LiveLongAgeWell

If you have high cholesterol, and are taking or considering taking (prescription) “statin” medication to lower cholesterol and decrease heart attack risk, you might be interested in this large Israeli study. The results suggested that those who faithfully took their statin medication over a four- to five-year period had a significantly lower death rate (45 percent) than those who took their medication only occasionally. It’s interesting research—worth talking to your doctor about if you are in a high risk group—but it’s not a perfect study. It may be that those who took their medication faithfully also took better care of themselves in other ways, and those other ways were more responsible for their better survival than the statin drug.

(This dedicated to my brother for his birthday today…he’s a faithful and accomplished marathon runner. I hope he avoids cataracts based on his running, because he doesn’t use sunglasses, and that increases his risk.) Particularly if you have a family history of AMD (age-related macular degeneration, the biggest cause for blindness in adults) or cataracts, you will be interested to know that people who run faithfully may have a much decreased risk of developing those eye diseases. For example, one report showed that those who run over 4 kilometers per day (2.5 miles) cut their risk of AMD by up to 54 percent. Much more detail here.

Do you know people who still smoke, and are crazy about their pets? More about this later, but it seems that pets really suffer the effects of secondhand smoke too, and that many smokers might be motivated to quit once they realize they are harming their pets!

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!

I have some good friends who still smoke, but they’re all careful and courteous smokers (as I think most are today) in that they try to keep their secondhand smoke away from non-smokers. But a research report just published in the medical journal Pediatrics suggests that smokers are generally not aware of another hazard from their cigarettes—they may be causing even non-smokers to become “third-hand smokers”. This is the first new medical term of 2009, and it’s good to know something about it as it will be talked about and maybe used as a basis for new laws aimed at smokers.

You notice this hazard for example when you enter a hotel room (especially common in certain cities, like Las Vegas) that has recently been occupied by smokers, and you are hit with that distinctive sick smell. You know there is something foul in the room, and it’s because some smoker has been there, leaving his mark, almost like a dog marking his territory. Sometimes it’s more of a feeling you get; it might be enough to prod you to march to the front desk and demand a non-smoking room. You might encounter the same in rental cars, homes and some offices. Twenty percent of the U.S. population still smokes, so it’s a persisting issue, and this research study suggests you should be concerned if you are (not of your own making) a third-hand smoker.

Particulate matter from cigarette smoke penetrates and persists in many surfaces, slowly leaking toxins to those in contact. Most at risk are pregnant or breastfeeding women and children, but everyone suffers some risk. The National Toxicology Program has identified in cigarette smoke some 250 poisonous gases, heavy metals, and other chemicals such as cyanide, carbon monoxide, butane, lead, arsenic, and even the highly radioactive and carcinogenic polonium-210 (used to kill an ex-Russian spy in London in 2006). Ten other substances in cigarette smoke are classified as Class I carcinogens (highest level). Besides these serious issues, cigarette smoke is very bad for looking good as you get older.

The research also showed that only 43% of smokers believed third-hand smoke was dangerous, yet 65% of non-smokers thought it was harmful. The good news is that when smokers become aware of the risks to others, most will change their behavior to minimize that risk. We need to keep encouraging smokers to quit, but, in the meantime, to smoke outside so at least disperse the damage so it won’t settle into our carpets and fabrics…(I think it’s rather ironic that some righteous non-smokers—I noticed this occasionally when I lived in California—will make an absolute scandal about people smoking outside, crying that they are fouling the air, and then they drive off in a Cadillac Escalade or Range Rover, causing much more collective harm than any cigarette.)

If you find yourself in a rental car or a hotel room and you notice you are about to become a third hand smoker, get out, change the car or room. Best to remember to reserve a non-smoking environment whenever you can.

If you ever wondered if restaurant and workplace indoor smoking bans have really improved the public health—beyond just clearing the air—consider this dramatic recent study from the Centers for Disease Control and Prevention (CDC). The authors found that after three years of an indoor smoking ban in Pueblo, Colorado, local heart attack hospital admissions dropped 41%. This large drop in the rate of heart attacks is surprising and unexpected, so let’s look at the study closer to see if the conclusions are accurate and reliable.

When doctors read a medical research report, particularly one with unexpected findings, they should examine how the study was done (“study design”), to see if there were any defects, and if so, how serious they were…are they enough that the conclusions can’t be trusted? Unfortunately, many medical studies have bad design, but often that fact is not reported in the media article.

Fortunately the scientists at the CDC are good, and this study was well designed. For example, the researchers studied what is called a control group at the same time they studied the people in Pueblo. The control group was two other municipal areas close to Pueblo which did not enact a smoking ban. They looked at their heart attack rates also, and found no drop as there was in Pueblo. So most likely, the smoking ban was responsible for the big drop in heart attacks.

Actually there have been eight studies before this one looking at the same issue, and all have shown a rapid drop in heart attacks following a smoking ban, but only this CDC study covered a long time period.

Often when we think of the bad effects of cigarettes, we think about lung cancer, but this study emphasizes how smoke seriously affects our hearts also. If we want to live long, one hint is to stay clear of it. Wherever you are—inside or outside—this study suggests that it’s really worthwhile to move away…

“Quitting smoking is easy. I’ve done it a thousand times.” Mark Twain (probably around now…Happy New Year’s!)

Actually, quitting is tough, but about half of smokers eventually do it. Usually it takes multiple attempts. Especially if you are around secondhand smoke, which may even increase the risk of breast cancer, this year stop the damage and excess aging you are suffering; if you know a smoker, send him this post.

A smoker who quits, no matter her age, will begin to undue the damage, maybe even most of the damage. It doesn’t matter how long you smoked, you will be better off if you quit, now. Like all addictions it’s not easy, but if your personal resolve is strong you can try “cold turkey”. Many motivated smokers have quit this way.

But—no shame—if you want extra help, talk to your physician about nicotine replacement therapy (gum, patch, inhaler, or nasal spray), or one of the available prescription pills that significantly improve your chances of quitting. Realize though that if you choose a medication option, you still need a strong desire to quit, or you will fail.

All medication options have possible side effects, but not necessarily bad ones (and continuing to smoke has lots of side effects!)  Ask your doctor, and maybe research yourself) about this: the pill that has been on the market as a stop-smoking aid since 1997 (available relatively cheaply as generic bupropion) is also used as an anti-depressant, and many people even lose weight while taking it.

There is a newer drug (trade name Chantix) which is more expensive and has been heavily marketed to doctors, but may have more risks than the older medication bupropion. If your doc wants you to take the newer medication, quiz her closely about why she wants you to take the heavily marketed med rather than bupropion. Are the possible benefits really worth the risks of this new drug which could, in several years, be withdrawn due to side effects? (There have been enough concerns that the FAA has banned its use by pilots and air traffic controllers.) Often it’s safer, cheaper, and better to stick to the tried-and-true when it comes to medication. The newest is NOT necessarily better when it comes to prescription drugs!

Whatever method you choose, get support from an organization such as the Center for Disease Control (puts your tax money to work and has lots of great links) or the American Cancer Society.  And be aware that when you quit, for some time you could feel worse, even beyond missing the cigarettes.  Recent ex-smokers may cough more, and bring up more mucous, which might be a sign that the lungs are starting to come alive again, and that you are clearing out years of built-up debris. Discuss with your doctor.

When you—or someone you know—successfully quits, they will likely be happier, more self-assured, sick less, and no longer contributing to secondhand smoke risks.  Beyond that, while quitting, think of another reward.  Maybe a vacation, which now you can afford because you won’t be spending on cigarettes, and your health care costs will likely be lower!

A main goal of this blog is to give you practical hints so you can live healthier and longer, but just as important is to give you information so you can live happier. There doesn’t seem to be too much point trying to live a super-long life if you aren’t reasonably happy. Now especially during these tough economic times, when I find information on ways you can increase your level of happiness, I will pass it along…

Earlier this year (before I started this LLAW blog), two reputable research reports appeared regarding, first, how quitting smoking, and then how obesity could be “contagious”. Yes, a team of researchers—from Harvard and UC San Diego—concluded that you are significantly more likely to lose or gain weight or quit smoking if you become aware of friends or relatives who recently lost or gained weight, or quit smoking, even if they live across the country. Just knowing about others who have changed in these ways seems to profoundly influence your own behavior. The influence of your friends spreads almost like a social virus, in a seemingly contagious manner.

Just last week the same researchers showed a similar type of effect with happiness: if you become aware of friends or even neighbors (who aren’t friends but just acquaintances), then YOU are more likely to also become happier. The effect is greater if these people actually are your friends, and the closer they live to you the greater the effect. There seems to be a larger effect from people your own gender who become happy. More surprising is that they found even “third degree” friends had some influence on your own happiness, meaning if a friend of one of your friend’s friends switched to becoming happy for some reason, then their happiness in a small way rubbed off onto you. If true, this truly speaks of an amazing strength of social networks.

When these researchers earlier this year released their studies on contagious obesity and smoking behavior, other scientists seemed to be surprised, but generally supportive that it all made sense. But this current study on happiness—even though it came from good institutions—has raised more skepticism.  Some have said that perhaps there is something in the statistical analysis that has lead to erroneous conclusions, particularly since they concluded that if your next-door friend suddenly became happy, that the effect on you was greater than if your own spouse became happy.

I suspect it will take a couple years for the various social scientists to argue all this out. Typically what happens when a study is controversial is that either another group of scientists will be able to repeat the first study and confirm the findings, or will conclude with their new research that the first study was wrong, or only partially right.

In the meantime however, we might take the conclusions of this happiness study at face value, and to maximize our own happiness, try to form bonds with people, or at least become aware of others who are doing positive things with their lives. It just might just rub off on us.