February

Browning meat in the oven, grill or frying pan produces chemicals which may increase the risk of developing dementia, US researchers suggest. Advanced glycation end (AGE) products have been linked to diseases such as type-2 diabetes. Mice fed a high-AGEs diet had a build-up of dangerous proteins in the brain and impaired cognitive function.

Experts said the results were “compelling” but did not provide “definitive answers”. AGEs are formed when proteins or fats react with sugar. This can happen naturally and during the cooking process.

Researchers at the Icahn school of medicine at Mount Sinai, in New York, tested the effect of AGEs on mice and people. The animal experiments, published in Proceedings of the National Academy of Sciences, showed that a diet rich in AGEs affects the chemistry of the brain. It leads to a build-up of defective beta amyloid protein – a hallmark of Alzheimer’s disease. The mice eating a low-AGEs diet were able to prevent the production of damaged amyloid.

The mice performed less well in physical and thinking tasks after their AGEs-rich diet. A short-term analysis of people over 60 suggested a link between high levels of AGEs in the blood and cognitive decline.

The study concluded: “We report that age-related dementia may be causally linked to high levels of food advanced glycation end products. Importantly, reduction of food-derived AGEs is feasible and may provide an effective treatment strategy.”

Derek Hill, a professor of medical imaging sciences at University College London, commented: “The results are compelling. Because cures for Alzheimer’s disease remain a distant hope, efforts to prevent it are extremely important, but this study should be seen as encouraging further work, rather than as providing definitive answers.

“But it is grounds for optimism – this paper adds to the body of evidence suggesting that using preventative strategies might reduce the prevalence of Alzheimer’s disease and other dementias in society and that could have very positive impact on us all.”

Dr Simon Ridley, from the charity Alzheimer’s Research UK, said: “Diabetes has previously been linked to an increased risk of dementia, and this small study provides some new insight into some of the possible molecular processes that may link the two conditions.It’s important to note that the people in this study did not have dementia. This subject has so far not been well studied in people, and we don’t yet know whether the amount of AGEs in our diet might affect our risk of dementia.”

Source: BBC

Nearly a third of American adults have high blood pressure, also known as hypertension. Often called the “silent killer” because it provides few warning signs, hypertension increases a patient’s risk for heart attack and stroke. New research suggests eating a vegetarian diet could help combat this deadly disease. A healthy blood pressure is 120/80 mm HG. Previous studies have shown that each increase of 20/10 mm Hg in that number doubles the patient’s risk of cardiovascular disease. But lowering that top number just 5 mm HG can reduce your chances of dying from cardiovascular disease by about 7%. And eating more fruits and vegetables may be a good way to do that, according to the new study, published Monday in the scientific journal JAMA Internal Medicine.

In seven clinical trials, participants following a vegetarian diet had a systolic blood pressure that was 4.8 mm Hg lower on average than their omnivore counterparts’. The vegetarians’ diastolic blood pressure was lower by an average of 2.2 mm Hg. In observational studies, the difference was slightly bigger. A vegetarian diet was associated with an average decrease of 6.9 mm Hg for systolic blood pressure and 4.7 mm HG for diastolic blood pressure. Many factors could be affecting the vegetarians’ blood pressure. Vegetarian diets are often lower in sodium and saturated fats, while being higher in fiber and potassium.

Vegetarians also tend to have lower body mass indexes because fruits and vegetables are less energy dense – meaning you can eat more of them for fewer calories. The definition of a “vegetarian diet” differs from person to person, so the researchers can’t tell you how much meat is too much. Some of the observational studies also did not adjust for lifestyle factors such as exercise or alcohol intake that could have affected the results. Eating more fruits and vegetables as part of an overall healthy diet could help lower your blood pressure, says study author Dr. Neal Barnard. You should also try to limit your sodium intake, exercise regularly and avoid drinking alcohol excessively.

Source: CNN

According to French researchers, the incidence of cancer is expected to increase by more than 75% by the year 2030 in developed countries, and over 90% in developing nations. The study is published Online First in the Lancet Oncology.

The researchers, led by Dr Freddie Bray of the International Agency for Research on Cancer (IARC) in Lyon, France, set out to determine how the current and future patterns of incidence and mortality of different types of cancer vary between nations with different levels of development, as measured by their Human Development Index (HDI).

In nations transitioning towards higher levels of human development, there appears to be a reduction in incidence rates of some types of cancer, such as stomach cancer and cervical cancer. However, the incidence of breast, colorectal, and prostate cancer is expected to increase substantially in higher-HDI countries.
Dr Bray explained:

“Cancer is already the leading cause of death in many high-income countries and is set to become a major cause of morbidity and mortality in the next decades in every region of the world; this study serves as an important reference point in drawing attention to the need for global action to reduce the increasing burden of cancer.”

Using data from GLOBOCAN, the researchers examined estimates of cancer incidence and mortality in 2008 in 184 countries. The team found the patterns of the most prevalent types of cancer varied according to four levels of human development.
The team then used these findings to project how the burden of cancer is likely to change by the year 2030. Their projections took into account predicted changes in population size and aging, in addition to the changing trends in incidence rates of 6 of the most prevalent types of cancer in nations with medium, high, and very high levels of HDI.

At present, there is a high incidence of cancers associated with infection in nations with a low HDI (mainly countries in sub-Saharan Africa), particularly cervical cancer, as well as stomach cancer, liver cancer and Kaposi’s sarcoma, depending on the region or country. By contrast, the burden of lung, breast, colorectal and prostate cancer is greater in countries with a higher HDI, such as the UK, Russia, Australia, and Brazil.
According to the researchers, by 2030, the number of cancer cases are expected to increase by 78% in medium HDI countries, such as China, India, and South Africa, and by 93% in low HDI countries.

The researchers also found the following trends:

• Even though very high HDI countries only contain 15% of the world’s population, they accounted for 40% of cancer cases in the world in 2008.
• Although the incidence of stomach and cervical cancer is decreasing in nations with medium, high, or very high levels of HDI, there are a number of exceptions for cervical cancer.
• The incidence of female breast cancer and prostate cancer seems to be increasing in the majority of countries currently with medium, high, or very high levels of HDI.
• Lung cancer incidence rates appears to be decreasing in men in countries with high and very high HDI levels, but increasing in women.
• Although lung cancer is currently not a leading cancer in low HDI regions, it will become a leading cause of cancer unless tobacco smoking is controlled in these areas.

Dr Christopher Wild, International Agency for Research on Cancer Director, explained:

“This study reveals the dynamic nature of cancer patterns in a given region of the world over time. Countries must take account of the specific challenges they will face and prioritize targeted interventions to combat the projected increases in cancer burden via effective primary prevention strategies, early detection, and effective treatment programs.”

Read more at Medical News Today.

Last week the Maryland State Public Health Laboratory identified Listeria preliminarily determined to be Listeria monocytogenes from retail cheeses produced by Roos Foods out of Kenton, Delaware. Roos Foods produces Latin-style cheeses under several product labels (Santa Rosa de Lima, Amigo, Mexicana, Suyapa, La Chapina, La Purisima, Crema Nica) and distributes its products to VA, MD and DC. Food safety inspectors from the Virginia Department of Agriculture and Consumer Services have also reported the presence of this bacterium in a sample of cheese collected from a Virginia retail location. As a measure of precaution District food safety officials are pulling the products from shelves at retail locations.

As of February 21, 2014, no cases of Listeria associated with this cheese have been reported to the DC Department of Health, but we would like clinicians to be aware of this potential health risk. Listeriosis associated with contaminated food can cause a wide spectrum of clinical symptoms ranging from febrile gastroenteritis to potentially fatal bacteremia and meningitis in higher risk groups such as older adults and persons with certain medical conditions1. Pregnant women infected with this bacterium frequently experience a mild influenza-like illness or an asymptomatic infection1. Pregnancy-associated listeriosis can result in fetal loss, preterm delivery, invasive neonatal infection, and infant death1. Anyone who purchased the product should be advised not consume it and to discard any remaining portions.

Listeriosis is a reportable disease in DC. Healthcare providers are required to report cases of Listeriosis to the DC Department of Health, Division of Epidemiology– Disease Surveillance and Investigation (DE-DSI) by fax at (202) 442-8060. If you have any questions, please contact us at (202) 442-8141.

                                   Some Listeria facts:

Listeria can be found in:

• Ready-to-eat deli meats and hot dogs
• Refrigerated pates or meat spreads
• Unpasteurized (raw) milk and dairy products
• Soft cheese made with unpasteurized milk, such as queso fresca, brie, feta, camembert
• Refrigerated smoked seafood
• Raw sprouts

Incubation period: 3-70 days

Symptoms: Fever, stiff neck, confusion, weakness, vomiting, sometimes preceded by diarrhea

Duration of illness: Days to weeks

Who’s at risk:

• Pregnant women
• Older adults
• People with weakened immune systems
• Organ transplant patients who are taking drugs to prevent them from rejecting the organ
• People with certain diseases such as HIV/AIDS, cancer, end-stage renal disease, liver disease, alcoholism, diabetes

Read more at NBC News.

While overall mortality from heart disease is declining, the number of younger women with heart disease is growing. A new study by the Canadian-led global INTERHEART group shows that nine factors account for 90% of the risk for a first myocardial infarction:

• Smoking
• Lipids
• Hypertension
• Diabetes
• Obesity
• Diet
• Physical Activity
• Psychosocial Factors

Cardiovascular disease has been the leading killer of American women since 1908. Death rates from heart disease are increasing in women aged 35 to 54 years, most likely as a result of obesity. Cardiovascular disease causes one death per minute in the U.S.– that amounts to a staggering 421,918 deaths every year. More than 12 million women in the U.S. are suffering from Type II diabetes. Across the globe, heart disease is the leading cause of death in women in every major developed country and most emerging economies.

Waking up and not feeling rested isn’t just annoying. Researchers say that “non-restorative sleep” is the biggest risk factor for the development of widespread pain in older adults.

Widespread pain that affects different parts of the body — the main characteristic of fibromyalgia — affects 15 percent of women and 10 percent of men over age 50, according to previous studies.

To identify the triggers of such widespread pain, British researchers compiled demographic data as well as information on the pain and physical and mental health of more than 4,300 adults older than 50. About 2,700 had some pain at the study’s start, but none had widespread pain.

The results, published Feb. 13 in Arthritis & Rheumatology, show that restless sleep as well as anxiety, memory problems and poor health play a role in the development of this type of pain.

Three years after the study began, 19 percent of the participants had new widespread pain, the researchers found.

This new pain in various parts of the body was worse for those who had some pain at the beginning of the study. Of those with some prior pain, 25 percent had new widespread pain. Meanwhile, 8 percent of those with no pain at the start of the study had widespread pain three years later.

“While osteoarthritis is linked to new onset of widespread pain, our findings also found that poor sleep, [memory], and physical and psychological health may increase pain risk,” concluded the study’s leader, Dr. John McBeth, from the arthritis research center at Keele University in Staffordshire, England.

“Combined interventions that treat both site-specific and widespread pain are needed for older adults,” McBeth added in a journal news release.

Increasing age, however, was linked to a lower chance of developing widespread pain. Muscle, bone and nerve pain is more common among older people. Up to 80 percent of people 65 and older experience some form of pain on a daily basis, according to the news release.

While the study finds an association between poor sleep and widespread pain, it does not establish a direct cause-and-effect relationship.

SOURCE: Arthritis & Rheumatology, news release, Feb. 13, 2014

Regardless of how much time older Americans spend being active, those who sit for more hours each day are more likely to be disabled, according to a new study. Researchers found that every hour people 60 years old and older spent sitting daily was tied to a 46 percent increased risk of being disabled – even if they also exercised regularly.

“It was its own separate risk factor,” Dorothy Dunlop told Reuters Health. Dunlop is the study’s lead author from the Northwestern University Feinberg School of Medicine in Chicago. “We know that being active is good for your health and we know a sedentary lifestyle is bad for your health,” she said. But few studies have examined whether moderate to vigorous physical activity offsets the possible negative effects of being sedentary.

Dunlop and her colleagues write in the Journal of Physical Activity and Health that Americans already lead sedentary lifestyles. Among older Americans disability is also a major concern because it has been linked to increased medical spending and a higher risk of going into a nursing home or other care facility.

If future studies can confirm that sedentary behavior causes disability, which this study does not, then older people may possibly avoid becoming disabled by being more active throughout the day. For the new report, Dunlop and her colleagues analyzed data collected in 2003 through 2006 as part of a long-term government study of American health. The researchers used information on 2,286 adults who were 60 years old or older, had worn a device that measures physical activity for at least four days and had a physical exam. Participants were considered to have a disability if they couldn’t perform a self-care task, such as getting dressed, by themselves. Survey participants spent about 14 hours awake each day, on average. Of that, an average of nine hours was spent sitting or otherwise not moving.

After taking into account the amount of time people spent doing moderate to vigorous physical activity, their age, their health and whether they were well-off, the researchers found that each hour of daily sitting was linked to a 46 percent increased risk of having a disability. The study can’t say whether a sedentary lifestyle leads to disability or if having a disability leads to a sedentary lifestyle, however. In addition, the authors note that their records of physical activity may not take into account some forms of exercise, because the devices that participants wore may not pick up upper body movement or cycling. Participants also didn’t wear the devices while swimming.

Stephen Kritchevsky told Reuters Health it’s too early to tell if interventions that get people moving during the day will prevent disability, but they couldn’t hurt because other studies suggest activity improves functioning. He heads the Sticht Center on Aging at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina and wasn’t involved in the new research. “The fact that people are physically limited in some way is even a bigger reason to try and do things, because there is plenty of research that shows that’s likely to improve function,” Kritchevsky said.

Dunlop said older adults should be as physically active as possible. They should also know that being sedentary is possibly bad for their health. “The goal here is to accumulate more light activities to replace the sitting and keep going on the moderate activity that you’re already engaged in,” she said.

SOURCE: (Reuters) Journal of Physical Activity and Health, online February 19, 2014.

A study at the National Cancer Institute (NCI) has shown that women who take aspirin daily may reduce their risk of ovarian cancer by 20%. Prior research has suggested that the anti-inflammatory properties of aspirin and non-aspirin NSAIDs may reduce overall risk of cancer, but studies specific to ovarian cancer have been inconclusive. This is the largest study to date on risk reduction in ovarian cancer and these medications. Britton Trabert, PhD, and Nicolas Wentzensen, MD, PhD, and their colleagues from NCI’s Division of Cancer Epidemiology and Genetics examined data from 12 large epidemiological studies (9 from the US) of nearly 8,000 women with ovarian cancer and close to 12,000 women without ovarian cancer. Eighteen percent reported that they used aspirin, 24% used non-aspirin NSAIDs, and 16% used acetaminophen. Daily aspirin users had a 20% lower risk of ovarian cancer compared to those who took it less than once a week. Women who reported using NSAIDs at least once a week showed a reduction in risk that was not statistically significant, and acetaminophen was not associated with a reduction in ovarian cancer risk.

Source: MPR

Worldwide prevalence of dementia is expected to reach 65.7 million and 115.4 million in 2030 and 2050, respectively. Currently, there is no effective therapy to delay the onset or halt the progression of dementia, a growing public health problem with priority for research. The potential protection on cognition has been examined for some nutrients such as fatty acids, vitamins, fish, fruit and vegetables but observational and experimental studies have provided inconsistent results. Defining the effect of diet on health by the overall dietary pattern instead of a single or a few nutrients allows to study the synergy among nutrients and avoids problems due to confounding, multiple testing and collinearity among them. The Mediterranean diet (MedDiet) is characterized by the use of olive oil as the main culinary fat and high consumption of plant-based foods (fruits and nuts, vegetables, legumes and minimally processed cereals). It also includes moderate-to-high consumption of fish and seafood and low consumption of butter or other dairy products and meat or meat products. Regular but moderate intake of alcohol, preferentially red wine during meals, is customary. An intervention with MedDiets enhanced with either EVOO or nuts appears to improve cognition compared with a low-fat diet. (Journal of Neurology, Neurosurgery, and Psychiatry)

Read more here.

According to the Centers for Disease Control and Prevention, cancer is the second most common cause of death, surpassed only by heart disease. It accounts for nearly one of every four deaths in the U.S. each year. At the Presidential Healthcare Center, we offer many different types of cancer screenings–customized to your lifestyle and risk factors–in order to catch diseases in their earliest stages.

Breast cancer is the most common cancer among American women, other than skin cancer. Mammography can detect breast cancer at an early stage when treatment may be more effective and a cure is more likely.

According to the Centers for Disease Control and Prevention, colorectal cancer is the second leading cause of cancer deaths in the U.S. More than 130,000 new cases are diagnosed each year. Regular colorectal screening can prevent colorectal cancer. Screening can detect precancerous polyps, which can be removed before they have the chance to turn into cancer. There are many types of screening tests available, although they have different testing frequencies.

An estimated 12,000 new cases of cervical cancer are diagnosed each year. When detected early, however, cervical cancer is preventable. Cervical cancer can be found early by having regular Pap tests. A Pap test can find changes in the cervix before cancer develops; it can also find cervical cancer early, in its most treatable stage.

At PHC, our preventive executive physicals provide the most extensive cancer screening available to ensure that our patients catch any abnormalities early, before they become major health issues. Each patient receives a custom-tailored program designed specifically for the individual’s needs, concerns, and risk factors, including family history. Celebrate Cancer Prevention Month by scheduling a preventive executive physical for yourself and your loved ones!