Exercise and Tea Consumption Might Prevent Depression among Breast Cancer Survivors

Posted on February 21, 2010 by wngai
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A study, published in the latest February issue of the Journal of Clinical Oncology suggested regular exercise and tea consumption might prevent depression in breast cancer patients. Tea set

The study was conducted between 2002 and 2006 in 1,399 women who had been diagnosed with stage 0 to III breast cancer in Shanghai, China.  Investigators collected lifestyle, clinical and sociodemographic information at 6 months and measured depression symptoms at 18 months after the diagnosis.

The study found that women who exercised regularly were 44% less likely to develop clinical depression than non-exercisers.  Also, regular tea consumption (>100 g dried tea leaves/mo) lowered risk of depression by 61%.

Since depression is a prognostic factor for breast cancer survivor, regular exercise and tea consumption might extend survival in patients with this disease.  However, a proper, well-designed clinical trial is required to confirm this hypothesis.

Chen et. al.  J Clin Oncol 28:991-998. 2010
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Aspirin Reduced Risk of Breast Cancer Metastasis and Death in Half

Posted on February 19, 2010 by wngai
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Following the findings on the effect of aspirin on colorectal cancer, researchers discovered aspirin can also reduce cancer recurrence and death in breast cancer patients.

Investigators evaluated the data from the Nurses’ Health Study, which included 4,164 female nurses aged 30 to 55 who were diagnosed with stage I, II or III breast cancer between 1976 and 2002 and were followed through June 2006.

Findings: they found that cancer patients who took aspirin two to seven days a week had their risks of cancer coming back or death from the disease reduced by nearly 50%.

Also, patients who took non-aspirin non-steroidal inflammatory drugs (NSAIDs) six or seven days a week also experienced a reduction in metastasis or death while those who took NSAIDS less frequently and those who used acetaminophen (TYLENOL) did no experience such benefits.

Investigators, however, did not recommend all breast cancer patients to start taking aspirin, since this is the first study and aspirin is known to cause stomach bleeding.  Patients should talk to their doctors before taking aspirin.

Reference: Journal of Clinical Oncology

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Does Aspirin Help to Treat Colorectal Cancer?

Posted on February 19, 2010 by wngai
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Taking aspirin regularly may help to improve survival in some colorectal cancer, a study reported in the August issue of JAMA.

The study was based on 12 years of follow-up data on 1,279 colorectal cancer patients enrolled in 2 prospective studies, the Nurses’ health Study (NHS) and the Health Professionals Follow-up Study (HPFS).

Findings: stage I, II or III colorectal cancer patients who took aspirin regularly were 29% less likely to die from the disease and 21% less likely to die overall.  The benefit was greater among patients who did not aspirin before and had tumor expressing COX-2, an enzyme that is associated with inflammation and cell growth.

The American Cancer Society, however, does not recommend all cancer patients to take aspirin since the benefits of aspirin might be offset by the gastrointestinal bleeding.

The best way to prevent colorectal cancer is to get routine tests.  People with no risk factors for colorectal cancer should begin regular screening at age 50.  Those who have family history or at risk of developing colorectal cancer (i.e. inflammatory bowel disease) should start screening at younger age.

Reference: JAMA. 2009;302(6):649-658.

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Short Night Sleeping and Day Napping Increase Risk of Diabetes in Older Adults

Posted on February 18, 2010 by wngai
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Less night time sleeping and napping during daytime are associated with an increased risk of developing diabetes in older adults.  The findings are based on the result of the National Institutes of Health (NIH)-AARP Diet and Health Study which involved 174,542 participants.

Researchers compared the hours of day napping and night sleeping, collected between 1996 and 1997, to diabetes cases diagnosed between 2000 and 2006.

The investigator discovered that short night sleeping or long day napping were associated with a higher risk of diabetes.  The researchers suggested changing napping habit may change the association between sleep duration and diabetes.

Gray bricks wallXu O. et.al. Diabetes Care (01/10) Vol. 33, No. 1, P. 78

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Health Tip on Breast-Feeding With Diabetes

Posted on February 18, 2010 by wngai
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The American Diabetes Association (ADA) recommended women with diabetes must regularly monitor their blood glucose levels after pregnancy as their system adapt to postpartum hormonal shifts, erratic sleep, and other everyday routine changes.

For breast-feeding mothers, the ADA also recommended the following:

  • Nurse after or while eating something
  • Drink lots of fluids every day
  • Avoid caffeinated drinks while breast-feeding
  • Keep something at hand to boost low blood sugar, so the baby is not interrupted if your blood sugar drops too low
  • Consult with your dietician and your doctor to reevaluate your diet while breast-feeding

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    Vinegar Decreases After-dinner Hyperglycemia in Type 1 Diabetes Patients

    Posted on February 18, 2010 by wngai
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    Patients with type 1 diabetes may supplement their diets with two tablespoons of vinegar, such as in a salad dressing, to help to lower their blood sugar levels.

    Studies already shown that vinegar can improve insulin sensitivity in healthy or insulin-resistant subjects, but the effects had not been examined in patients with type 1 diabetic patients.

    The new study evaluated the impact of vinegar in 10 Type 1 diabetic patients who have been treated with short-acting insulin before meals and long-acting once daily insulin in the evening.

    The subjects were randomly assigned to consume either vinegar (30 ml vinegar, 20 ml water) or placebo (50 ml water) five minutes before a meal of bread, cheese, turkey ham, orange juice, butter, and a cereal bar.

    Before having the meal, all subjects received a subcutaneous dose of insulin to ensure that the fasting blood glucose was similar in the vinegar and placebo groups.  However, 30 minutes after eating, blood glucose in the placebo group began to rise, while blood glucose in the vinegar group increased to about 8.6 mmol/l.  Compared to placebo group, patients in the vinegar group had their blood glucose reduced by nearly 20 percent.

    Panayota M et. a.  Diabetes Care (02/10) Vol. 33, No. 2, P. 27

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    Walnut Consumption Improve Blood Vessel Function in Type 2 Diabetes

    Posted on February 18, 2010 by wngai
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    A diet enriched with walnuts may improve the elasticity of blood vessel in type 2 diabetic patients.   This benefit, in turn, might reduce the overall cardiac risk in type 2 diabetic patients.

    The study, involving 24 participants[limited sample] with type 2 diabetes, randomly assigned patients to receive either an ad libitum diet enriched with 56 g (366 kcal) of walnuts/day or an ad libitum diet without walnuts.  The researchers performed blood vessel elasticity test and cardiovascular biomarkers test before and after the eight-week treatment.

    Compared to the diet without walnuts, individuals in the walnut-enriched diet experienced a significant improvement in the blood vessel elasticity.  The study also found that patients who ingested walnut showed increased fasting serum glucose and lowered serum total cholesterol and LDL cholesterol from baseline, even thought the difference was not significant from the group without walnuts.

    Ma Y. et. al.  Diabetes Care (02/10) Vol. 33, No. 2, P. 227

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    Tight Target Control Prevents Diabetic Nephropathy in Asian Population With Type 2 Diabetes

    Posted on February 18, 2010 by wngai
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    Tight achievement of multiple targets, recommended by the American Diabetes Association (ADA), can delay diabetic nephropathy in Chinese with Type 2 diabetes.

    The study, involving 1,290 type 2 diabetic patients with normoalbuminuria, revealed that patients who received intensified treatment and achieved the ADA goals (HbA1c of less than 7 percent, blood pressure of less than 130/80, LDL cholesterol of less than 100 mg/dL, and triglycerides of less than 150 mg/dL) were able to delay the onset of microalbuminuria.

    The researchers concluded that this multifactorial intervention should be started in patients with diabetes and normoalbuminuria.”

    Tu ST. et.al.  Archives of Internal Medicine (01/25/10) Vol. 170, No. 2, P. 155

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    Low-carb diet has same weight loss but better BP control than drug/diet combo

    Posted on February 17, 2010 by wngai
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    A new randomized study comparing 1) a low-carbohydrate diet with 2) combination of weight-loss drug, orlistat* (Xenical), and a low-fat diet has found that both strategies produced similar weight loss over a one-year period.  The low-carb diet, however, also produced a significant improvement in blood pressure.

    The study, published in the January 25, 2010 issue of the Archives of Internal Medicine, randomized 146 obese outpatients to either 1) a low-carbohydrate, ketogenic diet or 2) to orlistat (120 mg, three times daily) and a low-fat diet for over 48 weeks.  At the end of the study period, both strategies resulted in similar weight loss (10% or 20 to 25 pounds).

    HDL and triglycerides improvements were seen in both groups, LDL levels improvement was seen in the orlistat/low-fat diet group only while glucose, insulin, and HbA1c levels improvements were seen only in the low-carb group, although none of the differences were statistically meaningful.

    By contrast, patients in the low-carb group experienced a significant decrease in both systolic and diastolic blood-pressure levels when compared with the orlistat/low-fat diet group.

    Implications: This study did not suggest one diet is better than the other one.  It only provides another option, low-carb option, for those who want to lower their weight as well as their blood pressure.

    * Orlistat is not associated with increases in blood pressure, but other diet drug such as sibutramine (Meridia), has recently released an updated warning on its contraindication in patients with cardiovascular disease.

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    Rosuvastatin approved for reducing cerebral/cardiovascular events in LDL normal individuals

    Posted on February 17, 2010 by wngai
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    FDA has approved to expand the label of rousuvastatin (Crestor, Astra Zeneca).  The new label allowed rousuvastatin to be used to reduce the risk of stroke, MI and revascularization procedures in individuals who have normal LDL levels and no coronary heart disease but who have an increased risk based on age, CRP levels, and the presence of at least one additional CVD risk factor.

    The revised label is based on the results from the Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) study.

    Results from JUPITER (n=17,802) indicated that rosuvastatin 20 mg was effective in reducing relative risk of heart attack by 54%, stroke by 48% and arterial revascularization by 46% vs. placebo in the above patient type who has at least one additional risk factor.

    Nonetheless, it is important to point out that a higher percentage of rosuvastatin-treated patients discontinued study due to myalgia (muscle pain).

    Hs-CRP is not widely used in clinical practice due to concerns of variability between individuals or on repeat testing.  Earlier recommendations suggested testing hs-CRP twice and then taking the average to guide decisions have complicated clinical practice and create inconvenience among patients.

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