News Briefs: Fruit Consumption Cuts Breast Cancer Risk; Common Drugs Linked to Cognitive Decline; Air Pollution & High Blood Pressure

News Briefs Archives July 1, 2016

Apples, bananas and grapes consumed during adolescence were found to be particularly beneficial

Teens Who Eat Fruits Cut Risk of Breast Cancer by 25 Per Cent

Scientists have reported that eating fruits during the teen years may protect against the occurrence of breast cancer later in life. Fruits and vegetables are rich sources of fibre, vitamins, and other biologically active substances that are thought to offer protection against breast cancer. However, most previous studies have focused on consumption of fruit and vegetables starting from the midlife years. By then, breast tissue may no longer be so vulnerable to carcinogenic influences. These new findings indicate that eating fruits and vegetables during adolescence may be especially important. Breast cancer is the most common form of cancer for American women, apart from some skin cancers. It affects about 100 times as many women as men.

Researchers used data from a study that followed 90,000 nurses over 20 years. The nurses had reported their nutritional habits in early adulthood. For this study, high fruit and vegetable consumption was considered to be 2.9 servings a day, compared with low consumption of 0.5 servings. Those who reported a high consumption of fruit and vegetables during adolescence had about a 25 percent lower occurrence of breast cancer diagnosis in middle age. Apples, bananas, and grapes consumed during adolescence, and oranges and kale eaten during early adulthood, were found to be particularly beneficial. The authors noted that fruits and vegetables rich in alpha-carotene could offer the most protection.
This study was posted online early, ahead of publication in the British Medical Journal. The report is available at https://tinyurl.com/zghep54 free of charge.

Commonly Used Drug Type Linked to Cognitive Decline

Scientists have found new evidence that may explain a known link between drugs commonly used for colds, allergies, depression, high blood pressure, and heart disease on one hand, and cognitive impairment and dementia on the other. (These drugs, known as anticholinergics, stop a chemical called acetylcholine from working properly in the nervous system. By doing so, they can relieve unpleasant gastrointestinal, respiratory, or urinary symptoms. The list includes Benadryl for allergies, Paxil for depression, Zyprexa for psychosis, Dimetapp for colds, Unisom for insomnia.)

The researchers looked at brain scans and cognitive test results from 451 older adults, including 60 who had been taking anticholinergic drugs for at least a month. None had been diagnosed with cognitive problems such as Alzheimer’s or dementia. Brain scans of those who had used anticholinergics showed lower levels of glucose-processing in a region of the brain associated with memory and affected early in the course of Alzheimer’s. This indicates reduced brain activity. These subjects showed reduced brain volume and thickness in regions linked to cognitive function and scored comparatively lower on tests of immediate recall and executive function.

The study shows only an association and could not prove that the anticholinergics were the cause of the memory differences; it is possible, for example, that the conditions being treated with these drugs separately interfere with memory function. The authors acknowledged the limitations of their study. Still, a healthy patient concerned about future dementia risk due to family history or another reason may wish to consider alternative treatments. This study was recently posted at the site of JAMA Neurology and will appear in a future issue. It is now available at https://tinyurl.com/h5oj2su for a fee.

Air Pollution Linked to High Blood Pressure

New research shows that both short-term and long-term exposure to some air pollutants commonly associated with coal burning, vehicle exhaust, and airborne dust and dirt are associated with the development of high blood pressure. (High blood pressure was defined as systolic blood pressure more than 140 mm Hg or diastolic blood pressure over 90 mm Hg, or by the use of antihypertensive drugs by the individual. High blood pressure is a major risk factor for cardiovascular disease and stroke. Previous studies indicated that air pollution might be a risk factor for hypertension but the results were controversial.)

Scientists conducted an analysis of 17 previously-published studies and discovered a significant hypertensive risk from pollutants. They concluded that people in general should limit their exposure on days with higher air pollution levels, and that those with existing high blood pressure avoid even very short-term exposure on those days. The meta-analysis found that high blood pressure was significantly associated with short-term exposure to sulfur dioxide and particulate matter; and long-term exposure to nitrogen dioxide, which is produced from combustion, and from larger particulate matter. The mechanism by which air pollution could contribute to the development of high blood pressure includes inflammation and oxidative stress, which may lead to changes in the arteries.

This study was released May 31, 2016 but will not be published until a later issue of the journal Hypertension. It can be read online at https://tinyurl.com/hokclen free of charge.

Probiotic Supplements Found Beneficial for Rheumatoid Arthritis Patients

Scientists have found that probiotic supplementation provides benefits for patients with rheumatoid arthritis (RA). (Rheumatoid arthritis is a long-lasting autoimmune disorder that primarily affects joints.) Sixty patients aged 25 to 70 years with RA were randomly assigned to take either probiotic capsules or placebo capsules for eight weeks. The probiotic capsule contained Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum. Blood samples were taken before and after the study. Probiotic-supplemented volunteers showed significant disease improvement (measured by the Disease Activity Score of 28 joints or DAS-28), significant decrease in insulin levels, improved B-cell (immune) function, and reduced inflammation (C-reactive protein concentrations).

This study was posted online ahead of publication in International Journal of Rheumatic Diseases. The early version is available at https://tinyurl.com/jzm5v3r for a fee.

Medical Errors Constitute the Third Largest Cause of Death

A new analysis reports that preventable medical error is the third largest cause of death in the U.S. At least 250,000 people per year die – not from the illnesses or injuries that prompted them to seek hospital care – but from preventable mistakes by medical personnel. (An earlier study estimated this number to be potentially higher, between 250,000 and 400,000.) This 250,000 death toll exceeds all deaths from strokes and Alzheimer’s combined. It is topped only by heart disease and cancer, which each claim 614,000 and 591,000 lives, respectively, per year. The researchers included only deaths from hospital-related medical errors, and they found that the death toll from medical mistakes would be even higher if nursing homes and out-patient care were also included.

The reason the analysis was needed is that no one keeps track of deaths by medical error, and it is not included as a cause of death in mortality statistics; as a result, the official third greatest cause of death is instead listed as chronic lower respiratory diseases (147,000). The study author indicated that the analysis shows that deaths do not only result from disease and arterial plaque but from communication breakdowns, fragmented healthcare, diagnostic mistakes, botched surgeries, computer glitches, and overdosing, adding that these causes constitute one of the most under-reported killers in global health. The situation in the developing world is likely worse. The study author suggested that in Africa, poor quality medical care or preventable complications kill more people than HIV and malaria combined.

The study concluded that safety nets could be put in place to track medical errors and reduce their number. Death certificates could involve asking whether a preventable problem stemming from medical care might have contributed to the death. But asking hospitals and doctors to self-report their mistakes without offering a higher degree of protection from possible prosecution may not work. Other leading causes of death are accidents (133,000), diabetes (76,500), influenza or pneumonia (55,000), and suicide (43,000), according to the National Center for Health Statistics. This study was published May 3, 2016 in the medical journal BMJ. The full report is available online at https://tinyurl.com/zfwjvll free of charge.

DID YOU KNOW…?

The Journal of the International Society of Sports Nutrition reported that dark chocolate enhances fitness performance, including cycling. Its epicatechin compound increases nitric oxide, which dilates blood vessels, reducing oxygen use.

Antacid Medications Accelerate Blood-Vessel Aging

A new study has found that chronic use of proton-pump inhibitors (PPIs), which are drugs used to treat heartburn and gastroesophageal reflux (or GERD), speeds up the aging of blood vessels, which in turn could lead to increased cardiovascular disease, vascular dementia, and renal failure. (The FDA estimates about one in 14 Americans have used a PPI, the third most-taken type of drug in the U.S. PPIs have a variety of chemical names, but they always end with the suffix “–prazole.” For example, the PPI commonly known as Nexium is also called esomeprazole.)

This accelerated aging of blood vessels could explain the previously known epidemiological link between long-term use of PPIs and an increased risk of heart attack, renal failure, and dementia. These medications are sold over-the-counter in the U.S. so medical supervision is not required. Although effective when taken as prescribed, they are not approved for long-term use, and evidence suggests that up to 70 per cent of PPI use may be inappropriate. Chronic exposure to PPIs was shown to accelerate biological aging in human endothelials (cells that line the inside of blood vessels). Over time, these drugs were found to turn endothelials from a Teflon-like coating of vessels to more of a Velcro-like coating, which can promote arterial blockages. Cellular garbage accumulates in the endothelial cells, speeding up the aging process. No negative effects were seen when PPI use was limited to a few weeks. This study was posted online May 10, 2016 and will later be published in the journal Circulation Research. Meanwhile, this study can be read online in full at https://tinyurl.com/gooovtf without cost.

Tai Chi Helps Knee Osteoarthritis as well as Physiotherapy

A comparative study has found that Tai Chi improves pain and related health outcomes in patients with knee osteoarthritis as much as the standard physical therapy. Also, it was shown to produce significantly greater improvements in depression and the physical component of quality of life. (Knee osteoarthritis is a leading cause of age-related pain and disability. Over-the-counter pain medications seldom relieve symptoms and consequently, physiotherapy is globally recommended, although its benefits are modest. Tai Chi combines meditation with slow movements, deep breathing, and relaxation.)

Just over 200 participants were randomly assigned to one of two treatment groups: Tai Chi or standard physiotherapy. Patients in the Tai Chi group worked with a trained instructor twice per week for 12 weeks. Patients in the physical therapy group had standard physical therapy twice per week for six weeks, followed by six weeks of monitored home exercise. After 12 weeks, patients in both groups showed significant improvements in pain as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, with benefits maintained up to 52 weeks. In addition, patients in the Tai Chi group had significantly greater improvements in well-being. According to the authors, these findings support Tai Chi as an effective therapeutic option for knee osteoarthritis. This study was released in the Online First section of the site of Annals of Internal Medicine on May 17, 2016, and the full report can be read at https://tinyurl.com/jsucv65 with access fee.

DID YOU KNOW…?

Over 50 per cent of North American dogs and cats, amounting to almost 100 million animals, are obese. This leads to cancer, cardiovascular disease, and shorter life spans. Veterinarian researchers recommend that meal sizes be cut by 25 per cent, and that food not be given as a reward or to show love.