LiveLongAgeWell

In honor of our mothers, let’s consider some advice many of them have given—perhaps your own mother said “eat your carrots…you’ll see better at night”—now let’s just update that with the latest information. It’s a nice coincidence because a few days before Mother’s Day, the journal Ophthalmology came out with a report on the best (nutritional) advice to prevent macular degeneration, the progressive loss of function in the retina of the eye and the most common cause of adult visual loss. (Click on this link for a “macular degeneration simulator”.)

One reason macular degeneration is so worrisome is that it’s so common: 10% of people over 65 are affected, and that rises to 30% for people over 75. Your risk is higher if you have a history of smoking, and with a close relative with macular degeneration, your lifetime risk rises to 50%. So it’s good to know there is something you can do to help diminish this threat as we get older besides a carrot-a-day…

Here’s what the analysis of the diets of over 4000 people in the Age-Related Eye Disease Study suggested to keep your vision good as you get older:

1. Eat a low-glycemic index diet. The glycemic index is a rating of how foods spike your blood sugar once they are absorbed, and the less the spike, the better. Slow absorbing foods are best. Particularly bad are white bread, starchy foods such as potatoes, and sugary pastries. Best are whole-grain breads, nuts, proteins, and vegetables.

2. Try to get a wide range of antioxidants from fresh fruits, vegetables, nuts, and perhaps eggs. Especially good are green leafy vegetables, spinach, kale, broccoli, and when you buy lettuce, stick to the dark green romaine style rather than the wimpy pale “head lettuce” or “American lettuce”. Other good sources of the vision-beneficial antioxidants are eggs, beans (especially black), and again, nuts and whole grains.

3. Try to get lots of vitamin C from citrus fruits.

4. Omega-3 fatty acids are great for your eyes (as well as your brain), and you can best get those from fatty fish, such as salmon.

So go ahead and eat a carrot-a-day, it’s great advice, but if you are really concerned about keeping your vision intact as you get older, and particularly if you have a positive family history, there are plenty of other dietary measures you can take. Don’t wait…add to your shopping list: oranges, broccoli, spinach, whole-grain bread, romaine lettuce, nuts, and salmon!

If someone were to ask me to name the worst cancer, I would say cancer of the pancreas. This cancer has received much media attention recently. Patrick Swayze is now fighting it, and it killed Luciano Pavarotti and Professor Randy Pausch (author of The Last Lecture).  Even the president of the American Medical Association died of pancreatic cancer last year.

The survival statistics are grim: after diagnosis, only about 25% of the afflicted live even one year, only 5% survive five years. It is so deadly because this cancer is typically diagnosed late, after it has spread, and surgery in those cases won’t cure. While there is hope that new and experimental drugs will work better, standard chemotherapy usually gives disappointing results. It also tends to be one of the most painful cancers. Victims often quickly lose lots of weight and become yellow with jaundice.

The pancreas—which produces digestive juices and hormones involved in food metabolism—is buried deep in the abdomen below and behind the stomach, and this deep location masks symptoms until it has spread beyond the pancreas. The liver, close by, is a prime target. Clearly, it’s a disease you want to avoid, and fortunately medical researchers have identified some measures you can take to significantly cut your risk:

1.    Don’t smoke. Smokers suffer a two to five times risk of getting pancreatic cancer. But if you smoke and quit, after five to ten years of not smoking, your risk goes down to that of a non-smoker.

2.    Eat lots of fruits and vegetables, especially dark green and highly colored ones. These vegetables contain more cancer-inhibiting phytonutrients. Think tomatoes (high in lycopene), soy, broccoli, blueberries, carrots, cranberries, and many others. In general the darker, richer, more vibrant color the better!

3.    A diet high in legumes and whole grains seems to cut the risk. One reason may be because these foods help fill you up and keep you from getting obese.

4.    Avoid obesity! Especially central, or abdominal obesity is thought to be a risk factor for pancreatic cancer. If you are overweight, work on numbers 2 and 3 above, and as a minimum for exercise, start moving and walking more. For example, take the stairs rather than the elevator, and park your car farther from the store entrance so you are forced to walk more.

5.    Minimize your red meat consumption, especially processed meat. It may be the high level of iron or the fat in red meat are the carcinogenic components, and for processed meats (non-fresh meat), the high sodium and nitrates might be the problem. Also, meats cooked at high temperature, and charred or grilled meats are especially believed to be loaded with cancer-causing substances.

6.    Floss your teeth! Yes, it is thought that those with bad oral hygiene, gum inflammation, and periodontal disease have a higher level of inflammatory substances in their body, and these can spark a pancreas cancer. Men with periodontal disease have a 64% higher risk!

7.    Make sure you are getting enough vitamin D. Vitamin D deficiency is common world-wide, and studies have suggested those who get adequate vitamin D cut their risk of pancreatic cancer by 50%. For more on vitamin D, I recommend this article from the Harvard School of Public Health.

In future posts, I will discuss each of these hints in more detail, but in the meantime, the above is food for thought…and make that food highly colored vegetables!

Since cancer and heart disease are the number one and two causes of death in the U.S., I would love to report that taking vitamins will lower your risk, but several recent research reports cast doubts at least on vitamins C and E. Actually, these recent studies are part of a research trend showing that many vitamins—taken in pill form that is—have not been as effective as many had hoped for in preventing various diseases.

There is even the suggestion that taking some vitamin pills, particularly the B vitamin folic acid or vitamin E, might increase your chance for certain diseases, but the data is inconclusive and controversial, and further analysis is needed (and being done). Still, caution seems to be in order as far as taking vitamin pills.

At the recent American Association for Cancer Research “Frontiers in Cancer Prevention” meeting, the results of a 10-year long study were presented. This was a randomized clinical trial (the best type of research study), and it followed nearly 15,000 physicians. Some were given 400 IU of vitamin E every other day, some 500 mg. vitamin C every day, and others given placebo (dummy) pills. After a 10-year period the number of cancers was analyzed, and those who had taken the vitamins showed the same cancer rate as those who had taken the placebo. They also measured the rate of heart attack, heart failure, stroke, and angina, and again there was no benefit for the group that took the vitamins.

People who eat a diet full of fruits and vegetables seem to have a lower cancer risk, so it was hoped this long-term vitamin study would show similar benefits. Does this mean that vitamins have no benefit? No, but it does indicate that perhaps the only way to get the anti-cancer and heart-protective benefit, at least for these vitamins, is through your diet, and not through pills or supplements. Most likely there are many more substances in fruits and vegetables, particularly “phytochemicals“, that are more important for disease prevention than the vitamin content.

The status of vitamins in the medical literature will be unsettled for some time; for example, while vitamins C and E are falling out of favor, other vitamins such as D and B12, even in supplement form, are currently showing promise. And keep in mind that today we only considered if these vitamins help decrease the risk of cancer and heart disease; we haven’t touched on other diseases, such as cataracts, where vitamin supplements might be effective. I will discuss this in future posts and more completely in my book.

The trends though in vitamin research indicate this general recommendation: get your vitamins through a diet rich in a variety of fresh vegetables and fruits. Don’t rely on pills. As further vitamin research is released (a good study is underway on multivitamin pills), I will report it here.