There is a Difference

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June 2018

Can Testosterone Affect My Cholesterol Levels?

By: Epoch


Research on testosterone and cholesterol has produced mixed results, however.


Some researchers have found that testosterone lowers both high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. Others have found testosterone doesn’t affect either of them.

Studies on the effect of testosterone on total cholesterol are also contradictory. On the other hand, several studies have found testosterone has no effect on triglyceride levels. So, testosterone can’t lower triglyceride levels, but researchers don’t know how or even if it affects total, HDL, and LDL cholesterol.

What’s the connection?


Why testosterone therapy?


Testosterone therapy is usually given for one of two reasons. First, some males have a condition known as hypogonadism. If you have hypogonadism, your body doesn’t make enough testosterone. Testosterone is an important hormone. It plays a key role in the development and maintenance of male physical traits.

The second reason is to treat the natural decline of testosterone. Testosterone levels start to decline in males after age 30, but the decline is gradual. Some want to make up for the lost muscle mass and sex drive that results from this decrease in testosterone.


Cholesterol 101


Cholesterol is a fatlike substance found in the bloodstream. We need some cholesterol for healthy cell production. A buildup of too much LDL cholesterol, however, leads to the formation of plaque in the walls of arteries. This is known as atherosclerosis.

When a person has atherosclerosis, plaque inside the artery wall slowly builds up and bulges into the artery. This can narrow the arteries enough to significantly reduce blood flow.

When that happens in an artery of the heart called a coronary artery, the result is chest pain called angina. When the bulge of plaque suddenly ruptures, a blood clot forms around it. This can completely block the artery, leading to a heart attack.

Testosterone and HDL


HDL cholesterol is often referred to as the “good” cholesterol. It takes LDL cholesterol, the “bad” cholesterol, and other fats (like triglycerides) from your bloodstream to your liver.

Once LDL cholesterol is in your liver, it can eventually be filtered out of your body. A low HDL level is considered a risk factor for heart disease. A high HDL has a protective effect.

A 2013 review notes that some scientists have observed males who take testosterone medications may have a decrease in their HDL levels. However, results of studies haven’t been consistent. Other scientists found testosterone didn’t affect HDL levels.

The effect of testosterone on HDL cholesterol may vary depending on the person. Age may be a factor. The type or dose of your testosterone medication may also influence its effect on your cholesterol.

The review also notes other researchers found that males who had normal HDL and LDL cholesterol levels had no significant changes in their cholesterol levels after they took testosterone. But those same researchers found that males with chronic disease saw their HDL levels drop slightly.

Currently, the effect of testosterone on cholesterol isn’t clear. As more and more people consider taking testosterone supplements, it’s encouraging to know that there’s a lot of researchers looking into the safety and value of this type of hormone replacement therapy.

The takeaway


Unfortunately, researchers have yet to provide a definitive answer about testosterone and cholesterol. It’s important to understand that there may be a connection. If you decide to use testosterone therapy, make sure you consider all of the risks and benefits.

Follow your doctor’s advice about a heart-healthy lifestyle, and take any prescribed medications. This can help keep your cholesterol, blood pressure, and other manageable risk factors under control.

Assume there may be a connection between testosterone and cholesterol. Be proactive about keeping your cholesterol levels in a safe range.

Source: HealthLine











April 2018

Battle of the Bulge: Low T and Weight Management

By: Epoch

Men depend on the male hormone testosterone for everything from helping to build muscle to giving facial hair and a deeper voice. Research also shows that weight control can be added to that list.

“Testosterone has a critical role in metabolism,” says Abraham Morgentaler, MD, an associate clinical professor of urology at Harvard Medical School and director and founder of Men’s Health Boston. “Multiple studies have shown men with low testosterone have a higher percentage of body fat than men with higher testosterone.

Further evidence: Men who take medication to severely depress testosterone levels as treatment for advanced prostate cancer rapidly gain weight and increase body fat, according to Dr. Morgentaler.

The testosterone-weight connection also goes the other way. A 2013 review of weight loss and its effects on testosterone published in the European Journal of Endocrinology found that weight loss alone — without testosterone therapy — was associated with increases in testosterone levels.

Also, a 2013 German observational study published in the journal Obesity found that weight loss was an added bonus for men with low testosterone who were taking testosterone replacement therapy. The men took testosterone supplements for five years and lost an average of 36 pounds and 3.5 inches off their waists.

The Low Testosterone-Weight Gain Mystery

Low testosterone causes increases in body fat, especially in the midsection.

But why does this happen? “The exact biochemical mechanism by which testosterone causes this change is unknown,” Morgentaler explains.

However, it turns out that not only does low testosterone seem to cause weight gain in men, the reverse also seems to be true: Obesity is one of the risk factors for lower than normal levels of testosterone. Physiologically, the relationship between low testosterone and weight gain in men can become a vicious cycle.

“Body fat contains an enzyme that converts testosterone into estrogens,” says David Samadi, MD, chairman of the urology department at Lenox Hill Hospital in New York City. “Having extra estrogens triggers the body to slow its production of testosterone. The less testosterone you make, the more belly fat you accumulate, and so on.”

For men who already have low testosterone, excess body fat can worsen the condition: “Fat speeds up the metabolizing of testosterone,” Dr. Samadi says. “Therefore, the more fat you carry around, the faster you’ll burn through the already low testosterone levels in your body.”

However, not all men with low testosterone are overweight, and the symptoms vary from man to man. “Being overweight can worsen your ability to produce testosterone and can lower already low testosterone, but you don’t need to be overweight to be affected by low testosterone,” adds Samadi.

Regardless of weight, men with low testosterone are more likely to have less muscle than those with normal levels. “Even in men with low testosterone who are not overweight, it is likely they will have an increased percentage of body fat,” Morgentaler says.

A Recipe for Couch Potatoes

Another important reason low testosterone is tied with weight gain in men is the symptoms can take away incentive to exercise. “One of the subtle symptoms of low testosterone is that it often reduces motivation,” Morgentaler says. “Men describe this feeling as if they have become a couch potato. Staying fit and trim requires energy and drive, and if these are lacking, it is easier to gain weight.”

Even if you are able to drag yourself to the gym, low testosterone could mean you have less stamina to get through your workout and see results, which can be discouraging.

Tips for Managing Weight With Low Testosterone

To fight weight gain with low testosterone, the advice is the same as for others trying to drop pounds: Eat less and exercise more.

Weight lifting or another form of resistance exercise is particularly important. “This type of workout helps build more muscle faster and triggers testosterone production,” Samadi says. “Additionally, your body burns more fat for energy during resistance exercise, helping promote healthy weight and fat distribution.”

Treating low testosterone can boost overall energy, easing fatigue and prompting you to get moving and lose weight. Although testosterone supplements shouldn't be used to help men with symptoms of low testosterone drop pounds, if you have measurably low testosterone, treating it should make weight loss easier. “Normal levels of testosterone encourage fat loss, increased muscle mass and strength, and stamina,” Morgentaler says. “Also, workouts are better, and men feel encouraged by this, so they do them more often.”

Source: Everyday Health

Author: Elizabeth Shimer Bowers



April 2018

Study finds testosterone replacement therapy reduces cardiovascular risk

By: Epoch

Men who used testosterone replacement therapy to treat symptoms of androgen deficiency had a 33 percent lower risk of cardiovascular events such as heart attacks and stroke compared to those who did not receive any hormone therapy. The findings from the Kaiser Permanente study were published in JAMA Internal Medicine today.

Androgen deficiency in men is characterized by lower levels of male sex hormones, specifically testosterone, as well as symptoms that include loss of sexual desire, erectile dysfunction, breast enlargement or tenderness, hot flashes, reduced energy, irritability and depressed mood. Similar to women, men experience a normal decline in sex hormone levels beginning in their 30s. The decline in men is gradual and occurs over a number of years. It is estimated that approximately one in 200 men under the age of 60 has testosterone levels below normal, but as many as two in 10 men over the age of 60 have low levels. Not all men with low testosterone levels have symptoms of androgen deficiency.

Symptoms related to androgen deficiency can be treated with testosterone replacement therapy given by injection, orally or topically. Some recent studies, however, have raised concerns that testosterone replacement therapy may increase the risk for cardiovascular events such as heart attacks and strokes. Other studies report that low testosterone levels in older men are associated with increased cardiovascular risk and that testosterone replacement therapy may have cardiovascular benefits.

"Our study found no indication of an increased risk for cardiovascular events for men with androgen deficiency," said T. Craig Cheetham, PharmD, MS, study lead author, Kaiser Permanente Southern California Department of Research & Evaluation. "Our hope is that these findings help alleviate the concerns that patients with androgen deficiency and their doctors may have had about prescribing and taking testosterone replacement therapy."

The study evaluated 44,335 male patients at Kaiser Permanente medical centers in Northern and Southern California who had been diagnosed with androgen deficiency between January 1, 1999 and December 31, 2010. Of these, 8,808 men were treated with testosterone replacement therapy, while 35,527 were never dispensed testosterone. The men were followed for a median of 3.4 years and researchers found:

  • Of the men who never received testosterone, 10.2 percent had a heart attack or stroke during the study period.
  • Of those who received testosterone replacement therapy, 8.2 percent had a heart attack or stroke during the study period.

Source: Medical Press

Author: Kaiser Permanente




March 2018

What to Expect During Your First Colonoscopy

By: Epoch

Not that many people get excited about the prospect of having a doctor put a scope up their bum, but consider the alternative: 50,000 people die of colorectal cancer each year. If everyone got screened, that number could be cut in half, says Dr. Jordan Karlitz, an associate professor of gastroenterology at Tulane University and a member of the National Colorectal Cancer Roundtable. Tragically, many people (some 28%, or 1 in 3 people, according to the Centers for Disease Control and Prevention) do not get screened—some because they lack access to information and healthcare, and others who know they should get screened and have access but are squeamish about anything poop-related, or fearful that it will be painful or embarrassing.

(According to Dr. Patricia Raymond, a practicing gastroenterologist and assistant professor of clinical internal medicine at Eastern Virginia Medical School in Norfolk, Virginia, men are generally more reluctant than women to get screened, possibly because men are less likely to have had invasive procedures.)

Aren’t There Other Tests?

There are other tests, but because little research has been done comparing how the various forms of screening stack up against each other in terms of finding cancerous or pre-cancerous polyps and preventing death, major organizations including the United States Preventive Services Task Force and the American Cancer Society recommend only that you get screened, leaving the choice of the screening method up to you and your doctor. In their latest recommendationsthe U.S. Multi-Society Task Force of Colorectal Cancer, a group made up of gastroenterologists, state that colonoscopy is the preferred test for colorectal cancer. They say that when it comes to detecting polyps—in all stages of development—a colonoscopy is the most sensitive and offers a two-for-one deal: it allows a doctor to see polyps and remove them all at once. Plus, if your first one is normal, and you don’t have high risk factors, you don’t need to get another for 10 years.

Doctors also recommend the fecal immunochemical test (FIT), in which small amounts of stool are smeared on cards or collected in tubes and tested for the presence of blood. This test has to be done once a year and might not detect tumors that aren’t bleeding. If you test positive on the FIT, you’ll need to get a colonoscopy.

Less frequently used options include CT colonography, the FIT–fecal DNA test, and flexible sigmoidoscopy. All three of these are less sensitive than a colonoscopy and the FIT and must be done more often (once every five, three, and five to ten years respectively). You might have one of these tests if colonoscopies are not available in your area or you are uninsured (all insurance plans that are ACA compliant are required to follow the Task Force’s recommendations for cancer screening). “People should understand that these less invasive tests are not a way out of a colonoscopy,” says Dr. Durado Brooks, vice president of cancer control interventions at the American Cancer Society. “If those tests are abnormal, you’re going to have to have a colonoscopy.”

Dr. Brooks says it’s also important to know that if you opt to have a test other than a colonoscopy, get positive results, and are then sent to have a colonoscopy, that colonoscopy might be classified as a diagnostic rather than screening test, meaning that you might be responsible for a co-pay or deductible to cover it. This is not the case if the colonoscopy is the first test you get.

If you are colonoscopy-bound, know this: the procedure itself is a breeze, the prep has gotten a lot simpler, and the payoffs enormous. Below, what to expect—and how to prepare—for your first colonoscopy:

What Is a Colonoscopy and Why Get One?

During a colonoscopy, your doctor uses a very thin and flexible scope equipped with a light to inspect the lining of your colon for polyps. Most polyps are benign, but some are capable of becoming cancerous if they are not removed, and others are malignant. If the doctor finds a polyp, it can be immediately removed and sent to a lab for analysis.

Colorectal cancer is really common (it’s the third most common cancer in men and women) but it’s also very preventable. Death rates from colorectal cancer have been dropping in recent years, which the American Cancer Society attributes to increased screening and removal of polyps which, if left in place, might have turned into cancer. It can take as many as 10 to 15 years for a polyp to develop into colorectal cancer, and during this time it’s possible not to have any symptoms that might reveal its existence. As with most cancers, if colorectal cancer is found early, it’s much more likely to be curable.

“Average risk Americans—those without a family history—have a 6% chance of colorectal cancer. That is a huge chance,” says Dr. Raymond. “Just think how excited you would be if you had a 6% chance of winning the Powerball lottery—you’d be excited by the high odds. A colonoscopy with removal of polyps prevents up to 95% of colorectal cancer.”

Who Should Get a Colonoscopy?

The short answer is everyone; it’s a matter of when, not if, you need to take care of business. For starters, if you’re currently experiencing symptoms like a change in bowel habits, or seeing blood in your stool, see your doctor right away—regardless of your age—and inquire about getting a colonoscopy.

If you have a personal history of colorectal cancer or adenomatous polyps (the ones most likely to become cancerous), or a personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease) you should definitely be seeing your doctor on the regular and getting frequent colonoscopies. The same goes for those of us who have a family history (and “family” includes not just parents, grandparents, and siblings, but uncles, aunts, children, and half-siblings)* of colorectal cancer or polyps or a family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome. If this is you, don’t wait until you’re 45 or 50 to get screened. Bring it up with your doctor ASAP. 

If you’re African-American, aren’t having symptoms, and don’t have any of the risk factors above*, starting at age 45, you should get a colonoscopy every 10 years. For reasons that are unclear (but may involve lack of access to and awareness of screenings plus so-called “lifestyle factors” like smoking and obesity), African-Americans tend to be diagnosed with colorectal cancer at younger ages with cancers that are more advanced, and have worse survival rates than other groups in this country.

If you’re not African-American, aren’t having symptoms, and don’t have any other risk factors above*, starting at age 50 you should have a colonoscopy every 10 years.

*When was the last time you called your mom? Or your grandma? Do it. Not just to be kind or assuage your guilt; do it so you can grill them about your family’s health history. It’s so important and not something you want to put off (sorry to bring it up, but you want to have this conversation while they’re still around and have all their marbles).

I’m Way Under 45. Why Should I Think About Colorectal Cancer?

Recent studies have shown that while colorectal cancer rates are going down overall, people in their 20s, 30s, and 40s have been getting diagnosed with colorectal cancer and dying at higher rates than in previous decades. Dr. Jordan Karlitz, an associate professor of gastroenterology at Tulane University and a member of the National Colorectal Cancer Roundtable, says no one is sure why this is happening but that multiple studies hoping to answer this question are currently underway.

“The most important thing you can do is take any symptoms you might be having very seriously and see your physician to discuss the possibility of having a colonoscopy even if you’re younger,” says Dr. Karlitz, who also points out that it’s very important to know your family health history because clusters of certain kinds of cancer in a family could signal an increased risk of getting colorectal cancer at a young age.

When You Make Your Appointment

Different doctors use different types of sedation for a colonoscopy and you should discuss the options with them and decide on the level of sedation that’s right for you. The most common choice is propofol, which is fast-acting and offers a sedation level comparable to general anesthesia without its long recovery time. For most people propofol takes effect within seconds, renders you unaware of what’s going on during the procedure and unable to remember it afterwards. It’s very common to wake up in the recovery area wondering how you got there and when your procedure is going to happen. (Because it’s deeply sedating, you’ll likely encounter an anesthesiologist or sedation team in the procedure room who will monitor you.) Other drugs leave you awake but groggy. Some patients opt to have the procedure wide awake.

Your doctor will give you very specific instructions and you should read them when you get them, because you might need to follow a special diet (to avoid things that are hard to digest and will leave residue in your colon) for the days leading up to the procedure and you might have to pick up prescription preparations (you also might want to pick up some special wipes, if that’s your thing). If you normally take prescription medicines in the mornings, talk with your doctor about how to manage them on the day of your procedure. If anything’s unclear, ask.

Because you’ll be sedated during the procedure, you’ll have to arrange for someone to pick you up afterwards or, depending on the rules of the facility doing the procedure, arrange for a taxi or rideshare to collect you. Some facilities don’t want you going home alone because you might be light-headed. If you think transportation might be a problem, talk to your doctor; this is totally common and most facilities have work-arounds.

Colonoscopy Prep: Not That Bad, Really

Have you ever had serious diarrhea? I’m sorry. The good news is, colonoscopy prep isn’t remotely as bad as that. Yes, it’s yucky, and yes, you will be spending some quality time on the toilet the night before your screening and possibly the morning of, but you’re not sick. You shouldn’t experience painful cramping, nausea, or that feeling that you’re a complete idiot for eating whatever it was that you’ve decided made you sick. (If you share a bathroom, plan accordingly; you will be monopolizing the place for a stretch and you probably will want some privacy.)

The Day Before

Most likely you will be instructed to have only clear liquids the day before the test. This means clear sodas like Sprite, lemon Jell-O, apple juice (not cider) and water. As Dr. Karlitz says, “if you hold it up in glass you should be able to read a newspaper through it. It shouldn’t be opaque.” The clear liquids and the diet modifications and the special drink you’ll be enjoying (more on that below) all work to ensure that your colon is clean and sparkly so that when your doctor peeks inside, they get a really clear picture of what’s going on.

The Night Before

Your doctor might instruct you to drink a prescription liquid to get things started. The good news is that the liquids are generally less icky than they used to be and there is a lot less of it to drink than in years past; some doctors also now use something called “split prep” where you drink half the night before the procedure and half the morning of. The liquids vary and so do the people drinking it; some people find the liquid gross and some people just find it not that great.

Results vary, but typically it takes about an hour of drinking a set amount at specific intervals to finish your ration. In another hour or so you will likely start feeling a strong urge to “evacuate,” as the professionals say. You will spend the next couple of hours evacuating pretty regularly, and eventually you will just be passing clear liquid which is the goal (congratulations!).

And then, we promise, it will stop. You won’t be up all night waiting for it to end, and you won’t be getting up in the middle of the night for a surprise evacuation. If you have followed the doctor’s instructions you will have plenty of time to get to bed at your usual time and have a normal night’s sleep. It’s likely you will be instructed not to drink or eat anything (other than the prep liquid) after midnight. If you are doing the split prep, you will get up in the morning at a set time before the procedure and drink the rest of the liquid but by that point you will know what to expect (plus, you will only have the prep liquid to evacuate) and then it’s off to the procedure.

When You Arrive at the Facility

Your colonoscopy might take place in an ambulatory surgical center, hospital, or the doctor’s office. When you arrive, you’ll likely fill out some paperwork, including consent forms for the sedation medication you’ll be given (you’ll agree to not drive, operate machinery, or sign any documents for the rest of the day following the procedure). You’ll change into a gown and your vitals will be taken; you might answer questions from intake staff, nurses, or an anaesthesiologist (don’t be alarmed—you’re not going to be given general anaesthesia!), be briefed on the procedure and given a chance to ask questions.

Before The Procedure Begins

Along with the doctor, there might be a nurse, attendant, or anaesthesiologist in the procedure room. You might be asked to turn on your side and draw your knees up; a drape will cover you. Through an IV you’ll be given sedating medication.

The procedure takes 30 minutes on average, says Dr. Karlitz but can take up to an hour, depending on whether a polyp (or polyps) are detected and removed. The colonoscope is very thin (about the thickness of a finger) and is equipped with a camera, a light, and a channel through which air is passed, which slightly inflates the colon in order to allow a clearer view of its lining. The colonoscope begins its journey at the far end of the colon and travels its length, during which time the doctor follows what it sees on a large, high-definition TV screen. If polyps are encountered, they are removed via tiny instruments passed up through the scope and sent to a lab for analysis. If there’s bleeding, other tiny tools are passed up through the scope to stanch it. Any bleeding is typically minor, though, and complications from colonoscopies are uncommon. Your blood pressure, heart rate, and respiration are monitored throughout the procedure.

After the Procedure

You might feel sleepy or out of it until the sedation meds wear off; this can happen in a matter of matter of minutes or take up to a couple of hours. If you have arranged for someone to accompany you home, they might be in the recovery room with you as you wake up.

It’s not uncommon to feel a little bloated from the air that was piped into your colon and it’s possible that you’ll pass a little residual gas (sorry, friend who came to pick you up!). Once the doctor ascertains that you’re mentally clear, they will explain to you what they found, how soon you’ll get results, and possibly show you still images taken during the procedure. They’ll explain what’s normal to encounter over the next couple of days (a little bit of blood in your stool if polyps were removed) and what isn’t (pain, fever, serious bleeding). You’ll be given instructions on what to do if you encounter any problems, told how and how soon you’ll get results on any specimens taken; you’ll also be told when to get your next screening.

The doctors will also advise you to take it easy for the rest of the day and you might be offered some juice or crackers. Once you’re rested up, you’ll be ready to get dressed and go out into the world and, most likely get yourself something to eat that isn’t a clear liquid.

Source: LifeHacker

Author: Deb Schwartz





March 2018

If You Eat This Food, You Can Reduce Your Risk of Colorectal Cancer by 17 Percent

By: Epoch

Around 140,000 Americans are diagnosed with colon cancer every year. Colon and rectal cancers are striking adults at younger and younger ages, and millennials born starting in 1990 and have more than twice the risk of developing colorectal cancer than those born in 1950. “Colorectal cancer is one of the most common cancers,” according to Edward L. Giovanucci, MD, ScD, in a press release by the American Institute for Cancer Research (AICR).

An exciting new report by the AICR and the World Cancer Research Fund (WCRF) yields some good news: “There is a lot people can do to dramatically lower their risk.” The findings are “robust and clear,” Dr. Giovanucci says: “Diet and lifestyle have a major role in colorectal cancer.”

Specifically, the report demonstrates that eating whole grains daily reduces the risk of colorectal cancer by a whopping 17 percent. This adds to previous scientific evidence that foods containing fiber decrease the risk of this particular cancer. The report consisted of a comprehensive analysis of 99 existing scientific studies, including data on 29 million people, of whom over a quarter of a million had been diagnosed with colorectal cancer.

So what exactly qualifies as whole grains?

Our colorectal cancer expert, Darrell Gray, MD, MPH, of The Ohio State University Comprehensive Cancer Center, who was not directly involved in the study but who specializes in gastroenterology and colorectal cancers, explained to Reader’s Digest that whole grains include both the grain’s bran and germ.” The bran is the multi-layered outer skin of the edible kernel. It contains important antioxidants, B vitamins, and fiber. The germ is the part of the grain that has the potential to sprout into a new plant. It contains many B vitamins, some protein, minerals, and healthy fats. “The whole grain is a rich source of phytochemicals and antioxidants that have anticancer properties,” Dr. Gray explains. Further making sense of the connection between eating whole grains and reducing cancer risk, he adds that “whole grains are thought to exert beneficial effects in colorectal cancer prevention by lowering fasting insulin levels.”

How much do we have to eat in order to see these amazing benefits?

According to the study, three servings of whole grains per day (a total of 90 grams) is the magic number associated with the 17 percent decreased cancer risk. The Whole Grains Council, a not-for-profit consumer advocacy group, states that a single serving of whole grain is equal to a 1/2 cup of cooked brown rice, oatmeal, or other whole grain, or a cup of whole grain cereal. Dr. Gray suggests bran-flake cereal, but there are many other options. For foods that contain not only whole grain but also other ingredients (for example, whole grain crackers, granola bars, bread, and muffins), you’ll have to eat a larger amount to get the optimal dose of whole grain.

In addition to eating whole grains daily, the report warns against these habits, which can raise your risk of colorectal cancer:

  • Eating lots of red meat such as beef or pork (more than 500 grams, or a little over 1 pound, cooked, per week)
  • Eating hot dogs, bacon, and other processed meats on a regular basis 
  • Being overweight or obese
  • Consuming two or more daily alcoholic drinks (30 grams of alcohol), such as wine or beer

In addition, the report states that people who are more physically active (at least 30 minutes of physical activity per day) have a lower risk of colon (but not rectal) cancer compared to those who do very little physical activity. It also found limited evidence that eating fish and foods containing vitamin C (such as oranges, strawberries, and spinach) can lower the risk of colorectal cancer, in spite of some claims otherwise.

“All of this points to the power of a plant-based diet,” says Alice Bender, MS, RDN, AICR Director of Nutrition Programs. “Replacing some of your refined grains with whole grains and eating mostly plant foods, such as fruits, vegetables, and beans, will give you a diet packed with cancer-protective compounds and help you manage your weight, which is so important to lowering risk.”

“When it comes to cancer there are no guarantees,” she adds, “but it’s clear now that there are choices you can make and steps you can take to lower your risk of colorectal and other cancers.”

Source: Reader's Digest


Author: Lauren Cahn




March 2018

Eating cereal fibre increases chances of surviving colon cancer

By: Epoch

People who eat a diet high in cereal fibre or increase their fibre intake after a colon cancer diagnosis may be less likely to die from the disease, according to new research by Harvard Medical School.

During the study, which has been published in the journal JAMA Oncology, researchers examined data on 1575 adults diagnosed with colon cancer who completed diet surveys. They followed half of the participants for at least 8 years. During that period, 773 people died, including 174 who died of colon and rectal tumours.

Compared to the lowest fibre intakes in the study, each additional five grams of fibre intake was associated with 22 per cent lower odds of death from colorectal cancer during the study, as well as 14 per cent lower mortality from all causes of death.

Changing the diet after the diagnosis to add more fibre was also linked with survival rates. Each additional five grams added to the diets after a colorectal cancer diagnosis was associated with 18 per cent lower odds of death from colorectal cancer during the study, as well as 14 per cent lower mortality from all causes of death.

Fruit fibre, however, didn’t appear to lower rates of death from cancer or other causes.

The study’s senior study author, Dr. Andrew Chan, said: ‘Eating more fibre after colorectal cancer diagnosis is associated with a lower risk of dying from colorectal cancer. This seems to be independent of the amount of fibre eaten before diagnosis.’

‘It appears that cereal fibre and foods high in whole grains seem to be associated with the lowest risk of dying from colorectal cancer.’

Source: Spectator Health



February 2018

Here’s How Cold Weather Can Trigger a Heart Attack

By: Epoch

Chilling fact: Every 40 seconds, someone in the United States has a heart attack, according to the American Heart Association. Although the life-threatening event can seem random, a study presented in August 2017 at the European Society of Cardiology Congress found that the average number of heart attacks per day was significantly higher during colder versus warmer temperatures.

Your heart needs oxygen-rich blood to function. A heart attack happens when a buildup of plaque — a mix of fat, cholesterol, and other substances — in your arteries breaks free. A blood clot forms around the plaque to either completely block or restrict blood flow to your heart. And freezing weather can ignite this painful process.

The Connection Between Your Ticker and Subzero Temps

“Cold weather, especially a very rapid change in the weather, is more likely to cause your blood vessels to constrict. If you have narrowing of the blood vessels already because of underlying heart disease and your blood vessels are constricted further, it restricts the amount of blood that’s getting to vital organs,” says Lawrence Phillips, MD, cardiologist and assistant professor of medicine at NYU Langone Health in New York City. In other words, cold weather can make heart attack more likely to happen.

Instead of triggering a full-blown heart attack, cold weather can also just minimize blood flow to the heart, causing chest pain (angina), which is a symptom of coronary artery disease. This is the main form of heart disease, a disorder of the blood vessels of the heart that can lead to heart attack.

In addition to coronary artery disease, cold weather can put a strain on your heart and circulatory system, affecting other forms of cardiovascular disease, too.

“If you have a diagnosis of heart failure or advanced valve disease, you have to be very careful when the weather changes to the colder side as well,” Dr. Phillips says.

Moreover, research presented in August 2015 at the European Society of Cardiology Congress in London showed that cold weather may also increase the risk of ischemic stroke in patients with atrial fibrillation, a heart rhythm disorder. Ischemic stroke — the most common type of stroke — occurs when ruptured arterial plaque causes a blood clot to block a blood vessel to the brain, cutting off its much needed blood and oxygen supply.

Sudden bouts of energetic activity, such as rushing around to get out of the cold or shoveling snow, in combination with chilly temperatures can put additional strain on the blood vessels that feed your heart or brain. This puts you at greater risk of having a cardiovascular event, especially if you’re usually sedentary.

Symptoms of heart attack include uncomfortable pressure, squeezing, fullness, or pain in your chest (angina) or other areas of your body and shortness of breath.

Stroke symptoms to watch out for include facial drooping, especially on one side, arm weakness, and difficulty speaking.

Cold Weather Cures for Preventing Heart Attack and Stroke

The good news? If you’re an average healthy person, the cold weather won’t increase your risk of a cardiovascular event, such as heart attack, stroke, or angina. Trouble is, you can have underlying coronary artery disease — the clogged arteries (atherosclerosis) that are the underpinnings of a heart attack and stroke — and not even know it. Cardiovascular disease doesn’t always have signs or symptoms. So you might not even know you have it until you have a heart attack or stroke.

Here’s what to do to reduce your risk of heart attack and stroke, especially in cold weather.

Get a checkup. “As you’re gearing up for winter, make sure your health is optimized,” Phillips says. In other words, the start of winter is a good time for a routine physical to make sure your heart can take the cold. If you have a diagnosis of coronary artery disease, heart failure, or advanced valve disease, make sure to get the appropriate treatment and follow-up. You want to make sure your blood cholesterol and blood pressure are under control, too. High cholesterol and high blood pressure can increase the risk of heart attack and stroke.

Cover your mouth. If you have heart disease, heart failure, or advanced valve disease, cover your nose and mouth with a scarf before going outside. “Wearing a scarf allows the air to naturally get warmed before it comes into your body,” Phillips says. “It won’t be such a shock to your body.”

Bundle up. To avoid getting too cold, which may increase the risk of heart attack, don’t forget to wear a hat, gloves, and multiple layers, which can help you stay warm by trapping air and body heat. But don’t overdo it. If you get hot, take off a layer. And remember to stay well hydrated.

Know your body. If you notice heart-related symptoms, such as chest pain, shortness of breath, feeling winded, or fluttering in your chest, see your doctor. “If something feels different than normal, don’t ignore it. Get evaluated,” Phillips says. Similarly, if you’re having chest pain at rest, and it’s a new symptom, you need an immediate evaluation. Call 911. “Never drive yourself to the emergency department,” he says.

Don’t let snow-shoveling kick off your workout. “If you haven’t been exercising regularly, snow shoveling isn’t the best idea,” Phillips says. Because snow can be heavy, shoveling may be a lot more physical activity than you’re used to, which can put a strain on your heart. Anybody with a chronic medical condition, not just heart disease, should talk to their doctor about whether snow shoveling is a good idea. “I tell my patients with underlying heart disease not to shovel snow,” Phillips says. “But they can use a snow blower.”

Get a flu shot. A study published in October 2013 in The Journal of the American Medical Association found that a flu shot was associated with a lower risk of cardiovascular events; getting a flu shot may reduce your risk of heart attack or stroke. Likewise, reduce your chances of getting the flu by staying away from people who are sick, washing your hands with soap and water often, and avoiding touching your eyes, nose, and mouth.

Source: Every Day Health

Author: Sandra Gordon



February 2018

5 Stroke Signs: Knowing Them Could Save Someone’s Life

By: Epoch

A stroke happens when a blood vessel in the brain becomes blocked or bursts, and it stems from a cardiovascular condition such as atherosclerosis, high blood pressure or atrial fibrillation.

Time to medical treatment matters. A lot.

It can mean the difference between a person being able to walk and go home versus needing to move to a nursing home, says neurologist Shazam Hussain, MD, Director of the Cerebrovascular Center at Cleveland Clinic.

“Every minute in a situation of an acute stroke, you lose about two million brain cells and so it’s really a situation where every minute counts,” Dr. Hussain says.

The sooner you recognize the signs of a stroke and get someone to the hospital, the greater the chances of reducing the risk of disability and death.

Many of us wouldn’t recognize the signs of stroke. Fortunately, there’s a simple acronym to help:

BE FAST: Easy to remember, too important to forget

Look for these signs and act:

Balance — Loss of balance

Eyes — Changes in vision

Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile.

Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

Speech Difficulty – Is the person’s speech slurred? Is he or she unable to speak or difficult to understand? Ask the person to repeat a simple sentence such as, “The sky is blue.” Is the sentence repeated correctly?

Time to call 911 – If the person shows any of these symptoms, even if the symptoms go away, call 911 and get him or her to the hospital immediately.

Awareness can make the difference

Increasing awareness about the warning signs of stroke and critical response steps could lead to happier endings for more stroke victims.

“There is much that can be done in the first hours after identifying a stroke to help improve blood flow to the brain and impact recovery,” Dr. Hussain says.

Risk factors for stroke

Strokes and cardiovascular disease share many risk factors:

  • Excess weight — Obesity can lead to heart disease and high cholesterol, which can lead to a stroke.
  • Heart problems — Strokes are six times more likely to occur in people with cardiovascular disease. Atrial fibrillation, one of the most common heart rhythm problems, increases your risk of stroke by about 5 times.
  • High blood pressure — Strokes are four to six times more likely in people with hypertension.
  • High cholesterol — People with high cholesterol are at double the risk of having a stroke.
  • Heavy drinking — This increases the risk for stroke and cardiovascular disease.
  • Smoking — If you smoke, you double your risk for stroke compared to nonsmokers.

Some people will actually experience warning signs before a stroke occurs, which is called an ischemic attack, or a mini stroke.

It’s important to get regular checkups and report any symptoms or risk factors to your doctor. A doctor can help evaluate your risk for developing stroke and help you get any risk factors under control.

Source: Cleveland Clinic

Author: The Brain and Spine Team



February 2018

All Those Late Nights at the Office Might Be Taking a Big Toll on Your Heart

By: Epoch

It’s no secret that working long hours can take a toll on employees’ moods, stress levels, and even their waistlines. Now, a new study suggests a hidden heart danger, as well: People who put in more than 55 hours a week on the job may have an increased risk of developing atrial fibrillation—an irregular heart rhythm linked to stroke and other health problems—compared to those who work 40 hours or less.

The new analysis, published in the European Heart Journal and led by University College London researchers, combined data from eight previous studies including more than 85,000 men and women from the United Kingdom, Denmark, Sweden, and Finland. None of the participants had atrial fibrillation (also known as AFib) at the study’s start, but 1,061 people developed it over the next 10 years.

Those numbers were equivalent to 12.4 AFib cases per 1,000 people in the study. But when the researchers looked specifically at those working 55 hours a week or more, that rate jumped to 17.6 per 1,000 cases.

In other words, those who worked the most were 40% more likely to developing AFib, compared to those who worked 35 to 40 hours a week—even after the results were adjusted for factors such as age, gender, obesity, socioeconomic status, smoking status, risky alcohol use, and leisure-time physical activity.

What’s more, 90% of those cases occurred in people who did not already have cardiovascular disease—suggesting that it really was the excess time at work, and not any pre-existing condition, that was responsible for the rise in AFib.

The authors point out that a 40% increased risk of AFib may not be a big deal, depending on how high a person’s overall risk for heart disease already is. “In absolute terms, the increased risk of atrial fibrillation among individuals with long working hours is relatively modest,” they wrote. But for someone who already has several risk factors (like being older, male, diabetic, or a smoker, for example), any added risk could be important.

The researchers can’t say how, exactly, extra time on the job might trigger irregular heart rhythms. But they suspect that stress and exhaustion may play a role, making the cardiovascular and autonomic nervous systems more vulnerable to abnormalities.

They also say their finding could help explain, at least partially, why people who work long hours have been shown to have an increased risk of stroke. ( AFib is known to contribute to the development of stroke, as well as heart failure, stroke-related dementia, and other serious health problems.)

The study did have some major limitations, including the fact that work hours were only recorded at one point in time, and that people’s specific occupations were not included in the analysis. In an accompanying editorial, researchers at St. Antonius Hospital in The Netherlands noted how these factors may have influenced the findings.

“It is conceivable that job strain and night shifts may be more frequent in the long working hours group, which in turn may have confounded the risk association,” the editorial authors wrote.

Physically demanding work could also contribute to an increased risk of AFib and other heart problems, but the editorial writers point out that manual labor jobs are often well regulated so workers don't put in more than 55 hours a week. “It is often in higher management jobs and self-employed businesses that there is no constraint on working hours,” they wrote in the editorial, “and mental stress may be more important than direct physical demand.”

The editorial also notes that none of the original studies included in the new analysis had statistically significant results on their own—likely because of their limited sizes. Only when all of the data was combined did a meaningful pattern emerge.

“[T]he authors should be congratulated for the impressive collaborative effort required to integrate patient level data from multiple studies to increase the power,” they wrote. However, they added, the study is still not able to draw definitive conclusions as to whether working long hours is an independent risk factor for AFib.

The study authors acknowledge these shortcomings, but still believe that their findings “raise the hypothesis that long working hours may affect the risk of atrial fibrillation,” they wrote in their conclusion. More research is needed, they say, to determine why this could be the case, and whether their findings would apply to other groups of people.

Of course, there are other ways that working overtime can be hazardous to your health, regardless of whether these findings are confirmed in future studies. In a 2016 study in the Journal of Occupational and Environmental Medicine, people who worked 60 or more hours a week had higher rates of heart disease, cancer, diabetes, asthma, and arthritis, compared to those who worked 30 to 40. Some increased health risks were observed in both genders, but the effects were “tremendously more evident in women,” the study authors said.