Showing posts with label obesity. Show all posts
Showing posts with label obesity. Show all posts

Sunday, November 7, 2010

Diet and Lifestyle Habits: Decrease Colorectal Cancer Risk





Welcome to Weekly Health Update






"A critical weekly review of important new research findings for health-conscious readers..."






By, Robert A. Wascher, MD, FACS




Dr. Wascher



Updated: 10/28/2010


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.



DIET AND LIFESTYLE HABITS THAT DECREASE COLORECTAL CANCER RISK

In the United States, approximately 106,000 people will be newly diagnosed with colorectal cancer in 2010, and nearly 50,000 people will die of this disease. Colorectal cancer remains the third most common cancer (excluding skin cancer) in both men and women, and the third most common cause of cancer death in men and women. Unlike many other types of cancer, an effective method of screening for colorectal cancer is available, in the form of colonoscopy. Fortunately, the incidence of this cancer has been gradually declining over the past 20 years, due in great part to the early detection, and removal, of precancerous polyps from the colon and rectum at the time of colonoscopy.


The links between specific lifestyle choices and the risk of developing certain types of cancer forms much of the basis of my new book, “A Cancer Prevention Guide for the Human Race.” The risk of developing colorectal cancer, in particular, has been strongly linked to multiple dietary and other lifestyle factors. Now, a newly published public health research study from Denmark puts a number on the effectiveness of commonly recommended cancer prevention lifestyle strategies in preventing colorectal cancer.


In this study, which appears in the current issue of the British Medical Journal, 55,487 men and women between the ages of 50 and 64 were prospectively followed for an average of 10 years. Each of these Diet, Cancer and Health Cohort Study volunteers completed validated surveys regarding their social status, health status, reproductive history, and daily lifestyle habits. They also completed a food frequency questionnaire that included, among its 193 items, foods known to be associated with colorectal cancer risk (including alcohol). All study participants also underwent physical examinations that included measurements of their height, weight, and waist circumference. During the course of this large prospective public health study, 678 participants were newly diagnosed with colorectal cancer.


All study volunteers were assessed in terms of 5 modifiable lifestyle and dietary factors that have repeatedly been linked to a reduction in colorectal cancer risk: Increased levels of regular physical activity, avoidance of obesity, abstention from tobacco use, minimal intake of alcohol, and the observance of healthy diet habits (including increased fiber intake, decreased dietary fat content, decreased red meat and processed meat consumption, and increased fresh fruit and vegetable intake). Based upon only these 5 simple colorectal cancer risk factors, the adoption of any one of these 5 colorectal cancer prevention factors was associated with a 13 percent decrease in the risk of developing colorectal cancer. Among participants who generally observed all 5 lifestyle and dietary prevention factors, the risk of developing colorectal cancer was reduced by 23 percent. (Of note, while this observed reduction in the risk of colorectal cancer was noted for both colon cancer and rectal cancer, this finding was only statistically significant for cancer of the colon, specifically.)


The results of this large prospectively conducted public health study reaffirm the findings of previous studies, in that the risk of colorectal cancer can be significantly reduced by: Engaging in regular moderate exercise, maintaining a healthy body weight, avoiding tobacco use, minimizing alcohol consumption, and by reducing the intake of red meat and processed meats and fat, while simultaneously increasing the consumption of fresh fruits, fresh vegetables, and whole grain foods. For a more detailed evidence-based guide to colorectal cancer prevention, order or download your copy of “A Cancer Prevention Guide for the Human Race” now.



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For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing colorectal cancer, and other types of cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from Amazon, Barnes & Noble, Books-A-Million, Vroman’s Bookstore, and other fine bookstores!




I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people, from around the world, who visit our premier global health information website every month. (As of 9/16/2010, more than 1,000,000 health-conscious people have logged onto Weekly Health Update so far this year!) As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.



Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity



Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author



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Send your feedback to Dr. Wascher at:

rwascher@doctorwascher.net



Links to Other Health & Wellness Sites




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Copyright 2007 - 2010

Robert A. Wascher, MD, FACS

All rights reserved





Dr. Wascher's Archives:

10-28-2010: Diet and Lifestyle Habits that Decrease Colorectal Cancer Risk


10-21-2010: The Silent Epidemic of Surgeon Burnout and Depression


10-14-2010: Gum Disease (Gingivitis) and Breast Cancer Risk


10-7-2010: Hormone Replacement Therapy (HRT) and Breast Cancer Risk


10-3-2010: Mammograms Between 40 and 49 Years of Age


9-26-2010: Vitamin D, Cardiovascular Disease, Cancer, and Death


9-19-2010: Fruits and Vegetables Improve Memory


9-12-2010: Low-Carb Diet and Risk of Death


9-5-2010: Non-Compliance with Hormonal Therapy for Breast Cancer and Risk of Death


8-29-2010: New Treatment for Irritable Bowel Syndrome (IBS)


8-22-2010: Lactoferrin Reduces Abdominal (Visceral) Obesity


8-15-2010: Blueberries, Obesity, Diabetes and Metabolic Syndrome


8-8-2010: High LDL Cholesterol in Young Adults and Heart Disease Risk in Middle Age


8-1-2010: Physician Error


7-25-2010: Obesity and Cancer Risk


7-18-2010: Vitamin D Reduces Risk of Cognitive Decline & Dementia


7-11-2010: All Forms of Hormone Replacement Therapy (HRT) Increase Breast Cancer Risk


7-4-2010: Irritable Bowel Syndrome: Cause Discovered?


6-27-2010: Soy, Curcumin & Prostate Cancer Risk


6-20-2010: Green Tea Epicatechin Reduces Heart Damage & CHF


6-13-2010: Diacylglycerol (Diglyceride) Oil Reduces Obesity


6-6-2010: Important New Advance in the Breast Cancer Treatment: Intraoperative Radiation Therapy


5-30-2010: Medical Research Studies & “Spin”


5-23-2010: Soy & Curcumin Reduce Prostate-Specific Antigen (PSA)


5-16-2010: Coffee & the Risk of Death from Heart Disease & Cancer


5-9-2010: Soy Foods & Stomach Cancer Risk


5-2-2010: Chemotherapy for Breast Cancer & Memory Loss


4-25-2010: Smoking, Teenagers & Tobacco Company Advertising


4-18-2010: Coffee Improves HDL Cholesterol Levels


4-11-2010: Cruciferous Vegetables, Soy & Breast Cancer Risk


4-4-2010: Avodart (Dutasteride) & Prostate Cancer Prevention


3-28-2010: Aspirin & Breast Cancer Survival


3-21-2010: Obesity, Alcohol & Liver Disease


3-14-2010: Nuts, Diet & Obesity


3-7-2010: Walnuts, Cholesterol, LDL & Triglycerides


2-28-2010: Soy Isoflavones & Recurrent Prostate Cancer


2-21-2010: Testosterone Supplements in Frail Elderly Men


2-14-2010: Pancreatic Cancer Risk, Sodas & Juice


2-7-2010: Vitamin D, Cardiovascular Disease & Death


1-31-2010: Concord Grape Juice Improves Memory


1-24-2010: Mozart, Music, Babies & Health


1-17-2010: Breast Cancer, Physical Therapy & Lymphedema


1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery


1-3-2010: Ginkgo Biloba, Memory & Cognitive Health


12-20-2009: CT Scans & Cancer Risk


12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk


12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease


11-29-2009: Exercise & Prostate Cancer Risk


11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer


11-15-2009: Breast Cancer Treatment & Chronic Pain


1-8-2009: Vitamin D & Breast Cancer Risk


11-1-2009: Exercise & Prostate Cancer Risk


10-25-2009: HPV Virus & Risk of Breast Cancer


10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)


10-11-2009: Vitamin D & Falls in the Elderly


10-4-2009: Surgery, NSQIP, Complications & Death


9-27-2009 Stress, Heart Disease, Exercise & Death


9-20-2009: Vitamin D & Colorectal Cancer Survival


9-13-2009: H1N1 Swine Flu Update


9-7-2009: Green Tea, Aging & Lifespan


8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber


8-23-2009: Update on Prostate Cancer and Cryotherapy


8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors


8-9-2009: Breast Cancer Recurrence, Death & Vitamin D


8-2-2009: Honesty, Dishonesty & Brain Function


7-26-2009: Coronary Artery CT Scans & Cancer Risk


7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer


7-12-2009: Breast Cancer & Metformin (Glucophage)


7-5-2009: Prostate Cancer & Green Tea


6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)


6-21-2009: Red Yeast Rice, Statins & Cholesterol


6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)


6-7-2009: Diet, Soy & Breast Cancer Risk


5-31-2009: Diet and Prostate Cancer Risk


5-24-2009: Diabetes, Glucose Control & Death


5-17-2009: Drug Company Marketing & Physician Prescribing Bias


5-10-2009: Hemorrhoids & Surgery


5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)


4-26-2009: Are We Really Losing the War on Cancer?


4-19-2009: Exercise in Middle Age & Risk of Death


4-12-2009: Can Chronic Stress Harm Your Heart?


4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?


3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease


3-15-2009: Depression, Stress, Anger & Heart Disease


3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children


3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children


2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer


2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones


2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum


2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence


1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?


1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors


1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure


1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood


12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps


12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection


12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome


12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival


11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk


11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk


11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?


11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level


11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk


10-26-2008: Smoking & Quality of Life


10-19-2008: Agent Orange & Prostate Cancer


10-12-2008: Pomegranate Juice & Prostate Cancer


10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer


9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?


9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?


9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke


8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles


8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration


8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients


7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer


7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer


7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins


6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer


6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer


6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort


6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer


6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut


5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely


5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers


5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease


5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room


4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function


4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke


4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention


4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)


3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria


3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children


3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer


3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity


3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death


2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis


2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps


2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?


2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer


1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium


1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly


1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer


1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations


12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?


12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease


12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality


12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease


12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer




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Sunday, February 1, 2009

Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

Health Report:


Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding)

Obesity, Weight Loss & Urinary Incontinence
"A critical weekly review of important new research findings for health-conscious readers..."


By, Robert A. Wascher, MD, FACS


Last Updated: 02/01/2009


The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.

OBESITY AND THE COMPLICATIONS OF DIVERTICULOSIS (DIVERTICULITIS & BLEEDING)

Diverticulosis is an acquired condition that results in the formation of small pouches along the wall of the colon with advancing age. Diverticulosis is known to be much more common among populations that consume western diets, which generally lack significant daily fiber intake. In less developed countries where highly processed and refined foods are not frequently consumed, and where a large percent of the diet is in the form of fresh fruits and vegetables, diverticulosis of the colon is far less common. Most patients with diverticulosis will have no symptoms of this condition. However, there are two potentially life-threatening complications that can occur when diverticulosis is present.

Diverticulosis can result in significant bleeding from the colon within a diverticulum (the small colonic pouch that causes diverticulosis). In severe cases of diverticular bleeding, blood transfusions, and even emergency surgery, may be required (in some cases, radiologists may be able to identify the site of bleeding using angiography, and may also be able to inject material into the offending artery to stop the bleeding).

A second serious complication of diverticulosis is inflammation of a diverticulum, also known as diverticulitis. Mild cases of diverticulosis frequently respond to a 10 to 14 day course of oral antibiotics, while more severe cases of diverticulitis may cause perforation of the colon and abscess formation, or even diffuse peritonitis.

As previously mentioned, a low-fiber diet is thought to be the most important mechanism underlying the formation of diverticuli in the colon (and, most commonly, in the left side of the colon). However, other risk factors may also be involved in the development of diverticulosis, as well as the complications of diverticulosis.

A new prospective clinical study, just published in the journal Gastroenterology, evaluated more than 47,000 adult male physicians between the ages of 40 and 75 years, and followed them for an average of 18 years, making this a very high-powered study. The patient volunteers in this very large prospective clinical study were closely followed through detailed health surveys that were conducted every two years. During these biennial surveys, waste circumference, hip circumference, and body weight were measured and recorded.

In this very large cohort of study volunteers, there were 801 cases of diverticulitis and 383 cases of diverticular bleeding documented during the nearly 20 year duration of this study. After evaluating the resulting clinical data, the researchers found that being obese (BMI ≥ 30 kg/meter-squared) was associated with nearly twice the risk of developing diverticulitis as was observed among men who were of normal weight (BMI ≤ 21 kg/meter-squared). Similarly, the obese men in this enormous study population experienced more than 3 times the risk of diverticular bleeding when compared to the men who were of normal weight.

When the researchers looked at waist-to-hip circumference ratio, the resulting findings were similar. Men with a high waist-to-hip ratio (or, so-called “central obesity”) were approximately twice as likely to develop diverticulitis or diverticular bleeding when compared to men with a very low waist-to-hip ratio. Even simple measurements of waist circumference revealed the same findings, as men with larger waists were found to be about twice as likely to experience diverticular bleeding and diverticulitis when compared to their counterparts with narrower waists.

As if there weren’t already enough reasons to maintain your weight within a healthy range, this huge prospective clinical study strongly suggests that obesity (as measured by BMI, weight, waist-to-hip ratio, or waist circumference) is a significant risk factor for diverticulosis and its two major complications. Although this type of study was not designed to identify the mechanism(s) whereby obesity increases the risk of diverticular complications, it is very likely that the highly-refined, high-energy diets favored by obese people plays an important role in the development of diverticulosis (and its complications) in overweight people.

So, in addition to protecting your cardiovascular system and your joints (as well as reducing your risk of cancer), maintaining a healthy weight, and eating a diet rich in fruits and vegetables and whole grains, will probably do your colon a lot of good as well!


OBESITY, WEIGHT LOSS & URINARY INCONTINENCE

Urinary incontinence is a common affliction, particularly in older women. Urinary incontinence causes varying degrees of unintended urine leakage, especially when coughing or otherwise straining. Patients with urinary incontinence often must wear special water-proof undergarments to contain leaking urine. Hysterectomy and menopause are both well-known risk factors for urinary incontinence, which explains why this condition is much more common in women than in men. Obesity has long been known to increase the risk of developing urinary incontinence as well, most likely as a result of the increased pressures that arise within the abdomen with increasing levels of obesity. However, there has been very little prospective clinical research data available to suggest that losing excess weight can, in turn, reduce the severity of urinary incontinence symptoms in women.

Now, a new study published in the current issue of the New England Journal of Medicine provides compelling evidence that weight loss in overweight and obese women can indeed significantly reduce the severity of bothersome and often embarrassing urinary incontinence symptoms.

In this prospective randomized clinical research study, 338 middle-aged overweight and obese women were randomly assigned to either an intensive 6-month weight loss program (including diet, exercise, and behavior modification) or to a structured weight loss education program. Weekly measurements of body mass index (BMI) and the number of incontinence events were then recorded for all study participants over the course of 6 months.

The women who were assigned to the intensive 6-month weight loss program lost an average of 17 pounds (or about 8 percent of their initial body weight), while the women who were randomized to the weight loss education program only lost an average of about 3 pounds (or 1.6 percent of their initial body weight). Among the women who were assigned to the intensive exercise program, there was an impressive 47 percent reduction in the number of weekly incontinence episodes! However, even the women in the diet education group, despite their rather modest weight loss, appeared to benefit, and experienced a 28 percent decrease in weekly incontinence episodes.

While the significant decline in the number of weekly incontinence episodes reported by the women randomized to diet education classes suggests that there might be a placebo effect, or other factors not directly related to weight loss, involved in the improvements observed in this study, the women who participated in the intensive exercise program, and who lost 8 percent of their initial body weight, experienced a 68 percent greater reduction in the number of incontinence episodes when compared to the “education-only” group of women.

So… keeping one’s weight in a healthy range not only reduces the risk of cardiovascular disease, arthritis, cancer, and both benign and malignant diseases of the colon, but it may also sharply reduce the distressing symptoms of urinary incontinence as well!

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

Dr. Wascher is an oncologic surgeon, a professor of surgery, a widely published author, and the Physician-in-Chief for Surgical Oncology at the Kaiser Permanente healthcare system in Orange County, California

Send your feedback to Dr. Wascher at:

rwascher@doctorwascher.net


Dr. Wascher's Biography

Links to Other Health & Wellness Sites


http://doctorwascher.com


Copyright 2009

Robert A. Wascher, MD, FACS

All rights reserved


Dr. Wascher's Archives:

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?
1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors
1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure
1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood
12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps
12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection
12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome
12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival
11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk
11-23-2008: Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk
11-16-2008: Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?
11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level
11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk
10-26-2008: Smoking & Quality of Life
10-19-2008: Agent Orange & Prostate Cancer
10-12-2008: Pomegranate Juice & Prostate Cancer
10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer
9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?
9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?
9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke
8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles
8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration
8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients
7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer
7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer
7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins
6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer
6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer
6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort
6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer
6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut
5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely
5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers
5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease
5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room
4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function
4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke
4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention
4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)
3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria
3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children
3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer
3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity
3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death
2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis
2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps
2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?
2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer
1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium
1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly
1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer
1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations
12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?
12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease
12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality
12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease
12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer

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Sunday, January 4, 2009

Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

Health Report


Secondhand Smoke & Heart Attack Risk


Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood



"A critical weekly review of important new research findings for health-conscious readers..."


By, Robert A. Wascher, MD, FACS

Last Updated: 01/04/2009



The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author. Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.



SECONDHAND SMOKE & HEART ATTACK RISK

In one of the most important public health research studies published in 2008, the Centers for Disease Control published an update of the Pueblo Heart Study on December 30th. This epidemiological study was performed, prospectively, over a 3-year period between 2002 and 2004 in Pueblo, Colorado. During the second half of this study, Pueblo enacted stringent legislation to eliminate smoking in public places. The incidence of admissions to hospitals for heart attack in the Pueblo area were monitored throughout the course of this study, both before and after the smoking ban was initiated.

Although there is abundant evidence linking chronic smoking with heart and lung disease, and with multiple types of cancer (including lung cancer, the #1 cause of cancer death in the United States, and throughout much of the world), most of these diseases arise after several years of smoking. However, recent research has shown us that many deleterious health effects associated with smoking occur almost instantaneously. These rapid-onset effects of smoking include an increase in blood clot formation (increased coagulability) and a loss in the normal ability of blood vessels to dilate when increased blood flow is required within vital organs, including the heart. Smoking also drives up carbon monoxide levels in the blood, which prevents oxygen-carrying red blood cells from picking up and delivering life-sustaining oxygen. (These adverse health effects are known to occur within 30 minutes of lighting up.) Moreover, these same acute-onset smoking-associated adverse health effects have been documented not only in smokers, but in nonsmoking bystanders who are exposed to secondhand smoke, as well.
There are a couple of factors that make this public health study so powerful, including its prospective design, and the fact that the entire population of the Pueblo area was assessed for changes in the incidence of heart attack following the implementation of a new ban on smoking in public places. Also, the heart attack admission rates for two adjacent communities without public smoking bans, including the much larger Colorado Springs area, added an important set of controls that have not been included in similar previous studies.

In the initial report of the results of this study, in November of 2005, the Pueblo Health Study researchers identified a 27 percent reduction in the number of admissions to Pueblo-area hospitals for heart attack during the second half of the original 3-year study, after the smoking ban had been enacted. (In the 18 months before the smoking ban went into effect, there were 399 heart attack patients admitted. During the second 18 months, there were only 291 heart attack admissions to the same hospitals.) The Centers for Disease Control update extends the initial 3-year results from the Pueblo Heart study through June 2006, thus adding an additional 18 months of follow-up data.

The updated data from this study reveals a striking cumulative reduction in the number of hospital admissions for heart attacks. When compared to the number of heart attack admissions that occurred prior to the enactment of the public smoking ban, there was an incredible 41 percent reduction in such admissions noted during the additional 18 months of follow-up data. Thus, within 3 years of implementing a public smoking ban, the number of heart attacks in Pueblo dropped, amazingly enough, by nearly one-half. At the same time, similar data collected from two surrounding communities without a public smoking ban showed no significant changes in heart attack admissions during the same timeframe.

I should note that, while this study did not separate smokers from nonsmokers, previous studies have shown that susceptible nonsmokers appear to be at an especially high risk of experiencing heart attacks due to exposure to secondhand smoke. (Other less comprehensive studies have also shown, as the Pueblo Heart Study did, that smoking bans quickly result in rapid declines in heart attack admissions.)

As with previous and similar studies, the beneficial effects of public smoking bans appear to be related to at least two factors. First, nonsmokers are spared exposure to the acutely toxic cardiovascular and lung effects of secondhand smoke. Secondly, strict public smoking bans have been shown not only to decrease smoking behaviors among smokers, but to also improve quitting rates among smokers.

While the Pueblo Heart Study is subject to the same limitations as other so-called observational studies, and other undetected factors may have also, therefore, contributed to the dramatic decline in heart attacks after the smoking ban was implemented, this study joins 8 previous and similar studies that also identified a significant reduction in heart attacks after public smoking bans were enacted. Taken together, these 9 studies strongly suggest that the dangers of secondhand smoke may be far greater than public health experts have previously believed. (According to the Centers for Disease Control, exposure to secondhand smoker causes at least 46,000 deaths due to heart disease every year, as well as 3,000 or more lung cancer deaths among nonsmokers each year.)

Based upon more than five decades of scientific data linking tobacco smoke with cancer, chronic lung disease, and cardiovascular disease, it still amazes me that there are so many communities that still permit smoking in public places, or that have enacted hopelessly anemic limitations on the ability of smokers to subject the 80 percent of the U.S. population that does not smoke to highly toxic secondhand tobacco smoke. An estimated 500,000 people die every year in the United States, alone, from completely preventable tobacco-associated diseases. This updated data from the Pueblo Heart Study should galvanize public health advocates and agencies, and government leaders, to better protect the public from unwanted exposure to tobacco smoke.



POOR PHYSICAL FITNESS DURING CHILDHOOD & HEART DISEASE RISK DURING ADULTHOOD

interesting very long-term prospective clinical study from Norway has been following more than 1,000 volunteers who first entered the study, in 1979, as children (the Oslo Youth Study). In this study, which has just been published in the journal Pediatrics, all of the study’s volunteers were assessed for cardiovascular disease factors upon entering into the study at an average age of 13 years. Subsequently, the volunteers were reassessed at an average age of 15, 25, 33 and 44 years. The findings of this study are rather intriguing given the worsening epidemic of decreased physical activity and obesity among children in many countries throughout the world, including the United States.

Early on in this study, lower levels of physical fitness among the child volunteers were associated with an increased likelihood of obesity and increased blood pressure, which are known cardiovascular disease risk factors. However, as the children matured into adults, the impact of their previous childhood physical fitness levels upon known cardiovascular disease factors diminished with advancing age. By age 40, there was no longer any correlation between the level of physical fitness and physical activity that was present at 13 years of age and the presence or absence of cardiovascular disease factors in adulthood.

I do not want to send the wrong message here by quoting the results of this epidemiological study, but I do believe that there is a positive message here as long as one does not over-interpret the results of this research study (as with all observational studies, there are many potential sources of bias that can skew either the results of such studies, or the interpretation of their results). There is no question but that physically inactive children are at increased risk of becoming obese, or that obese children have a higher risk of the same diseases that plague obese adults. (These obesity-associated illnesses include arthritis, high blood pressure, lung disease, cardiovascular disease, diabetes, and cancer.) But what this study seems to suggest is that adverse cardiovascular risk factors associated with poor levels of physical fitness during childhood can be reversed by middle age. While this study leaves many unanswered questions, it does offer some reassurance that physically inactive and unfit children can still grow into otherwise healthy adults, presumably because they adopt healthier lifestyles that, over time, nullify the effects of childhood physical inactivity, including childhood obesity and hypertension.
Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity.


Dr. Wascher is an oncologic surgeon, professor of surgery, widely published author, and the Director of the Division of Surgical Oncology at Newark Beth Israel Medical Center:

http://www.sbhcs.com/hospitals/newark_beth_israel/mservices/oncology/surgical.html


Send your feedback to Dr. Wascher at:

rwascher@doctorwascher.net



Dr. Wascher's Biography


http://doctorwascher.com



Copyright 2009. Robert A. Wascher, MD. All rights reserved.




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12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

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11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008: Smoking & Quality of Life

10-19-2008: Agent Orange & Prostate Cancer

10-12-2008: Pomegranate Juice & Prostate Cancer

10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208: Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008: Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008: Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008: Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008: Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008: Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008: Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008: Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008: Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008: Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008: Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008: Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008: Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008: Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008: Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008: Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008: Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008: BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008: Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008: Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008: Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008: Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008: Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008: Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity

3-2-2008: Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008: Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008: Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008: Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for Down's Syndrome?

2-3-2008: Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008: Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008: Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008: Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008: Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007: Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007: Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007: Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality

12-11-2007: Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007: Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer