Thursday, November 21, 2013

(Video) Nuts Cut Risk of Cancer, Heart Disease, and Early Mortality

Earlier this month, we posted about recent findings linking nut consumption with a lower risk of benign breast disease in young women.  Further confirming the power of nuts, new results from a large study published in the New England Journal of Medicine reports that men and women who are frequent nut eaters (7 or more time per week) have a lower risk of heart disease and cancer, as well as a 20 percent lower risk of early death than those who rarely eat nuts (less than once per week).

We could further summarize the findings, but this short animated video put out by the Journal does a very good job.

Overall, the evidence is quite compelling that nuts are an important part of a healthy diet and healthy lifestyle.  Just a few ounces of whole nuts or peanut butter a week can have real benefits, and you don't need to be fixated on peanuts.  Other types of nuts or nut-butters have benefits as well and also taste great. So, more than ever, you have license to go nuts.

Wednesday, November 20, 2013

Obesity shortening life among breast cancer survivors, national US data

Obesity is a strong driver for postmenopausal breast cancer. Consistent data from around the world show that overweight and obese women are at increased risk of breast cancer through their postmenopausal years. It is estimated that obesity causes more than 10% of postmenopausal breast cancer. Mechanisms for this include higher circulating estrogen levels among overweight and obese women compared to lean women, and insulin pathways. After menopause the ovaries are less active, and fat cells produce estrogen. Obesity is also related to mortality from many other causes (heart disease, stroke, diabetes, etc.). To put the breast cancer burden in context and evaluate the population health impact of breast cancer on lifespan Dr. Chang and colleagues draw on US National Health Interview Survey data and the linked mortality data. They then estimate life expectancy for women who are normal weight and obese, and the life years lost to breast cancer (see report).

The national data show that the life years lost among women diagnosed with breast cancer are greater for younger women than those diagnosed at older ages. This makes good sense. In addition, obese women with breast cancer had greater loss of life than non-obese women. For example, women who were obese and diagnosed with breast cancer before age 50 lost on the average 9.8 years compared to non-obese women who lost 7.8 years. For women diagnosed after age 70 obese women lost approximately 5 years and the nonobese 3.7 years. This pattern was also seen in analysis of African American women.

Choosing measures for evaluation of population level health remains an area that the National Academy of Sciences continues to address. They have recommended life expectancy and quality of life as appropriate measures for population health. This report, evaluating life years lost associated with breast cancer applies this framework. The data clearly support a greater emphasis on the prevention and control of obesity given its impact on this the second most common cause of cancer mortality in women.

Monday, November 4, 2013

Prevention's True Potential in the Ongoing "War on Cancer"

The latest in the New York Times' Retro Report series tackles the launch and subsequent progress of the Nixon administration's 1971 National Cancer Act, dubbed the "War on Cancer."  The ultimate hope of the act was that - with an economic and human power push similar to that used with the first moon landing in the late 60s - cancer as a disease could be controlled and cured nationally in just a handful of years.

As the incisive video reports, the reality has been quite different. No overall cure arose in 5, 10, or even 40 years. And for most of those years, in fact, cancer seemed to be a disease continually on the rise.

More recently, however, there have been positive signs - most notably a downward trend in overall death rates from the disease.  Some of these gains have certainly come from new and improved treatments, and some from factors related to prevention and screening - drops in smoking, fewer women using post-menopausal hormones, and improving rates of screening for breast, colon, and cervical cancer.

And it is this progress in prevention that makes the closing sentence of the video's accompanying article written by Gina Kolata very strange.  She closes the piece saying that prevention is the area least understood when it comes to the fight against cancer:
"The biggest challenge, prevention, remains. And other than stopping smoking, nothing yet has been terribly promising."
The reality, though, could not be be farther from the truth.  The real hope in controlling cancer - especially from a practical standpoint - is through prevention, and there is compelling evidence that over half of all cancer cases (and 75 percent of some specific kinds of cancer) could be prevented by things we already know and that we can all do:  such as exercising, maintaining a healthy weight, avoiding smoking, eating a healthy diet, avoiding too much alcohol, and getting appropriate screening tests.

Yes, the challenge in cancer prevention - as in most other important chronic diseases - is helping people put such behaviors into practice.  But to deny their potential benefits in the efforts to control cancer is careless and wrong.

To see just how much of an impact a healthy lifestyle can have on cancer risk, see these resources: