Showing posts with label smoking. Show all posts
Showing posts with label smoking. 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:

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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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Saturday, April 18, 2009

Exercise in Middle Age & Risk of Death

Health Report:


Exercise in Middle Age & Risk of Death



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

By, Robert A. Wascher, MD, FACS


Updated: 04/19/2009

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.



EXERCISE IN MIDDLE AGE & RISK OF DEATH

We all know that getting regular exercise is an important part of staying healthy. Low levels of physical activity have been directly linked to a higher risk of cardiovascular disease and cancer, which are the two most common causes of death throughout most of the world. We also know that even moderate levels of increased physical activity can improve overall health and reduce the risk of developing life-threatening diseases, while higher levels of regular exercise provide even greater protection against illness and premature death. Ideally, we should all engage in regular and vigorous physical exercise throughout our entire lives, beginning in childhood and continuing into the latter years of our lives. If you’ve already reached middle age, however, and you haven’t exactly been a regular at your local neighborhood gym, what clinical or scientific evidence is there that starting a new exercise regimen can substantially improve your prospects of living a longer and healthier life when compared to your more fit same-age peers? A new prospective long-term clinical research study, performed in Sweden and just published in the British Medical Journal, includes some very important data that will, hopefully, provide sedentary middle-aged folks with an even greater incentive to slip on some exercise togs, and hit the gym or track right away.

In this prospective cohort study, 2,205 men, all of whom were 50 years old when they entered the study between 1970 and 1973, were followed for an average of more than 35 years. All of these participating men were re-evaluated at ages 60, 70, 77, and 82 years of age. These men were divided into distinct groups, based upon their self-reported levels of physical activity at the time they entered into this research study, and at each point of re-evaluation. In order to accurately categorize these men in terms of their average levels of physical activity, a previously validated questionnaire was utilized. The men who answered “yes” to the following question were placed in the “low activity” group: “Do you spend most of your time reading, watching TV, going to the cinema, or engaging in other mostly sedentary activities?” The men who answered “yes” to the following question (and “no” to the other three questions) were placed in the “medium activity” group: “Do you often go walking or cycling for pleasure?” Finally, men who answered “yes” to the following two questions were placed in the “high activity” group: “Do you engage in any active recreational sports or heavy gardening at least 3 hours every week” and “Do you regularly engage in hard physical training or competitive sport?”

The annual death rates for this cohort of middle-aged men were then observed for nearly 4 decades, and their risk of death as a function of physical activity levels was then analyzed. Additionally, improvements in death rates associated with increasing levels of physical activity were also compared with improvements in death rates associated with smoking cessation among these men, which makes this very long-term prospective clinical research study very unique.

One particularly important finding of this study was that the men who continued to live a sedentary lifestyle were twice as likely to die prematurely as the men who began the study in the “high level of physical activity” group, which is consistent with the findings of other similar public health studies. When looking more closely at each of the three groups of men, based upon their levels of physical activity, the researchers found that the risk of death (mortality) over a period of approximately 35 years was 27, 24, and 18 per “1,000 person-years” of life among the men with low, medium and high levels of physical activity, respectively. The men who increased their levels of physical activity from “low activity” to “high activity” experienced a 32 percent relative reduction in their risk of mortality, while the “low activity” physical activity group of men who increased their level of physical activity to the “medium” level experienced a 22 percent relative reduction in their risk of death. A critically important observation in this study was that after 10 years of “high” level physical activity, the middle-aged men who had began this study while in the “low activity” group had attained a death rate that was essentially identical to that of the men who had been in the “high activity” group from the very beginning of this study. It should also be noted that during the first 5 years of increased exercise and physical activity, the men who had transitioned from the “low activity” group to the “high activity” group actually had a somewhat higher level of mortality when compared to the men who were already in the “high activity” group at the beginning of the study. After 10 years of sustained “high” level physical activity, however, the men who had started out in the “low activity” group had achieved the same approximately 50 percent reduction in mortality (when compared to the men who remained in the “low activity” group) as was observed in the men who had been in the “high activity” group from the very beginning of this very long-term clinical research study.

Improvements in mortality rates for this cohort of middle-aged men as a result of smoking cessation were also evaluated and, in turn, were compared with the improvements in mortality rates that were observed among the men who boosted their physical activity levels during the course of this study. Cessation of smoking for 10 years reduced the risk of death in these men by about 40 percent (when compared to the men who continued to smoke), while increasing one’s level of physical activity from the lowest level to the highest level resulted in a 49 percent reduction in mortality after 10 years. One important limitation of this study is, of course, that women were not included. However, while the exact magnitude of benefit from increased levels of physical activity may or may not be identical between men and women, there is ample clinical research data available showing that mortality rates decline for both men and women with increasing levels of regular physical activity.


In summary, this important public health study has shown that sedentary middle-aged men who increase their levels of regular physical activity (from “low activity” to “high activity”) for at least 10 years are able to achieve the same level of mortality risk reduction (when compared with men who continue to live a sedentary life) as is observed in other middle-aged men who have spent at least 35 years exercising at the same high level. Moreover, improvements in mortality among middle-aged men who change from low levels to high levels of regular physical activity for at least 10 years appears to be comparable to giving up smoking for at least 10 years. The twin lessons from this study are, therefore, that (1) it is never too late to get up off of the couch and start exercising if you want to maximally reduce your risk of premature death, and (2) throwing away your cigarettes will also significantly decrease your risk of an early and otherwise preventable death (needless to say, implementing both of these important lifestyle changes will tremendously reduce your risk of an early and preventable death!). As a reminder, I recommend that you receive a thorough physical examination by your physician before you embark on a new exercise program, and that you begin your new fitness program in a gradual, graded manner to reduce your risk of injury.


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 a Surgical Oncologist 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:

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

Dr. Wascher's Home Page

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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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

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

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