Fruit and Vegetables Give Hope For Healthier Hearts

Wednesday, October 31 (Medical News Today): The daily consumption of vegetables and fruit combined with a diet consisting of wholegrain products, fish, beans and small amounts of alcohol can more than halve the risk of developing cardiovascular disease. Researchers at Karolinska Institutet have analysed the eating habits of 25,000 Swedish women and found two specific dietary patterns that correlate significantly with a healthy heart.

It is hardly the first time that a link has been studied between diet and the risk of cardiac arrest, for instance. What is new about this particular piece of research is that the scientists have unreservedly mapped out the women's dietary habits instead of deciding in advance the kind of food they wanted to examine. Doing this, the researchers were able to identify two specific dietary patterns that were clearly linked to a reduced risk of cardiovascular disease.

"The first was characterised by a high consumption of vegetables and fruit, and the second by the moderate consumption of alcohol; we're talking about the equivalent of four vegetables and two pieces of fruit a day and half a glass of wine," says Agneta Akesson, one of the scientists behind the study.

She stresses that the dietary patterns in question included the regular consumption of wholegrain products, fish and beans. Almost one third of the women in the study showed this healthier eating behaviour, which in turn gave a 57 per cent lower risk of myocardial infarction than a diet low in these foodstuffs.

Using this dietary behaviour as a basis, the researchers added other health factors, such as a healthy body weight, abstinence from smoking, and regular exercise (by which was meant a daily walk of at least 40 minutes or a cycle ride, and one hour's more intense training a week). All these conditions were met by only one in twenty women, who, it transpired, had a full 92 per cent lower risk of suffering a heart attack than the women who smoked, were overweight, ate unhealthy food, and were physically inactive.

"If all women lived like the healthy group, 75 per cent of heart attacks would be prevented," says Agneta Åkesson. "It's also important to produce data based on the situation in Sweden so that we can improve public health in our country."

The newly published study was based on data from 25,000 women born in Uppsala and Västmanland County between 1914 and 1948, who have been monitored since 1997 with regard to their chances of suffering a myocardial infarction. The material is part of the Swedish Mammography Cohort. Since the study is based on healthy women, the percentage eating a wholesome diet is higher than the 20 per cent or less that would be expected amongst women in Sweden over the age of 50.

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Exercise slows prostate cancer

Study: Exercise slows prostate cancer

If you want to lower your risk of dying from prostate cancer, it's time to get moving. A study published in the journal Archives of Internal Medicine found vigorous exercise - and lots of it - can help slow the progression of prostate cancer in older men.

Researchers tracked a total of more than 47,000 men enrolled in the Health Professionals Follow-up Study over a 14-year period. During that period, 2,892 men were diagnosed with prostate cancer, including 482 advanced cases. Of those, 280 men died of prostate cancer.

Participants in the study were asked to report the amount of time they spent per week, on average, engaging in such vigorous activities as bicycling, hiking, jogging, playing tennis or racquetball, swimming laps and, other such exercise, as well as the amount of time they spent on non-vigorous exercise such as walking and climbing stairs.

While the researchers found no link in the overall study population between prostate cancer risk and total exercise, they did find an association in men above the age of 65 who engaged in three or more hours per week of vigorous exercise. In fact, these men face a 67% lower risk of being diagnosed with advanced prostate cancer and a 74% lower risk of dying of prostate cancer than their less active counterparts. Younger men did not share this association.

"Although the mechanisms are not yet understood, these findings suggest that regular vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer, particularly given the many other documented benefits of exercise," the researchers write.

Other research is also pointing to the benefits of exercise for colon cancer survivors. In a study presented at the annual meeting of the American Society of Clinical Oncology, researchers looked at the effects of physical activity on more than 800 people who were still alive a year after undergoing surgery and chemotherapy to treat colon cancer.

Participants were asked to complete surveys detailing their physical activity, including type of exercise, duration, and intensity. More than two years after completing chemotherapy, participants who reported the most exercise - 3 to 4 hours a week of jogging or a daily brisk walk at a speed of about 5 to 6 km per hour - were 35% less likely than the least active participants to have their cancer come back.

Earlier studies have pointed to the benefits of exercise for decreasing the risk of developing colon cancer in the first place, but this is the first study to show its effect on people who have already undergone treatment, the researchers said.

Consult your doctor before beginning any new or strenuous exercise routine.

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Obesity Can Hurt Kids' Hearts

Early signs of cardiovascular disease are there, researchers say

WEDNESDAY, Oct. 24 (HealthDay News) -- Obese children and those at risk for obesity show early signs of heart disease -- similar to that seen in obese adults, U.S. researchers say.

The study, by a team at Washington University School of Medicine, St. Louis, included 168 children ages 10 to 18. All of the children had undergone cardiac ultrasound to check on symptoms such as heart murmur, chest pain, acid reflux or high blood cholesterol. Of the children, 33 were obese, 20 were at risk for obesity, and 115 were normal weight.

The researchers used a new tissue Doppler imaging technique called "vector velocity imaging" that can track the movement of the heart's muscular wall.

"In the patients who are obese, the rate of motion of heart muscle changed," Dr. Angela Sharkey, an associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children's Hospital, said in a prepared statement. "As a child's BMIA (body mass index for age) increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," Sharkey said.

The findings were published in the winter issue of the Journal of Cardiometabolic Syndrome.

Vector velocity imaging could help doctors follow obese children to see if these changes in the heart progress and to determine if interventions -- such as dietary changes, increased exercise, and the use of cholesterol-lowering statin drugs -- have any effect, Sharkey said.

About 19 percent of American children ages 6 to 11 and 17 percent of those ages 12 to 19 are overweight, according to the U.S. Centers for Disease Control and Prevention.

More information

The Nemours Foundation has more about overweight and obese children.

-- Robert Preidt

SOURCE: Washington University School of Medicine, St. Louis, news release, Oct. 16, 2007

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Study Shows How Exercise Helps Women's Hearts

Much of the benefit comes from changes in blood pressure, inflammation

MONDAY, Oct. 22 (HealthDay News) -- About 60 percent of the protection provided to women by exercise against heart disease and stroke comes from its effect on a few specific risk factors, says a U.S. study in the journal Circulation.

Researchers assessed cardiovascular risk factors and exercise levels in more than 27,000 women, ages 45-90 (average age 55) enrolled in the Women's Health Study who were followed for more than 11 years for new diagnosis of heart attack and stroke.

Women who exercised the most were 40 percent less likely to have a heart attack or stroke than those who did the least amount of exercise.

"Regular physical activity is enormously beneficial in preventing heart attack and stroke," lead author Dr. Samia Mora, instructor of medicine at Harvard Medical School in the divisions of preventive and cardiovascular medicine at Brigham and Women's Hospital in Boston, said in a prepared statement.

"We found that even modest changes in risk factors for heart disease and stroke, especially those related to inflammation/hemostasis and blood pressure, can have a profound impact on preventing clinical events. This study is the first to examine the importance of a variety of known risk factors in explaining how physical activity prevents heart disease and stroke," Mora said.

The Harvard team found that exercise-related changes in inflammatory and hemostatic biomarkers -- fibrinogen, C-reactive protein and intracellular adhesion molecule-1 -- had the largest impact, lowering heart attack and stroke risk by 33 percent.

"Inflammatory and hemostatic factors as a group have overlapping functions and roles and, in our study, had the biggest effect in mediating exercise-related cardioprotection, more so than blood pressure or body weight," Mora said.

Exercise-related improvement in blood pressure was the second most important (a 27 percent reduced risk), followed by lipids (blood fats), body mass index, glucose abnormalities, kidney function, and homocysteine.

Due to a lack of clinical evidence, the inclusion of inflammatory and hemostatic biomarkers as risk factors in assessing cardiovascular disease isn't yet recognized by the American Heart Association.

More information

The American Academy of Family Physicians has more about exercise.

SOURCE: American Heart Association, news release, Oct. 22, 2007

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Exercise Helps Older Adults Improve Balance

Newswise — According to a new review of research, exercise helps people stay steady on their feet in later years, when diminished balance can put older adults at risk for falls.

The review shows gains in balancing ability across different groups of adults who participated in a variety of exercises including walking, strength and balance training, dancing and tai chi.

Some of the balance exercises included rising from a chair and training on one leg.

“Our message is that some form of exercise will improve balance and it’s never too late to exercise. Specifically, exercise that challenges your balance is best,” said lead review author Tracey Howe.

The analysis gathered evidence from 34 studies, which collectively included more than 2,800 participants. On average the study participants were over age 75, generally healthy, and the majority were women.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

After engaging in an exercise program, study participants achieved improvements in different kinds of balance measures including walking speed, standing on one leg and reaching forward without tipping over.

Health researchers want to learn more about balance because they suspect it relates to an individual’s risk for falls. In old age, falls can lead to disability and a loss of independence. Howe said the review did not gauge the effect of exercise on falls, so there is no way to tell from the review if balance improvements led to fall prevention.

Still, Howe said, the balance gains documented in the study are significant because balance is involved in almost everything we do.

“You use it every time you move positions, even walking. Walking is nothing more than movement without falling — controlled falling,” said Howe, director of HealthQWest, a research consortium based at Glasgow Caledonian University in Scotland.

“Good balance allows you to react to change. As they get older, some people have problems with their muscles being rigid. Think of the wind blowing through a tree. If the tree sways too much, or if it is rigid, the tree will fall over. If you can sway with the wind, by responding to the subtle changes in everyday life you are more stable and less likely to fall,” she said.

The American College of Sports Medicine recently revised its guidelines for older adults. The recommendations include balance exercise for people who are at risk for falls, but the Cochrane review did not find that one kind of exercise outperformed any other.

Healthy aging researcher Debra Rose said health professionals need more information on how the risk of falls interacts with different types of exercise.

“The type of physical activity or exercise that’s appropriate is really going to be determined by a person’s level of risk for falls,” said Rose, professor of kinesiology and co-director of the Center for Successful Aging and Fall Prevention at California State University, Fullerton.

“When you are at low risk for falls, there are lots of exercise options, but the choices narrow as balance diminishes and fall risk increases,” Rose said.

The reviewers’ analysis could not determine if the balance gains for older adults were long lasting.

“I agree with the summary that there isn’t sufficient evidence of the efficacy of exercise over the long term,” said Rose. “There’s a notion that exercise is a quick fix — it isn’t. It has to be incorporated into an overall lifestyle change.”

Howe, TE et al. Exercise for improving balance in older people (Review). Cochrane Database of Systematic Reviews 2007, Issue 4.

The Cochrane Collaboration is an international non-profit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

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Obesity epidemic 'could bankrupt the NHS'

By Rebecca Smith

Tackling Britain’s obesity epidemic could bankrupt the NHS, a leading expert has warned.

It is anticipated that obesity could cost as much as £45 billion a year by 2050, to pay for growing incidents of diabetes, strokes and heart disease as well as the loss of earnings by those too heavy to work, a conference was warned.

Dr Colin Waine, chairman of the National Obesity Forum (NOF), said the financial implications of obesity were "huge" and claimed the Government would have to confront the food industry to tackle the problem.

The obesity crisis is currently thought to cost the NHS £1 billion a year to treat but with half the population expected to be obese by 2050, the bill is due to rise much higher.

Dr Waine’s warning comes as the Government was accused of shelving its target to stop the rise in childhood obesity by 2010.

The British Heart Foundation said even this modest target has been replaced, quietly, with a longer-term goal to give ministers time to "get their act together".

The new target to reduce childhood obesity to 2000 levels by 2020 was hidden in the Comprehensive Spending Review published last week.

Peter Hollins, chief executive of the British Heart Foundation, said: "Setting new targets for 2020 is presumably a tactic to buy the Government more time to get its act together.

"It’s not as if this crisis is new – we have been warning of its severity and urgency for years but no coordinated cross-Government strategy has been formed. The pace of change needs to be quickened."

At the National Obesity Forum conference in London yesterday, experts said the Government needs a co-ordinated approach across all aspects of life.

Dr Waine said there had been a tendency for the obesity problem to be heaped on the individual, whereas the situation was more complex than that.

"It may need Government to confront the food industry... it also means governments rethinking environments to plan them around the pedestrian, not the motor car.

"It does require a large amount of political courage to do it.

"I’m cautiously optimistic that the Health Secretary seems to have appreciated the sheer size of the problem.

"I hope he influences his colleagues to come up with the right policies."

Dr Waine estimated it could take five to 10 years before such action would really produce results. He said: "It means the sooner we start, the better.

"Even with the very generous funding that we have had, the problem is escalating so quickly we are not just going to get an epidemic of obesity, we are going to have an epidemic of type II diabetes.

"The complications of that are very costly."

He warned the financial cost of obesity would have "huge implications". "It could bankrupt the NHS," he said.

Health Secretary Alan Johnson said at the weekend that the obesity epidemic could lead to a public health crisis on the "scale of climate change".

He said efforts to promote exercise and healthy eating had to go "further and faster" in response to the stark findings of the new Government Foresight study

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Obesity 'fuelling cancer timebomb'

By Caroline Gammell

The growing obesity epidemic is fuelling a cancer timebomb, cancer research experts warn today.

One in three primary-school leavers overweight Ten ways to stay thin

Being overweight increases the risk of developing a number of cancers, including breast, womb and prostate.

According to a study by Cancer Research the number of men and women under the age of 45 who are morbidly obese has doubled in the past decade. This increase in obesity means more people are at risk of developing cancer.

Professor Jane Wardle, the director of Cancer Research UK's health behaviour unit, said slim people stayed roughly the same size over the 10 years, but the weight of heavier people dramatically increased.

The charity said a more sedentary lifestyle – often sitting at a computer – takeaway meals and snacking were all contributory factors.

Prof Wardle said two cancers that claimed most lives in Britain – breast and colorectal – were among those that had been linked with obesity. "We are seeing evidence of a rise in the number of cancers that can be caused by obesity just when we are seeing a reduction in those caused by smoking," she said.

Being overweight or obese upsets the metabolic environment and accelerates cell damage as well as the fat secreting hormones that could trigger tumours, she went on.

Obese people are at a greater risk of getting cancers of the womb, gall bladder and kidney and could also increase the risk of prostate and pancreatic cancers. "The biological link between obesity and cancer is complicated but maintaining a healthy body weight will reduce cancer risk.

"We need to continue raising awareness of the dangers of obesity and offer information to help people lose those extra pounds."

Dr Lesley Walker, of Cancer Research UK, said: "This research adds to the evidence that the UK is in the grip of an obesity epidemic.

"We know that high body weight increases the risk of a number of cancers and it is important we get this message to as many people as possible. A healthy diet with plenty of fibre, fruit and vegetables as well as regular exercise can help people to lose weight and reduce their risk of cancer."

Obesity growth in England was measured by taking the weight and waist measurements of 12,000 people in 1993-94 and contrasting them with a similar group 10 years later.

The number of men classed as obese rose from 13.4 per cent to 22.7 per cent, while the level of obese women increased from 15.8 per cent to 22.4 per cent. Men's waist circumference expanded by 1.37in (3.48cms) and women's by 1.71in (4.35cms).

The study also looked at a person's Body Mass Index (BMI), which is calculated by dividing weight in kilograms by the square of a person's height in metres. To be considered morbidly obese, a person must have a BMI of 35 or more. Between 1994 and 2004, the number of women with a BMI of more than 40 doubled.

Research has shown that 12,000 cases of cancer could be prevented each year if a person's BMI did not exceed 25 – classed as overweight.

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Obesity Driving Rising U.S. Health Costs

Americans outspend Europeans when it comes to chronic disease care, study finds

By Steven Reinberg
HealthDay Reporter

TUESDAY, Oct. 2 (HealthDay News) -- Obesity is a big factor driving soaring rates of chronic disease in the United States, with many more Americans chronically ill than their European counterparts, a new study finds.

It's an expensive problem, too: According to researchers, chronic illnesses such as diabetes and heart disease account for some $100 to $150 billion in health-care spending in the United States each year.

"The United States spends twice as much as European countries on health care," noted lead researcher Kenneth Thorpe, chairman of the department of health policy and management at Emory University's Rollins School of Public Health in Atlanta. "Seventy-five percent of what we spend in this country is associated with patients that have one or more chronic conditions and most of the growth is due to obesity."

"We have got to find more effective means to reduce, and at the worst, stabilize this persistent rise in obesity among adults and kids in this country," he said.

In addition, experts must find better and less expensive ways of managing chronic health-care problems, Thorpe said.

"That's where all the money is being spent," he said. "We are not going to control costs until we get the level and growth in chronic disease prevalence down."

The report appears in the Oct. 2 online edition of Health Affairs.

In the study, Thorpe's team compared 2004 data on the prevalence and treatment of diseases among adults aged 50 and older in the United States and Austria, Denmark, France, Germany, Greece, Italy, Netherlands, Spain, Sweden and Switzerland.

They report that about 17 percent of European adults are obese, compared with around a third of American adults. In addition, 53 percent of adult Americans are either former or current smokers, compared with 43 percent of those in Europe. American adults were also more likely than Europeans to have heart disease, cancer, diabetes and chronic lung disease -- all associated with obesity and/or smoking.

"The United States spends more on health care than any country in Europe," Thorpe said. In the United States, in 2004 the per capita spending on health care was $6,102 -- about twice as much as in the Netherlands and Germany, and almost twice that of France.

If the prevalence of obesity could be reduced (and along with it, chronic disease), Thorpe's team estimates that health spending could be cut by $100 billion to $150 billion per year, trimming up to 18.7 percent off the nation's total health-care budget.

There are several reasons for the costs of chronic disease in the United States, Thorpe's group notes. In addition to high rates of obesity and smoking, these include more aggressive cancer screening in the United States than in Europe, and more intensive drug treatment for chronic disease than in Europe, further driving up costs.

Thorpe believes the only way to get health-care costs under control is to find ways to reduce obesity. "There is a lack of an effective primary-care system in this country," he said. "We have to manage patients with chronic conditions more effectively, and we have got to find a way to prevent this rise in obesity."

One expert agreed with the scope of the problem, but said solutions remain elusive.

"There are two reasons why the U.S. might spend more of our total economy on health care than any other country -- treatment here costs more, and more of us need treatment," said Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine.

That Americans are fatter than Europeans comes as no surprise, Katz said, but that more Americans smoke is surprising. "This finding does make me question the reliability of the data to some degree. But even if we know for sure that Americans have more chronic disease risk factors than populations abroad, it doesn't necessarily tell us how to fix the problem," he said.

Obesity rates in Europe are rising fast, so "we are exporting our bad example and higher health-care costs may well follow [there]," Katz said. "Without a doubt, the high costs of health care are best reduced by the propagation of health. Defining how best to get there from here is as yet a challenge inadequately met."

Another health-care cost expert agreed.

"I'm not sure obesity is a medical condition that lends itself to medical treatment," said Greg Scandlen, the founder of Consumers for Health Care Choices, a health-care lobbying group. "Certainly, it does suggest the need for more exercise and better diets, but that is a grandmother's advice. Do we need highly trained and expensive professionals telling people what grandmothers have told them for free for generations?"

"I'm just not sure this information is of much use to the health-care system, though it may be for the education system," Scandlen said. His suggestions? "Bring back P.E. classes, [use the] transportation system, use more bicycles and fewer cars, and urban design, get rid of escalators so people will walk up stairs," he said.

More information

For more information on the cost of health care, visit the Kaiser Family Foundation.

SOURCES: Kenneth Thorpe, Ph.D., chairman, department of health policy and management, Emory University Rollins School of Public Health, Atlanta; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Greg Scandlen, founder, Consumers for Health Care Choices, Hagerstown, Md.; Oct. 2, 2007, Health Affairs online

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Heart-Healthy Exercise May Also Be Knee-Healthy Exercise

The world's most common joint disease, osteoarthritis (OA) is a major cause of disability among adults over the age of 50. Whether physical activity is beneficial or detrimental to weight-bearing joints, knees in particular, has been open to debate. Some studies implicate physical activity in provoking knee OA, while others suggest that physical activity may actually protect the knee joint from the disease. Confounding the matter is the fact that knee injury is a known risk factor for knee OA. Then, there's the unclear role of osteophytes in knee OA progression, compounded by the limitations of radiographs for monitoring small yet significant changes in joint structure.

For a clearer picture of the impact of physical activity on the knee joint, a team of researchers in Australia turned to magnetic resonance imaging (MRI). This highly accurate high-tech tool makes it possible to directly visualize joint structures, detect early and pre-disease states of OA, and assess the influence of potential risk factors. Taking advantage of this novel methodology, the researchers studied the effect of physical activity, in various degrees of intensity, frequency, and duration, on knee structures in a total of 257 healthy adults between the ages of 50 and 79, with no history of knee injury or OA. Their findings, presented in the October 2007 issue of Arthritis Care & Research , suggest that exercise that is good for the heart is also good for the knee.

Recruited from an established community-based research population, the Melbourne Collaborative Cohort Study, subjects all underwent MRI exams on the tibia bone and tibiofemoral joint of their dominant knee -- the one on the leg they first step forward when walking. MRI was used to assess cartilage defects and bone marrow lesions, as well as measure cartilage volume, an indicator of cartilage health and strength. Loss of knee cartilage is linked to worsening knee symptoms in OA sufferers. Subjects also answered specific questions regarding their exercise and walking habits, as well as routine activity at home and at work, to determine their level of physical activity in both the 6 months and 7 days prior to the study. To create a baseline for each subject, past information on weight, height, body mass index, and physical activity, from questionnaires completed between 1990 and 1994, was obtained. Then, the team performed a series of analyses and comparisons.

Among the notable findings, both baseline and current vigorous physical activity -- exercise that gets the heart pumping and the body sweating -- were associated with an increase in tibial cartilage volume, free from cartilage defects. What's more, tibial cartilage volume increased with frequency and duration of vigorous activity. Recent weight-bearing exercise was also linked to increased tibial cartilage volume and reduced cartilage defects. Finally, moderate physical activity, including regular walking, was associated with a lower incidence of bone marrow lesions.

"This is the first study to demonstrate a potentially beneficial effect of walking on the reduction in the risk of bone marrow lesions in the knee," notes the study's leading author, Dr. Flavia M. Cicuttini. "Bone marrow lesions have been associated with pain and radiograph-defined progression of osteoarthritis, type II collagen degradation, and loss of cartilage volume."

Demonstrating a protective effect of past and current vigorous physical activity on knee cartilage in healthy adults, this study strongly supports the benefits of exercise for older individuals at risk for OA. Though both the intensity and duration of physical activity had a significant positive impact on cartilage, the ideal amount of physical activity for joint health remains unclear. "Our data suggest that at least 20 minutes once per week of activity sufficient to result in sweating or some shortness of breath might be adequate. This is similar to, if not somewhat less than, the recommendations for cardiovascular health," Dr. Cicuttini observes.

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Article: "Effect of Physical Activity on Articular Knee Joint Structures in Community-Based Adults," Tina L. Racunica, Andrew J. Teichtahl, Yuanyuan Wang, Anita E. Wluka, Dallas R. English, Graham G. Giles, Richard O'Sullivan, and Flavia M. Cicuttini, Arthritis Care & Research, October 2007; (DOI: 10.1002/art.22990).

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