LiveLongAgeWell

At the end of this post I’ll tell you how you can be considered to enter the study…

If you follow LLAW, you might know that my “favorite supplements” are, currently, fish oil tablets and vitamin D. In various posts I have detailed all sorts of possible benefits from these two supplements, and note that you can get both through natural sources (such as small doses of sunshine, or salmon) as well as from pills (and generally, natural sources are the better option).

The problem is that various other supplements have been heralded in the past as being wonderful and great for a variety of problems, especially for cutting the risk of cancer and cardiovascular disease. But then when really well-designed research studies are done, the supplements often fail to show a good effect, and sometimes they even result in more harm than good.

Vitamin E, folic acid, selenium, and beta-carotene all fall into this category, like Michael Jackson, of “fallen super-stars”, and, who knows, in five years we might be saying the same thing about vitamin D or fish oil (though I doubt it). The type of study that needs to be done—to see if vitamin D and fish oil are really any good—is a double-blind, randomized, prospective clinical trial. This sort of study is not commonly done as it’s expensive and it takes years to see the results.

Such a study starts with a large group of people, preferably many thousands, and splits them up into equal groups, that is, groups that are equally healthy or unhealthy, and then the researchers give some of them an active pill, for example, vitamin D, and the other group a fake pill, a placebo, and then a few years later compare the two groups to see how they did. Best if neither the people taking the drug nor the researchers know who is taking what (“double-blind”), and only break the “code” at the end of the experiment.

But most studies on vitamins and supplements are not like this; instead, they are “retrospective”…the researchers look at the health of different groups of people and look backwards in time (retrospectively) and see what they were taking or doing or eating, and try to deduce if a particular behavior or vitamin or whatever was responsible for the good or bad effect. But this research method leaves a lot to be desired, and it’s one reason you read a study that comes out stating that such-and-such is great, then a year later, you read the opposite. The problem could well be that either study, or both, was poorly-designed, and unless you really dig into an article to see if the study was prospective, double-blind, etc, you don’t know which research to better believe.

So starting early next year Harvard University is going to be doing one of the prospective clinical trials with vitamin D and fish oil (they are calling this the VITAL study). The research will study the subjects for five years into the future (prospective) and see how they all do. In 2016, then, we should know if fish oil and/or vitamin D are good for decreasing the risk of stroke, heart disease, or cancer—the three diseases the research is studying. Now even this is not going to be a perfect study, as it relies on people self-reporting their health via questionnaire (at times inaccurate), and while the researchers try to disguise the placebo pills, some people will try to figure out what they’re taking, try to outguess the researchers, and/or will take extra vitamin D or fish oil or other agents on the side, or not take the pills as they promised to if they think they are placebo.

But still, this study is probably the best we’ll get, and is better than any retrospective study. Here’s your chance to be a part of it… Harvard is now recruiting potential “subjects”. If you are interested in participating, or just want to read more details about this study, click here.

Anti-Aging Supplements

The American Medical Association AMA) has issued a report about hormones promoted on anti-aging websites. These include such products as Human Growth Hormone (HGH), DHEA, and testosterone, and they are sometimes available through online websites, or at many stay-young clinics around the world. HGH is one of the most popular, and the AMA states “evidence suggests long-term use can present more risks than benefits”. I agree. The research regarding this product, in particular, is turning more and more negative. I would be very suspicious of anything you take by mouth and especially injections, even of  “natural” products, that promise to keep you young.

Zinc Nasal Products and Loss Of Sense of Smell

Speaking of natural, one of the most popular over-the-counter products sold to prevent and treat the common cold is Zicam spray, and the active ingredient is the metal zinc. Here’s a glowing report from 2003 citing research showing that if you start Zicam within 48 hours of the onset of a cold, your symptoms can be cut by 50%. Now it turns out that the makers of Zicam have received over 800 reports of partial or complete loss of the sense of smell, often permanent. The company has settled 340 lawsuits regarding the product, and many more will be filed. Fortunately, the company has withdrawn many of their products from the market. “Natural” doesn’t mean effective, nor safe. Some of them are, but most probably are not, and like Zicam, can be found to be harmful years later when serious side effect reports roll in. Most are not regulated by the FDA. Buyer beware, even for “natural” over-the-counter products.

Vitamin D and Dieting

Here’s another possible benefit of what is currently the “hottest” vitamin, that is, vitamin D. (You can search on this blog to see the various recent reports.) The latest research, just presented at the Endocrine Society Annual Meeting in Washington, showed that people who had a higher vitamin D blood level before dieting lost a significantly greater amount of weight during their diets than people with lower vitamin D levels, and the higher the level, the greater the weight loss. This doesn’t prove that if you take vitamin D, you will lose weight. More research will be done to see if taking vitamin D supplements allows you to lose weight more successfully.  While there is no proof at this point, vitamin D in reasonable doses is considered safe, so if I was trying to lose weight, I would make sure I was getting enough of this vitamin, either through sunshine, diet (especially fatty fish, such as salmon), or supplements.

One of the hottest topics in medical research regarding aging is that many problems—from some cancers to atherosclerosis to Alzheimer’s disease and even some aspects of aging itself—can be in part caused by inflammation, which we might describe as a low-grade infection in the body over many years. This chronic irritation gradually results in damage to various organs such as the brain and the lining of our blood vessels, and might be one of the major factors in determining who among us will lose our mental capacity as we get older…the more the chronic inflammation, the greater the long-term damage, the higher the risk for dementia.

So for the past several years at least, the conventional wisdom has been that drugs that decrease inflammation also lower the risk of dementia, and much hope has been directed towards the non-steroidal anti-inflammatory drugs (NSAIDs) such as over-the-counter ibuprofen and naproxen (U.S. trade names like Aleve, Advil, Motrin).

Indeed, it was almost exactly one year ago that the esteemed journal Neurology published a huge study of veterans (about 250,000 people) over the age of 55, and found that during a five-year period, NSAID use appeared to lower the risk of developing Alzheimer’s by 24-40%. Considering the grand theory of inflammation, this all made sense. But now a University of Washington study, spanning 12 years, showed the opposite result—those who used NSAIDs most heavily (which, we would think, should markedly cut the inflammatory effect), had a 66% higher risk of developing Alzheimer’s than those who didn’t use NSAIDs.

The authors of this new study suspect the reason for this contradiction is that the earlier research studied younger people, and the latest study looked at people over 75. So perhaps NSAIDs only have the protective effect for younger people, and if you are above 75, NSAIDs markedly raise your risk? Is it perhaps that NSAID use by younger people delays the onset of Alzheimer’s, but ultimately raises the risk? This is still a very messy and complex topic, which won’t be resolved soon. What is certain is that much new research will come out over the next decade, and maybe by then the issue will be resolved.

The news about vitamin D just keeps getting better and better. In fact, it’s hard to find much news that is negative about this vitamin. The latest work comes from studying Costa Rican children with asthma, and those with the lowest vitamin D levels had a much higher risk of severe asthma.

Want to avoid diabetes? (who doesn’t?)  It seems likely that most cases of diabetes in people 65 or older are preventable… it’s not just fate, or family history. Nine out of ten cases can be avoided if you “live right”. According to a recent report in The Annals of Internal Medicine, people who follow some basic health principles regarding diet and exercise have a 89% lower risk of developing diabetes.

Here’s how to do it…see the details in MedPageToday, and of course, consult your physician for your specific situation:

1. above average physical activity
2. healthy diet regarding fat and fiber intake
3. don’t smoke, or have quit 20 or more years ago
4. light to moderate alcohol use, vs. not drinking at all
5. avoiding obesity
6. keeping your waist under 34.6 inches (88cm) for women, and under 36.2 inches (92 cm.) for men

For a long time scientists have suspected that the progressive, degenerative neurological disease Parkinson’s can be triggered by exposure to pesticides. Animal studies have shown exposure to the common pesticides paraquat and maneb will damage the brain’s dopamine producing neurons, and a lack of dopamine in the brain can lead to the rigidity and tremors seen human Parkinson’s disease.

A recent report from UCLA studied people in California’s agricultural Central Valley who lived close to crops exposed to the pesticides paraquat and maneb (and a matched “control group” who lived far away from the treated crop fields) and found that the people living close by had a 75% increased risk of developing Parkinson’s. Those pesticides are commonly used on a number of vegetables including soybeans, potatoes, lettuce, and corn. This is another reason to seriously consider buying organic when you can. Especially if you have a worrisome family history for any neurological problems, the cost difference should be well worthwhile. On the positive side, keep in mind, as mentioned in a previous post, that caffeinated coffee seems to markedly decrease the risk of Parkinson’s disease.

And, while the UCLA study was only directed at the association between pesticides and Parkinson’s disease, I suspect further research will show an association between chronic pesticide exposure and other neurologic disorders….it seems logical that if pesticides cause damage in the dopamine-producing neurons, that they also cause damage elsewhere in the nervous system, and increase the risk of other degenerative neural disorders. Maybe dementia, or the tremor commonly seen in many (not all) older people…for example the little shake when some grab a cup of coffee…that is harmless but serves as one marker indicating that yes, this person seems to be getting “old”.

OK, now here comes a link that will make the cost of your subscription to LLAW worthwhile (hehe…drDave just wanted a little chuckle to himself there)—it’s my favorite list of veggies and fruits with the highest pesticide content, with lower pesticide alternatives (if you don’t or can’t buy organic)…print and consult this list.  You just might live longer and better!

http://www.organicconsumers.org/organic/pesticide-residues.cfm

To finish the week…vitamin D and the racial health gap

You probably know that in the U.S. at least, African-American individuals suffer from a greater incidence of many health disorders, and at an earlier age, such as colon and breast cancer, and more aggressive forms of prostate cancer, and there are various theories why. Now it’s been found that darker-skinned individuals have lower levels of vitamin D, and perhaps that’s  one of the major reasons for the health gap.

Darker-skinned people, and people who live farther from the equator—especially during the winter—can easily suffer from low vitamin D levels, and more and more data is showing how important vitamin D is for our health (click on the “Pick A Topic” cloud on the LLAW right sidebar, and you’ll find a number of posts about vitamin D). While the current recommendation for D is from 200 to 600 units a day, most likely in a year or so these will be raised, maybe to 1000 units per day. Check out and click on Pick A Topic to see more about the vitamin that probably deserves so much praise. Keep posted here for the latest updates. Have a great weekend!

p.s. If you want to read even more about vitamin D this weekend (or whenever), check out this non-profit source:

http://www.vitamindsociety.org/about.php

Today’s post is dedicated to the people in the Eastern United States who are now being blanketed with up to 10 inches (25 cm.) of snow, along with temperatures down to 12 degrees F (-11 C)…what a miserable way to start a week. We wish them a quick end to their long cold winter, and now, speaking of “colds”…

If you ask people what vitamin they think of to prevent or treat the common cold, most people will answer: vitamin C. But a review by the Cochrane Collaboration (an international, non-profit group of scientists who develop unbiased recommendations based on analysis of the best accumulated research), found that in most cases, vitamin C has at best a mild effect in preventing colds, and doesn’t do much to treat colds. The biggest benefit was for people exposed to very cold weather or extreme exercise situations.

For sure, the subject of the common cold and vitamin C will continue to be studied and be controversial, but a very new study from Harvard Medical School strongly suggests that people with low levels of vitamin D in their blood get colds significantly more often.  People with a low D levels were 40% more likely to suffer from colds than people with the highest vitamin D levels. And people with pre-existing respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) seemed to have an even stronger beneficial effect from higher vitamin D levels—people with asthma and low vitamin D levels were five times more likely to suffer from colds than people with high levels. Those with COPD and low D levels were two times more likely to have cold symptoms.

This study was a retrospective analysis (it looked at data from the past), and for that reason the Harvard scientists couldn’t say whether taking additional vitamin D would cut your risk of getting a cold. To know if taking extra vitamin D cut one’s risk of getting a cold, a study would have to start with a large group of people, randomly separate them into two equal groups, then give one group vitamin D pills, and the other group an identical looking/tasting placebo pill, and study over time if one group got colds less frequently. Best if this study was “blinded” to cut the risk of researcher bias, meaning the researchers themselves wouldn’t know which group an individual person was in, so each study participant would be identified only by a code or number, and the code broken only at the end of the study. Such a study has yet to be done.

Still, the lead author in the recent Harvard study, Dr. Adit Ginde, stated “I think we can say that most Americans probably do need more vitamin D for its effects on bone health, as well as for its general benefits with respect to the immune system.” So the reason that vitamin D seemed to help cut the risk of colds is that vitamin D helps strengthen the immune system.

Vitamin D is one of the more difficult vitamins to get from the average diet….stay tuned to LLAW for how to!  (If you want lots of information on how to get vitamin D now, go to the Vitamin D Council link on the LLAW right sidebar under “Nutrition”).

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!

Last week I wrote about how a major research study showed that vitamin C and E supplements were ineffective for reducing the risk of heart disease and cancer. In general, these two vitamins, particularly vitamin E, are falling out of favor in the medical literature. But several others, particularly vitamins D and B12, are gaining more positive reviews in recent research. An interesting study from Oxford University, published in the journal Neurology, showed that individuals with a higher B12 level in their blood had significantly less brain shrinkage as they got older, than people with a lower B12 blood level. (Brain size was measured by serial MRI scans.)

B12 in the diet comes only from animal sources such as meat, including chicken; fish; milk; and eggs. (Strict vegetarians—vegans—require B12 supplements.) Many nutritional experts believe that especially as people are eating less meat, there is a growing crisis of B12 deficiency, and that middle-agers and above need to pay much more attention to B12 intake, either through diet or supplements. I will take up supplements in a later post, but the concern about B12 deficiency is another great reason to regularly eat fish! Salmon in particular is rich in B12. (For much more detail on this vitamin, go to the Nutrition section in the LLAW right sidebar, then click Linus Pauling Institute>Vitamins>Vitamin B12.)

In the next week I will discuss some other ways to help prevent brain shrinkage, at any age, and not through diet or supplements.

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.

Over the years, various vitamins are touted as the having the most wonderful benefits, yet some—such as vitamins C and E—while still important, have lost their super-star status. Now the new darling of the vitamin world is vitamin D, and numerous reports have been published recently linking higher levels of vitamin D (the “sunshine vitamin”) with decreased risk of heart disease, diabetes, even various cancers. Hopes are running high that this vitamin will, over time, maintain its lofty status.

This week’s study showed that people with Parkinson’s disease and Alzheimer’s had lower blood levels of vitamin D, but since this was not a clinical trial, it’s not known if taking more vitamin D will cut the risk of those diseases. Again, more studies are needed. Until then, it seems wise to ensure you are getting plenty of vitamin D either through your diet (not so easy for adults), sunshine, or supplements. This site will keep you informed of the various studies that appear. Much more vitamin D information, including how to ensure you are getting an adequate intake, can be found here (from the very useful Dietary Supplement Index on the LLAW right sidebar).