Tuesday Health Notes

Research: Repeated Antiobiotic Users at Greater Risk of Non-Hodgkin's Lymphoma

The American Journal of Epidemiology just published research associating the repeated use of antiobiotics with an elevated risk for Non-Hodgkin's Lymphoma (NHL).

Use of antibiotics more than 10 times during adulthood was positively associated with risk of NHL and most major NHL subtypes; when users were compared with nonusers, the odds ratio for NHL was 1.8 (95% confidence interval: 1.4, 2.3); ptrend for total antibiotic use <0.001. In addition, high cumulative use of nonsteroidal anti-inflammatory drugs was marginally associated with elevated NHL risk. Other medications evaluated were not associated with risk of NHL or its most common subtypes. Findings suggest that inflammation, infections, susceptibility to infections, and/or use of antibiotics or nonsteroidal anti-inflammatory drugs to treat these conditions may increase the risk of NHL.

Ellen T. Chang, Karin Ekstr�m Smedby, Henrik Hjalgrim, Claudia Sch�llkopf, Anna Porwit-MacDonald, Christer Sundstr�m, Edneia Tani, Francesco d'Amore, Mads Melbye, Hans-Olov Adami, and Bengt Glimelius wrote the article.

Intelihealth reports that NHL affects about 45,000 Americans, and adds that "for unknown reasons, this cancer has been becoming more common." Perhaps the work of Chang et al will move us a step closer to understanding that trend more clearly.

Intuitive Eating

In his books and in his practice, Dr. Fuhrman repeatedly describes the idea that we should learn to listen to our bodies and respond to "true hunger," as opposed to "toxic hunger." Toxic hunger, as he writes in Disease-Proof Your Child, is not the product of your body saying it needs nourishment, but rather "withdrawal symptoms from an unhealthful diet."

The notion that our bodies know, on some level, how to eat healthily, is supported somewhat by some new research. Dr. Steven R. Hawks of Brigham Young University in Provo, Utah has been instructing people in what he calls "intuitive eating," and in a pilot study they have reportedly been losing weight and feeling good.

Reuters Health News desbribes the approach:

To become an intuitive eater, a person also needs to adopt two key behaviors. They must learn how not to eat for emotional, environmental or social reasons and they must listen to their body and eat only when hungry and stop when full. They must also learn how to interpret body signals, cravings, and hunger and respond in a healthy way.

Of course, the day before Thanksgiving--our national salute to overeating--could be just about the worst time to bring this up, right? Something to keep in mind, anyway.

Study: A Better Measure than Body Mass Index

Canadian researchers have just had an article published in The Lancet that suggests their may be a simple technique to determine your risk of heart disease that is more effective than the standard Body Mass Index. Nicholas Bakalar reports in The New York Times. Warning: you'll be wanting a tape measure and a calculator, so you might as well get those now...

A waist-to-hip ratio (waist measurement divided by hip measurement) below 0.85 in women or 0.9 in men is average. Anything above that is a risk for heart disease.

The researchers, led by Dr. Salim Yusuf, a professor of medicine at McMaster University near Toronto, studied 12,461 people who had had a first heart attack and compared them to a matched group of 14,637 without heart disease.

A body mass index greater than 28.2 in women or 28.6 in men did indicate an increased risk of heart attack, but the relationship disappeared after adjusting for age, sex, geographic region and tobacco use.

Waist-to-hip ratio, on the other hand, showed a continuous relationship to heart attack risk even after adjusting for other risk factors. Those in the highest fifth were 2.52 times as likely to have a heart attack as those in the lowest fifth.

Dr. Fuhrman wrote about this in his book Eat to Live. In fact, Amazon.com will let their customers read that part of Eat to Live online for free.

You'll see he cites the work of Harvard's Dr. I-Min Lee--who studied nearly 20,000 men over nearly thirty years. She found that you practically can not be too thin: the lightest group of men had the lowest mortality. (Of course, he cautions, there is such a thing as being too thin, which is usually anorexia and is a topic for another time.)

And as you can read, Dr. Fuhrman describes various favored techniques for measuring body fat: like Dr. Yusuf, he finds that fat around the waist is a more useful measure than body mass index.

Two quickie rules of thumb from Eat to Live to assess whether or not you are at your ideal weight:

  • Men shouldn't be able to pinch more than a half-inch of skin near the belly button. Women should not be able to pinch more than an inch.
  • If you have gained as little as ten pounds since you were 18 or 20 years old, then you could have a significantly increased risk for health problems like heart disease, diabetes, and high blood pressure.

Research: Diet as Children Affects Lifelong Cancer

Dr. Fuhrman's book Disease-Proof Your Child contains a huge new idea: that childhood diet plays an important role in many cancers and other chronic diseases that occur decades later.

Since the book came out, there has been even more research to support the theory. Alert Followhealthlife reader Rick Miller sent us an MSNBC article about new evidence that bad adolescent diets can inspire later breast cancer.

The article, by Karen Collins, R.D., focuses on a phytochemical found in soy, called genistein:

The University of Alabama researcher who presented the new studies at the conference said that genistein offered no protection from breast cancer when it was first given to animals in adulthood. But when the animals ate it before puberty, they had less breast cancer development.

The benefits were even greater when they continued to eat it into adulthood. The evidence suggests that the time around puberty offers a chance to imprint cells with a "blueprint" that creates cellular pathways for long-term protection.

The Lancet: Cruciferous Vegetables Protect Against Lung Cancer

It's a great day: the big photo at the moment on the website of the medical journal The Lancet is of some of Dr. Fuhrman's favorite medicines: cabbage, kale, Brussels sprouts, broccoli, and all those cruciferous vegetables that are so good for you.

The caption explains the results of an important new study:

Eating vegetables from the cabbage family could help individuals with a certain genetic make-up reduce their risk of lung cancer. Weekly consumption of cruciferous vegetables had a 72% protective effect against lung cancer in people who had inactive forms of both the GSTM1 and GSTT1 genes.

If you read the whole abstract, you will find this summation:

These data provide strong evidence for a substantial protective effect of cruciferous vegetable consumption on lung cancer.

Observational studies have provided consistent evidence for a protective role of vegetable consumption against lung cancer, with the evidence being most apparent for green cruciferous vegetables such as broccoli and cabbage. Such vegetables are rich in isothiocyanates, which have been shown in animals to have strong chemopreventative properties against lung cancer.

The article is by Paul Brennan, Charles C Hsu, Norman Moullan, Neonilia Szeszenia-Dabrowska , Jolanta Lissowska, David Zaridze, Peter Rudnai, Eleonora Fabianova, Dana Mates, Vladimir Bencko, Lenka Foretova, Vladimir Janout, Federica Gemignani, Amelie Chabrier, Janet Hall, Rayjean J Hung, Paolo Boffetta, and Federico Canzian.

NYTimes Tackles Cancer Prevention Through Exercise

A few weeks ago, Gina Kolata of The New York Times wrote the first in a series about diet's role in preventing cancer. Dr. Fuhrman wrote a lengthy response (one of his main points: by ignoring the influence of diet during childhood, she missed the major nutrition/cancer link).

Today marks the second article in Ms. Kolata's cancer prevention series, and it focuses on exercise. The article is well worth a read. While I'm sure there are those who would argue some of her conclusions, she touches on a lot of the same issues that Dr. Fuhrman often talks about--like the early onset of menstruation and its effect on breast cancer rates (one doctor she quotes, for instance, says girls only begin menstruating when they have excess calories).

But what struck me most was the clear presentation of a rather sad notion: we Americans seem to not want to learn from the best medical research, if it means doing "boring" things like eating right and exercising.

The article quotes several studies and doctors making clear that there is a strong correlation between exercise and colon cancer. But doctors who prescribe exercise have little luck:

"I'm pretty confident it will work," Dr. Sandler said of the exercise prescription. But, he adds, most patients dismiss that advice.

"They kind of blow me off," he said.

Dr. John Min, an internist in private practice in Burlington, N. C., loves exercise - he runs in marathons - and he believes it can improve health and possibly protect people from colon and breast cancer. But he does not even mention it to his patients as a way to protect against those cancers.

"Unfortunately, trying to get patients, even those who are very interested, to start exercising is very difficult," he says.

He said he has tried, and patients have left his office seeming excited about turning their life around. But they soon return to their sedentary ways.

"This is unfortunately what I have realized," Dr. Min said. "The ability for someone to significantly change their lifestyle, which they've lived with for years, is extremely difficult unless it is personally important to them. I can't make it personally important to them in the time of an office visit."

Hmm... that's seriously too bad. I'm interested in any ideas people might have about smart tactics to change that reality. Who knows how much healthier we would all be if we did simple, low-tech things like ate right and exercised?