Eat More Fish and Less Meat Lower CHD risk

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A new study indicated shifting dietary protein sources aware from red meat to more poultry, fish, and nuts can reduce an individuals’ risk of coronary heart disease. 

The results came from the Nurses’ Health Study, which followed 84,000 women, aged 30 to 55 years for 26 years.  Their results were published online August 16, 2010 in Circulation.  

During the 26 years of follow-up, the consumption of red meat and high-fat dairy were significantly associated with an increased risk of coronary heart disease, whereas higher intakes of poultry, fish, and nuts were significantly associated with lower risk. 

For example, replacing one serving per day of red meat with one serving per day of nuts reduced the risk of coronary disease by 30%.  Similar benefits were also seen in eating more fish, poultry and low-fat dairy.  The corresponding coronary disease risk reductions were 24%, 19% and 13% respectively. 

The authors believed that the increase in systolic blood pressure due to iron, the high sodium content of processed meats, and the compounds created by cooking red meat, such as heterocyclic amines and advanced glycaion end products might all contribute to the increase cardiovascular risk.  In some previous studies, iron has been positively associated with MI and fatal coronary disease. 

Source: Circulation 2010; DOI:10.116/circulationaha.109.915165.

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Home Monitoring of INR is Equal to Clinic Care

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For patients who are taking warfarin and need to check their INR every month at the clinics, the result of the following study might be a good news for them. 

A newly published article that suggests weekly self-testing of INR levels is equal, but not superior to monthly high-quality clinic testing in delaying the time to first stroke, major bleeding episode or death in patients taking warfarin.  The result was published in the latest issue of New England Journal of Medicine. 

The study, The Home INR Study (THINRS) included 2,922 patients who took warfarin because of mechanical heart valves or atrial fibrillation and who were trained in self-testing of INR.  They were randomized to either weekly self-testing at home or monthly high-quality testing in a clinic. 

After a follow-up for two to 4.75 years, both groups had similar rates of the primary end point.  The self-testing group has more minor bleeding episodes, but was better than the clinic testing group in achieving greater patient satisfaction and maintaining the INR within the target range. 

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Statin Might Reduce Colorectal Cancer

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Currently, the strategies to look for colon cancer are to detect it early using colonoscopy and fecal occult blood testing.  The ultimate goal to prevent this disease is to use chemoprevention. 

Last month, a presentation at the American College of Gastroenterology 2010 Annual Scientific Meeting and postgraduate course, showed a significant stain users have a lower risk of developing colon and rectal cancer. 

The presentation was based on a meta-analysis of 22 studies involving more than 2.5 million participants who have used statin drugs.  The results indicated that statin can lower the risk of developing colorectal cancer by 12%.   

Furthermore, the benefits of statin were greatest among patients with Crohn’s and ulcerative colitis.  In those patients, patients who used statin had a 70% reduction in their colon cancer risk compared with patients who didn’t use those drugs. 

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20-Year Study: Aspirin Reduces Colon Cancer Incidence and Mortality

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Use of low-dose aspirin was found to reduce long-term incidence of and mortality related to colorectal cancer, according to a study published in the October 21 issue of Lancet. 

Particularly, the benefit was greatest for cancers of the proximal colon, which are not prevented effectively by screening with sigmoidoscopy or colonoscopy. 

The results were based on the analysis of 20-year data from 14,033 Swedish and British patients who participated in randomized trials (Thrombosis Prevention Trial, British Doctors Aspirin Trial, Swedish Aspirin Low Dose Trial, UK-TIA Aspirin Trial and Dutch TIA Aspirin Trial) that were originally designed to evaluate the effect of low-dose aspirin in preventing vascular disease. 

Patients who used aspirin for an average of 6 years experienced a 24% reduction in the 20-year risk for colon cancer and a 35% reduction in the mortality from colon cancer.  The effect was greatest in the reduction of cancer of the proximal colon (55% reduction) and the related mortality (66% reduction).  There was, however, no reduction in the risk of rectal cancer.  

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Soy Intake Lowers Recurrence of Hormone-Sensitive Breast Cancers

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The intake of soy isoflavones among women with breast cancer has become a public health concern since these compounds have been found to have weak estrogenic effects.  

A study published in the Canadian Medical Association Journal, however, suggested soy intake could prevent the recurrence of hormone-sensitive breast cancer. 

The investigators evaluated associations between dietary intake of soy isoflavones and breast cancer recurrence and mortality among 524 patients who underwent surgery for breast cancer between August 2002 and July 2003 and who were receiving adjuvant endocrine therapy. 

After a median follow-up of 5.1 years, postmenopausal patients who had the highest intake of soy isoflavone had 33% lower risk of recurrence than those in the lowest intake. 

This study indicated that high dietary intake of soy isoflavones was associated with lower risk of recurrence among postmenopausal patients with breast cancer positive for estrogen and progesterone receptor and those who were receiving anastrozole as endocrine therapy.  

The results of this study might have implication on future recommendation of the intake of soy isoflavones in conjunction with endocrine therapy. 

Source: CMAJ. Published online October 18, 2010. 

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Aspirin Reduces Mortality in Prostate Cancer

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In the Chinese Medicine, the cause of cancer is thought to be associated with the dysfunction of the coagulation system.  

Now, a study presented at the 52nd Annual Meeting of the American Society for Radiation Oncology (ASTRO) has confirmed this theory.  The results of the study indicated that antioagulant use in prostate cancer patients lowered prostate cancer mortality by more than 50%. 

The study cohort consisted of 5,295 men with localized adenocarcinoma of the prostate who underwent treatment with either radical prostatectomy (n = 3,523) or radiotherapy (n = 1772).   

Within this group, 37% (1,982 patients) received either warfarin (n = 428), clopidogrel (n = 287), enoxaparin (n = 26), aspirin (n = 1649), or a combination (n = 408) at the time of enrollment or during the follow-up period. 

After a median follow-up of 59 months (~5 years), prostate cancer mortality was significantly lower in patients who used anticoagulants than in nonusers (1% vs. 4% at 7 years and 4% vs. 10% at 10 years; P<.01). 

Further analysis by anticoagulant type indicated that the observed benefit was primarily due to the aspirin use.

Source: American Society for Radiation Oncology (ASTRO) 52nd Annual Meeting: Abstract 270. To be presented November 3, 2010.

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Heavy Smoking in Midlife Increase the Risk of Dementia, Alzheimer’s Disease and Vascular Dementia

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A new study published in the October 25, 2010 issue of the Arch intern Med indicated that smoking in midlife hasten the loss of memory. 

Researchers analyzed data from 21,123 members of a health care system who participated in a behavior survey between 1978 and 1985.  The survey recorded the incidence and the frequency of smoking.  

These individuals were followed for 30 years and data on the diagnosis of dementia, Alzheimer’s disease or vascular dementia were collected.  

Researchers then performed statistical analysis to identify the relationship between smoking and risk of dementia, Alzheimer’s disease and vascular disease. 

Compared with non-smokers, those smoking more than 2 packs a day were 2 times more likely to develop Alzheimer’s disease, vascular disease and dementia. 

If you like to enjoy your retirement with your memory intact, you should avoid smoking or consider quitting smoking when you are young. 

Source: Arch Intern Med. October 25, 2010 

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FDA approves New Antibiotic for Pneumonia and Skin Infections

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The US Food and Drug Administration (FDA) approves a new injectable antibiotic, ceftaroline fosamil (Teflaro; Forest Laboratories), for treating community-acquired bacterial pneumonia (CABP) and acute bacterial skin and skin-structure infections (ABSSSI), including the methicillin-resistant Staphylococcus aureus (MRSA). 

Ceftaroline is a cephalosporin, which kills the bacteria by interfering with their cell walls. 

The drug’s approval comes at a time when bacteria strains such as MRSA have gained resistance to existing antibiotics, leading to higher morbidity and mortality. 

MRSA, a common pathogen in ABSSSI and CABP, has become resistant to not only methicillin, but also to more common antibiotics such as amoxicillin and penicillin. 

Common adverse effects associate with the new antibiotic include diarrhea, nausea, and rash. Patients who are allergic to cephalosporin antibiotics should not take this drug. 

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Lack of Sleep Compromises Weight Loss Efforts

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If you are trying to lose weight, make sure you get enough sleep.  A study published in the October 5 issue of the Annals of Internal Medicine indicated that lack of sleep thwarted the efficacy of dieting to lose weight. 

In this study, researchers randomized 10 overweight, nonsmoking adults (3 women, 7 men) with body mass index ranging from 25 to 32 kg/m2 to 14 days of dieting and 8.5 hours of nighttime sleep and then to a similar period of dieting but only 5.5 hours of nighttime sleep. 

The study found that the reduced sleep decreased the proportion of weight lost as fat by 55%. Subjects who slept 8.5 hours per night lost a mean weight of 1.4 kg, compared with those who slept only 5.5 hours per night lost a mean of only 0.6 kg (P = .043). 

They also found less sleep time resulted in increased hunger and higher acylated ghrelin concentrations but lower resting metabolic rate. 

Ghrelin is a hormone that has been shown to reduce energy expenditure, stimulate hunger and food intake, promote retention of fat, and increase glucose production in the body.  The increase in ghrelin level helps to explain why sleep-deprived participants also reported feeling hungrier during the study. 

Source: Ann Intern Med. 2010;153:435-441, 475-476.

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How to Prevent Your Brain from Getting Old?

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Walking at least 6 miles per week appears to maintain brain volume and preserve memory in old age, according to new research. 

The results were reported in the October 13 online issue of Neurology. 

In the study, 299 dementia-free people (mean age, 78 years) from the Cardiovascular Health Cognition Study were assessed for physical activity, as measured by the number of blocks they walked in 1 week. 

Nine years after the physical activity assessment, magnetic resonance imaging (MRI) scans were used to measure brain size. Four years later, the participants were tested for cognitive impairment and dementia. 

Participants who walked at least 72 blocks — approximately 6 to 9 miles — per week had more gray matter (which control your cognitive function) than people who walked less.  However, walking more than 72 blocks did not appear to increase gray matter volume any further. 

Furthermore, participants who had greater gray matter volume and exercised had a 2-fold reduced risk for cognitive impairment. 

The study indicated that there is a relation between the amount of walking earlier in life and brain volume in later adulthood and that greater volume of tissue related to walking are associated with a reduced risk of cognitive impairment. 

Source: Neurology. 2010;75:1415-1422. 

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