In The News: January 2016

The 2015 European Cancer Congress was the site of a presentation on the finding of longer overall survival associated with use of aspirin following diagnosis of gastrointestinal cancer.*

Martine Frouws, MD, analyzed data from 13,715 men and women diagnosed with a GI cancer from 1998 to 2011. Aspirin was used prior to cancer diagnosis by 30.5% of the subjects and by 8.3% after being diagnosed.

Nearly 28% of the patients were still alive for at least five years over a median follow-up period of 48.6 months. Among those who used aspirin after diagnosis, the chance of surviving was double that of nonusers.

According to European Society for Medical Oncology spokesperson Nadir Arber, MD: “Aspirin may serve as the magic bullet because it can target and prevent ischemic heart disease, cancer, and Alzheimer’s disease, the three major health catastrophes in the third millennium.”

Editor’s Note: “Medical research is focusing more and more on personalized medicine, but many personalized treatments are expensive and only useful in small populations,” Dr. Frouws observed. “We believe that our research shows quite the opposite. It demonstrates the considerable benefit of a cheap, well-established, and easily obtainable drug in a larger group of patients, while still targeting the treatment to a specific individual.”

An article in BMC Medicine reports that older individuals who eat an unhealthy Western diet have smaller brains, which researchers say is further proof that junk food has a terrible impact on health.*

The results of the study, conducted by researchers at Deakin University and the Australian National University, suggest that older adults who consume more junk foods, such as sweet drinks, salty snacks, and processed meats, have smaller left hippocampi. It also shows that older adults who eat healthier foods, such as vegetables, fruits, and fish, have larger left hippocampi. These relationships existed over and above other factors that may explain these associations, such as gender, levels of physical activity, smoking, education, or depression.

The researchers used magnetic resonance imaging to measure the size of hippocampus in Australian adults aged 60-64 years. They also measured the participants’ regular diets and took into account a range of other factors that could affect the hippocampus. These findings that consuming junk foods accelerates brain atrophy have substantial relevance for both dementia prevention and mental health.

Editor’s Note: “This study sheds light on at least one of the pathways by which eating an unhealthy diet may influence the risk for dementia, cognitive decline, and mental disorders such as depression and anxiety in older people,” said lead author Felice Jacka. “However, it also points to the importance of diet for brain health in other age groups. As the hippocampus is critical to learning and memory throughout life, as well as being a key part of the brain involved in mental health, this study underscores the importance of good nutrition for children, adolescents, and adults of all ages.”

A study presented at the European Association for the Study of Diabetes conference in Stockholm shows that those with poor blood sugar control have 50% higher risk for dementia.*

The study included almost 350,000 people with type II diabetes who were registered in the Swedish National Diabetes Registry between January 2004 and December 2012. Participants, with a mean age of 67 when the study began, had no history of dementia when they were diagnosed with type II diabetes.

Volunteers were tracked until the study ended in 2012 or when they were hospitalized for dementia or died. Using a computer model, the researchers calculated the link between average blood sugar levels and dementia. Average blood sugar levels were based on the results of hemoglobin A1C tests (HbA1C). This test provides doctors with a several-month average of blood sugar levels. Dementia risk was sharply elevated in those with higher hemoglobin A1c readings.

Editor’s Note: Say study authors: “The positive association between HbA1c and risk of dementia in fairly young patients with type II diabetes indicates a potential for prevention of dementia with improved blood sugar control.”

In a new study of older adults published in the Journal of the American Geriatric Society, having multiple chronic conditions was linked with an increased risk of mild cognitive impairment (MCI) or dementia.*

Researchers assessed 2,176 cognitively normal participants with an average age of 78.5 years who were followed for a median of four years. Participants with more than one chronic condition were 38% more likely to develop MCI/dementia. Participants with four or more conditions had a 61% increased risk compared with those with one or no condition. Men also had a higher risk than women.

“We were not able to investigate the specific mechanisms by which multimorbidity contributes to cognitive impairment; however our findings are consistent with the hypothesis that multiple etiologies may contribute to late-life cognitive decline and thus emphasize the importance of prevention,” said study author Dr. Rosebud Roberts. “They also emphasize that chronic diseases, once diagnosed, should be efficiently managed.”

While the researchers are confident about the link between chronic illness and cognitive impairment, they note they are uncertain about why it occurs, but offer different theories. “An important potential mechanism is through cardiovascular diseases: hypertension, hyperlipidemia, and cardiac diseases, specifically CAD,” the authors wrote. They add that chronic conditions such as arthritis limit mobility and physical activity, leaving people more susceptible to cardiovascular disease, which in turn may increase cognitive impairment. Aging people with concurring chronic conditions are also more likely to have harmful interactions with an increasing number of medications, which may leave them vulnerable to dementia.

Editor’s Note: The findings suggest that the prevention of chronic diseases may help aging adults maintain their mental health.

In an article published in the Journal of Nutrition, Ilse Reinders and colleagues report an association between higher plasma phospholipid omega-3 polyunsaturated fatty acids (PUFAs) and lower pulse wave velocity, a measure of arterial stiffness which, when increased, has been correlated with a greater risk of cardiovascular disease and related mortality.*

The study involved participants in the ongoing Age, Gene/Environment Susceptibility–Reykjavik (AGES-Reykjavik) Study. Of those who had plasma phospholipid polyunsaturated fatty acids measured upon enrollment, 501 subjects had carotid-femoral pulse wave velocity measured at a five-year follow-up examination.

Higher total plasma omega-3 polyunsaturated fatty acids and individual omega-3 fatty acids EPA and DHA were associated with lower pulse wave velocity. In contrast, subjects whose total plasma omega-6 fatty acids and the omega-6 fatty acid linoleic acid were higher had increased carotid-femoral pulse wave velocity measurements.

Editor’s Note: “Our results for plasma phospholipid omega–3 PUFAs are confirmed by a recent randomized, controlled trial showing that omega–3 supplementation resulted in lower carotid-femoral pulse wave velocity,” the authors remark. “The effect of omega–3 PUFA supplementation on carotid-femoral pulse wave velocity might be explained by improved endothelial function and a decrease in inflammatory markers.”

An article published in Gastroenterology reports the results of research that uncovered an effect for the inflammatory mediator prostaglandin E2 (PGE2) as a driving force in the metastasis of colorectal cancer.*

“The normal role of PGE2 is to come to the rescue when you do something like cut your finger,” explained lead researcher Raymond N. DuBois, MD, PhD. “It attracts the body’s immune cells and stimulates pathways that heal the wound site. The level of PGE2 goes up and then goes down within a few days of healing the wound. But in cancer, the cells keep making PGE2 chronically, so it’s like this wounding process that never heals. In doing so, it generates these cancer stem cells that promote cancer progression and metastatic spread.”

By measuring levels of prostaglandin E2 in colorectal carcinoma specimens and normal tissues, Dr. DuBois and associates found a correlation between the compound and colon cancer stem cell markers.

Editor’s Note: “We’ve long known that simple things like taking aspirin or other anti-inflammatory drugs (called nonsteroidal anti-inflammatory drugs, or NSAIDs), have beneficial effects on reducing the risk of colorectal cancer,” Dr. DuBois observed. “But non-aspirin NSAIDs can cause serious cardiovascular side effects when taken over a long period of time, so we’ve needed to discover better drug targets. This study points us in the right direction.”

A study published in JAMA Neurology found that older adults with low vitamin D levels may lose their memories and thinking abilities faster than those with normal levels, especially when it comes to memory loss related to Alzheimer’s disease and dementia.*

Dr. Joshua W. Miller and colleagues at University of California, Davis, Alzheimer’s Disease Center, looked at the association between blood levels of vitamin D and changes in memory and thinking ability in 318 adults over an average of five years.

The researchers defined adequate blood levels of 25-hydroxyvitamin D—the form of vitamin D generated when the body converts the vitamin D made in the skin by sunlight and consumed from foods like eggs, oily fish, and milk—to be in the range of 20 ng/mL to 50 ng/mL. Insufficient levels are 12 ng/mL to less than 20 ng/mL, and levels below 12 ng/mL are deficient.

Study participants had a mean age of 76 and were cognitively normal, had mild cognitive impairment, or dementia. Researchers found that more than 60% had low vitamin D levels, including more than a quarter who had a deficiency. Individuals with dementia had lower vitamin D levels (about 16.2 ng/mL) than those with mild cognitive impairment (average 20 ng/mL) or whose memory was normal (19.7 ng/mL). Over the course of the study, those with low vitamin D levels showed an accelerated decline in executive function—working memory, reasoning, task flexibility, problem solving, planning, and execution—and in the ability to remember their own past personal experiences. These rates of decline were similar for individuals who had normal brain function at the beginning of the study and for those who already had dementia or mild cognitive impairment.

Editor’s Note: Among people with cognitive impairment, an estimated 70% to 90% have insufficient vitamin D. “This work, and that of others, suggests that there is enough evidence to recommend that people in their 60s and older discuss taking a daily vitamin D supplement with their physicians,” Miller said.

The results of a trial reported in Neurology reveal an association between supplementation with resveratrol and improvement in markers of Alzheimer’s disease.*

One hundred-nineteen men and women diagnosed with probable Alzheimer’s disease were randomized to receive a placebo or 500 mg synthetic resveratrol daily, with a dose increase of 500 mg every 13 weeks that ended with a 1,000 mg dose twice per day at the end of the 52-week study. Plasma and cerebral spinal fluid were analyzed for resveratrol and its metabolites, and amyloid beta 40 and 42 at the beginning and end of the study.

While plasma and cerebrospinal amyloid beta 40 levels had significantly decreased among the placebo group by the end of the study, they remained relatively stable among those who received resveratrol. “A decrease in amyloid beta 40 is seen as dementia worsens and Alzheimer’s disease progresses,” explained lead author R. Scott Turner, MD, PhD.

Editor’s Note: “It does appear that resveratrol was able to penetrate the blood brain barrier, which is an important observation,” Dr. Turner noted. “Resveratrol was measured in both blood and cerebrospinal fluid.”

A trial reported in JAMA Internal Medicine found a significantly lower risk of invasive breast cancer among women who consumed a Mediterranean diet supplemented with extra virgin olive oil in comparison with women assigned to a control diet who were given advice to eat a reduced fat control diet.*

The trial included 4,282 women enrolled in the PREDIMED study who were at increased cardiovascular disease risk due to the presence of diabetes or other factors. Subjects were assigned to a Mediterranean diet supplemented with olive oil or nuts, or a control diet.

After a median follow-up of 4.8 years, 35 cases of invasive breast cancer were identified. While both Mediterranean diets were associated with a reduced risk of the disease, the diet supplemented with olive oil was associated with the lowest risk, which was 68% less (after adjustment) than the control group.

Editor’s Note: The authors suggest several mechanisms for extra virgin olive oil’s anticarcinogenic effect. They observe that while all olive oil provides a high amount of monounsaturated fatty acids (mainly oleic acid) as well as squalene, extra virgin olive oil also provides biologically active compounds that include the polyphenols oleocanthal, oleuropein, hydroxytyrosol, and lignans. The combined effects of oleic acid’s antiproliferative property, squalene’s beneficial effect on intracellular oxidative stress, and polyphenols’ anticancer properties could be responsible for the protection associated with olive oil observed in this study.

Aging may be one thing to your liver and another to your brain, according to research published in Cell Systems.*

Researchers compared brain and liver cells of 6-month-old rats to those of 24-month-old animals. They found that aging equally affected immune and stress responses, as well as inflammation. However, metabolic processes were mainly impacted in the liver, and aging mainly affected signaling processes in the brain. “We chose to compare brain and liver because these two organs have very different capacities for self-renewal,” stated co-corresponding author Martin Hetzer.

“We found that in the brain, age-related changes very often have to do with the loss of molecules that help signals to spread among neurons,” reported lead researcher Martin Beck. “This could explain why old rats have a reduced ability to form new connections between neurons, as well as other traits observed in the aging brain.”

Editor’s Note: “This research may shed new light on the molecular mechanisms underlying age-related diseases, enabling the identification of risk factors to predict which individuals are most susceptible based on their genetic makeup,” Dr. Beck noted. “In the end, a better understanding of the molecular mechanisms of aging could lead to the development of novel therapies to prevent or treat a range of age-related diseases.”

According to a new animal study published in The American Journal of Pathology, traumatic brain injury affects the body as well as the brain, and treatment with hypertension drugs blocks the production of proteins related to inflammation.*

Researchers from the Georgetown University Medical Center found that in an animal model, brain injury produces an inflammatory response in the blood as well as body’s organs, especially the liver. The liver responds with up to a 1,000-fold increased production of a protein that increases inflammation in the brain, leading to chronic inflammation, nerve cell death, and reduced blood flow.

In a mouse model, researchers found that small doses of the blood pressure drug telmisartan blocked production of one of the molecules in the protein’s biological pathway, which leads to a dramatic decrease in inflammation. The brain can then possibly heal, says study author Sonia Villapol, PhD.

“This study established a connection between the peripheral regions and the brain, highlighting the importance of regulating the peripheral damage when trying to mitigate the consequences of brain injury,” said Villapol.

In earlier research, the same team found that telmisartan and another hypertension drug, candesartan, had beneficial effects in mice with traumatic brain injury several hours after injury.

Editor’s Note: According to the American College of Cardiology, telmisartan “keeps blood vessels from narrowing, which lowers blood pressure and improves blood flow.” Telmisartan was recommended in the March 2015 edition of Life Extension magazine as the ideal anti-hypertensive medication.