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May 2009

Lifestyle choices prevent diabetes
Flavonoids lower ovarian cancer risk
Foods reduce macular degeneration
Fatty fish lower heart failure risk
Diet, weight loss, long-term heart risk
Soy reduces breast cancer risk
Multivitamins preserve telomeres

Lifestyle choices prevent diabetes

Lifestyle choices play a large role in preventing and treating many conditions. One of those most influenced is diabetes. In a new report, the effect of a variety of health habits is related to the risk of developing maturity-onset diabetes. Researchers evaluated 4883 men and women enrolled in the Cardiovascular Health Study over a 10-year period. (Mozaffarian D, et al., Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardio-vascular health study. Arch Intern Med. 2009 Apr 27;169(8):798-807.)

The subjects were over 65 years old at the start of the study in 1989. Those with the lowest risk for developing were the ones with all of the following habits: they were non-smokers; they were physically active; they had a high dietary score (meaning high-fiber intake, less saturated fat compared to polyunsaturated fat, low trans-fat, and low-glycemic foods in the diet); and they consumed low to moderate amounts of alcohol. They also had normal body mass index or a small waist size, indicating less fat surrounding the abdominal organs.

Overall, the risk of diabetes was 35 percent lower for each healthy lifestyle factor, and for those subjects with all four lifestyle choices in the low-risk group the risk of diabetes was reduced by 82 percent compared with all other participants. Adding either low body mass index or waist size to the healthy habits reduced the risk even further.

The authors concluded that overall, 9 out of 10 new cases of diabetes could be attributed to these five lifestyle factors. Diabetes is one of the most costly illnesses in the elderly, and leads to a host of other serious health problems, including heart and other vascular diseases, vision loss, and neuropathy. Controlling it through simple (although sometimes challenging) lifestyle choices is one of the most effective ways to improve your own health and to lower health care costs.

Flavonoids lower ovarian cancer risk

Flavonoids are a broad group of plant-derived chemicals (phytochemicals) found in a wide variety of fruits, vegetables, whole grains, beans, and seeds. Among the most common ones are myricetin, kaempferol, quercetin, luteolin, and apigenin, Antioxidant phytochemicals like these are highly protective against a variety of health problems. A recent study shows that a high intake of one of these nutrients, apigenin, is associated with a reduced risk of ovarian cancer.

Apigenin is found in citrus fruit, tomatoes, red wine, parsley, and thyme, among other foods. In a case-control study, among 1141 cases of ovarian cancer compared to 1183 controls, analysis showed that those with the highest intake of apigenin had a 21 percent lower risk than those with the lowest intake. (Gates MA, et al., Flavonoid intake and ovarian cancer risk in a population-based case-control study. Int J Cancer. 2009 Apr 15;124(8):1918-25.)

This benefit is relatively small, but is supported by other research on flavonoid protection against ovarian cancer as well as other cancers.

Foods reduce macular degeneration

A new analysis from the Age-Related Eye Disease Study (AREDS) shows that a variety of nutrients are related to a reduction in the risk of age-related macular degeneration. The study included 4003 participants and evaluated them for intake of vitamins C and E, omega-3 oils, zinc, the carotenoids lutein and zeaxanthin, and foods with a high glycemic index (GI). High GI foods lead to a higher level of sugar (glucose) in the blood.

Drusen are pigmented or white deposits on the retina and optic nerve, and are among the earliest signs of macular degeneration. The results of this study showed that a high intake of most of these nutrients combined with a low intake of high GI foods resulted in a 28 to 43 percent lower incidence of both drusen and advanced macular degeneration. High blood sugar leads to sugar-protein complexes that deposit in the retina (as well as the lens, leading to cataracts). These sugar-protein complexes also damage other tissues, such as the kidneys, and contribute to the aging process.

Low GI foods include lentils, chick peas, soybeans, plain yogurt, and high-fiber whole grains, such as whole wheat and oatmeal. White flour is a high GI food that is low in fiber. Sugar and white flour provide a large percentage of the calories in the Western-style diet. (Chiu CJ, et al., Dietary compound score and risk of age-related macular degeneration in the age-related eye disease study. Ophthalmology. 2009 May;116 (5):939-46.)

Fatty fish lower heart failure risk

Diets that include a small amount of fish rich in omega-3 fatty acids are associated with a lower risk of congestive heart failure in men. A population-based study of 39,367 middle-aged and older Swedish men evaluated food intake through questionnaires and they were then followed for seven years. (Heart failure is a weak heart muscle that cannot effectively pump out all of the blood that comes in, leading to fluid congestion in the tissues.)

Those men who consumed moderate levels of oil-rich fish once per week had a 12 percent reduction in the risk of developing heart failure. Oil-rich fish include salmon, mackerel, sardines, and herring. Among those who took small amounts of omega-3 oils, there was a risk reduction of 20 to 30 percent. (Levitan EB, et al., Fish consumption, marine omega-3 fatty acids, and incidence of heart failure: a population-based prospective study of middle-aged and elderly men. Eur Heart J. 2009 Apr 21. [Epub ahead of print].

However, in this study, those who ate fish two or more times per week had no better risk profile than those who did not consume any fish. One possible explanation is that those who ate more fish did so because they already had heart problems and had changed their diets to treat themselves. It is also possible that eating too much fish increases exposure to some toxins that might diminish the benefits.

Diet, weight loss, long-term heart risk

Researchers evaluated the effects of three different weight-loss diets on long-term cardiovascular risks. They followed 18 healthy participants who were normal weight for one year after three different four-week phases of dietary intervention, including the Ornish diet (very low fat), the South Beach diet (30 percent fat), and the Atkins diet (50 percent fat).

They tested the CRP level, an inflammatory marker for heart risk, and a blood-vessel dilation test in the arm (brachial artery), as well as HDL- and LDL-cholesterol levels. Each subject served as his own control by following each diet sequentially with a 4-week break between phases. (Miller M, et al., Comparative effects of three popular diets on lipids, endothelial function, and C-reactive protein during weight maintenance. J Am Diet Assoc. 2009 Apr;109(4):713-7.)

The most favorable dietary benefits were seen with the very low fat diet (Ornish). The Atkins-type maintenance diet led to higher LDL levels, an increase in serum CRP, and lower brachial artery blood flow than either of the other two diets. Because of these unfavorable effects in healthy people, the authors suggested that patients with metabolic syndrome and abdominal obesity, already at risk of heart disease, would be put at even greater risk from a diet that adversely affects lipids, CRP, and blood vessels.

Soy reduces breast cancer risk

Asian women have a historically low risk of breast cancer. However, when they immigrate to the United States, their descendents’ breast cancer risks increase over several generations. In a population-based study among women of Chinese, Japanese, and Filipino descent, researches evaluated 597 cases of women with breast cancer and 966 women who served as controls. They ranged from 20 to 55 years old.

Those with the highest soy intake during childhood had a 60 percent lower risk of breast cancer compared to those with the lowest soy intake. High adult soy intake led to a 24 percent drop in risk. Adolescents in the high soy group had a 20 percent lower risk, but this did not reach statistical significance. (Korde LA, et al., Childhood soy intake and breast cancer risk in asian american women. Cancer Epidemiol Biomarkers Prev. 2009 Apr;18(4):1050-9.)

These findings were consistent for all three ethnic groups, and for all three study sites (Hawaii, San Francisco, and Los Angeles). In addition, it did not matter whether they were born in Asia or in the United States. The strongest effect was related to childhood soy intake, probably because the effects were diminished as adolescents and adults modified their other health habits. This data strongly suggests that lifestyle is a more important contributor to the risk of breast cancer than genetics. Soy isoflavones might contribute to the protective effect.

Multivitamins preserve telomeres

Telomeres are the end segments of chromosomes that protect them from damage. With aging, telomeres gradually shorten when cells divide (and only when cells divide), leaving the chromosomes less protected. A new study of 586 female participants aged 35 to 74 years, was designed to see the effect that taking multivitamins might have on telomere length.

Using polymerase chain reaction (the same as the forensic test used to analyze DNA), researchers measured the length of white blood cell telomeres. They showed that in women taking multivitamins the telomeres were 5.1 percent longer than in women who did not take them, corresponding to 9.8 years less age-related telomere shortening. (Xu Q, et al., Multi-vitamin use and telomere length in women. Am J Clin Nutr. 2009 Mar 11). Higher dietary intakes of vitamins C and E were both associated with longer telomeres.

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From September to June, I see patients in New Smyrna Beach, Florida.
Call 386-409-7747, or send an email to to make arrangements.

In summer, I have a variable schedule, and I see patients in offices at the
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Information herein is not medical advice or direction. All material in this newsletter is provided for information only. Its contents should not be used to provide medical advice on individual problems. Consult a health care professional for medical or health advice.

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