Doctor HealthHealth Tips

Elementary schools can have a significant impact on low-income students’ consumption of fruits and vegetables by providing a lunch salad bar, according to a recent UCLA study. The findings, published in the December issue of the international journal Public Health Nutrition, show that the frequency of students’ fruit and vegetable consumption increased significantly—from 2.97 to 4.09 times daily—after a salad bar was introduced. In addition, students’ mean daily intake of energy, cholesterol, saturated fat and total fat declined considerably.

“One of the major contributing factors to the high rate of overweight children in the United States is that they do not consume the daily recommended servings of fruits and vegetables,” said lead author Dr. Wendy Slusser, assistant professor of pediatrics at Mattel Children’s Hospital UCLA and the UCLA School of Public Health. “Increasing the availability and accessibility to healthy foods is one way to improve children’s diets. In turn, this sets up opportunities for kids to have repeated exposure to healthy food and positively impact their choices.”

The UCLA pilot study was conducted at three Los Angeles Unified School District elementary schools participating in the salad bar program and the U.S. Department of Agriculture’s reimbursable lunch program. Study participants included 337 children in grades 2 through 5. Children were interviewed using a 24-hour food-recall questionnaire, both before and after the salad bar intervention—in 1998 and 2000, respectively.

The study was offered in conjunction with a nutritional education component, including a school assembly to teach children about the proper etiquette of serving themselves salad and picking a well-balanced lunch, as well as an artwork project and visits to farmers markets or a farm. The salad bar program was developed together by LAUSD Food Services and Occidental College in Los Angeles.

“The results are clear—if we provide fresh fruits and vegetables in kid-friendly ways, we will increase consumption,” said school board member Marlene Canter. “I am excited to see that our efforts to find new and creative ways to improve our students’ nutrition and help reduce obesity are working.”

Since the study, the LAUSD school board voted positively on a 2003 obesity-prevention motion that includes recommending fruit and vegetable bars as a modification of the hot lunch program.

An important source of nutrition, fruits and vegetables help with weight management and can also be beneficial in reducing the risk of certain cancers, heart disease, stroke and Type 2 diabetes. Eating a variety of fruits and vegetables can improve health by increasing amounts of vitamin C, phytonutrients, potassium and fiber in the body and displacing energy-dense fatty foods.

The U.S.D.A. has reported that only 36.4 percent of U.S. children between the ages of 2 and 19 eat the recommended three to five servings of vegetables per day, and only 26 percent eat the two to four recommended daily servings of fruit.

“The salad bar program showed us that children will indeed eat more fruits and vegetables if offered in an appetizing and accessible manner,” Slusser said. “Future studies should evaluate parent education with school lunch menu changes, as well as why boys are less likely to eat from the salad bar at lunch than girls.”

The study was funded by the Joseph Drown Foundation and the Center for Advanced Studies in Nutrition and Social Marketing at the University of California, Davis.

Source: University of California

The next cancer-fighting therapeutic could be growing in your garden, according to research presented at the American Association for Cancer Research’s Sixth Annual International Conference on Frontiers in Cancer Prevention Research.

For example, a black raspberry-based gel might offer a means of stopping oral lesions from turning into a particularly dangerous and disfiguring form of cancer. And new studies show that cancer prevention might come in drinkable form: green tea extract, a powerful antioxidant, shows efficacy against colorectal cancer; and a new berry-rich beverage, made from a combination of known plant-based antioxidants, could prevent or slow the growth of prostate cancer.

Some of the promising studies include:

Chemopreventative effects of a topically applied black raspberry gel on oral premalignant tumors.

Oral squamous cell carcinoma is a deadly cancer that, even when treated successfully, often leaves patients permanently disfigured. Other than radical surgery, there are few known treatments. Researchers at Ohio State University, however, report a Phase I/II trial demonstrating that a gel made from black raspberries shows promise in preventing or slowing the malignant transformation of precancerous oral lesions.

“Black raspberries are full of anthocyanins, potent antioxidants that give the berries their rich, dark color, and our findings show these compounds have a role in silencing cancerous cells,” said Susan Mallery, D.D.S., Ph.D., professor in the Department of Oral Maxillofacial Surgery and Pathology at Ohio State University’s College of Dentistry. “This gel appears to be a valid means of delivering anthocyanins and other cancer-preventing compounds directly to precancerous cells, since it slowed or reduced lesion progression in about two-thirds of study participants.”

According to American Cancer Society statistics, oral cancer is one of the deadliest of all cancers, with about 35,000 new cases each year in the United States and 7,500 deaths annually. These cancers generally begin as small, often unnoticed, lesions inside the mouth. “More than a third of untreated precancerous oral lesions will undergo malignant transformation into squamous cell cancer, but we do not have the capability to predict which lesions will progress,” Mallery said.

The National Cancer Institute-funded trial included 30 participants, 20 of whom had identifiable precancerous lesions, and 10 normal controls. Each of the participants was instructed to gently dry the lesion sites (or a pre-selected control site for the normal participants) and rub the gel into the area four times a day, once after each meal and at bedtime.

After six weeks, about 35 percent of the trial participants’ lesions showed an improvement in their microscopic diagnosis, while another 45 percent showed that their lesions had stabilized. About 20 percent showed an increase in their lesional microscopic diagnoses. Importantly, none of the participants experienced any side effects from the gel.

"The trial was designed to test the safety of the gel and detect any possible toxicity, but the next obvious step is a multicenter, double-blind, placebo-controlled Phase II study," Mallery said. "Such a study would enable us to determine that the black raspberries are the active factor and not just the gel base or the act of drying and rubbing the lesions."

The researchers also collected cell samples from the lesion sites of each participant before and after treatment in order to study the genetics and biology of the lesions. The majority of patients with precancerous lesions at the start of the trial showed elevated levels of COX-2 and iNOS, two proteins closely correlated with inflammation and malignant progression. Following treatment, Mallery says, levels of those proteins in the treated lesional epithelial cells decreased dramatically.

Mallery and her colleagues also examined samples for three tumor suppressor genes in order to determine what researchers call "loss of heterozygosity," whether or not a cancer cell has lost one of its two copies of the gene. Such loss greatly increases a cell’s chances of losing the benefit of the tumor suppressor genes due to a second mutation or gene silencing event. Following the trial, the researchers noted that many lesions returned to normal, retaining both copies of each tumor suppressor gene. "We speculate that the chemopreventive compounds in black raspberries assist in modulating cell growth by promoting programmed cell death or terminal differentiation, two mechanisms that help "reeducate" precancerous cells," Mallery said.

"Oral cancer is a debilitating disease and there is a desperate need for early detection and management of precancerous lesions," Mallery said. "While screening can help detect the disease early – and survival rates are definitely improved the earlier the disease is caught – many of these precancerous lesions recur despite complete surgical removal. There are currently no effective chemopreventive treatments which could conceivably serve as either adjunctive or alternative approaches to surgery."

According to Mallery, the development of black raspberries as potential cancer-fighters is the result of decades of research into identification of naturally derived chemopreventive compounds by Ohio State researcher Gary D. Stoner, Ph.D., an emeritus professor at Ohio State University’s College of Medicine and Public Health. Clinical studies stemming from his research are currently underway for oral, esophageal and colorectal cancer.

The gel looks deceptively like black raspberry jam, but it certainly does not taste like something you would want to spread on toast, Mallery says. The bioadhesive gel, which contains 10 percent freeze dried black raspberries, is devoid of many of the tasty sugars found in native berries.

The black raspberry gel was manufactured by the University of Kentucky’s Good Manufacturing Production (GMP) facility. NanoMed Pharmaceuticals is partnering with OSU investigators Mallery, Stoner and Peter E. Larsen D.D.S. and Russell J. Mumper, Ph.D., of the University of North Carolina, in product development.

<h3>Suppressive effects of a phytochemical cocktail on prostate cancer growth in vitro and in vivo. Abstract no. A104:</h3>

A commercially available nutrition drink reduces the growth of tumors in a mouse model of human prostate cancer by 25 percent in two weeks, according to researchers from the University of Sydney. The drink, Blueberry Punch, is a mixture of plant-based chemicals – phytochemicals – known to have anti-cancer properties.

In particular, Blueberry Punch consists of a combination of fruit concentrates (blueberry, red grape, raspberry and elderberry), grape seed and skin extract, citrus skin extracts, green tea extract (EGCG), olive leaf and olive pulp extracts, tarragon, turmeric and ginger.

"We have undertaken efficacy studies on individual components of Blueberry Punch, such as curcumin, resveratrol and EGCG, in the same laboratory setting and found these effective in suppressing cell growth in culture," said Jas Singh, Ph.D., research fellow at the University of Sydney.

"While individual phytochemicals are successful in killing cancer cells, we reasoned that synergistic or additive effects are likely to be achieved when they are combined."

Singh and her colleagues studied the effect of the beverage on both cancer cell cultures and in mouse models that mimic human prostate cancer. After 72 hours of exposure to increasing concentrations of Blueberry Punch, prostate cancer cells showed a dose-dependent reduction in size and viability when compared with untreated cells, Singh says. After feeding mice a 10 percent solution of the punch for two weeks, the tumors in the test mice were 25 percent smaller than those found in mice that drank only tap water.

Because Blueberry Punch is a combination of several ingredients, it could have multiple mechanisms of action, Singh says. "Based on our initial findings, the mechanisms include, at least, the inhibition of the inflammation-related pathways, which is similar to the action of non-steroidal anti-inflammatory drugs; and inhibition of cyclin D1, which is similar to green tea action."

Based on these results, the researchers believe Blueberry Punch is now ready for human prostate cancer trials. Because Blueberry Punch is a food product rather than a drug, it is unlikely to have adverse reactions or side effects assuming that the individual is tolerant to all ingredients, Singh says. "The evidence we have provided suggests that this product could be therapeutic, although it requires clinical validation," Singh said.

The study was partially funded by the makers of Blueberry Punch, Dr. Red Nutraceuticals, a firm located near Brisbane, Australia, but the experiments were designed and conducted independently in the University of Sydney.

<h3>Inhibition of colorectal tumorigenesis in azoxymethane (AOM)-treated rats by green tea polyphenols. Abstract no. A134:</h3>

Elucidating a decade’s worth of conflicting studies of the cancer-fighting benefits of green tea, researchers at Rutgers University have conclusively demonstrated that a standardized green tea polyphenol preparation can prevent the growth of colorectal tumors in a rat model of human colorectal cancer.

Results from previous studies using different tea constituents in this particular rat cancer model, which is thought to closely mimic human cancer, had been inconsistent. The researchers believe their findings will pave the way for clinical trials with green tea polyphenols in humans.

"Our findings show that rats fed a diet containing Polyphenon E, a standardized green tea polyphenol preparation, are less than half as likely to develop colon cancer," said Hang Xiao, Ph.D., research associate at the Department of Chemical Biology in Ernest Mario School of Pharmacy of Rutgers University.

According to Xiao, these results are consistent with previously published results by the project’s primary investigator, C.S. Yang, Ph.D., professor and chair of the Department of Chemical Biology at Rutgers, which showed that green tea consumption was associated with lower colon cancer rates in Shanghai, China.

Xiao and his colleagues treated two groups of mice with azoxymethane (AOM), a widely used agent that has been shown to generate in rats colorectal tumors that share many characteristics with colorectal cancer in humans, Xiao says. They then split the rats into two groups that were each fed a high fat diet, which the researchers believe closely resembles a Western diet; half received a 0.24 percent solution of Polyphenon E. According to Xiao, the green tea extract contains four major polyphenols, the majority of which (about 65 percent) is EGCG, thought to be the main active ingredient.

"When you account for caloric consumption, 0.24 percent Polyphenon E in diet gave the experimental rats the equivalent of about four to six cups of tea a day," Xiao said. "While I can’t make any recommendations for how much green tea people should drink each day, it isn’t uncommon for some to drink that much tea."

After 34 weeks, rats that received Polyphenon E developed 55 percent fewer tumors compared to the control rats that did not receive Polyphenon E. Moreover, the tumors were 45 percent smaller in rats treated with green tea extract. Histopathological analysis by his colleague, Xinpei Hao, Ph.D., also showed that the treatment group had significantly lower incidence and number of malignant colon tumors. The researchers could also detect green tea polyphenols in the blood plasma as well as the colorectal mucosa of the rats who received the extract.

Meanwhile, the test rats weighed about five percent less than their control group counterparts, a result Xiao attributes to the ability of the green tea polyphenols to block lipid absorption in the body, which the researchers had previously demonstrated in a mouse model of obesity.

Source: American Association for Cancer Research (AACR)

According to a recent study by the National Institutes of Health, pre-menopausal women with even mild depression have less bone mass than do their nondepressed peers, The level of bone loss is at least as high as that associated with recognized risk factors for osteoporosis, including smoking, low calcium intake, and lack of physical activity.

Hip bones, the site of frequent fractures among older people, were among those showing the most thinning in depressed premenopausal women. The reduced bone mass puts them at higher risk of these costly, sometimes fatal fractures and others as they age, the researchers note in the November 26 issue of the Archives of Internal Medicine. The report was submitted by Giovanni Cizza, MD, PhD, MHSc, of NIMH and the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); Farideh Eskandari, MD, MHSc, of NIMH; and colleagues.

“Osteoporosis is a silent disease. Too often, the first symptom a clinician sees is when a patient shows up with a broken bone. Now we know that depression can serve as a red flag — that depressed women are more likely than other women to approach menopause already at higher risk of fractures,” said NIMH Deputy Director Richard Nakamura, PhD.

After bone mass reaches its peak in youth, bone-thinning continues throughout life, accelerating after menopause. Preliminary studies had suggested that depression may be a risk factor for lower-than-average bone mass even in young, premenopausal women. Results of the current study lend considerable weight to those earlier findings. The study?s design reduced the possibility that the lower bone mass was linked to factors other than depression.

Study participants included 89 depressed women and 44 nondepressed women, for comparison. All were between 21 and 45 years old and were premenopausal. Except for depression, the two groups were similar in risk factors, including calcium, caffeine, and alcohol intake; smoking; level of physical fitness; use of oral contraceptives; and age of first menstrual period. Both groups were of relatively high socioeconomic status and were well nourished.

One difference was that the depressed women were taking antidepressant medications. A previous study suggested that older adults taking antidepressants called selective serotonin reuptake inhibitors had more bone fractures than others. However, the current study showed that these medications were not linked to low bone mass in premenopausal women.

The researchers found that 17 percent of the depressed women had thinner bone in a vulnerable part of the hip called the femoral neck, compared with 2 percent of those who were not depressed. Low bone mass in the lumbar spine, in the lower back, was found in 20 percent of depressed women, but in only 9 percent of nondepressed women. Bone mass was measured via an X-ray technique called DXA scanning.

There was no significant link between the degree of bone loss and the severity of depression or the cumulative number of depressive episodes, the researchers found. The depressed women had been diagnosed with mild depression and were having, or had recently had, a depressive episode.

“Depression generally isn?t on clinicians? radar screens as a major risk factor for osteoporosis, particularly for premenopausal women. It should be,” said Cizza.

Blood and urine samples also showed that depressed women have imbalances in immune-system substances, including those that produce inflammation, compared to their healthy peers. This additional finding strengthens the case for a suspected link between depression-induced imbalances in the immune system and accelerated bone loss. The blood and urine samples were taken every hour for a full day, providing a truer picture than does less frequent testing, as had been done in previous studies.

The immune-system imbalances may be tied to excess adrenalin, since the part of the nervous system that produces adrenalin is over-active in depressed people. Increased adrenalin can over-stimulate the immune system. Compared to the others, the depressed women in this study had higher levels of immune-system proteins that promote inflammation, and lower levels of those that prevent it.

One of these inflammation-promoting proteins, IL-6, is known to promote bone loss. At the molecular level, bones routinely break down, and their minerals, notably calcium, are reabsorbed into the blood, where they travel throughout the body to perform crucial functions in cells. At the same time, the body builds the bone back up. Imbalances in this normal loop of bone re-absorption and build-up, such as high levels of IL-6, could promote bone loss, the researchers suggest.

The study was funded in part by the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH). Other NIH contributors to the study, in addition to NIMH and NIDDK, included the NIH Clinical Center and the National Center for Complementary and Alternative Medicine.

Source: National Insitutes of Health

Alzheimer’s disease may progress more rapidly in people with high blood pressure or a form of irregular heartbeat called atrial fibrillation, according to results of a Johns Hopkins study published in the Nov. 6, 2007, issue of Neurology. The findings suggest that treating these conditions may also slow memory loss in people with Alzheimer’s.

While current medications for Alzheimer’s disease are effective for some patients in slowing the rate of Alzheimer’s progression, many patients do not benefit from the treatments or cannot tolerate them, says leAlzheimer’s researcher Michelle M. Mielke, Ph.D., of the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins University School of Medicine.

“The possibility that specific vascular conditions may affect how fast a person with Alzheimer’s declines,” Mielke says, “provides new opportunities for slowing the rate of Alzheimer’s progression. Treatments for atrial fibrillation and high blood pressure are relatively inexpensive and safe and may reduce memory decline in Alzheimer’s patients with these conditions.”

The study examined 135 men and women over 65 who were newly diagnosed with Alzheimer’s. All hAlzheimer’s undergone annual memory tests for an average of three years.

Results showed that 10 with high blood pressure (systolic pressure over 160) at the time of Alzheimer’s diagnosis showed a rate of memory loss roughly 100 percent faster than those with normal blood pressure.

In Alzheimer’sdition, 10 with atrial fibrillation at the time of the diagnosis showed a rate of memory decline that was 75 percent faster than those with normal heartbeats.

The study participants were part of the Cache County Study on Memory Health and Aging, which has been following a group of 5,092 people 65 or older living in Cache County, Utah, since 1995.

“What makes this group and study unique is that we have been following these participants in the community for over a decAlzheimer’se, even before they were first diagnosed with Alzheimer’s, so we know a good deal about their medical history,” says Mielke. “Studies that enroll Alzheimer’s patients only from clinics may miss key factors, such as date of onset and history of cardiovascular disease and treatment.”

Mielke says she is currently working on similar studies using larger sample sizes to better understand the potential role that vascular factors play before Alzheimer’s diagnosis and their role over the course of the disease’s progression.

Mielke also recently contributed to a study by Johns Hopkins psychiatrist Paul Rosenberg, M.D., that examined drugs that modify high blood pressure and high cholesterol, such as beta-blockers, diuretics, calcium-channel blockers and statins, and their effects on cognitive and functional decline. Results from that study are expected to be released this year.

Constantine Lyketsos, M.D., Paul Rosenberg, M.D., and Peter Rabins, M.D., M.P.H. of the Department of Psychiatry and Behavioral Sciences at The Johns Hopkins University School of Medicine also contributed to this study. Alzheimer’sditional researchers include JoAnn Tschanz, Ph.D., Maria Norton, Ph.D., Ron Munger, Ph.D., Larry Cook, and Chris Corcoran, Ph.D., of Utah State University in Logan, Utah; Kathleen Hayden, Ph.D., and Kathleen Welsh-Bohmer, Ph.D., of Duke University in Durham, N.C.; Robert Green, M.D., of Boston University; and John Brietner, M.D., of the University of Washington in Seattle.

This study was supported by grants from the National Institute on Aging.

Source: Neurology, November 6, 2007

Antonio Zadra, PhD, asked 109 women and 64 men to keep a dream diary for two to four weeks. Participants were about 30 years old, on average.

According to Zadra, only two other studies have probed the frequency and content of sexual dreams, and both of those studies were done more than 40 years ago.

In Zadra’s study, participants jotted down every dream they had, whether it was sexual or not. All in all, they noted 3,564 dreams. Of those dreams, 292 included sexual content.

“Sexual intercourse was the most common type of sexual content, followed by sexual propositions, kissing, and fantasies,” Zadra writes.

For men and women alike, sexual dreams accounted for 8% of all reported dreams. Zadra also notes that “masturbation accounted for approximately 6% of both male and female sexual dreams and an orgasm was experienced in approximately 4% of all sexual dreams.”

However, there were some gender differences in sex dreams.

By Miranda Hitti

“Men’s sexual dreams were more likely to take place in public or unknown settings, to have the dreamer initiate sexual contact, and to involve unknown characters or multiple partners,” Zadra writes, adding that “gender differences in the content of everyday sexual dreams may reflect people’s waking needs, experiences, attitudes, and concerns with respect to sexuality.”

His findings were presented today in Minneapolis at Sleep 2007, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

So-called “DES daughters,” born to mothers who used the anti-miscarriage drug diethylstilbestrol during pregnancy, are at a substantially greater risk of developing breast cancer compared to women who were not exposed to the drug in utero.

Reporting in the recent issue of the journal Cancer Epidemiology, Biomarkers & Prevention, a nationwide team of researchers found that DES daughters over age 40 had 1.9 times the risk of developing breast cancer, compared to unexposed women of the same age. They also found that the relative risk of developing the cancer was even greater in DES daughters over age 50, but say the number of older women in their study group is, as yet, too small for a firm statistical comparison.

“This is really unwelcome news because so many women worldwide were prenatally exposed to DES, and these women are just now approaching the age at which breast cancer becomes more common,” said the study’s lead author, Julie Palmer, Sc.D., professor of epidemiology at the Boston University School of Public Health.

She said an estimated one to two million women in the U.S. were exposed to DES, which was frequently prescribed to women from the 1940s through 1960s to prevent miscarriages.

The ongoing study suggests that DES-exposed women are developing the typical range of breast cancers after age 40 at a faster rate than non-exposed women of the same ages. The researchers also found that the highest relative risk of developing breast cancer was observed in study participants from the cohorts with the highest cumulative doses of DES exposure.