How Can You Reduce Your Risk of Getting Cancer?

Recent reports suggest that about 2 out of 3 cancers may be due to “bad luck.” Today, we focus on the other third: What can you do to reduce your risk of cancer?

What You Need to Know:

  • Maintaining a healthy body weight and being physically active had the greatest impact on overall risk of a cancer-related death. 
  • Restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal).

Background

  • As people make their resolutions for 2015, two new studies — which show that curbing alcohol consumption, adding more plant foods to the diet, and losing excess weight can help reduce the risk of developing cancer — serve as a reminder that a healthy lifestyle is important.
  • In 1997, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued cancer prevention guidelines for weight management, diet, and physical activity. These were updated in 2007 and are considered to be the most comprehensive scientific analysis of cancer prevention and causation ever undertaken. Specifically, the guidelines reported that excess body fat is associated with an increased cancer risk and that there is convincing evidence that the consumption of alcohol, red meat, and processed meat elevates cancer risk. Since that time, numerous studies have reported links between colorectal cancer risk and alcohol, between breast cancer mortality and obesity, between breast cancer relapse and obesity, and between breast cancer risk and red meat.

The Evidence: The first study, published online January 6 in Cancer Causes & Control, showed that eating a plant-based diet and limiting alcohol intake, both already included in various cancer prevention guidelines, could help cut the risk for obesity-related cancers (about a third of all of cancers). In a cohort of nearly 3000 adults, the researchers found that restricting alcohol consumption to one drink per day for women and two drinks per day for men was associated with 29% reduced risk for obesity-related cancers. Additionally, the risk was up to 71% lower for the most common site-specific cancers in the United States (breast, prostate, and colorectal). For individuals who consume starchy vegetables, such as corn, potatoes, and yams, sufficient consumption of nonstarchy legumes, fruits, and vegetables was associated with a reduction in the risk for colorectal cancer.

Pronounced Effect on Cancer Risk

In their study, Makarem and colleagues investigated whether the healthful behaviors outlined in the WCRF/AICR guidelines were associated with the risk for obesity-related cancers, in particular, breast, prostate, and colorectal cancer. Of the 2983 adults enrolled in the Framingham Offspring cohort from 1991 to 2008, the researchers identified 480 incident obesity-related cancers.

Data from food frequency questionnaires, anthropometric measures, and self-reported physical activity were used to develop a 7-component score based on recommendations for body fatness; physical activity; foods that promote weight gain; plant foods; animal foods; alcohol; and food preservation, processing, and preparation. The cohort was, on average, middle aged to older and overweight, but had a relatively high level of physical activity. The mean duration of follow-up was 11.5 years.

The overall score was not associated with obesity-related cancer risk after adjustment for confounders such as age, sex, smoking, energy, and pre-existing conditions (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.86 – 1.02). However, when the score components were considered separately, the researchers found that for every unit increment in the alcohol score (representing an improvement and more closely meeting the guideline recommendations), there was 29% lower risk for obesity-related cancers (HR, 0.71; 95 % CI, 0.51 – 0.99) and a 49% to 71% reduced risk for breast, prostate, and colorectal cancers.

Similarly, each unit increment in the subcomponent score for nonstarchy plant foods (fruits, vegetables, and legumes) for those who eat starchy vegetables was associated with a 66% lower risk for colorectal cancer (HR, 0.44; 95% CI, 0.22 – 0.88).

Healthy Body Weight and Exercise Reduce Mortality

The second study, published online January 7 in the American Journal of Clinical Nutrition, reported similar results. Researchers found that greater adherence to the cancer prevention guidelines of the American Cancer Society (ACS) was associated with a reduction not only in cancer incidence, but also in cancer mortality and total mortality.

The ACS guidelines recommend that individuals avoid smoking, achieve and maintain a healthy weight, be physically active, and eat a healthy diet that emphasizes plant foods. In their study, Geoffrey Kabat, PhD, senior epidemiologist in the Department of Epidemiology & Population Health at the Albert Einstein College of Medicine in Bronx, New York, and colleagues report that maintaining a healthy body weight and being physically active had the greatest impact on overall mortality for both men and women.

The researchers used data from the NIH-AARP Diet and Health Study, a prospective cohort study of 566,401 adults who were 50 to 71 years of age in 1995 and 1996, when they enrolled in the study. They were followed for a median of 10.5 years for cancer incidence, 12.6 years for cancer mortality, and 13.6 years for total mortality.

During the study period, there were 73,784 cases of cancer, 16,193 cancer deaths, and 81,433 deaths from any cause. The patients were stratified by how closely they adhered to ACS guidelines, and adherence to the guidelines was associated with a reduced risk for all cancers combined. When the highest level of adherence was compared with the lowest level, the hazard ratio was 0.90 for men and 0.81 for women.

In addition, increased adherence was associated with a reduction in risk for 14 of 25 specific cancers. Reduction in the risk for gallbladder cancer was 65% in men and women combined, for endometrial cancer was 60%, for liver cancer was 48% in men, for colon cancer was 48% in men and 35% in women, and for rectal cancer was 40% in men and 36% in women.

My Take: These results add to the existing evidence on the potential role of limiting alcohol intake and increasing the intake of plant foods in influencing cancer risk. Dietary advice on cancer should focus on encouraging the consumption of a plant-based diet providing abundant non-starchy fruits, vegetables, and legumes, and restricting alcohol, if consumed at all, to the recommended levels. Try to stick to the ACS Guidelines, as the closer you follow them, the greater the benefit in cancer risk-reduction. Finally, exercise and don’t use tobacco. I’m Dr. Michael Hunter.

References: Cancer Causes Control. Published online January 6, 2015. Abstract; Am J Clin Nutr. Published online January 7, 2015. Abstract; http://www.medscape.com/viewarticle/837976#vp_2

Lower Your Breast Cancer Recurrence Risk

What You Need to Know: Patients with breast cancer who reduced their dietary fat intake for 5 years after a diagnosis of hormone-unrelated early-stage breast cancer had signficantly reduced all-cause death rates, according to data from the Women’s Intervention Nutrition Study (WINS) presented at the 2014 San Antonio Breast Cancer Symposium.

The Study: For WINS, a randomized trial, Dr. Chlebowski and colleagues recruited 2,437 women ages 48 to 79 years with early-stage breast cancer receiving standard-of-care treatments at 39 centers in the United States. Of them, 1,597 had ER-positive breast cancer, 478 had ER-negative breast cancer, and 362 had ER/PR-negative breast cancer. Within 6 months of diagnosis, subjects were randomly assigned either to a dietary intervention group (n=975; 205 with negative cancer, and 147 ER/PR-negative cancer) or to a control group (n=1,462; 273 ER-negative cancer, and 215 ER/PR-negative cancer).

The dietary intervention was centered on a goal of lowering fat intake for 5 years while maintaining nutritional adequacy. Centrally trained, registered dieticians implementing a low-fat eating plan, gve women in the intervention group a fat gram goal, and the women underwent 8 biweekly individual counseling sessions with subsequent contacts every 3 months. Subjects also self-monitored their fat/gram intake using a “keeping score” book. Fat intake was externally monitored by unannounced annual 24-hour telephone recalls done.

“The current findings with respect to long-term influence of dietary lifestyle intervention on overall survival are mixed, but of potential importance,” said Rowan Chlebowski, MD, PhD, medical oncologist at the Los Angeles Biomedical Research Institute at the Harbor-UCLA Medical Center. “In a prior report of WINS after 5-years’ follow-up, relapse events were 24% lower in the intervention group. In the current report, the intervention influence on long-term survival was examined. Overall, while the death rate was somewhat lower in the intervention group compared with control group (13.6% versus 17%, respectively), the difference was not statistically significant. However, in exploratory subgroup analyses, in women with estrogen receptor [ER]-negative cancers, a 36 percent, statistically significant reduction in deaths was seen in women in the intervention group,” said Dr. Chlebowski.

  • In women with cancers that were both ER- and progesterone receptor [PR]-negative, the reduction was even more significant (56%), Dr. Chlebowski added.
  • After 5 years of dietary intervention, researchers found that fat calories were lowered by 9.2% and body weight was lowered by nearly 6 pounds in the intervention group, compared with the control group.

“HER2 evaluation was not available when this study was conducted, but it is likely that a substantial number of ER/PR-negative breast cancers were also negative for HER2, making them triple-negative breast cancers, which generally have a poor prognosis,” said Dr. Chlebowski. “The signal that perhaps a lifestyle intervention targeting dietary fat intake associated with weight loss could substantially increase the chances of survival for a woman with triple-negative breast cancer could influence this group of patients.”

My Take: It is wonderful that we have an increasing body of evidence that dietary manipulation may lower your risk of recurrence. The drop is not small: It is more than half for those whose tumors are not driven by either estrogen or progesterone. In addition, you may lower your risk of heart attack, stroke, other cancers, and a myriad of other medical problems. Researchers in this study supported the dietary intervention for a median of 5 years. Aim for a lifelong change rather than be a short-term alteration in your diet. I’m Dr. Michael Hunter.

Reference: 37th San Antonio Breast Cancer Symposium (December, 2014); San Antonio, TX

Fight Prostate Cancer with a Tomato-Rich Diet

What You Need to Know: New research suggests that men who eat over 10 portions a week of tomatoes have an 18 percent lower risk of developing prostate cancer. Prostate cancer is the second most common cancer in men worldwide. Rates are higher in developed countries, which some experts believe is linked to a Westernised diet and lifestyle.

The Evidence:  To assess if following diet and lifestyle recommendations reduces risk of prostate cancer, researchers at the Universities of Bristol, Cambridge and Oxford (England) looked at the diets and lifestyles of 1,806 men aged between 50 and 69 with prostate cancer and compared them with 12,005 cancer-free men. The study is the first study of its kind to develop a prostate cancer ‘dietary index’ which consists of dietary components — selenium, calcium and foods rich in lycopene — that have been linked to prostate cancer.

Men who had optimal intake of these three dietary components had a lower risk of prostate cancer. Tomatoes and its products — such as tomato juice and baked beans — were shown to be most beneficial, with an 18 per cent reduction in risk found in men eating over 10 portions a week.

My Take: The reduction in risk may be due to lycopene, an antioxidant that makes tomatoes and watermelon red in color. Lycopenes may help fight off toxins that can cause damage to your DNA (genes). Tomatoes may reduce the risk of prostate cancer among men, and should be considered as a part of a diet containing a wide variety of fruits, vegetables, and fiber. And don’t forget the physical activity and maintenance of a good weight (e.g. body mass index 20-25). 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: V. Er, J. Athene Lane, R. M. Martin, P. Emmett, R. Gilbert, K. N. L. Avery, E. Walsh, J. L. Donovan, D. E. Neal, F. C. Hamdy, M. Jeffreys. Adherence to dietary and lifestyle recommendations and prostate cancer risk in the Prostate Testing for Cancer and Treatment (ProtecT) trial. Cancer Epidemiology Biomarkers & Prevention, 2014; DOI: 10.1158/1055-9965.EPI-14-0322

 

 

Breast Cancer Spread: Can Dieting Reduce Risk?

overweight obese woman

What You Need to Know: Women with an aggressive subtype of breast cancer known as “triple negative” may be able to reduce the chance of disease spreading distantly by reducing their calorie intake. But… the data thus far is based on mice (and not human) studies.

Well, it does work for mice: The study published in the Journal Breast Cancer Research and Treatment, used mice models to investigate the impact of diet on triple negative disease, which is found in about one in five women with breast cancer. It found that when mice were given 30 per cent fewer calories, changes occurred in the body in the way cells were regulated. Mice on restricted diets produced more protective proteins in the tissues around the tumour, which make it harder for cancer to spread, the study by Thomas Jefferson University found.

My Take: We know that in among some groups of women (for example, women who are post-menopausal), obesity increases the risk of breast cancer. Unfortunately, treatment such as chemotherapy (and steroids) can cause weight gain. This weight gain can lead to worse cancer outcomes. Human trials are examining the impact of calorie restriction on outcomes. For now, I advise my patients to try to achieve, and maintain, an optimal Body Mass Index (BMI) of 20 to 25. 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: http://www.telegraph.co.uk/journalists/laura-donnelly/10856597/Dieting-may-reduce-chance-of-cancer-spread.html#source=refresh:

For Oral Health, Have a Tea Party

green tea cup and plants

Epidemiological studies evaluating the association of tea consumption and the risk of oral cancer risk have produced inconsistent results. Thus, the authors of a recent study conducted a meta-analysis (study of studies) to assess the relationship between tea consumption and oral cancer risk.

METHODS: Pertinent studies were identified by a search in PubMed, Web of Knowledge and Wan Fang Med Online. The fixed or random effect model was used based on heterogeneity test. Publication bias was estimated using Egger’s regression asymmetry test.

RESULTS: 14 articles with 19 studies comprising 4675 oral cancer cases were included in this meta-analysis. The relative risk (95% confidence interval) of oral cancer for the highest versus the lowest category of tea consumption was 0.853 (0.779-0.934), and the association was significant between oral cancer risk and green tea consumption [0.798 (0.673-0.947)] but not in the black tea consumption [0.953 (0.792-1.146)]. [This implies that you can reduce the risk by about 1/5th if you consume green tea.]

TAKE-AWAY MESSAGE: Tea consumption may have a protective effect on oral cancer, especially green tea consumption. Previous studies suggested that coffee may lower the risk of cancer of the mouth region, but now we know green tea may work, too! Obviously, more research is needed, but the link seems logical. 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: Oral Oncol. 2014 Jan 2. pii: S1368-8375(13)00802-6. doi: 10.1016/j.oraloncology.2013.12.014. [Epub ahead of print]

Do Antioxidants Promote Lung Cancer?

vitamin E antioxidants

A decades-old medical mystery – why antioxidants such as vitamin E and beta carotene seemed to accelerate the growth of early lung tumors in high-risk populations such as smokers, rather than protect them from cancer, as theory suggests – may have been solved, according to new research.

“Antioxidants allow cancer cells to escape cells’ own defense system” against tumors, biologist Per Lindahl of Sweden’s University of Gothenburg and a co-author of the study told reporters. That lets existing tumors, even those too small to be detected, proliferate uncontrollably. The findings imply that “taking extra antioxidants might be harmful and could speed up the growth of (any) tumors,” said biologist and co-author Martin Bergo of Gothenburg, adding, “If I had a patient with lung cancer, I would not recommend they take an antioxidant.”

The study did not examine whether antioxidants can also initiate lung cancer, rather than accelerate the growth of existing tumors. Nor did it examine whole foods naturally high in antioxidants. But it adds to a growing pile of research challenging the health benefits of taking vitamin supplements except in cases of malnutrition.

Last month, a review of dozens of studies found “no clear evidence of a beneficial effect of supplements” on heart disease, cancer or mortality. An accompanying editorial in the Annals of Internal Medicine warned that “beta carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful,” while other antioxidants are “ineffective.”

The new antioxidant study “seems quite sound,” said Eliseo Guallar, professor of epidemiology at Johns Hopkins Bloomberg School of Public Health and a co-author of the editorial. “It’s unfortunate that the public has the idea that vitamin supplements are good and antioxidants are better.”

One concern about the new study is that the mice received doses of vitamin E at least four times, and as much as 50 times, Americans’ recommended daily intake, noted Duffy MacKay of the Council for Responsible Nutrition, the supplement industry trade group. Government data show that 90% of Americans have diets that contain less than the recommended intake of vitamin E, he said, calling the Swedish study “very interesting and hypothesis-generating,” but not one that should change behavior.

PROTECTING DNA

Of all the gaps between biological theory and medical reality, few are as stark as that involving antioxidants. In cells growing in the lab, antioxidants scavenge and disable free radicals, reactive chemicals produced during normal metabolism that can harm DNA and other components of cells. By the 1980s that had led to the idea that by protecting DNA from damage, antioxidants might prevent cancer and other disease and launched a bull market in antioxidants that continues unabated, with packages of cereal, granola bars, juice and more all touting their antioxidants and health magazines and television shows urging consumers to load up on them.

For the new study, the Gothenburg scientists gave vitamin E and a generic drug called N-acetylcysteine, both antioxidants, to mice with early lung cancer. The vitamin E doses were comparable to those in supplements; the doses of acetylcysteine, which is prescribed for chronic obstructive pulmonary disease (COPD) to reduce mucus, were relatively low.

The antioxidants caused a 2.8-fold increase in lung tumors, made the tumors more invasive and aggressive, and caused the mice to die twice as quickly – all compared to mice not given antioxidants.

When the antioxidants were added to human lung tumor cells in lab dishes, they also accelerated cancer growth. That result jibed with the many studies finding that “antioxidants do not protect against cancer in healthy people and may increase it” or promote it in those who already have cancer, said Bergo.

The significant advance in the study was pinpointing how this can be. What seems to happen is that antioxidants indeed decrease DNA damage, as expected. But the damage becomes so insignificant as to be undetectable by the cell. The cell therefore does not deploy its cancer-defense system, which is based on a protein called p53.

Ordinarily, if p53 detects significant DNA damage, such as from ultraviolet light, it kills the cell before it can become malignant. By allowing cancer cells to stay below the radar of p53, antioxidants allow tumors to thrive, the study found. The scientists stressed that the results do not pertain to foods such as fruits and vegetables that are naturally high in antioxidants.

As for people with COPD who are taking acetylcysteine, “we think that should be carefully evaluated,” Bergo said. Although the study investigated only lung cancer and two antioxidants, previous research suggests that other cancers can also be accelerated by antioxidants, Bergo said, and that other antioxidants have this effect.

The National Cancer Institute already advises cancer patients that antioxidant supplements “should be used with caution.”

The discovery of how antioxidants thwart cells’ innate cancer-fighting machinery might explain why a groundbreaking 1994 study found an 18% higher incidence of lung cancer among 29,133 male smokers who received beta carotene than those who did not. The result was so unexpected and unwelcome that the editorial in the journal where it was published tried to dismiss it as “an extreme play of chance.”

“It’s disappointing but not surprising that people’s beliefs are not modified by scientific evidence,” said Dr. Paul Marantz, an epidemiologist at Albert Einstein College of Medicine in New York. “People so want to believe there is a magic bullet out there.”

I’m Dr. Michael Hunter, and I recommend that we all eat whole fruits. Mix your colors! Orange! Blue! Red! There is more than vitamins there… Cheers!

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.

References: http://bit.ly/1d8gb1s; http://www.medscape.com/viewarticle/819933

Nut Consumption Linked to Lower Mortality

nuts cashews hazelnuts and almonds

The frequency of nut consumption was inversely associated with total and cause-specific mortality independent of other predictors of death, according to a study from 2 large prospective US cohorts, published in the November 21 issue of the New England Journal of Medicine.

“Nuts are rich in nutrients, such as unsaturated fatty acids, fiber, vitamins, and minerals, which may confer cardioprotective, anticarcinogenic, antiinflammatory, and antioxidant properties,” lead author Ying Bao, MD, ScD, associate epidemiologist and instructor in medicine, Brigham and Women’s Hospital and Harvard Medical School, Channing Division of Network Medicine, Boston, Massachusetts. “Previous studies have shown that nut consumption has beneficial effects on various mediators of chronic diseases (eg, blood cholesterol, inflammation, and insulin resistance), and increased nut intake is associated with reduced risks of many chronic diseases (eg, coronary heart disease and type 2 diabetes mellitus).”

The Study: The investigators studied the association between nut intake and mortality among 76,464 women in the Nurses’ Health Study (1980 – 2010) and 42,498 men in the Health Professionals Follow-up Study (1986 – 2010). The authors excluded participants with a history of cancer, heart disease, or stroke. They evaluated nut consumption at baseline and every 2 to 4 years thereafter. During 3,038,853 person-years of follow-up,16,200 women and 11,229 men died.

Compared with participants who did not eat nuts at all, those who ate nuts less than once per week had a 7% decrease in mortality risk, after adjustment for other known or suspected risk factors, including total sodium intake, adherence to a Mediterranean diet, and olive oil intake. Pooled multivariate HRs were 0.89 (95% CI, 0.86 – 0.93) for eating nuts once per week, 0.87 (95% CI, 0.83 – 0.90) for 2 to 4 times per week, 0.85 (95% CI, 0.79 – 0.91) for 5 to 6 times per week, and 0.80 (95% CI, 0.73 – 0.86) for 7 or more times per week (P < .001 for trend).

There were also significant inverse associations between nut consumption and deaths resulting from cancer, heart disease, and respiratory disease. Results were similar for peanuts and tree nuts, and the inverse association persisted across all subgroups.

“In two large prospective U.S. cohorts, we found a significant, dose-dependent inverse association between nut consumption and total mortality, after adjusting for potential confounders,” the authors write. “[C]ompared with participants who did not eat nuts, those who consumed nuts seven or more times per week had a 20% lower death rate.”

Study Strengths and Limitations: Study strengths include prospective design, large sample size (more than 27,000 deaths), 30 years of follow-up with a follow-up rate exceeding 90%, repeated assessment of diet and lifestyle variables (including separate data on peanuts and tree nuts), and extensive data on known or suspected confounding variables.

“Given the observational nature of our study, it is not possible to conclude that the observed inverse association between nut consumption and mortality reflects cause and effect,” the authors write. “However, our data are consistent with a wealth of existing observational and clinical-trial data in supporting the health benefits of nut consumption for many chronic diseases. In addition, nutrients in nuts, such as unsaturated fatty acids, high-quality protein, fiber, vitamins (e.g., folate, niacin, and vitamin E), minerals (e.g., potassium, calcium, and magnesium), and phytochemicals (e.g., carotenoids, flavonoids, and phytosterols), may confer cardioprotective, anticarcinogenic, antiinflammatory, and antioxidant properties.”

Other study limitations include reliance on self-report, possible underestimation of the association, lack of data on method of nut preparation, and restriction of the study sample to health professionals, which could limit generalizability of the results.

I usually offer my take in these blogs, but the author says it best: “[C]linical trials have shown that nut consumption has beneficial effects on some intermediate markers of chronic diseases, such as high cholesterol levels, oxidation, endothelial dysfunction, hyperglycemia, and insulin resistance,” the authors write. “Moreover, recent findings from the [Prevención con Dieta Mediterránea (PREDIMED)] trial [ N Engl J Med. 2013;368:1279-1290] have shown a protective effect of a Mediterranean diet against cardiovascular disease, and one component of the diet was the availability of an average of 30 g of nuts per day.”

Dr. Bao added, “A reasonable recommendation would be to follow the [USDA] Dietary Guidelines, and adding nuts to daily diet may also be beneficial.”

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: N Engl J Med. 2013;369:2001-2011.