Smell Test May Help Detect Alzheimer’s Dementia

The Evidence: Scientists have found that individuals who are unable to identify certain odors are more likely to experience cognitive impairment. The researchers believe that brain cells crucial to a person’s sense of smell are killed in the early stages of dementia.

Background: The ability to smell is associated with the first cranial nerve, and is often one of the first things to be affected by cognitive decline. There is growing evidence that the decreased ability to correctly identify odors is a predictor of cognitive impairment and an early clinical feature of Alzheimer’s. As the disease begins to kill brain cells, this often includes cells that are important to the sense of smell.

The Study: Matthew E. Growdon, B.A., M.D./M.P.H. candidate at Harvard Medical School and Harvard School of Public Health, and colleagues investigated the associations between sense of smell, memory performance, biomarkers of loss of brain cell function, and amyloid deposition in 215 clinically normal elderly individuals enrolled in the Harvard Aging Brain Study at the Massachusetts General Hospital. The researchers administered the 40-item University of Pennsylvania Smell Identification Test (UPSIT) and a comprehensive battery of cognitive tests. They also measured the size of two brain structures deep in the temporal lobes — the entorhinal cortex and the hippocampus (which are important for memory) — and amyloid deposits in the brain.

Results: Growdon reports that, a smaller hippocampus and a thinner entorhinal cortex were associated with worse smell identification and worse memory. The scientists also found that, in a subgroup of study participants with elevated levels of amyloid in their brain, greater brain cell death, as indicated by a thinner entorhinal cortex, was significantly associated with worse olfactory function — after adjusting for variables including age, gender, and an estimate of cognitive reserve.

“Our research suggests that there may be a role for smell identification testing in clinically normal, older individuals who are at risk for Alzheimer’s disease,” said Growdon. “For example, it may prove useful to identify proper candidates for more expensive or invasive tests. Our findings are promising but must be interpreted with caution. These results reflect a snapshot in time; research conducted over time will give us a better idea of the utility of olfactory testing for early detection of Alzheimer’s.”

My Take: Exercise may reduce your risk of cognitive decline. For those who are able, aim for a minimum of 150 minutes per week of the equivalent of a brisk walk. I’m Dr. Michael Hunter.

Reference: Alzheimer’s Association. “Smell and eye tests show potential to detect Alzheimer’s early.” ScienceDaily. ScienceDaily, 13 July 2014. <www.sciencedaily.com/releases/2014/07/140713155512.htm>.

Lower Your Heart Disease Risk in Just 5 Minutes

A new study suggests running, every for a few minutes a day, can reduce your risk of dying from heart disease – whether you plod along or go at race speed.

The Evidence: Researchers studied more than 55,000 adults between the ages of 19 and 100 over a 15-year period, looking at their overall health, whether they ran, and how long they lived.

  • Runners had a 30% lower risk of death from all causes and a 45% lower risk of death from cardiovascular disease.
  • Runners on average lived 3 years longer than those who did not run.
  • When the data was broken down by age, sex, body mass index, and smoking and alcohol use, the benefits were the same. Even those with negative factors such as obesity, smoking, and diabetes benefit. For example, those who were obese and ran had a lower likelihood of death from heart problems (as compared to obese people who did not run). The same for smokers, diabetics, etc.
  • Speed and frequency did not make a huge difference. In fact, runners who ran less than an hour per week had the same mortality benefits compared to runners who ran more than 3 hours per week.

Researchers did find that consistency is important. Participants who ran consistently over a period of 6 years or more gained the most benefits, with a 29% lower risk of death for any reason, and a halving of the risk of death from heart disease or stroke. 

My Take: This study adds to a growing pile of studies linking physical activity to better (and longer) life. And, you don’t have to run: If you are able, after checking with your health care provider, aim for a minimum of the equivalent of a brisk walk for 150 minutes per week (for example, 30 minutes for five times per week). I’m Dr. Michael Hunter.

Reference: Journal of the American Journal of Cardiology, Volume 64, Issue 5; 5 August 2014, Pages 482-484.

How Antioxidants Can Accelerate Cancers

Background: For decades, health-conscious people around the globe have taken antioxidant supplements and eaten foods rich in antioxidants, figuring this was one of the paths to good health and a long life.

Yet clinical trials of antioxidant supplements have repeatedly dashed the hopes of consumers who take them hoping to reduce their cancer risk. Virtually all such trials have failed to show any protective effect against cancer. In fact, in several trials antioxidant supplementation has been linked with increased rates of certain cancers. In one trial, smokers taking extra beta carotene had higher, not lower, rates of lung cancer.

In a brief paper appearing in The New England Journal of Medicine, David Tuveson, M.D. Ph.D., Cold Spring Harbor Laboratory Professor and Director of Research for the Lustgarten Foundation, and Navdeep S. Chandel, Ph.D., of the Feinberg School of Medicine at Northwestern University, propose why antioxidant supplements might not be working to reduce cancer development, and why they may actually do more harm than good.

The Science: Their insights are based on recent advances in the understanding of the system in our cells that establishes a natural balance between oxidizing and anti-oxidizing compounds. These compounds are involved in so-called redox (reduction and oxidation) reactions essential to cellular chemistry.

Oxidants like hydrogen peroxide are essential in small quantities and are manufactured within cells. There is no dispute that oxidants are toxic in large amounts, and cells naturally generate their own anti-oxidants to neutralize them. It has seemed logical to many, therefore, to boost intake of antioxidants to counter the effects of hydrogen peroxide and other similarly toxic “reactive oxygen species,” or ROS, as they are called by scientists. All the more because it is known that cancer cells generate higher levels of ROS to help feed their abnormal growth.

Drs. Tuveson and Chandel propose that taking antioxidant pills or eating vast quantities of foods rich in antioxidants may be failing to show a beneficial effect against cancer because they do not act at the critical site in cells where tumor-promoting ROS are produced — at cellular energy factories called mitochondria. Rather, supplements and dietary antioxidants tend to accumulate at scattered distant sites in the cell, “leaving tumor-promoting ROS relatively unperturbed,” the researchers say.

Quantities of both ROS and natural antioxidants are higher in cancer cells — the paradoxically higher levels of antioxidants being a natural defense by cancer cells to keep their higher levels of oxidants in check, so growth can continue. In fact, say Tuveson and Chandel, therapies that raise the levels of oxidants in cells may be beneficial, whereas those that act as antioxidants may further stimulate the cancer cells. Interestingly, radiation therapy kills cancer cells by dramatically raising levels of oxidants. The same is true of chemotherapeutic drugs — they kill tumor cells via oxidation.

Paradoxically, then, the authors suggest that “genetic or pharmacologic inhibition of antioxidant proteins” — a concept tested successfully in rodent models of lung and pancreatic cancers — may be a useful therapeutic approach in humans. The key challenge, they say, is to identify antioxidant proteins and pathways in cells that are used only by cancer cells and not by healthy cells. Impeding antioxidant production in healthy cells will upset the delicate redox balance upon which normal cellular function depends.

The authors propose new research to profile antioxidant pathways in tumor and adjacent normal cells, to identify possible therapeutic targets.

I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Cold Spring Harbor Laboratory. “How antioxidants can accelerate cancers, and why they don’t protect against them.” ScienceDaily. ScienceDaily, 10 July 2014. <www.sciencedaily.com/releases/2014/07/140710094434.htm>

Elizabeth G. Phimister, Navdeep S. Chandel, David A. Tuveson. The Promise and Perils of Antioxidants for Cancer Patients. New England Journal of Medicine, 2014; 371 (2): 177 DOI: 10.1056/NEJMcibr1405701

Bothered by Hot Flashes? Acupuncture May Help, Analysis Suggests

What You Need to Know:  A meta-analysis (study of studies) of randomized controlled trials  indicates that acupuncture can affect the severity and frequency of hot flashes for women in natural menopause. Background: In the 2,500+ years that have passed since acupuncture was first used by the ancient Chinese, it has been used to treat a number of physical, mental and emotional conditions including nausea and vomiting, stroke rehabilitation, headaches, menstrual cramps, asthma, carpal tunnel, fibromyalgia and osteoarthritis, to name just a few. The Study: An extensive search of previous studies evaluating the effectiveness of acupuncture uncovered 104 relevant students, of which 12 studies with 869 participants met the specified inclusion criteria to be included in this current study. While the studies provided inconsistent findings on the effects of acupuncture on other menopause-related symptoms such as sleep problems, mood disturbances and sexual problems, they did conclude that acupuncture positively impacted both the frequency and severity of hot flashes.

  • Women experiencing natural menopause and aged between 40 and 60 years were included in the analysis, which evaluated the effects of various forms of acupuncture, including traditional Chinese medicine acupuncture (TCMA), acupressure, electroacupuncture, laser acupuncture and ear acupuncture.
  • Interestingly, neither the effect on hot flash frequency or severity appeared to be linked to the number of treatment doses, number of sessions or duration of treatment. However, the findings showed that sham acupuncture could induce a treatment effect comparable with that of true acupuncture for the reduction of hot flash frequency. The effects on hot flashes were shown to be maintained for as long as three months.

Although the study stopped short of explaining the exact mechanism underlying the effects of acupuncture on hot flashes, a theory was proposed to suggest that acupuncture caused a reduction in the concentration of β-endorphin in the hypothalamus, resulting from low concentrations of estrogen. These lower levels could trigger the release of CGRP, which affects thermoregulation.

“More than anything, this review indicates that there is still much to be learned relative to the causes and treatments of menopausal hot flashes,” says NAMS executive director Margery Gass, MD. “The review suggests that acupuncture may be an effective alternative for reducing hot flashes, especially for those women seeking non- pharmacologic therapies.”

A recent review indicated that approximately half of women experiencing menopause-associated symptoms use complementary and alternative medicine therapy, instead of pharmacologic therapies, for managing their menopausal symptoms. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

 

Reference: The North American Menopause Society (NAMS). “Bothered by hot flashes? Acupuncture might be the answer, analysis suggests.” ScienceDaily. ScienceDaily, 14 July 2014. <www.sciencedaily.com/releases/2014/07/140714122812.htm>.

Vasectomy May Increase Risk of Aggressive Prostate Cancer

What You Need to Know: Vasectomy is associated with a small increased risk of prostate cancer, and a stronger risk for advanced or lethal prostate cancer, according to a new study from Harvard School of Public Health (HSPH). The researchers found that the association remained even among men who received regular prostate-specific antigen (PSA) screening, suggesting the increased risk of lethal cancer cannot be explained by diagnostic bias. It is the largest and most comprehensive study to date to look at the link between vasectomy and prostate cancer. The study appeared online July 7 in Journal of Clinical Oncology.

Results: The results showed 1.1x increased risk of prostate cancer overall in men who had a vasectomy. Vasectomy was not significantly associated with risk of low-grade cancer; however, it was associated with stronger risks of advanced and lethal prostate cancer, by an additional 20 percent and 19 percent respectively. Among men who received regular PSA screening, the relative increase in risk of lethal prostate cancer was 56 percent (about 1.5x more likely to get the disease, compared to someone who did not have a vasectomy). The effect appeared to be stronger among men who had a vasectomy at a younger age.

“This study follows our initial publication on vasectomy and prostate cancer in 1993, with 19 additional years of follow-up and tenfold greater number of cases. The results support the hypothesis that vasectomy is associated with an increased risk of advanced or lethal prostate cancer,” said co-author Lorelei Mucci, associate professor of epidemiology at HSPH.

Vasectomy is a common form of contraception in the United States, with about 15 percent of men undergo the procedure. Prostate cancer is the second-leading cause of cancer death among American men, so identifying risk factors for lethal prostate cancer is important for public health.

The researchers analyzed data from the Health Professionals Follow-Up Study, which followed 49,405 American men for up to 24 years between 1986 and 2010. During that time, 6,023 cases of prostate cancer were diagnosed, including 811 lethal cases. One in four of the men in this study reported having a vasectomy.

Prior work on this topic raised concerns that the positive associations could be linked to bias. However, in the present study, the researchers had access to diverse information and could rule out potential biases, including the possibilities that men who have vasectomies seek more medical care in general or have higher rates of PSA screening, or that the association was due driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment.

Among the men in this study, 16 in 1,000 developed lethal prostate cancer during 24 years of follow-up. Although the relative increase in the risk associated with vasectomy was significant, this translates to a comparatively small increase in absolute difference in the risk of lethal prostate cancer, the researchers said. “The decision to opt for a vasectomy as a form of birth control is a highly personal one and a man should discuss the risks and benefits with his physician,” said co-author Kathryn Wilson, research associate in the Department of Epidemiology at HSPH.

My Take: About 16 in 1,000 men developed lethal prostate cancer during 24 years of follow-up. While the relative increase in the risk associated with vasectomy was significant, this translates to a relatively small increase in the risk for an individual. Still, prostate cancer is one more risk we must factor in when we think about vasectomy. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Harvard Gazette – http://news.harvard.edu/gazette/story/2014/07/vasectomy-may-increase-risk-of-aggressive-prostate-cancer/

Primary source: The study appeared online July 7 in Journal of Clinical Oncology.

Can Exercise Reduce Your Risk of Alzheimer’s Dementia?

What You Need to Know: Exercise may help keep the brain robust among people who have an increased risk of developing Alzheimer’s disease, according to an inspiring new study. Even moderate amounts of physical activity may help to slow the progression of one of the most dreaded diseases associated with aging.

Background: Alzheimer’s disease is characterized by a gradual and then quickening loss of memory and cognitive functioning. All of us are vulnerable. But in recent years, scientists have found that individuals with a specific variant of a gene (known as the APOE epsilon4 allele or e4 gene for short) have a substantially increased risk of developing the disease. Brain imaging shows that a memory center (hippocampus) is considerably shrunken among those with Alzheimer’s disease. But, a previous study published in 2011 showed that exercise can slow progression among those with the e4 gene. What that study did not do, however, was look at brain structure.

The Evidence: Researchers at the Cleveland Clinic (Ohio, USA) recruited almost 100 older men and women, ages 65 to 89, many of whom had a family history of Alzheimer’s disease. At the study start, about have the population was found to carry the e4 gene. None showed signs of memory loss beyond what would be expected to be normal for their age.

  • Investigators asked the volunteers how often and intensely they exercised. About half didn’t move at all. But the other half walked, jogged, or otherwise exercised moderately a few times every week.
  • The researchers then did brain scans on the participants. Eighteen months later, they repeated the scan. In this short interval, those with the e4 gene who did not exercise had significant shrinkage of their hippocampus (memory center): It shrank by about 3%. Those who had the e4 gene and regularly exercised had no such shrinkage! Finally those without the e4 gene had little change in the hippocampus. 

My Take: Why not get up and move? I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: Physical activity reduces hippocampal atrophy in elders at genetic risk for Alzheimer’s disease. Front Aging Neurosci 2014; 6: 61.

 

 

Drinking Alcohol Provides no Heart Health Benefit for Some Individuals

What You Need to Know: Reducing the amount of alcoholic beverages consumed, even for light-to-moderate drinkers, may improve cardiovascular health, including a reduced risk of coronary heart disease, lower body mass index (BMI) and blood pressure, according to a new multi-center study published in the British Medical Journal and co-led by the Perelman School of Medicine at the University of Pennsylvania. The latest findings call into question previous studies which suggest that consuming light-to-moderate amounts of alcohol (0.6-0.8 fluid ounces/day) may have a protective effect on cardiovascular health.

The Evidence: The new research reviewed evidence from more than 50 studies that linked drinking habits and cardiovascular health for over 260,000 people. Researchers found that individuals who carry a specific gene which typically leads to lower alcohol consumption over time have, on average, superior cardiovascular health records. Specifically, the results show that individuals who consume 17 percent less alcohol per week have on average a 10 percent reduced risk of coronary heart disease, lower blood pressure and a lower Body Mass Index.

“Contrary to what earlier reports have shown, it now appears that any exposure to alcohol has a negative impact upon heart health,” says co-lead author Michael Holmes, MD, PhD, research assistant professor in the department of Transplant Surgery at the Perelman School of Medicine at the University of Pennsylvania. “For some time, observational studies have suggested that only heavy drinking was detrimental to cardiovascular health, and that light consumption may actually be beneficial. This has led some people to drink moderately based on the belief that it would lower their risk of heart disease. However, what we’re seeing with this new study, which uses an investigative approach similar to a randomized clinical trial, is that reduced consumption of alcohol, even for light-to-moderate drinkers, may lead to improved cardiovascular health.”

In the new study, researchers examined the cardiovascular health of individuals who carry a genetic variant of the ‘alcohol dehydrogenase 1B’ gene, which is known to breakdown alcohol at a quicker pace. This rapid breakdown causes unpleasant symptoms including nausea and facial flushing, and has been found to lead to lower levels of alcohol consumption over time. By using this genetic marker as an indicator of lower alcohol consumption, the research team was able to identify links between these individuals and improved cardiovascular health.

My Take: Not so fast. I think that we need to interpret the study narrowly: For those who carry a genetic variant of the alcohol dehydrogenase 1B gene, decreasing alcohol consumption may have a cardiovascular benefit. Since we do not routinely test for this gene, I suggest moderation for those who drink: Aim for no more than one (women) or two (men) standard drinks daily (women). I look forward to the day when we can individualize recommendations regarding diet, physical activity, and cancer screening, based on individual genetics. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: University of Pennsylvania School of Medicine. “Drinking alcohol provides no heart health benefit, new study shows.” ScienceDaily. ScienceDaily, 10 July 2014. <www.sciencedaily.com/releases/2014/07/140710151947.htm>.