In The News: December 2016

An article in the Journal of Nutrition reveals that women who drink more coffee have longer white blood cell telomeres—protective caps at the ends of chromosomes whose length is considered a biomarker of aging.* Shorter telomeres have been associated with an increased risk of cardiovascular disease and other age-related conditions.

The study included participants in the Nurses’ Health Study, which enrolled 121,700 female nurses beginning in 1976. The investigation was limited to 4,780 women with available data concerning coffee and caffeine intake and white blood cell telomere measurement.

In comparison with subjects who reported no coffee intake, women who consumed two cups of coffee per day had a 29% higher chance of having average telomere length that was above the median of the group. For those who drank three cups or more daily, the odds were 36% higher.

Editor’s Note: When decaffeinated and regular coffee were separately examined, only regular coffee’s effects were found to be significant. However, analysis of the association between caffeine from all dietary sources and telomere length suggests that compounds other than caffeine may be responsible for the association.

Researchers have found that cardiac patients who ingested omega-3 supplements before undergoing surgery had shortened hospital stays and fewer postoperative heart arrhythmias compared with patients who received placebos.*

The meta-analysis, published in Clinical Nutrition, was based on a total of 1,038 subjects in 11 randomized controlled trials.

The researchers concluded that the reduced hospital stays for the omega-3 group—up to 2.4 days shorter—appeared to be due to a reduction in postoperative atrial fibrillation, a rapid and irregular heartbeat.

Study co-author Dr. Pascal L. Langlois said, “Omega-3s are well known for their benefits on cardiovascular health, including a reduced risk of arrhythmias and reduced mortality in patients with recent myocardial infarction or cardiac failure. Furthermore, they exhibit interesting anti-inflammatory properties and modulate the immune system.”

Editor’s Note: Besides lending support to an already large body of research supporting the cardiac benefits of omega-3, this study suggests a concurrent reduction in overall healthcare costs and hospital utilization.

Research reported at the 58^th Annual Scientific Meeting of the American Headache Society in San Diego found deficiencies of several nutrients in a young population with migraine headaches.*

Based on previous studies, Suzanne Hagler, MD, and colleagues examined data from children, teenagers and young adults who had undergone blood testing for riboflavin, folate, vitamin D and CoQ10. About 89% of the subjects had vitamin D of 40 ng/mL or less, and 71% had CoQ10 concentrations of 0.7 mcg/mL or less—levels at which the researchers said that supplementation is suggested.

Dr. Hagler’s team discovered a greater likelihood of vitamin D deficiency in boys and young men with migraine and an increase in CoQ10 deficiencies among girls and young women with the condition. Chronic migraine patients were likelier to be deficient in riboflavin and CoQ10 than subjects with sporadic migraines.

Editor’s Note : “Further studies are needed to elucidate whether vitamin supplementation is effective in migraine patients in general, and whether patients with mild deficiency are more likely to benefit from supplementation,” Dr. Hagler and colleagues concluded.

The Journal of Clinical Oncology published findings from Northwestern University of an association between insufficient serum vitamin D levels and aggressive prostate cancer.*

The researchers utilized data from a larger study involving 1,760 subjects in the Chicago area, 190 of whom had undergone radical prostatectomies. Blood samples collected prior to surgery were analyzed for serum 25-hydroxyvitamin D.

Eighty-seven men had indications of aggressive disease at the time of their surgeries. Having an insufficient vitamin D level of less than 30 ng/mL was associated with a 2.64 times greater adjusted risk of adverse pathology compared with higher levels of the vitamin.

The findings could aid in deciding when patients would be appropriate candidates for active surveillance (aka watchful waiting), an option for those with nonaggressive disease.

Editor’s Note: “Vitamin D deficiency may predict aggressive prostate cancer as a biomarker,” commented Dr. Adam Murphy, an assistant professor of urology at Northwestern University Feinberg School of Medicine. “All men should be replenishing their vitamin D to normal levels. It’s smart preventive health care.”

A trial reported in Diabetes Research and Clinical Practice found that supplementing with zinc improved the ability of prediabetic men and women to handle glucose.*

The trial included 55 prediabetic patients residing in Bangladesh, one of the most zinc-deficient regions in the world. Subjects received 30 mg of zinc sulfate or a placebo daily for six months. Fasting glucose, pancreatic beta cell function, insulin sensitivity and resistance, serum zinc, and lipids were measured at the beginning and end of the study.

At the end of the treatment period, participants who received zinc had lower fasting glucose compared to the placebo group as well as in comparison with levels measured in their own group at the beginning of the study. Beta cell function, insulin sensitivity and insulin resistance also improved among those who received zinc.

Editor’s Note: As potential mechanisms, the authors note that zinc is needed for insulin’s action, for carbohydrate metabolism, to moderate inflammatory cytokine levels that can destroy beta cells, for preventing human islet amyloid polypeptides from aggregating to form amyloid fibers that have a toxic effect on beta cells, to reduce oxidative stress and for other protective functions.

The JAMA Network Journals reported on May 2, 2016, that a new study from the Pennington Biomedical Research Center in Baton Rouge, Louisiana, found that calorie restriction in non-obese adults is linked to a number of health benefits.*

The team, led by Corby K. Martin, PhD, focused on a variety of negative health effects that had been thought to be related to calorie restriction.

The clinical trial looked at 218 subjects, about 30% men and 70% women. All participants had a body mass index of 22 to 28. About two-thirds of the subjects had their caloric intake restricted by 25% for two years, while the remainder ate as they liked. The results showed that the calorie-restricted group lost significant weight—16.7 pounds on average. More interestingly, compared with the control group, the calorie-restricted group had improved sleep after one year, as well as reduced tension, improved mood, increased energy and improved sex drive.

Editor’s Note: The study’s authors conclude that “calorie restriction among primarily overweight and obese persons has been found to improve QOL (quality of life), sleep and sexual function, and the results of the present study indicate that two years of CR (calorie restriction) is unlikely to negatively affect these factors in healthy adults; rather, CR is likely to provide some improvement.”

In a new study published in eLife, scientists from the Gladstone Institutes identified a new mechanism by which aspirin could fight inflammation and cancer.*

The researchers discovered that salicylic acid, a major compound in aspirin, and diflunisal, an analgesic that’s derived from salicylic acid, suppress two key proteins, p300 and CREB-binding protein. These epigenetic regulators are in charge of controlling levels of proteins that prompt inflammation or are instrumental in cell growth, both of which are related to the promotion of cancer.

The study could have significant clinical implications, as it represents the first solid evidence that CREB-binding protein and p300 can be targeted by drugs.

“Salicylic acid is one of the oldest drugs on the planet, dating back to the Egyptians and the Greeks, but we’re still discovering new things about it,” said senior author Eric Verdin, MD.

Editor’s Note: Study coauthor Stephen D. Nimer, MD, stated, “We have conducted a clinical trial of salicylic acid in patients with hematologic cancers and found it to be safe. Thus, this collaborative effort to develop novel epigenetic therapies is an important step in our journey to find more effective treatment for leukemia patients.”

A new study suggests that as women with elevated levels of triglycerides approach menopause, they may have an increased risk of bone fractures.*

The study, published in the Journal of Clinical Endocrinology and Metabolism, followed over 2,000 premenopausal women who had never had any broken bones. After nearly 15 years, researchers found that women with high triglycerides suffered fractures more than twice as often as others. And an increase of 50 mg/dL in blood triglycerides found during an annual exam was associated with a 31% increased risk of fractures within the next two to five years.

Levels of triglycerides increase as women go through menopause, but researchers aren’t sure if the rise in blood fats has a detrimental effect on bone strength. If so, it could explain the higher risk of fractures.

“This study suggests that women entering midlife should take action to lower elevated triglycerides,” said senior study author Dr. Jennifer Lee.

Editor’s Note: Naila Khalil, a community health researcher at Wright State University in Dayton, Ohio, suggests women can lower their risk of fractures by exercising regularly and getting adequate amounts of vitamin D and calcium.

An article in the Journal of Clinical Endocrinology & Metabolism reveals a potential benefit of soy isoflavones for women with polycystic ovary syndrome—a disorder characterized by mildly elevated male hormones and insulin which is associated with weight gain, infertility, and a greater risk of diabetes and coronary heart disease.*

For 12 weeks in a randomized trial, 70 women aged 18 to 40 years with polycystic ovary syndrome were assigned to consume 50 mg per day of a soy isoflavone supplement or a placebo. Blood samples collected at the beginning and end of the study were analyzed for levels of hormones, lipids, and biomarkers of inflammation and insulin resistance.

At the end of the trial, participants who received soy isoflavones had lower insulin and markers of insulin resistance, free androgens, and serum triglycerides in comparison with those who received a placebo.

Editor’s Note: Participants also experienced an increase in plasma glutathione and a decrease in malondialdehyde, a marker of oxidative stress.

Options for treating prostate cancer may soon expand to include a laser technique, based on a recent study published in the Journal of Neurology.*

Researchers at the University of California, Los Angeles, have discovered that a laser-powered tool can safely treat tumors in patients with intermediate-risk prostate cancer. The process, called focal laser ablation, involves the insertion of a laser fiber into cancerous tissue, guided by magnetic resonance imaging. Laser-generated heat destroys the tumor.

No serious adverse effects in urinary or sexual function were found for a period of six months following the procedure.

A follow-up study presented at a meeting of the American Urology Association demonstrated the potential for the new technique to be performed in clinics using a device called the Artemis, which performs real-time imaging using a fusion of both magnetic resonance imaging and ultrasound. The Artemis has previously been used just for biopsies rather than treatment.

Editor’s Note: “Our feeling was that if you can see prostate cancer using the fusion MRI and can put a needle in the spot to biopsy it, why not stick a laser fiber in the tumor the same way and kill it,” said study senior author Dr. Leonard Marks. “What we are doing with prostate cancer now is like using a sledgehammer to kill a flea.”

Many doctors and healthcare professionals aren’t fully aware of the cancer risk of CT scans for patients, according to a new study published in the Journal of Medical Imaging and Radiation Sciences.*

Researchers from the University of Saskatchewan surveyed medical professionals and found that 73% of doctors, 97% of radiologists, and 76% of technologists knew that a single abdominal-pelvic CT increases cancer risk. But while 48% of doctors, 78% of radiologists and 63% of technologists either accurately estimated or overestimated how the dose from a CT scan compares to the amount of radiation from a chest X-ray, many underestimated it. The radiation exposure from one CT scan is equal to about 100 to 250 chest X-rays.

The survey also found that, while ultrasounds don’t use ionizing radiation, 11% of physicians think that they do.

Editor’s Note: Lead researcher Dr. David Leswick observed that, although the risk from radiation exposure as used in medical imaging procedures is small, “it is real, as evidenced from atomic bomb survivors and nuclear industry workers showing significantly increased risk of malignancy after exposure to doses in the range of diagnostic CT.” The risk of a fatal malignancy may be as high as one in 1,000 for an exposure that is the approximate dose of an abdominal-pelvic CT.