citrinesun.com Blog

Yoga for backpain

Posted on October 27, 2011 by Dr. Bob Avery

Here is a very large study comparing yoga and stretching in people with back pain. The yoga used was viniyoga and it was compared to an aggressive stretching program. The stretching program was actually similar to standard yoga. http://www.medicalnewstoday.com/releases/236530.php

The results show both interventions improved back pain and the participants also were found to use fewer pain medications. This proves the point that many people with back pain don’t have good core strength. Out of shape people are more likely to get hurt and have back pain. A regular program of stretching and core exercises is needed to prevent back pain.

Here are some exercises that strengthen your core. http://www.mayoclinic.com/health/core-strength/SM00047

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Posted in Exercise | Tagged back pain, core exercises, core muscles, stretching, yoga | 1 Comment

Low fat diet with fish oil supplement slows prostate cancer growth

Posted on October 26, 2011 by Dr. Bob Avery

How interesting is this? Just 4-6 weeks of a low fat diet with fish oil supplementation changed the composition and slowed the growth of prostate cancer prior to surgery when compared to the typical high fat Western diet. Just think what would happen if you ate that kind of diet supplemented with omega-3 fatty acids all the time? I could imagine we would see a lot less prostate cancer, as well as heart disease. http://www.sciencedaily.com/releases/2011/10/111025135931.htm

There are many studies demonstrating the benefits of omega-3 fatty acids. We need to add them to our diets. I’ve said this before, I think the best diet is a Mediterranean type diet, composed of fruits, vegetables, fish, and olive oil. That’s the key to good health.

More reading here: http://en.wikipedia.org/wiki/Fish_oil

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Posted in Cancer Therapy, Nutrition | Tagged fish oil, omega-3 fatty acids, prostate cancer | Leave a comment

Coffee lowers skin cancer rates

Posted on October 25, 2011 by Dr. Bob Avery

This prospective study demonstrates that coffee decreased the risk of basal cell skin cancers 18% for women and 13% for men. The benefit may be from the caffeine or other nutrients in the coffee. In any case, enjoy your morning cup-o-joe!

http://www.medicalnewstoday.com/articles/236490.php

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Posted in Health, Nutrition | Tagged basal cell skin cancer, caffeine, coffee, skin cancer | 1 Comment

Nutrients and skin properties, from the FALL 2011 ANA Conference

Posted on October 21, 2011 by Dr. Bob Avery

The third presentation at the Fall 2011 American Nutriceutical Conference was by Dr. Silke DeSpirt of the Institute of Biochemistry and Molecular Biology, Heinrich-Heine-University Dusseldorf. Her presentation was entitled “can nutrients modulate skin properties?”

Synopsis: Through a series of studies, Dr. DeSpirt and her colleagues have demonstrated that nutrients can influence the skin’s protection, improve the microcirculation, and influence the properties and appearance of the skin. It demonstrates that simple lifestyle modifications in diet can improve the health and appearance of our skin. Healthy skin means a healthy body.

The skin is the largest organ in the body. It acts as a barrier to protect against infection and fluid loss. There are three levels in the skin, the subcutis, dermis, and epidermis. Nutrition and nutrients are very important for skin health.

Healthy skin is dependent on several factors including water, lipids/essential fatty acids, carbohydrates, proteins, minerals, vitamins and phytonutrients. The research presented by Dr DeSpirt looked the effects of lipids and nutrients on several parameters of skin health.

First, what causes skin aging? This is a multifactorial process that is affected by sex, our biological clock, genes, illness and the environment. Factors that cause increased skin aging include sun exposure, smoking, poor nutrition, and air pollution.

Sun damage is caused by ultraviolet (UV) light. There are two forms of UV light, UV-A and UV-B. A third type, UV-C, is filtered by the ozone and does not reach the earth surface. Both UV-A and UV-B contribute to tanning of the skin, but the UV-B is associated with sun burns. UV-B penetrates only into the epidermis while UV-A penetrates deeper into the dermis. UV-A was once thought to offer a safe, burn free skin tan, but this is not true. UV-A penetrates deeply into the dermis and leads to an increased risk of melanoma. Sun blocking agents need to block both UV-A and UV-B to offer protection against burning, skin damage and malignancy.

Ultraviolet light causes many changes in the skin. The UV light causes the formation of reactive oxygen species which oxidizes and damages proteins, lipids, and DNA. This leads to breakdown of the skin, the collagen, the lipid matrix which offers barrier protection and leads to DNA mutations and cancer. UV light has been found to damage DNA by causing strand breaks, thymine cross-links, and mutation of the p53 tumor suppressor gene. This causes not only DNA damage and mutations but an inability of the DNA to be repaired.

The skin has an active antioxidant network to combat the oxidation produced by the sun. These include enzymes (SOD, catalase, peroxidase, heme-oxygenase), glutathione, vitamins, carotenoids, flavonoids. The antioxidant systems work to scavenge reactive oxygen species and prevent damage. As with any system in the body, good nutrition is vital to the system working properly.

How are nutrients delivered to the skin? The microcirculation delivers nutrients into the dermis. The epidermis is supplied through passive diffusion. One can deliver topical nutrition to the skin but these agents do not penetrate to the deeper levels of the skin. The best way to deliver nutrition would be from the inside out.

The clinical markers of skin health used in Dr. DeSpirt’s studies include: Skin surface evaluation, skin hydration (transepidermal water loss), Ultrasonic B-scan of the epidermis and dermis (skin thickness), microcirculation, and photoprotection using irradiation. Healthy skin will be well hydrated, thick, have an active microcirculation and the appearance will be smooth and without scaling. The following studies evaluated the effects of nutrients (anti-oxidants and flavonols) and lipids on a variety of these healthy skin parameters.

Study 1: This is a photoprotection study in two parts. Part one compared the effects of 12 weeks of tomato based or pure lycopene supplementation on the redness produced by a dose of radiation to the skin. A dose of irradiation sufficient to produce minimal redness (1.25 minimal erythema dose) was given to subjects. The second part of the study compared 12 weeks of green tea extract to cocoa-polyphenol drinks. The same 1.25 MED of radiation was given. (Aust et. al. J Vit Nutr Res 2005;75:54, Heinrich et. al. J. Nutr 2006;136:1565-1569)

Findings: Both supplements improved photoprotection of the skin. The tomato based supplement was slightly better; 38% improvement of erythema vs. lycopene (26% improvement). The second part also demonstrated improvement with both supplements. Green tea improved redness by 25% and cocoa by 69%. The SPF value of these supplements is estimated to be 2. Compare that to sunblock lotions with an SPF of 30 or more. These supplements are not a good substitute for sun block.

Study 2: This is a skin sensitivity study using nicotinate which irritates the skin and causes inflammation and redness. This study evaluated the effects of 12 weeks supplementation of flaxseed or Borrageseed oils. Both contain a mix of omega-3 and omega-6 fatty acids which are both necessary for a healthy lipid barrier level in the skin. (DeSpirt et. al. BJN 2009;101:440-445)

Findings: Both lipid supplements were found to protect the skin against the nicotinate irritation. Flaxseed decreased sensitivity by 45% and borage seed by 35%.

Study 3: This is a skin hydration study as measured by electric capacity. Again subjects were given 12 weeks of supplementation with either flaxseed or borage seed oils. Level of hydration and appearance of the skin were measured. (DeSpirt et al. BJN 2009;101:440-445)

Findings: Flaxseed improved hydration by 19% and borage seed by 17%. Roughness and scaling were also decreased by 35% and 28% respectively.

Study4: This study looked at the effects of 12 weeks supplementation of an encapsulated fruit and vegetable powder on microcirculation, hydration, and skin texture. Subjects were given either placebo or a fruit and vegetable powder for the study period. Laser Doppler was used to assess the microcirculation. Ultrasound was used to assess skin thickness. (DeSpirt et. al. Skin Pharmacol Physiol 2012;25:2-8)

Findings: The fruit and vegetable powder was found to improve blood flow by 39%, and oxygen saturation by 16% compared to placebo. Additional studies showed an improvement in skin thickness and density and thickness by 16%. Hydration was minimally improved by 9%. The issue here may be that only 7 of the 26 subjects had dry skin. There may have been more benefit demonstrated if more subjects had dry skin.

Study 5: This study looked at the effects of 12 weeks supplementation of green tea’s effect on microcirculation, hydration, and skin texture. (Heinrich et. al. J. Nutr 2011;141:1202-1208)

Findings: Green tea, improved blood flow 29%, oxygen sat 34%, density 7.7%, hydration 17%, and improved roughness 16%.

Study 6: This study evaluated the effects of 12 weeks of cocoa flavonols on microcirculation, density, thickness, hydration and appearance of the skin. (Heinrich et. al. J Nutr 2006;136:1565-1569)

Findings: Cocoa improved blood flow 100%, density and thickness 17/18%, hydration 13%, and improved roughness and scaling 30%/43%.

With this series of studies, Dr. DeSpirt and her colleagues have demonstrated that nutrients can influence the skin’s protection, improve the microcirculation, and influence the properties and appearance of the skin. It demonstrates that simple lifestyle modifications in diet can improve the health and appearance of our skin. Healthy skin means a healthy body.

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Posted in Health, Nutrition | Tagged american nutriceutical society, borage seed oil, cocoa, flavonols, flaxseed oil, fruit powder, hydration, juice powder, microcirculation, nutrients, skin health, skin thickness, UV-A, UV-B | 1 Comment

Folate Research Update from the Fall 2011 ANA Conference

Posted on October 20, 2011 by Dr. Bob Avery

The second lecture at the Fall ANA conference was an update on folate presented by Dr. Gail P.A. Kauwell, PhD, RD, LDN, from the University of Florida. She gave an interesting and though provoking talk on this important vitamin.

There are two forms of folate. Naturally occurring folate is found in legumes, spinach, asparagus, avocado, tomato, orange juice, eggs, and cantaloupe, and synthetic folic acid found in fortified cereals, grains, and vitamin tablets.

The recommended daily allowance ( RDA) of folic acid is 400mcg daily for adults, 600mcg daily for pregnant women and 500mcg daily lactation. There is not daily allowance for natural folate nor are there known adverse effects for eating lots of folate containing foods.

Folate has many functions in the body, predominantly in DNA synthesis, DNA methylation, neurotransmitter synthesis, and amino acid metabolism. A deficiency of folate leads to decreased DNA synthesis and repair, altered DNA methylation. Lack of folate also causes thymidine deficiency, which is one of the building blocks of DNA (thymidine, cytosine, adenine, and guanine). Without thymidine, uracil is incorporated into DNA causing strand breaks and instability.

The most well-known complication of folate deficiency is neural tube defects such as anencephaly and spina bifida. Folic acid supplementation during pregnancy has led to a 60-100% risk reduction in neural tube defects. This is why there is an official recommendation that all women of childbearing potential take 400mcg of folic acid daily, starting before they become pregnant.

Because of the potential health benefits, the FDA mandated fortification of grains and cereals in 1998. Since then, serum folate levels have improved for all age groups, and races. We have also seen a drop in the incidence of neural tube defects, pediatric neuroblastoma, and congenital heart defects. We know that Down ’s syndrome children have an increased risk of congenital heart defects. If the mother has adequate serum folate levels, the risk of heart defects in her child is much less.

Too much folic acid can have adverse consequences. High levels can mask early B12 deficiency by correcting the anemia associated with B12 deficiency. We want to find B12 deficiency early before the neurologic symptoms start because they may not be reversible once the B12 supplementation is started.

I think the most interesting portion of her talk was asking the question “does folic acid supplementation cause cancer? I have written on this subject before. It has been unclear in the past, but now the data seem to be clearer.

Multiple studies have demonstrated that folic acid may decrease the risk of colonic polyps and early colon cancers, especially if your serum folate is low. Further studies did not show that it would prevent a second cancer if you already had cancer, in fact it increases the risk of a second cancer. So timing is very important. Folate in high risk individuals or those who have had cancer can promote the growth of new tumors. Those people should stay away from folic acid supplementation.

Regarding other cancers, other Prevention trials have showed no increase or decrease in risk of cancer with folic acid supplementation.

How about prevention of stroke or heart attack? Again, as in the colon cancer studies, there was not benefit of folic acid to prevent a second stroke or heart disease (secondary prevention). There may be a small benefit to prevent a first stroke or heart attack but only if your serum levels are low.

As far as folic acid helping with memory, there are two randomized trials published with opposite results. The answer here is not clear.

Who should take folic acid supplementation? In the United States, folate levels are adequate in the majority of people so no recommendation to take a folic acid supplement. Between foods with natural folate and supplemented grains and vitamins there seems to be no widespread folate deficiency in the U.S. The only group that should take folic acid is women of childbearing potential before they become pregnant.

The risk in the United States is to have too much folic acid. The people at risk of this are people who take vitamin supplements. A small percentage of this group is getting too much folic acid. For the most part, it you eat plenty of fruits, vegetables, legumes, and fortified grains, there is no need to take a vitamin.

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Posted in Health, Nutrition | Tagged American nutriceutical association, colon cancer, congenital heart defects, DNA damage, DNA repair, folate, folic acid, folic acid supplements, heart disease, neural tube defects, spina bifida, stroke, thymidine | Leave a comment

Osteoporosis Update from the ANA Fall 2011 Conference

Posted on October 19, 2011 by Dr. Bob Avery

The American Nutriceutical Association held their fall education conference in Nashville this last weekend and once again it was an excellent conference. The first lecture was presented by Dr. Susan Brown, PhD from the Center for Better Bones in East Syracuse, NY. She presented an insightful update in osteoporosis. This was very interesting to me since this is not an area that I research on a regular basis. I think you will find the information interesting as well.

In the United States there are nearly 2 million osteoporotic fractures annually. Most of these (27%) are in the spine, and only 14% are in the hip. Hip fratures are very relevant though because they account for 72% of the $17 billion spent annually to treat fractures. The numbers of hip fractures is increasing because we have an increasing population of elderly persons in this country.

Bone mineral density (BMD) is the “gold standard” test to determine if a person has osteoporosis. It is an xray that measures the density of the spine and the hip. We have used these for years to determine who should take bisphosphonate therapy but there is one major problem with BMD, it does not predict who will have a fracture. In fact 65-78% of “osteoporotic” fractures occurs in a woman with a normal bone mineral density.

It is now clear that there are multiple factors involved in a woman’s risk of fracture. The new focus is on risk factors for fracture not BMD. The World Health Organization (WHO) has developed a fracture risk assessment tool call FRAX. The FRAX assessment tool takes into account age, sex, previous fractures, family history of fractures, smoking, glucocorticoid therapy, rheumatoid arthritis, secondary osteoporosis, alcohol intake, femoral neck BMD and body mass. The FRAX is available her if you want to see what your risk is: www.shef.ac.uk/FRAX

There are some problems with the FRAX assessment in that it does not take into account several other factors including vitamin D level, lifestyle, exercise, other medical conditions associated with increased risk, other high risk medications, or bone turnover markers. High risk medications include acid blockers (nexium, pepcid, prilosec etc) which increase the fracture risk 2.6 X and antidepressants which double the risk of fracture. Recently, emotional stress has been implicated because it causes overproduction of cortisol which leads to osteoporosis. Canada has developed osteoporosis guidelines in which they take into account these other factors. It is available here: www.osteroporosis.ca/multimedia/guidelines.html

What is new with vitamin D? Vitamin D is essential for bone health. Vitamin D is necessary to allow calcium to be absorbed from the diet. In a vitamin D deficient state only 10-15% of dietary calcium is absorbed, with adequate vitamin D, 30-40% is absorbed. Vitamin D is produced from sun exposure, and because modern humans spend most of the day inside, most people are deficient in vitamin D. It is known that a blood level of 32ng/ml is necessary to maintain normal parathyroid function and absorb calcium. Studies have demonstrated supplemental vitamin D will improve done density in deficient women and also decrease the risk of fracture by 37-50%! This has been confirmed by multiple studies in the U.S. and Europe.

What is new with calcium? Calcium is necessary for mineralization of the bones. Women typically take 1000 to 1500mg of calcium daily in the United States not including dietary sources, but does this help? Calcium alone does not prevent fractures and with adequate vitamin D, only 500-600mg a day are necessary. The current daily recommendation from the Institute of Medicine is 1200mg daily for women and 1000mg daily for men. www.iom.edu/reports/2010/dietary-reference-intakes-for-calcium-and-vitamin-D/DRI-values.aspx

The problem with too much calcium is it may be associated with an increased risk of coronary disease. Some studies have demonstrated this, others have not so it is controversial. The key to calcium and heart disease is vitamin K.

What is new with vitamin K? People don’t associate vitamin K with bones or the heart but it is a very important vitamin for these systems. Vitamin K serves as a cofactor for adding a carboxyl group to protein-bound glutamate producing gamma-carboxyl glutamate (GLA). These proteins are not activated until the glutamate is carboxylated. GLA containing proteins include blood clotting proteins, osteocalcin (bone) and matrix GLA in blood vessel walls.

A low vitamin K with lead to bleeding because of the lack of GLA-clotting proteins. Likewise deficient vitamin K leads to a deficiency of GLA-osteocalcin and deficient mineralization of the bones. So there can be weakened bones even with a normal vitamin D and calcium supplementation. The matrix GLA is the most interesting. Matrix GLA inhibits calcification of the arteries. In a vitamin K deficient state, the calcium in our bodies does not move into the bones, it moves into the arteries causing hardening of the arteries. This is very important information because vitamin K levels are not often checked.

Where do you get vitamin K? Vitamin K1 is found in green leafy vegetables. It is short-lived and so you need to eat green leafy vegetables every day. Vitamin K2 is more potent and stays in your system longer. It is found in fermented foods like fermented soy (Natto), hard cheeses, cheese curd, or sauer kraut. There is also a vitamin K supplement available.

Therapy

We have treated osteoporosis for years with bisphosphonates. These are agents that inhibit bone breakdown. They have been found in studies to reduce fractures by 50%. Outside of a study, many patients stop the meds because of side effects. The “real world” intent to treat analysis of these meds only shows a reduction of 22%. Compare that to vitamin D which decreases fractures 37-50% and vitamin K supplementation which decreases fractures by 80%! We need to rethink the use of bisphosphonates. They have their role in select patients, but a risk analysis and therapy based on risk factors would be more effective.

Dr. Susan Brown Ph.D., The Center for Better Bones. http://www.betterbones.com/default.aspx

American Nutriceutical Association. http://www.ana-jana.org/

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Posted in Health | Tagged American nutriceutical association, antidepressant, bone mineral density, calcium, fracture risk, FRAX, gamma carboxy glutamate, GLA, osteoporosis, proton pump inhibitor, vitamin D, vitamin K | 8 Comments

Estrogen and Breast Cancer

Posted on October 17, 2011 by Dr. Bob Avery

In the United States, one in eight women will develop breast cancer over their lifetimes. There are multiple risk factors for breast cancer, and many of these are risk factors because of their effect on estrogen.

Estrogen is a feminizing hormone. It is involved in development of secondary sexual characteristics in women and also helps regulate ovulation and menstruation. It works through interaction with the estrogen receptor. There are two estrogen receptos ER-alpha and ER-beta. They are located primarily on the sexual organs, but are also present in the cardiovascular, skeletal, immune, gastrointestinal, and nervous systems. The estrogen receptors work through regulating genes and through stimulating growth enzymes (kinases).

The effects of estrogen on the body are depicted here.

ER-alpha has a strong growth (proliferative) effect on breast tissues while ER-beta appears to have an anti-proliferative effect. The two work in a balance. When the balance is shifted to overstimulation of ER-alpha and growth, there is an increased risk of breast cancer. Likewise, if the ER-beta function is suppressed, there is an increased risk of breast cancer.

This explains how too much estrogen (ER-alpha stimulation) can be harmful. Women with a history of breast cancer tend to have higher blood levels of estrogen. Situations that lead to increased estrogen include early menarche (periods), late menopause, birth control pills, estrogen replacement therapy, poor diet choices, alcohol, and lack of exercise.

Supplemental estrogens do increase the risk of breast cancer slightly depending on the dose of estrogen. Birth control pills appear to increase the risk slightly for about 10 years after the pill is stopped. Hormone replacement therapy for menopausal women was common place until 10 years ago. At that time date from the Womens Health Initiative trial was published showing in increased risk of breast cancer, heart disease, stroke, and venous clots in women who took hormone replacement therapy. After publication of that article the use of hormone replacement therapy dropped by 38% in the next year. There was also noted an incredible drop in diagnosed breast cancer cases over the next several years as demonstrated in the next slide.

This real life situation demonstrates how estrogen works as a growth promoter in cancer cells. Take the estrogen away, and there was an immediate drop in cancer cases.

Lifestyle, what you eat, drink and how much you exercise also affects your risk of breast cancer. First is weight. Women with a body mass index over 33kg/m2 have an 27% increased risk of breast cancer over women with a body mass index of < 22kg/m2. How do you determine your body mass index? Look here: http://www.nhlbisupport.com/bmi/ The increased risk is likely due to increased estrogen levels. There is production of estrogen in fatty tissues. Women who are overweight will have more estrogen produced and higher blood levels. This risk is mainly in post-menopausal women. The risk of breast cancer in obese premenopausal women may be slightly lower, but studies are conflicting.

Dietary fat has been the subject of intense study for years. Oriental women have a very low risk of breast cancer and they eat a very low fat diet. It seemed natural to think that fat intake would affect breast cancer risk. The data from the studies is conflicting however. It is always a good idea to avoid animal fats as much as possible and eat omega-3 fatty acids in larger quantities because of their protective benefit for other diseases.

Red meat intake of greater than 5 servings per week was associated with a greater risk of breast cancer in the nurses health study II and the women’s cohort study in the UK.

Calcium and vitamin D intake may decrease the risk of breast cancer, but again there are conflicting data in trials. On ongoing trial with high doses of vitamin D and omega-3 fatty acids is ongoing and should help answer this question.

Alcohol intake is associated with a modest increase in breast cancer especially when hormone therapy is also ongoing. Alcohol causes alterations in the body that increase estrogen levels. The recommended daily amount of alcohol is one ounce of alcohol daily, or one drink daily.

Phytoestrogens, are plant sources of estrogen. Plant sources include soy as well as other beans and nuts. Phytoestrogen intake in the form of soy is thought to be protective against breast cancer especially if the woman takes the soy from childhood on. Phytoestrogens bind to the ER-beta receptor and therefore would be expected to help downregulate cell growth and prevent breast cancer. When used with tamoxifen, soy has been found to improve the effectiveness. In the past, we recommended against the use of soy and tamoxifen, we now know it is beneficial.

Here is a brief overview of estrogen and breast cancer. Any questions, please let me know.

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Posted in Cancer Therapy | Tagged birth control pills, breast cancer, breast cancer risk. women's health study, ER-alpha, ER-beta, estrogen, hormone replacement therapy, phytoestrogens, soy | Leave a comment

Epigenetics and Heart Disease, how diet changes genetic risk

Posted on October 12, 2011 by Dr. Bob Avery

http://www.sciencedaily.com/releases/2011/10/111011171553.htm

DNA is not destiny. The study of genes has left us with the thought that we cannot control our own health. There are genes identified for just about every medical problem including heart disease. Thanks to mass media, people think if they have a gene they will get the disease but this is not true. We all have bad genes in our bodies that are silent. This is because genes are constantly being turned on or off. This process is called epigenetics, and it is a field we are starting to learn a lot about. Nutrigenomics is the study of how the foods we eat affect our genes. The best case is when all the good genes are turned on and the bad genes turned off. This unfortunately doesn’t happen all the time.

This study looked at how diet affects heart disease risk in people with abnormalities of the 9p21 gene. We know that people with genetic varients in this gene are at increased risk of heart disease. What the researchers found is that people with the 9p21 gene varients who at a healthy diet of fruits and vegetables improved their risk of heart disease to that level expected of people who do not have the gene. Their analysis included 27,000 individuals of 5 different nationalities. This is fantastic data! They have essentially demonstrated that bad genes can be neutralized by diet. Their next area of study will be to identify the mechanism behind this finding.

Through epigenetics and nutrigenomics, everyone has the opportunity to be healthy if we just eat right and give our bodies a chance to heal.

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Posted in epigenetics, Nutrigenomics, Nutrition | Tagged 9p21 gene, epigenetics, fruits, heart disease, nutrigenomics, vegetables | 1 Comment

Antioxidant vitamins can be harmful

Posted on October 11, 2011 by Dr. Bob Avery

Another research article demonstrating an increased chance of dying in women who take anti-oxidant vitamins was published in the Archives of Internal Medicine. Although we know that micronutrients are helpful to maintain health, there is no data that synthetic vitamins prevent disease. There is also no data that the excessive amounts of nutrients in vitamins is healthy, in fact, the reverse may be true. In this analysis, women who took vitamins had an extra 2.6% chance of dying during the study period. This doesn’t sound like a lot but the study included 12,769 women who took vitamins. An extra 332 women died in the group that took vitamins. http://news.yahoo.com/vitamins-may-increase-womens-risk-dying-research-finds-212402256.html

This is not an isolated study. A previous meta-analysis in the Journal of the American Medical Association demonstrated the same finding. http://jama.ama-assn.org/content/297/8/842.full?sid=9d3c517f-10f1-4e1c-b61e-5ff822931d32

The American Institute for Cancer Research also notes that nutrition is best from whole fruits and vegetables not vitamins. There is no data to say that vitamins prevent cancer. They presented this information in a press release in 2008. www.aicr.org

Now is not the time to turn to a synthetic vitamin for health. It is time to get some fruit and vegetables in your diet.

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Posted in Nutrition | Tagged AICR, American Institute for Cancer Research, antioxidant vitamins, cancer prevention, mortality, Vitamins | Leave a comment

Screening for Breast Cancer

Posted on October 11, 2011 by Dr. Bob Avery

We’ve made some great improvements in breast cancer therapy. Since 1990, breast cancer mortality has dropped 1.8% per year. That means that over the last 15 years, mortality has dropped by 26%! That is fantastic news, but still approximately 40,000 women die of the disease every year so we have much work to do.

The improvement in survival in women with breast cancer is due not only to improved therapy but also to early detection. When you find a cancer early, it is much easier to cure. We have made some great improvements in breast cancer survival because women are getting screened.

In the past, women were not routinely screened. In 1985, 75% of women never had a mammogram! Currently, as of the year 2000, less than 20% of women have not had a mammogram. There are multiple programs available to ensure that even uninsured women can get a mammogram.

The American Cancer Society has published breast cancer screening guidelines. These guidelines are made by experts in the field, and they help guide us in finding breast cancers early.

Recently, there has been some controversy in the screening guidelines for breast cancer, especially if you are between the ages of 40 and 50. Part of this controversy exists because mammogram is not a perfect screening tool. Standard mammograms are not as effective in finding breast tumors in dense breast tissue. Women between the ages of 40 and 50 tend to have dense breasts, and so there lies a problem. There is a solution to this however. I’ll discuss this later.

First, if you see the guidelines, they suggest a screening MRI for women with a high risk of breast cancer. How do you determine your risk of breast cancer? One tool is the GAIL risk assessment calculator. It is available online here, www.cancer.gov/bcrisktool/ .

The GAIL risk assessment tool takes into account a person’s age, birth history, family history and history of any breast biopsy. It then gives you a general idea of your possible risk.

Families with multiple family members with breast cancer and/or ovarian cancers may have a breast cancer gene, BRCA-1 or BRCA-2. In these families the risk of breast cancer is very high. You may want to ask your doctor to test you if you have this kind of family history.

Screening Tests

Mammogram: standard mammogram has been used since the mid 1980′s. It is good at detecting calcifications or other breast lesions but it is not perfect. It can miss up to 20% of breast tumors. If you can feel a mass and the mammogram is negative, you still need the mass biopsied or removed.

Digital mammogram, uses computer technology to make the mammogram more effective. It is better than standard mammogram at detecting breast cancers in women with dense breasts, which includes women between the ages of 40 and 50. This modality is available at most breast centers. The digital image is on the left, the standard on the right in the following picture.

MRI (magnetic resonance imaging). This scan uses a powerful magnet to image the body. It is used in multiple areas and is also approved to image the breasts. It is recommended as a screening tool for women who are at high risk of getting breast cancer. This includes women who have a breast cancer gene, BRCA-1 or BRCA-2, or women with a high risk based on the GAIL assessment, or if they have received chest radiation for Hodgkins disease.

BSGI (Breast Specific Gamma Imaging): BSGI is a nuclear medicine study in which a nuclear agent is injected in the vein. It will light up breast tumors and is an effective tool to assess abnormal lesions in the breast. It is very helpful when the mammogram cannot determine if a lesion is cancer or not. The BSGI machine can be used in situations where MRI is used but is is a simpler test and easier for the patient. The patient sits in a comfortable position on a chair in front of the machine as opposed to lying prone on a table as in MRI.

PET scan (positron emission tomography): PET scans are used in multiple areas in cancer staging. It is also a nuclear medicine study that shows areas where energy is being used. Tumors tend to use a lot of energy, so a PET scan helps find tumors. Unfortunately for breast cancer, small tumors will not reliably show up on PET scan so it is not recommended for screening for breast cancer.

The most important way to remain cancer free is through a healthy lifestyle, but everyone is still at risk and should be screened. If you have any questions, please ask your doctor.

Here are some other resources for reading.

http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient

Can breast cancer be found early? http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-detection

Breast screening and detection http://www.webmd.com/breast-cancer/guide/breast-cancer-screening-detection-overview

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Posted in Cancer Therapy | Tagged Breast cancer screening, breast specific gamma imaging, BSGI, digital mammogram, early detection, GAIL risk assessment, magnetic resonance imaging, mammogram, MRI | Leave a comment

citrinesun.com Blog

Yoga for backpain

Low fat diet with fish oil supplement slows prostate cancer growth

Coffee lowers skin cancer rates

Nutrients and skin properties, from the FALL 2011 ANA Conference

Folate Research Update from the Fall 2011 ANA Conference

Osteoporosis Update from the ANA Fall 2011 Conference

Estrogen and Breast Cancer

Epigenetics and Heart Disease, how diet changes genetic risk

Antioxidant vitamins can be harmful

Screening for Breast Cancer

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