292 case patients and 51, 460 controls from administrative claims data. 7.0% of patients and 9.8% of the controls had previously undergone a colonoscopy. Logistic regression showed that colonoscopy was significantly associated with fewer deaths from left-sided colorectal cancer (Odds ratio 0.33; C.I. 0.28 to o.39) but not from right-sided colorectal cancer.

Above studies may call into question the beneficial value of colonoscopy for colorectal cancer screening. Ranshoff argues that based on these data, we should probably tell our patients that high quality colonoscopy results in a 60% to 70% reduction iof the risk for death from colorectal cancer as opposed to 90% reduction that has been largely assumed.

Above Ranshoff suggestion notwithstanding, an even more important question may be whether the widespread use of colonoscopy as the screening method is actually a cost-effective versus a grossly wasteful method of screening. Colonoscopy has a much higher risk for significant complications as compared to other cancer screening modalities. An extreme view might be that colonoscopy as a primary tool of colon cancer screening is a misuse of health care dollars and that flexible sigmidoscopy should suffice in average risk subjects. 

Obviously, such confusion and controversy has occured because of the use of colonoscopy based on indirect data and now we have poulation based studies challenging the degree of its effectivensss. Only large randomized controlled trials can help answer these vexing questions.

In the emantime, is there a significant incremental benefit of colonoscopy over flexible sigmoidoscopy for colorectal cancer screening? Is the magnitude of increased benefit from colonoscopy as compared to flexible sigmoidoscopy sufficient to justify the huge increase in cost, not to mention the additional risk for complications.

Baxter and Rabeneck argue that as more observational evidence accumulates, the answer to this question becomes less certain. Is it time to set up an expert panel to re-examine the issue whether the colonoscopy offers substantial benefit over flexible sigmoidoscopy in a cost effective manner.

What are your views on the above studies and resultant cdontroversy? please share your thoughts.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

 

Aesbestosis mesothelioma lung and GI cancer

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Aesbestosis and mesothelioma: A rough estimate suggests that about 7-9 million living persons in the US United States have been  exposed to asbestos at work over the past 50 years. Mesothelioma occurs in about 10% of subjects with aesbestosis. The more the exposure to aesbestosis, higher the risk. Risk of cancer is dramatically increased in subjects if they smoke as well.   

  

Medical problems associated with aesbestosis:

• Type of mesothelioma associated with aesbestosis is primarily pleural mesothelioma, while peritoneal mesothelioma may also occur.
• A estimate suggests that 8 percent of subjects with aesbestosis are likely die of respiratory failure while 50% are likely to die of cancer either primary lung carcinoma or mesothelioma. 
• Interestingly, aesbestosis also increases risk for gastrointestinal cancer.

Incidence of mesothelioma: About 3300 cases of mesothelioma occur in US each year although the incidence has been declining over the last decade. In contrast, the incidence has been increasing in other parts of the world especially in developing nations.

 

Lag peiod for developing mesothelioma: It takes about 30 to 40 years from initial exposure to aesbestosis to the actual development of mesothelioma.

 

What is aesbestos: It is commercial name for a group of magnesium silicate fibrous minerals, primarily of serpentine and amphibole types. It is very resistant e to heat and combustion and as such is attractive for use in cement, tiles, automobile brake linings, and shipbuilding. OSHA guidelines require that workers at risk for occupational excposure use protective clothing, respirators, and showers.

 

MIsc factors associated with mesothelioma: Radiation therapy, viruses,use of intrapleural thorium dioxide r Thorotrast, and inhalation of other fibrous silicates e.g. erionite.  In addition, nonoccupational aesbestosis and consequently increased risk of mesothelioma may occur due to high levels of aesbestoss in soil,.The jury is still out on the magnitude of risk associated with workers exposed to carbon nanotubes. 

Please click for occupations and industrial workers at risk

  

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Broccoli versus selenium for cancer protection

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Data suggests the efficacy of selenium for prevention of colon cancer in humans. The source of selenium may be an important factor as well since selenium in broccoli does not accumulate in the body as fast as other forms of Selenium.

Ine one experiment, rats (n = 45) were administered torula yeast-based diets supplemented with the following: 1) no Se; 2) selenium as selenate; 3) selenized broccoli. In another experiment, rats were given same basal diet supplemented with the following: 1) no added Se; 2) selenium as selenite; 3) selenium as as selenite + low Selenium broccoli; and 4) selenized broccoli.

Rats were also fed a chemical carcinogen or control vehicle. Supranutritional amounts of selenium ingested as high selenium broccoli significantly reduced the incidence of preneoplastic aberrant crypts and aberrant crypt foci as compared to other groups.This was despite controlling for the presence or absence of broccoli and for the total amount of selenium ingested.

The authors concluded that the decrease in preneoplastic lesions was due to selenium in high selenium broccoli and not a result of broccoli alone or selenium alone.

This suggests that selenium dervived from high selenium broccoli is metabolized such that it diverts much of the selenium into a pool that protects against against colon cancer.

Do you prefer taking supplements as opposed to fresh vegetables and fruit? Please share your thoughts on this article in context of your dietery habits.

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Green tea and colon polyps cancer prevention

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Evidence for beneficial effects of green tea continues to grow. Experimental data suggests that green tea is helpful in chemoprevention. Studies in Japanese shows that people who drink greater than 10 cups were day have a decrease in risk of colon cancer.

A recent randomized controlled trial examined the effect of green tea on precancerous colon polyps (adenoma) in patients with history of polyps but cleared on subsequent colonoscopy.

The investigators (Dr. Shimizu and colleagues) used supplemental green tea extract tablets equivalent to increase green tea ingestion from an average of 6 cups (1.5 g green tea extract) daily to 10 cups equivalent (2.5 g green tea extract) by supplemental green tea extract tablets. The controls did not get any supplementation. Follow up colonoscopy was performed after 1 year.

Save 10% on your Slimm Green Tea order by using code "slimm10"

At the end point colonoscopy, colon polyps (adenomas) were detected in 15% of the green tea extract group as compared to 31% in the controls. The size of the adenoma detected in the green tea extract group was also smaller than the ones in controls suggesting that even the polyps detected may have less potential for colorectal cancer. Are you a fan of green tea or for that matter tea? If not, would news like this lead you to increase your intake of green tea?

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Enjoy apple to prevent colon cancer

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Does apple help health or is it a myth? Can it help against cancer? Do apple pectin and juice extract produce anticarcinogens during the fermentation in the colon? The answer seems to be yes.

Dr. Waldecker and colleagues in the journal Nutrition studied the fermentation supernatants from incubation of human fecal slurry with apple pectin and apple juice extracts. The Inhibition of the enzyme histone deacetylase (HDAC) seems to play a central role in these anticancer effects. The authors found that  fecal slurry from fermentations with pectin was rich in butyrate and very active in HDAC inhibition in colon tumor cell lines.

The HDAC-inhibitory potency from pectin-rich fermentations correlated with the butyrate levels. Fecal slurry from fermentations with apple juice extract had lower butyrate yields but similar HDAC inhibition and potentially similar anticarcinogenic effect.

This is how it works: Apple fermentation leads to increase in short chain fatty acids like butyrate. Butyrate is a chemopreventive metabolite that can prevent the occurrence of colorectal cancer. The mechanism is via inhibition of histone deacetylase leading to retarding the carcinogensis, the process of tumor formation.

The authors concluded that apple products exert anticarginogenic effects in the colon.

What are your thoughts about fruit in general and apple in particular? Are you going to go more for fruits or apples in the grocery store? Please share your thoughts.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger. 

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Do antioxidants lower cancer risk

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Antioxidants are frequently in news related to cancer. Experts differ on role of these antioxidants in health and sickness including cancer.

Antioxidants in esoohageal cancer

Antioxidants have been studied in esophageal cancer (cancer of esophagus) which is one of the fastest growing cancers in the US. Antioxidants as part of nutrition is a potentially modifiable factor in cancer. Use of antioxidants has been advocated but studies have been conflicting. Lack of antioxidants in the body has potential to increase risk for cancer through oxidative stress and DNA damage etc.

Dr. Kubo and colleagues from University of Californiain San Fransisco recently conducted a meta-analysis of these studies and recently published their results in the American Journal of Gastroenterology 2007.

These investigators identified 10 studies. Summary estimates suggested that greater ingestion of anti-oxidants like vitamin C, beta-carotene or vitamin A, and vitamin E resulted in lower incidence of esophageal cancer. Individuals ingesting highest levels of beta-carotene/vitamin A or vitamin C had about 50% reduction in risk for cancer of esophagus. Vitamin E intake was however not helpful.

By the way, recent data suggested beneficial effect of beta-carotene in mental health also.

Of note, trials for use of antioxidant supplementation for cancer prevention in general (as opposed to diet rich in antioxidants) have frequently been disappointing and perhaps even increasing risk in some cases.

Do you take anti-oxidants or any other nutritional supplements? What are your thoughts on these supplements? Please feel free to share.

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 Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Is folic acid supplement good or bad ?

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Folic acid or folate supplementation is considered part of alternative medicine.Folate/folic acid is involved in numerous vital biochemical reactions in the body. Multiple studies have documented that folic acid supplementation during pregnancy reduces the risk of neural tube defects.

Folate/folic acid in cancer

Since folate deficiency may contribute to abnormal DNA synthesis, it has been widely believed that folic acid supplementation may help prevent certain cancers. Multiple previous studies including the Nurses Heart Study found beneficial effect of folic acid in colon but not breast cancer.

In contrast to the observational studies, results from a recent randomized controlled trial suggest that folic acid may actually be harmful and increase the risk of colon cancer. Cole and colleagues studied the role of folic acid supplementation in 1021 men and women with a recent history of colorectal adenomas. Repeat colonoscopy was done at 3 years and than 3 or 5 years later.

The authors found that there was an increased risk of cancer/advanced colon lesions in the folic acid group. Interestingly, the investigators also found there was an increased risk of non-colonic cancers, primarily prostate cancer.

Interestingly, Lashner and  colleagues reported (1993) that higher folic acid levels increase risk for colon cancer in patients with ulcerative colitis. Subsequently, the same investigator based on his two other studies suggested that folic acid supplementation probably reduces risk of colon cancer in ulcerative colitis. Folic acid supplementation has been recommended in patients with ulcerative colitis.

In recent years, the wheat flour and other grains have been fortified with folic acid. Interestingly, there has been a concommitant increase in colon cancer during the same period.

Pregnant females and those desiring pregnancy should continue to get folic acid supplementation. Recent data indicates that folic acid supplements are safe in this population. However, the policy of adding folic acid to wheat flour and grains may need to be re-evaluated. At the same time, so as to temper our enthusiasm for denigrating folic acid supplementation altogether, we have another recent study that documents that folic acid supplements reduce risk of stroke by 18 percent.

Do you take vitamin, mineral or other nutritional supplements? What are your thoughts on the literature about folate or folic acid and cancer. Certainly, one size does not fit all!

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Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Black raspberries lower cancer risk

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BLACK RASPBERRIES PREVENT CANCER

 Nutrition especially fruits like black raspberries can impact health including cancer. Yes, black raspberries may prevent cancer.

Mechansim of black raspberries

Black raspberries are a rich natural source of chemopreventive phytochemicals and have been documented to prevent cancer of oral cavity, esophagus and colon in experimental animals.

The potential anti-cancer components of  raspberries include the following:

• Vitamins A, C, E and folic acid
• Calcium
• Selenium, beta and alfa carotene, lutein
• Polyphenols
• Phytosterols

Black raspberry extract prevents esophageal cancer by 40-60% and colon cancer by 60-80% in experimental models of these tumors in rodents.

Ethanol-extract of berries prevents ultra-violet induced skin cancer in mice.

In addition, black raspberries may lower blood cholesterol by up to 15 percent so may help reduce heart disease as well.

 Do you like raspberries? Are you likely to add or increase black raspberries in your diet? Please share your thoughts.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

Does tea make you healthier?

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Black and green tea benefit health and fight disease

Evidence keeps accumulating that drinking tea contributes to reduction in sickness and positive health in many ways. Friedman and colleagues recently published their findings in the Journal of the Agricultural and Food Chemistry and suggested that the beneficial effects are due to polyphenols in the tea.

 

 

Green tea has about 30 and 40 per cent polyphenols. Black tea is basically green tea that has undergone fermentation process. The polyphenol content of black tea varies from 3 to 10 percent. Oolong tea is semi-fermented tea and thus its polyphenol content falls in between green and black tea. 

Both green and black tea have ingredients that fight against a variety of cancer cells including breast, liver, ovarian, prostate cancer.

Drinking tea has been linked to fighting obesity by causing weight loss via several mechanisms.

Several studies have shown that tea protects against Alzheimer's disease.

There is decreased risk of gallstones

Tea protects against liver injury.

Tea fights against food-borne and other pathogenic bacteria, virulent bacterial protein toxins, viruses and fungi.

Do you drink tea often? Will this post alter your beverage drinking habit

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Colon cancer prevention: Another reason to enjoy red wine

Red wine prevents colon cancer

Red wine is popular because of the many health benefits including protecting against heart disease. A new study claims it protects against colon cancer also. This is especially significant since many studies have linked alcohol negatively with colon cancer. Red wine may be an exception to the rule.

This study was presented at the annual meeting of American College of Gastroenterology held in Las Vegas (October 2006). The study was titled, "Lifestyle or resveratrol? Comparison of white and red wine consumption  and colorectal neoplasia" and was presented as Abstract number 920 at the meeting.

Dr. Anderson and colleagues conducted a dietary analysis of 1741 patients undergoing colorectal screening. After controlling for the effect of age and smoking, these investigators found that those who consumed 3 or more glasses of red wine per week were 68% less likely than non-drinkers to be diagnosed with significant colorectal polyps or cancer were. White wine did not have any impact. The authors speculated that the positive impact of red wine might be related to its resveratrol content.

A note of caution: The results of presentation of an abstract at a meeting should be understood with the caveat that the data is preliminary and has not undergone a thorough and rigorous peer-review process. This not withstanding, the results of this study are consistent with results from pre-clinical studies of resveratrol.

Do you enjoy wine, red or white? Do you drink for pleasure or health benefits or both? No matter what, drink responsibly!

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Chronic back pain? Acupuncture helps	Homeopathy benefits fibromyalgia
Are you obese? Bacteria in your gut may be the cause!	When travelling, prevent motion sickness
Breast feeding benefits, alternatives	Yoga improves sex in both sexes
Acupuncture for chronic heartburn?	Folic acid supplement to prevent cancer controversial, Could it be harmful.
Reduce mortality with this vegetarian diet and lose weight too	Does tea make you healthy?

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger.

When is colon cancer screening not worth it?

Colon cancer and rectal cancer screening: timing and benefit

Colorectal cancer is preventable and screening saves lives. How long should this periodic screening or surveillance continue during a person's life is controversial and raises health, economic and societal issues and concerns.

Dr. Cary Gross and colleagues from the Robert Wood Johnson Clinical Scholars Program at the Yale University School of Medicine tackled this controversial and emotional issue and recently published their findings in the journal Annals of Internal Medicine .

Study

Gross et al.  conducted a retrospective cohort study in patients with prior colorectal cancer using population-based cancer registry with linked administrative claims data.

Methodology

They assessed each patient's chronic illnesses based on Medicare claims. Chronic conditions included myocardial infarction, congestive heart failure, peripheral vascular disease, stroke, COPD, dementia, diabetes, renal or liver failure, AIDS etc.

Results

The overall study sample consisted of 35,755 patients. Not surprisingly, they documented that thelife expectancy depended on patient's age and the number of chronic illnesses.

Age versus cancer detection: The investigators found that among men diagnosed with stage I cancer (curable form of cancer) at the age of 67 years, the life expectancy was 19 years for those without significant illnesses; it was 12 years for those with 1 or 2 chronic conditions as compared to 7.6 years among those with 3 or more illnesses. The numbers for females were 2, 16 and 7 years respectively.

At the other extreme,, these investigators found that if same cancer was diagnosed at the age of 81 years with no concurrent medical illness, the life expectancy was 10 and 14 years among men and women respectively.

Conclusions

Coexisting chronic illness results in significant reduction in life expectancy after diagnosis of early-stage colorectal cancer. Further screening among such patients should depend upon the overall health of the patient.

Caveat: These recommendations are controversial since these are based on a retrospective examination of data. Each patient is different and statistical averages may not apply to each and everyone. In addition, we should also partner with the patient and take into account his/her expectations and desired quality of life.

If you are planning on colonoscopy, be sure to follow your doctor's instructions meticulously. Colon needs to be clean for a good colonoscopy exam and the definition of clean colon sometimes lies in the eyes of beholder.

Simple things help too: Lets us not forget that healthy diet such as fruits, vegetables, curry and calcium contribute to lower risk for colon cancer.

Are you above the age of 50 years? Have you had your colorectal cancer screening? Please share your thoughts/experience.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger

Exercise makes radiation therapy easier

Radiation therapy is frequently undertaken as part of treatment of breast cancer. However, these beneficial effects come with a price. Sometimes the side effects can make the therapy intolerable and reuire additional medications to combat the unwanted adverse effects.

A recent study by Dr. Drouin and colleagues published in the journal Cancer  suggests that aerobic exercise during therapy would help make this otherwise toxic treatment more tolerable.

They conducted a randomized controlled trial to study the impact of aerobic exercise twenty sedentary females with breast carcinoma during radiation therapy.

These investigators found that moderate intensity aerobic exercise maintains red blood cell counts and hemoglobin levels better during radiation treatment of breast cancer compared with the declines observed in patients who were not doing moderate level of exercise.

They concluded that exercise is a safe and cost-effective method to improve fitness and maintain hemoglobin levels in women during radiation treatment of breast cancer.

Do you exercise regularly? Do you do it with a trainer, in a group or by yourself?

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger

Grape seed extract helps colon cancer and fatty liver

Grape seed extract for cancer and fatty liver

When we talk about health benefits of grape seed, we usually think about heart. Data indicates grapeseed extract reduces platelet reactivity in humnans and reduces insulin resistence (good for diabetics) in animals. Dose for better glucose regulation in animals is 25 mg/kg/d.

There are studies suggesting they may be good for fatty liver and prevention of colon cancer too.

Effect of grapeseed in colon cancer

Dr. Kaur and colleagues from the University of Colorado Health Sciences Center studied the effect of grape seed extract on the cancer. They conducted in vitro and in vivo experiments in mice. They found that feeding grape seed extract to mice results in inhibition of tumor growth.

The mechanism of action of grape seed extract is thought to be mediated through proanthocyanidins contained in the grape seed extract.

These results emphasize that our diet does influence state of our health and predisposition to sickness. At the same time, decades of poor diet may not get easily reversed. Thus, remember that colonoscopy is an effective tool for prevention of colorectal cancer.

Effect of grapeseed in fatty liver, NASH or NAFLD

In addition to effects against cancer, a double blind study by Koshbaten and colleagues showed that grape seed extract is  helpful in patients with nonalcoholic fatty liver disease or fatty liver seen commonly among obese and diabetic persons.

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger

Fruit or vegetables for stomach cancer prevention?

The role of frequent intake of fruits and vegetables to prevent cancer continues to be a matter of debate. The current study adds to the age-old thinking that fruits and vegetables are good for you!

Dr. Larsson and colleagues from Karolinska Institutet in Stockholm, Sweden studied prospectively this question in over 8000 men and women. They hypothesized that fruit and vegetable intake protects against stomach cancer and published their findings in the journal Cancer Epidemiol Biomarkers and Prev.

They found that vegetable consumption lowered the risk of gastric cancer, whereas fruit intake was not helpful in this regard. Among vegetables, green leafy vegetables and root vegetables lowered the risk of gastric cancer significantly.

I would like to point out that there are studies that have demonstrated fruit intake is better for cancer prevention. Until more data is available, we should have both as part of our daily diet.

How many servings of fruits and vegetables do you eat everyday? Do you just like the taste or eat them for health reasons?

Disclaimer: Everything on this site including the blog and the ads are for your information only. I am not your doctor or pharmacist. Please do your own due diligence and consult your health care professional advisor. Dr. Minocha does not offer any opinion as to the ads on this site. The ads have potential to generate income for the blogger