Sep
21
2019

What Makes Us Sick And What Keeps Us Healthy

By | diet, food, green tea, lifestyle, Nutrition

An article in Nature Communication essentially asks what makes us sick and what keeps us healthy? The publication is about eating enough flavonoids to protect you from heart attacks and cancer.

The publication appeared on Aug. 13, 2019. It is a prospective study involving 56,048 participants of the Danish Diet, Cancer, and Health cohort. The medium age of the participant in the beginning of the study was 56 (range 52 to 60). This was cross-linked with Danish nationwide registries. The observation time was 23 years during which 14,083 participants died. As this study had a high number of participants and had a long observation period, the data are quite robust.

The researchers found that when people consume 500 mg of flavonoids from vegetables and fruit per day, they are dying significantly less from heart attacks and cancers.

Details of the study on flavonoid intake

Flavonoids are polyphenolic compounds in plant-derived foods and beverages such as vegetables, fruit, dark chocolate, coffee, tea, and red wine. There are six major subcategories of flavonoids: flavonols, flavan-3-ols, flavanones, flavones, isoflavones and anthocyanins. But it does not matter, which ones we consume, just that we consume enough (more than 500 mg per day).

The results were obtained with much stratification. For instance, in one set of results they normalized for age and sex. They called this model1. In another set they adjusted for age, sex, BMI, smoking status, physical activity, alcohol intake, hypertension, hypercholesterolemia, social economic status (income), diabetes, and prevalent disease. They called this model 2.

Participants with 536 mg of daily flavonoid intake had a reduction of 39% of heart attacks according to model 1. Using model 2 this changed to a reduction of 18% of heart attacks.

Cancer mortality reduction

The investigators did a similar analysis for cancer mortality reductions. At 536 mg of daily flavonoid intake model 1 showed a 36% reduction of cancer mortality. Model 2 still calculated a 21% reduction of cancer mortality. In both cases, the cardiovascular mortality risk and the cancer risk showed that more than 500 mg of flavonoids per day were not necessary as no more lives were saved by increasing the flavonoid dose beyond that. Unfortunately the opposite is true: people eat too many processed foods devoid of flavonoids, and they die of heart attacks and cancer prematurely.

Reducing the risk of heart attacks and cancer is not new

Many studies have shown what researchers found in this study, namely that vegetables and fruit can prevent heart attacks and cancer. Here is a brief summary with links to show this.

We heard many times that small amounts of alcohol consumption will keep the arteries clear of fatty deposits. This prevents heart attacks and strokes, but as the following study shows even small amounts of alcohol can cause various cancers.

Small doses of alcohol are still cancer producing

Dr. Timothy S. Naimi from Boston University Medical Center was the main investigator of an international team of scientists. The study found that every year 18,200 to 21,300 cancer deaths in the US (that is 3.2% to 3.7% of all US cancer deaths) are due to alcohol consumption. The authors of the study determined that every person who dies from alcohol related causes lost on average approximately 18 years of his/her life (scientists call this “years of potential life lost”).  51% of women developed breast cancer from alcohol exposure, 62% of men came down with upper airway and esophageal cancers. Less than 1.5 drinks per day caused between 26% and 35% of alcohol-related cancer deaths. There was no safe lower margin. The authors concluded, “Reducing alcohol consumption is an important and underemphasized cancer prevention strategy”.

Lifestyle important for longer life expectancy

I am reminded of a talk that Dr. David Katz delivered in a keynote address. He said that lifestyle improvements create profound changes in our system. This talk took place at the 22nd Annual World Congress on Anti-Aging Medicine in Las Vegas Dec. 10-14, 2014. One study that was mentioned showed that in men who adopted a healthy lifestyle 35% of heart attacks could be prevented. With healthy lifestyle the authors meant consuming a healthy diet, not exceeding moderate alcohol consumption, no smoking, regular physical activity and having a normal waist circumference (less than 95 cm).

The ingredients you need to make it to age 100

A Swedish longevity study that went on for 50 years gave me the idea to write a blog about the factors that can help you to turn 100 and still have your mental capacity and good health.Let me introduce you to this study. Researchers at the Sahlgrenska Academy in Göteborg, Sweden (which is located at the University of Gothenburg) decided back in 1963 to follow a group of 855 Gothenburg men born in 1913 until they would either die or turn 100. The idea was to find out what killer diseases are in the way to reach such a ripe old age and if they would survive, what was it that made them reach this age. Think of it as a race to turn 100.

What diseases killed at older age and what led to longevity?

The researchers had checkpoints along that journey: various surveys were conducted at the age of 54, 60, 65, 75, 80 and 100 to analyze the factors that lead to longevity. 27% (232) of the original group reached the age of 80, and 13% (111) made it to 90. Only 1.1% of the men made it to the age of 100. What were the causes of death for the other ones who did not make it? 42% of deaths after the age of 80 were due to heart attacks, 20% due to infectious diseases, 8% due to strokes, 8% due to cancer, 6% due to pneumonia and 16% due to other causes. 23% of the men over 80 were diagnosed with Alzheimer’s or dementia. Factors that made people survive were refraining from smoking, maintaining a healthy cholesterol level and limiting coffee consumption to not more than 4 cups per day.

Beneficial effects of green tea and black tea

A meta-analysis involving 194,965 people and 4378 strokes found that there was a reduction of strokes with increasing tea consumption. Those who drank 3 or 4 cups of green tea or black tea per day were the experimental group. Researchers compared them to the control group that drank less than one cup of tea per day. The experimental group had a 21% lower risk of getting a stroke than the control group.

A meta-analysis of 18 studies from China showed that green tea and black tea consumption was beneficial for prevention of cardiovascular disease and for cancer prevention. The highest consumption of green tea reduced cardiovascular mortality (heart attacks and strokes) by 33%. The highest black tea consumption lowered mortality by 12%. Cancer mortality turned out different. Green tea did not produce a reduction in mortality, but black tea lowered it by 21%. I suspect that the different subcomponents of the bioflavonoid content in green and black tea are key to those findings.

Plant-based diet versus animal protein based diet

A 2016 study that had gone on for 49 years was involving 131,342 participants. Animal protein intake showed an association with higher mortality from heart attacks and strokes. The investigators substituted 3% of energy from processed red meat by an equivalent amount of plant protein. This reduced the all-cause mortality by 34%. For unprocessed red meat the 3% substitution reduced the all-cause mortality by 12%. If 3% of egg consumption is reduced, all cause mortality drops by 19%.

British Medical Journal study

A new study has shown that you can save lives when you replace red meat and processed red meat. The replacement was with fish, poultry or protein from vegetables. The study appeared in the British Medical Journal on June 12, 2019. It involved 53,553 women nurses and 27,916 male doctors in the United States and ran from 1986 to 2010. Here is my summary of the blog where I reviewed this study in detail. A new study in the British Medical Journal showed that an increase in red meat consumption of only ½ serving per day for 8 years caused an increased mortality of 9% over the following 8 years. With regard to processed red meat the mortality was even bigger, namely 13%. The researchers replaced some of the meat with white chicken meat or vegetables and the mortality normalized.

In contrast, a Japanese study showed that there was no increase in cardiovascular disease with the consumption of up to 100 grams of beef or other meat products per week. The study went on for 16 years.

Using antibiotics as growth promoters is illegal in Japan and Europe

I pointed out before that there is literature explaining why there is a discrepancy: the beef industry in the US feeds the animals antibiotics as growth promoters. This changes the bowel flora in humans who eat the beef. The changed bacterial strains in the gut use carnitine from beef and make trimethylamine N-oxide (TMAO). This is a toxin that causes both cardiovascular disease and cancer. This explains why in the US beef is one of the culprits that cause heart attacks and colorectal cancer. In Japan this is not the case. Both Japan and Europe do not use antibiotics as growth promoters in the cattle industry, as it is illegal.

In the US it is likely safe to eat organic meats (beef, chicken) as these meats will not contain antibiotics. Due to the numerous additives in processed red meat, it is a sensible idea to skip these products altogether, as they produce cancer.

What Makes Us Sick And What Keeps Us Healthy

What Makes Us Sick And What Keeps Us Healthy

Conclusion

Several studies have pointed out the importance of eating less animal protein and increasing vegetables and fruit in your diet. Heart attacks, strokes and cancers are still the major causes of death in all of the developed countries. The Danish study mentioned in the beginning showed that keeping the daily intake of bioflavonoids at 500 mg or more prevented 18% to 39% of heart attack mortality and 21% to 36% of cancer mortality.

In other studies we learnt that deaths between the ages of 80 and 100 were mainly due to heart attacks, strokes and cancer (these accounted for 58% of deaths). Only 1.1% of the men in that Swedish study made it to the age of 100.

More evidence that flavonoids and plant protein save lives

Another study measured the effect of green and black tea consumption: There was a 21% reduction of strokes with green or black tea consumption.

Another study found reduced cardiovascular mortality by 33%. Green tea reduced cancer mortality by 21%.

Another study showed that when plant protein replaced red meat there was an astounding drop of the all-cause mortality by 34%.

All of these studies show that you must eat enough flavonoids to protect yourself from heart attacks and cancer. Of course you also need to engage in a regular physical exercise program to stay fit and healthy.

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May
21
2014

Forty Percent Of Premature Deaths Can Be Prevented

By | Cancer, Diabetes, Fitness, Health, heart attack, Heart Disease, High Blood Pressure, Lung Disease, Nutrition, Obesity, Prevention, Stroke, Vitamins and supplements

A new report from the CDC (Center of Disease Control) in the US has revealed that up to 40% of premature deaths could be prevented by simple lifestyle changes. As this link shows every year about 900,000 premature deaths occur in the US, which are due to 5 major diseases that in the opinion of the CDC can be prevented by 20 to 40%. Here are the diseases that kill: cancer, heart disease, COPD/emphysema, stroke and accidents/injuries. These conditions were responsible for 63% of all deaths in the US in 2010.

Let’s discuss each of these conditions and how one could lower the risk of dying from them.

1. Cancer:

The Framingham Heart Study has shown that smoking and cancer are closely related. Smokers who quit can significantly reduce their risk of getting cancer. We also know that exercise and prophylactic supplements like fish oil and vitamin D3 have cancer preventative effects.

Antioxidant supplementation that included beta-carotene, vitamin A, vitamin C, and vitamin E daily or on alternate days for 1 to 12 years, along with selenium supplementation reduced the incidence of cancer of the esophagus, colon, pancreas, stomach or the liver. Insulin resistance due to sugar and starch overconsumption is causing cancer, particularly breast cancer, colorectal cancer and endometrial cancer. I have discussed this in a recent blog.

Pollution has been linked to increased lung cancer risks as discussed here.

2. Heart disease:

Heart disease can be caused by several factors in combination. Lifestyle issues are important: Smokers need to quit smoking as the Framingham Heart Study has shown more than fifty years ago that smoking causes heart attacks. Obesity and diabetes also contribute significantly to the risk of heart disease. Often these are connected to faulty nutrition, which is another lifestyle issue that comes to mind when too much sugar and starchy foods are taken in; your liver will convert these into fatty acids, triglycerides and elevated, oxidized LDL cholesterol, which gets deposited under the lining of the arteries. A lack of exercise adds to this problem as a lack of exercise lowers the protective HDL cholesterol and fat is deposited under the lining of the arteries. Start exercising and your protective HDL cholesterol will rise, your total cholesterol to HDL ratio will lower to healthier levels and your risk for hardening of the arteries and for getting a heart attack will fall. If you have diabetes, it is important that you manage your blood sugars well; this means that if you inject insulin, you want the blood sugar tests to be within the normal range and the hemoglobin A1C values to be below 5.5%. Poorly controlled diabetes is an important cause of heart attacks and strokes. High blood pressure is also an important cause of developing heart attacks and strokes. It is important to control your blood pressure by taking blood pressure lowering pills and also by exercising regularly. Exercise seems to send a signal to relax the blood vessels thus lowering the blood pressure, which in turn prevents heart attacks.

Forty Percent Of Premature Deaths Can Be Prevented

Forty Percent Of Premature Deaths Can Be Prevented

 

3. COPD/emphysema:

Chronic obstructive pulmonary disease (COPD) or emphysema is mostly caused by chronic exposure to cigarette smoke from smoking. The earlier you can quit, the better your chances that your breathing will not be the limiting factor when you age. But it is also important to avoid exposure to other noxious gases, such as from welding and from exposure to pollution. This may involve a decision to move to a less polluted area. Or it might involve a job retraining. Those who are suffering from COPD can be helped to a certain extent by a portable oxygen tank with nasal prongs.

4. Stroke:

As mentioned before, quitting smoking, controlling high blood pressure and controlling blood sugar, if you suffer from diabetes have been shown to stabilize your blood vessels including the ones that supply your brain. The key is to prevent hardening of the arteries by a healthy lifestyle. Exercising and keeping your weight under a body mass index of 25.0 have been shown to be effective stroke prevention. Healthy nutrition as indicated above under “heart disease” is equally important for stroke prevention. Go green (eat more vegetables, consume more green smoothies), cut down grains, sugar and starchy foods and you will live longer without strokes and heart attacks. Remember, what’s good for your heart is good for your brain!

5. Unintentional accidents/injuries:

Wearing helmets when bicycling, wearing seat belts when driving in a car, avoiding risky behaviors are all measures that save lives. One factor stands out in all of this: if you drink too much, you run the risk of being involved in unintentional accidents or injuries. People may not like to hear this, but your brain lacks the natural inhibitory impulses when you are under the influence of alcohol, so you become more daring and you may not pay attention for the split second that could have prevented an injury or accident. People react very differently to alcohol. Some people feel inebriated after only ½ a glass of wine or beer whereas others can drink more before they make mistakes. The best is to be sober when you drive, ski, use power tools or walk in traffic. Even climbing ladders requires a clear mind!

Conclusion:

As the CDC said 20 to 40% of premature deaths (deaths that occurred before the age of 80) could have been prevented, if the above-mentioned recommendations were followed. Let me rephrase this: 180,000 to 360,000 premature deaths every year in the US before the age of 80 could have been prevented! Curative medicine cannot help with these statistics as a heart attack or stroke has happened when it has struck you. Cancer and end stage lung disease are similar conditions that you are suddenly faced with when they occur and unintentional accidents just seem to happen. This is where the importance of prevention can be seen, because these little baby steps every day are adding up to something formidable, a force to be reckoned with. Be part of the solution, think prevention!

More information on:

1. Cancer mortality: http://nethealthbook.com/cancer-overview/overview/cancer-mortality-rate/

2. Higher vitamin D3 intake lowers mortality from heart attacks, strokes, cancer, fractures due to osteoporosis: http://nethealthbook.com/news/higher-vitamin-d-levels-associated-lower-risk-mortality/

Last edited Nov. 8, 2014

Mar
10
2013

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

By | Cancer, Gastrointestinal Disease, Health, Men's Health, Prevention, Women’s Diseases

Introduction

March is colorectal cancer awareness month, so let’s discuss prevention. Only 40 years ago cancer of the cervix was one of the major killers for women, but with the introduction of the Pap test this has all changed.  For those women who get that screening done, there is no need for fear. The mortality rate from cervical cancer since the 1970’s has steadily decreased as shown in this link.

As far as cancer of the prostate is concerned, a lot of progress with regard to early detection has been made due to the introduction of the PSA blood test, which is used as a method of screening. As a result men are diagnosed earlier with prostate cancer resulting in more cures as the cancer found is at an earlier stage. Here is a link depicting the effect of the PSA test on mortality rates from prostate cancer in time.

March is colorectal cancer awareness month, so let’s discuss prevention

March is colorectal cancer awareness month as this article explains. The key is early detection and treatment as with any type of cancer. Specifically, with rectal and colon cancer there are mostly no symptoms, as blood in stool or any other symptoms occur only late into the disease. What we do know, however, is that there is a long latent phase where precancerous mucous membrane changes lead to polyps and these will degenerate in time into cancer of the colon or rectum.

Not everyone has the same risk of developing colon cancer or rectal cancer.  There are people with a higher rate of colorectal cancer, as they carry a susceptibility gene in their families. A healthy lifestyle can also reduce the risk of colorectal cancer.

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

March Is Colorectal Cancer Awareness Month, So Let’s Discuss Prevention

Polyps are the precancerous precursors for colorectal cancer

It is now widely accepted that polyps are the precancerous precursors for colorectal cancer and colonoscopies done on everybody starting at age 50 (those with family risk factors much earlier) have already been shown to have decreased the frequency of the disease as the data from the CDC show. The problem is that the survival curves for colorectal cancer have only a swallow incline. A steeper decline would mean better survival of colorectal cancer patients. In the case of the mortality rates of cervical cancer and prostate cancer the slope showed a more rapid decline translating int much better survival rates.

Not enough colonoscopies are done

The incidence of colon cancer should have gone down to almost the zero point. All that has been achieved so far is a reduction of a portion of cases (those who went for colonoscopies early enough before it turned into colon cancer); this is by far not an elimination of colorectal cancer. The reason for this is the fact that in many cases people have colonoscopies too late when the polyp has already turned cancerous, or invasive colon or rectal cancer is already present at the time of the first colonoscopy.

Designating March as colorectal awareness month makes a lot of sense to me

I happen to come from a family where my mother died in 1980 from colon cancer at the age of 59. Because of this my doctor told me that I have a risk of about 3-fold higher than the population at large to also develop colon cancer. I have had colonoscopies since the age of 40 every 3 years. Ironically a few days ago right during the colorectal awareness month, I was getting my 9th colonoscopy. On three occasions polyps were removed, which tells me that the cancer-screening program works!

Why screen for colon cancer in regular intervals?

So why is it important to screen in regular intervals? One reason is that we are now exposed to more toxic chemicals in our environment and food than 100 years ago. So all cancers, but especially colorectal cancer rates have increased. We know the pathophysiology, which is the science that studies how an illness develops. We know that it takes several years between the occurrence of the first precancerous cells that form in the lining of the gut (called “mucosa”) and the formation of polyps. It takes another few years before polyps turn cancerous. This means that there is enough of a time interval to do screening. If we are not aware of this and ignore it (as unfortunately many people do), the process will run down the conveyor belt on an automatic program, which ends up in end stage colorectal cancer. The stages of colon cancer are depicted in this link.

Invasive colon cancer is deadly

As the table of my chapter on colon cancer staging shows, the invasive end stage colon cancer (stage IV or Duke D) has a 5-year survival rate of only 6%. Even when the cancer is limited to stage II (also called Duke stage B) there would be a 5-year survival of only 80% (see table in link).

What does screening really achieve? On an individual basis the gastroenterologist who does the colonoscopy can screen the whole colon for premalignant polyps and remove them during the procedure. This moves the potential cancer staging backwards to beyond any detectable cancer, as all of the potential early cancer cells would have been inside the polyp (called local “in situ” disease) and were removed by cauterizing the stalk (see above link). There is another potential factor that can help to reduce colorectal cancer incidence: Recently a connection was made between

Helicobacter pylori as a risk factor for colorectal cancer

Helicobacter pylori (H. pylori) infection of the stomach and polyps in the colon as well as colon cancer. In the past several smaller studies failed to show this correlation. It took 156,269 patients in this study to show that there was a correlation. As H. pylori is being tested for and treated more and more, this will also have a positive effect on lowering the frequency of colorectal cancer.

Mass colonoscopy screening

On a population basis with mass colonoscopy screening the incidence of colorectal cancer is reduced. The reduction of colon cancer would be much faster. Eventually it would turn into a disease similar to cancer of the cervix. Here it still matters whether you screen or not, but very few people have to suffer from it. Here is an image from a paper (look for Fig. 2, halfway down the page). It shows that survival benefits (longer lives) are registered only after 10 years or more following colonoscopy.

Colorectal cancer statistics

Every polyp that is removed will add up to the colon and rectum health of the nation at large. This shows statistically, when you sum up all of the colonoscopies done around the country year after year.  We need a nationwide and worldwide awareness that colorectal cancer screening is something worthwhile doing. This cancer is the third most frequent cancer in many parts of the world.

I am grateful that colonoscopy screening works, as I had polyps removed three times over a 29 year span and I did not have to go through all the surgical procedures that my mother had to endure. Had I lived 50 years earlier I may not have lived long enough to tell you how important colonoscopy screening is.

Here are the recommendations

      1. Let us assume there is no risk of colorectal cancer in your family. In this case screen once at the age of 50. This makes sure you are not one of the spontaneous colorectal polyp producers. If OK, screen every 10 years provided the colonoscopy is always negative.
      2. A family history of direct bloodline relative increases the risk for colorectal cancer. Direct bloodline relatives are: mother, father, brother or sister. If one of them had cancer of the colon or rectum, you have a higher cancer risk. In these individuals a gastroenterologist must do colonoscopies every 3 years.
Missed polyps during a colonoscopy
      1. There may be up to 15% of missed polyps during a colonoscopy. But with the next colonoscopy there is a high likelihood that the physician catches the abnormal polyp in time. The pathologist confirms that the subsequent screening caught them before they turn cancerous.
      2. There are special cases, families with genetic syndromes like the familial polyposis of the colon. In these families a gastroenterologist needs to screen children/young adults for polyps when they are still young. This is from the age of 20 to 25 years onwards.

Don’t complain, if you belong to category 1 or 2 as it could be much worse (category 3). Cancer is serious business. Remember, March is colorectal cancer awareness month.

More information about colon cancer.

Mar
01
2006

Dementia Prevented With Diet And Exercise

By | Alzheimer’s disease, Nutrition

According to an Australian review a low-fat diet along with physical and mental activity is the best way to avoid dementia late in life.
The Australian team looked at numerous studies and concluded that many drugs and supplements promoted as treatments do not work. They did find that maintaining healthy blood pressure levels and an ideal body weight, staying physically and mentally active and consuming a low-fat diet reduces the risk of developing dementia. Dr. Michael Woodward, lead researcher of the report “Dementia: Can It Be Prevented?” states a very simple fact: any advice that is good for the heart is also good for the brain. A number of dietary supplements and medications have been suggested as being useful in the prevention of dementia, but none of them have been conclusive. One small study from Portugal suggested that even coffee could prevent dementia. It made headlines in the media, especially in the American press. However this was a small study involving only 54 people in Portugal. Another study a few years ago claimed that hormone replacement therapy for menopausal women reduced the risk of dementia. Again, this study got a lot of coverage. The study had a strong selection bias: these women were generally more health conscious, in better physical health and from a more socioeconomically privileged background.

The results of this review are further confirmed by Australian and American researchers led by Dr. Ralph Martins of the Center for Aging and Alzheimer’s disease in Joondalup, Australia and Dr. Samuel Gandy of the Farber Institute of Neurosciences in Philadelphia. They found that overweight and obese people are having a higher risk of developing Alzheimer’s disease than normal weight individuals. Increased body mass index and higher levels of plasma amyloid-beta, which is a key substance in the development of Alzheimer’s, go hand in hand.

Dementia Prevented With Diet And Exercise

Dementia Prevented With Diet And Exercise

Experts in the area of dementia caution that we cannot count on drugs and supplements, instead prevention is the key with dementia, which comes in the form of a healthy lifestyle.

More info about:

1. Research that has revealed a number of causes for Alzheimer’s disease: http://nethealthbook.com/neurology-neurological-disease/alzheimers-dementia-and-delirium/alzheimers-research/

2. Fitness:  http://nethealthbook.com/health-nutrition-and-fitness/fitness/

The Medical Post, January 24,2006,page 39.

3. Blog showing that exercise delays onset of Alzheimer’s: https://www.askdrray.com/regular-exercise-will-delay-onset-of-alzheimers-or-dementia/

Last edited October 30, 2014