November is American Diabetes Month - From National Health Observances, Nov. 2013

American Diabetes Month is a time to raise awareness of diabetes prevention and control. In the United States, more than 25 million people are living with diabetes and 79 million more are at risk of developing type 2 diabetes.

Over time, if it’s not controlled, type 2 diabetes can cause serious health problems like heart disease, stroke, and blindness. You may be at risk for type 2 diabetes if you:

You can do a lot to lower your chances of getting type 2 diabetes by:

Learn how to prevent or delay type 2 diabetes by losing a small amount of weight. To get started, use these tips to help you move more, make healthy food choices, and track your progress.

Reduce Portion Sizes

Portion size is the amount of food you eat, such as 1 cup of fruit or 6 ounces of meat. If you are trying to eat smaller portions, eat a half of a bagel instead of a whole bagel or have a 3-ounce hamburger instead of a 6-ounce hamburger. Three ounces is about the size of your fist or a deck of cards.

Put less on your plate, Nate.

1. Drink a large glass of water 10 minutes before your meal so you feel less hungry.

2. Keep meat, chicken, turkey, and fish portions to about 3 ounces.

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3. Share one dessert.

Eat a small meal, Lucille.

4. Use teaspoons, salad forks, or child-size forks, spoons, and knives to help you take smaller bites and eat less.

5. Make less food look like more by serving your meal on a salad or breakfast plate.

6. Eat slowly. It takes 20 minutes for your stomach to send a signal to your brain that you are full.

7. Listen to music while you eat instead of watching TV (people tend to eat more while watching TV).

How much should I eat?

Try filling your plate like this:

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Move More Each Day

Find ways to be more active each day. Try to be active for at least 30 minutes, 5 days a week. Walking is a great way to get started and you can do it almost anywhere at any time. Bike riding, swimming, and dancing are also good ways to move more.

If you are looking for a safe place to be active, contact your local parks department or health department to ask about walking maps, community centers, and nearby parks.

Dance it away, Faye.

8. Show your kids the dances you used to do when you were their age.

9. Turn up the music and jam while doing household chores.

10. Work out with a video that shows you how to get active.

Let's go, Flo.

11. Deliver a message in person to a co-worker instead of sending an e-mail.

12. Take the stairs to your office. Or take the stairs as far as you can, and then take the elevator the rest of the way.

13. Catch up with friends during a walk instead of by phone.

14. March in place while you watch TV.

15. Choose a place to walk that is safe, such as your local mall.

16. Get off of the bus one stop early and walk the rest of the way home or to work during the week if it is safe.

Make Healthy Food Choices

Find ways to make healthy food choices. This can help you manage your weight and lower your chances of getting type 2 diabetes.

Choose to eat more vegetables, fruits, and whole grains. Cut back on high-fat foods like whole milk, cheeses, and fried foods. This will help you reduce the amount of fat and calories you take in each day.

Snack on a veggie, Reggie.

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17. Buy a mix of vegetables when you go food shopping.

18. Choose veggie toppings like spinach, broccoli, and peppers for your pizza.

19. Try eating foods from other countries. Many of these dishes have more vegetables, whole grains, and beans.

20. Buy frozen and low-salt (sodium) canned vegetables if you are on a budget. They may cost less and keep longer than fresh ones.

21. Serve your favorite vegetable and a salad with low-fat macaroni and cheese.

Cook with care, Claire.

22. Stir fry, broil, or bake with non-stick spray or low-salt broth. Cook with less oil and butter.

23. Try not to snack while cooking or cleaning the kitchen.

24. Cook with smaller amounts of cured meats (smoked turkey and turkey bacon). They are high in salt.

Cook in style, Kyle.

25. Cook with a mix of spices instead of salt.

26. Try different recipes for baking or broiling meat, chicken, and fish.

27. Choose foods with little or no added sugar to reduce calories.

28. Choose brown rice instead of white rice.

Eat healthy on the go, Jo.

29. Have a big vegetable salad with low-calorie salad dressing when eating out. Share your main dish with a friend or have the other half wrapped to go.

30. Make healthy choices at fast food restaurants. Try grilled chicken (with skin removed) instead of a cheeseburger.

31. Skip the fries and chips and choose a salad.

32. Order a fruit salad instead of ice cream or cake.

Rethink your drink, Linc.

33. Find a water bottle you really like (from a church or club event, favorite sports team, etc.) and drink water from it every day.

34. Peel and eat an orange instead of drinking orange juice.

35. If you drink whole milk, try changing to 2% milk. It has less fat than whole milk. Once you get used to 2% milk, try 1% or fat-free (skim) milk. This will help you reduce the amount of fat and calories you take in each day.

36. Drink water instead of juice and regular soda.

Eat smart, Bart.

37. Eat foods made from whole grains every day, such as whole wheat bread, brown rice, oats, and whole grain corn.

38. Use whole grain bread for toast and sandwiches.

39. Keep a healthy snack with you, such as fresh fruit, a handful of nuts, and whole grain crackers.

40. Slow down at snack time. Eating a bag of low-fat popcorn takes longer than eating a candy bar.

41. Share a bowl of fruit with family and friends.

42. Eat a healthy snack or meal before shopping for food. Do not shop on an empty stomach.

43. Shop at your local farmers market for fresh, local food.

Keep track, Jack.

44. Make a list of food you need to buy before you go to the store.

45. Keep a written record of what you eat for a week. It can help you see when you tend to overeat or eat foods high in fat or calories.

Read the label, Mabel.

46. Compare food labels on packages.

47. Choose foods lower in saturated fats, trans fats, cholesterol (ko-LESS-tuh-ruhl), calories, salt, and added sugars.

Take Care of Your Mind, Body, and Soul

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You can exhale, Gail.

48. Take time to change the way you eat and get active. Try one new food or activity a week.

49. Find ways to relax. Try deep breathing, taking a walk, or listening to your favorite music.

50. Pamper yourself. Read a book, take a long bath, or meditate.

51. Think before you eat. Try not to eat when you are bored, upset, or unhappy.

From BBC Health News
Tuesday, 3 March, 2009

Low-fat, Mediterranean and low-carb diets 'help heart'

Atherosclerosis in carotid artery
Fatty deposits in arteries iincrease the risk of stroke and heart disease

Three diets - Mediterranean, low-fat and low-carbohydrate - are equally effective in helping reverse blocked arteries, say Israeli researchers.

The study of 140 people, reported in the journal Circulation, found diet could reduce the fatty build up in arteries.

The Ben-Gurion University team found that by the end of the two-year study, the arterial wall had been cut by 5%.

Experts said the study was interesting, but diet was not a "magic bullet".

Atherosclerosis is a progressive condition in which the arteries thicken with fatty deposits, increasing the risk of heart attacks and strokes.

It was very interesting to see that these very different diets had a similar effect
Iris Shai, study author

The authors of this Israeli study, which was carried out in collaboration with researchers in the US, Canada and Germany, set out to see if this natural part of ageing can be reversed through diet.

Volunteers followed one of three diets - a low-fat diet, a low-carbohydrate diet or a Mediterranean diet, which is based on eating lots of fruit and vegetables, and using olive oil as the main source of fat.

They were asked to stick to the diet for two years, and record what they ate in food diaries.

The study was carried out among overweight volunteers, mostly men, who were aged 40 to 65.

Using three-dimensional imaging, the researchers measured the volume of the wall of the carotid artery, the large artery in the neck which takes blood up to the brain. This was done at the start of the study and again after two years.

Clogged arteries

Lead researcher Iris Shai said: "It was very interesting to see that these very different diets had a similar effect.

"Some people suggest that low-carbohydrate diets are more likely to clog arteries, but we did not see that."

The research paper suggested the link could be related to falling blood pressure caused by the change in diet.

This study shows you can do something to reduce plaque build-up, even without pills
Dr Charles Knight, British Cardiovascular Society

The findings were welcomed by UK experts.

Dr Charles Knight, secretary of the British Cardiovascular Society and a consultant cardiologist, said although the study was "relatively small" and was not able to follow through to find out how many people eventually had heart attacks or strokes, the results were nevertheless "very interesting".

He pointed out that the study adds weight to the growing body of research that suggests that atherosclerosis is a modifiable disease.

Ten to 15 years ago, it was thought that fatty build-up in the arteries was irreversible, but since then drugs trials have shown that it is possible for fatty deposits to be cut.

"This study shows you can do something to reduce plaque build-up, even without pills," Dr Knight said.

"It sends an effective message from a public health perspective."

However, he warned that the scale of reduction in the volume of artery walls was relatively small and that changing diet, although helpful, was "no magic bullet".

Beetroot juice 'boosts stamina'

Nitrates seem to be the key ingredient in beetroot

Drinking beetroot juice boosts stamina and could help people exercise for up to 16% longer, a UK study suggests.

A University of Exeter team found nitrate contained in the vegetable leads to a reduction in oxygen uptake - making exercise less tiring.

The small Journal of Applied Physiology study suggests the effect is greater than that which can be achieved by regular training.

Beetroot juice has previously been shown to reduce blood pressure.

We were amazed by the effects of beetroot juice
Professor Andy Jones
University of Exeter

The researchers believe their findings could help people with cardiovascular, respiratory or metabolic diseases - and endurance athletes.

They focused on eight men aged 19-38, who were given 500ml per day of organic beetroot juice for six consecutive days before completing a series of tests, involving cycling on an exercise bike.

On another occasion, they were given a placebo of blackcurrant cordial for six consecutive days before completing the same cycling tests.

After drinking beetroot juice the group was able to cycle for an average of 11.25 minutes - 92 seconds longer than when they were given the placebo.

This would translate into an approximate 2% reduction in the time taken to cover a set distance.

The group that had consumed the beetroot juice also had lower resting blood pressure.

Mechanism unclear

The researchers are not yet sure of the exact mechanism that causes the nitrate in the beetroot juice to boost stamina.

However, they suspect it could be a result of the nitrate turning into nitric oxide in the body, reducing how much oxygen is burned up by exercise.

Study researcher Professor Andy Jones - an adviser to top UK athlete Paula Radcliffe - said: "We were amazed by the effects of beetroot juice on oxygen uptake because these effects cannot be achieved by any other known means, including training.

"I am sure professional and amateur athletes will be interested in the results of this research.

"I am also keen to explore the relevance of the findings to those people who suffer from poor fitness and may be able to use dietary supplements to help them go about their daily lives."

Professor John Brewer, an expert on sports science at the University of Bedfordshire, said: "These findings are potentially exciting for many people involved in sport and exercise, but will almost certainly require further more extensive studies before the exact benefits and mechanisms are understood.

"We must also remember that exercise and training and a sensible diet will always remain as the essential ingredients for a balanced and healthy lifestyle."

Dr Simon Marshall, of the University of San Diego, has carried out work on exercise and health.

He said much more work was needed involving many more subjects to draw firm conclusions.

"Certainly, a diet high in nitrate-rich fruits and vegetables is good for your heart health and this study provides further evidence of this."

From BBC Health News Tuesday, 16 September 2008

Exercise 'can cut diabetes risk'

Woman running
A group of at-risk women were put on a seven-week programme of exercise
Woman at high risk of developing type 2 diabetes can increase their chances of staying healthy through exercise, according to a new study.
Researchers from Glasgow University found that insulin resistance in "high risk" women dropped by 22% after seven weeks of an exercise programme.
Insulin resistance is considered to be the most important biological risk factor for developing diabetes.
The British Heart Foundation (BHF) study will be published on Wednesday.
Dr Jason Gill, who heads the team that carried out the study, said: "The offspring of people with type 2 diabetes are about three times more likely to develop the disease than those with no family history of the disease.
"Not only is type 2 diabetes a very serious condition itself, but it can double or triple the risk of heart disease.

People at high risk have it within their power to substantially reduce their risk by increasing their activity levels
Dr Nick Barwell
University of Glasgow
"In fact, more than two thirds of all people with diabetes will die from heart disease."

Dr Gill's team studied women between the age of 20 and 45 who usually did less than one hour of physical activity per week and had a sedentary job.

They tested 34 volunteers who had at least one type 2 diabetic parent against 36 volunteers whose parents had no history of the condition.

At the outset of the study the offspring of diabetics had higher insulin resistance than the controls.

All the women undertook an exercise training programme of three 30 minute exercise sessions in the first week, working up to five 60 minute sessions in weeks six and seven.

Exercise was focused on cardiovascular activities such as running, using a rowing machine, aerobics and cycling.

'Vulnerable group'

Dr Nick Barwell, who led the study, said: "The same exercise programme reduced insulin resistance to a vastly greater extent in the women with diabetic parents, telling us that exercise is particularly good at reducing diabetes risk in this vulnerable group.

"Our research shows that developing diabetes is not inevitable for people with a family history of diabetes.

"People at high risk have it within their power to substantially reduce their risk by increasing their activity levels."

Professor Peter Weissberg, medical director at the BHF, which funded the study, said: "We know that exercise is good for you, but seeing in black and white that this high risk group improved their own bodies' insulin resistance in just a couple of months is a striking demonstration of how effective it can be."

The research team said additional studies were needed to determine whether the benefits of exercise were are also seen in men with diabetic parents.

From BBC Health News Monday, 15 September 2008

Chamomile tea 'may ease diabetes'

Chamomile tea
The tea appeared to inhibit key enzymes

Drinking chamomile tea daily may help prevent the complications of type 2 diabetes, such as loss of vision and nerve and kidney damage, a study says.

UK and Japanese researchers fed a chamomile extract to diabetic rats.

The extract appeared to cut blood sugar levels and block activity of an enzyme associated with the development of diabetic complications.

Charity Diabetes UK cautioned against patients acting on the findings until further research had been carried out.

However, researchers say the Journal of Agricultural and Food Chemistry study raises hope of a new anti-diabetes drug.

More research would be needed before we can come to any firm conclusions about the role chamomile tea plays in fighting diabetes-related complications
Dr Victoria King
Diabetes UK

Cases of type 2 diabetes, many of which are linked to obesity, are on the increase throughout the developed world.

Chamomile, also known as manzanilla, has been used for years as a medicinal cure-all to treat a variety of medical problems including stress, colds and menstrual cramps.

Researchers from University of Toyama, led by Atsushi Kato, fed chamomile extract to a group of diabetic rats for 21 days and compared the results with a group of control animals on a normal diet.

Enzyme inhibition

Blood glucose levels - high levels of which are a sign of diabetes - were significantly lower in the animals fed the extract, which appeared to inhibit production of the sugar in the liver.

Tests also showed reduced activity of an enzyme called aldose reductase in tissue samples from the extract group.

This enzyme helps change glucose into a sugar alcohol called sorbitol.

In people with type 2 diabetes, the activity of aldose reductase increases as glucose levels rise in the blood.

However, sorbitol does not move easily across cell membranes and it can collect in excess quantity, particularly in eye and nerve cells, where it can cause serious damage.

Dr Victoria King, of the charity Diabetes UK, said: "More research would be needed before we can come to any firm conclusions about the role chamomile tea plays in fighting diabetes-related complications.

"Diabetes UK wouldn't recommend people with diabetes increase their chamomile tea intake just yet.

"Eating a healthy balanced diet, taking regular physical activity and adhering to any prescribed medicines remain key ways to effectively control blood glucose levels, blood pressure and blood fats.

"Good diabetes management will help reduce the risk of serious complications such as heart disease, stroke and blindness."

From BBC Health News, Wednesday, 2 July 2008

Mediterranean diet 'cuts cancer'

Mediterranean diet
The Mediterranean diet is rich in fruit and vegetables

Adopting just a couple of elements of the Mediterranean diet could cut the risk of cancer by 12%, say scientists.

A study of 26,000 Greek people found just using more olive oil alone cut the risk by 9%.

The diet, reports the British Journal of Cancer, also includes higher amounts of fruits, vegetables, cereals, and less red meat.

A separate study found adding broccoli to meals might help men vulnerable to prostate cancer cut their risk.

It shows there are a number of things you can do, and there is no one 'superfood' that can stop you developing the disease
Sara Hiom
Cancer Research UK

The Mediterranean diet came under scrutiny after researchers noticed lower rates of illnesses such as heart disease in countries such as Spain and Greece.

They noticed that people living there generally ate more vegetables and fish, less red meat, cooked in olive oil and drank moderate amounts of alcohol.

The latest study is one of the largest yet to look at the potential impact on cancer of the various parts of this diet.

'No superfood'

Researchers from Harvard University persuaded thousands of Greek people of various ages to record their food intake over an eight-year-period.

Broccoli may help ward off prostate cancer

Their adherence to the Mediterranean diet was ranked using a scoring system, and the group with the worst score compared with those who followed a couple of aspects of the diet, and those who followed it the most closely.

The biggest effect they found - a 9% reduction in risk - was achieved simply by eating more "unsaturated" fats such as olive oil.

But just two changes - eating less red meat, and more peas, beans and lentils, cut the risk of cancer by 12%.

Dr Dimitrios Trichopoulos, who led the study, said: "Adjusting one's overall dietary habits towards the traditional Mediterranean pattern had an important effect."

Sara Hiom, from Cancer Research UK, said the research highlighted the importance of a healthy balanced diet.

"It shows there are a number of things you can do, and there is no one 'superfood' that can stop you developing the disease."

Broccoli benefit

The other study suggesting that food had the power to prevent cancer came from the Institute of Food Research in Norwich.

Scientists compared the effects of adding 400 grams of broccoli or peas a week to the diet of men at high risk of prostate cancer - and in the case of broccoli found differences in the activity of genes in the prostate which other studies have linked to cancer.

Their findings raised the possibility that broccoli, or other "cruciferous" vegetables, such as cauliflower and Brussels sprouts, could help prevent or slow down the disease, particularly if the man had a particular gene variant - GSTM1.

Professor Richard Mithen, who led the research, published in the Public Library of Science journal, said: "Eating two or three portions of cruciferous vegetables per week, and maybe a few more if you lack the GSTM1 gene - should be encouraged."

Professor Karol Sikora, medical director of CancerPartnersUK, said the study was the first time in a properly controlled clinical trial that broccoli had been shown to change the expression of specific genes in the prostate gland.

"Although the observation period was too short and the numbers too small to show that the incidence of cancer actually fell, it is the first clear demonstration that broccoli and presumably other cruciferous vegetables may well reduce cancer risk."

Fish oil appears to help against heart failure

By MARIA CHENG, AP Medical Writer Sun Aug 31, 8:18 AM ET

MUNICH, Germany - Fish oil supplements may work slightly better than a popular cholesterol-reducing drug to help patients with chronic heart failure, according to new research released Sunday.

Chronic heart failure is a condition that occurs when the heart becomes enlarged and cannot pump blood efficiently around the body.

With few effective options for heart failure patients, the findings could give patients a potential new treatment and could change the dietary recommendations for them, said Dr. Jose Gonzalez Juanatey, a spokesman for the European Society of Cardiology, who was not connected to the research.

"This reinforces the idea that treating patients with heart failure takes more than just drugs," Juanatey said.

The study findings were published online in the medical journal The Lancet on Sunday. They were simultaneously announced at a meeting of the European Society of Cardiology in Munich.

"With a lot of these patients, you have no other choice," said Dr. Helmut Gohlke, a cardiologist at the Heart Centre in Bad Krozingen, Germany. "They've tried other treatments and are at the end of the road."

Italian researchers gave nearly 3,500 patients a daily omega-3 pill, derived from fish oils. Roughly the same number of patients were given placebo pills. Patients were followed for an average of four years.

In the group of patients taking the fish oil pills, 1,981 died of heart failure or were admitted to the hospital with the problem. In the patients on placebo pills, 2,053 died or were admitted to the hospital for heart failure.

In a parallel study, the same team of Italian doctors gave 2,285 patients the drug rosuvastatin, also known as Crestor, and gave placebo pills to 2,289 people. Patients were then tracked for about four years. The doctors found little difference in heart failure rates between the two groups.

Comparing the results from both studies, the researchers concluded that fish oil is slightly more effective than the drug because the oil performed better against a placebo than did Crestor.

"It's a small benefit, but we should always be emphasizing to patients what they can do in terms of diet that might help," said Dr. Richard Bonow, chief of cardiology at Northwestern University Hospital in Chicago and past president of the American Heart Association.

Both studies were paid for by an Italian group of pharmaceuticals including Pfizer Inc., Sigma Tau SpA and AstraZeneca PLC.

Omega-3 fatty acids from fish such as salmon and tuna have long been proven to offer health benefits like protecting the heart and brain, though scientists aren't exactly sure how.

Bonow said that since cell membranes are made of fatty acids, fish oils may help to replace and strengthen those membranes with omega-3.

Fish oils also are thought to increase the body's good cholesterol levels, as well as possibly stabilizing the electrical system in heart cells, to prevent abnormal heart rhythms.

In contrast, statins act on the body's bad cholesterol, which may not have a big impact on heart failure.

Previous studies that investigated the benefits of omega-3 fatty acids have largely been observational, and have lacked a direct comparison to a placebo. It has also been unknown whether taking fish oil supplements would be as good as eating fish.

"This study changes the certainty of the evidence we have about fish oils," said Dr. Douglas Weaver, president of the American College of Cardiology.

Weaver said that guidelines in the United States would likely change to recommend that more heart patients eat more fish or take supplements. "This is a low-tech solution and could help all patients with cardiovascular problems."

Click here to see our Omega-3 Fish Oil Capsules

Watermelon, the New Oyster? Fruit Said to Have 'Viagra-Like' Effects on Blood Vessels

Tuesday, July 01, 2008


Forget the oysters. Texas A&M scientists say watermelon contains ingredients that deliver Viagra-like effects to the body's blood vessels and may even increase the libido.

Researchers from Texas A&M have long-studied the fruit and found that it contains natural "enhancers" to the human body.

"We've always known that watermelon is good for you, but the list of its very important healthful benefits grows longer with each study," said Dr. Bhimu Patil, director of Texas A&M's Fruit and Vegetable Improvement Center, in a news release from the university.

Watermelon and some other fruits and vegetables contain phyto-nutrients, including lycopene, beta carotene and citrulline, which are compounds that produce healthy reactions in the body, Patil said.

Specifically, scientists believe it's the citrulline that has the ability to relax blood vessels, much like Viagra does.

When watermelon is consumed, citrulline is converted into the amino acid arginine, which works “wonders on the heart and circulation system, and maintains a good immune system,” Patil said.

"Watermelon may not be as organ specific as Viagra," he said, "but it's a great way to relax blood vessels without any drug side-effects."

The highest concentrations of citrulline are found in the rind of the watermelon. Because the rind is not commonly eaten, Texas A&M researchers Steve King and Hae Jeen Bang are working to produce watermelon hybrids that would bring higher concentrations of citrulline to the flesh of the fruit.

From BBC Health News:

Why some just cannot resist food

Chocolate cake
A typical image shown to volunteers
Scientists have discovered why some people just can't resist food.

They used scans to show the reward centres in some people's brains are particularly sensitive to food advertising and product packaging.  Greater stimulation of this area by food images is likely to encourage over-eating, and obesity.

The study, published in the Journal of Neuroscience, was carried out by the Medical Research Council's Cognition and Brain Sciences Unit.

This helps explain why some individuals are more vulnerable to developing certain disorders like binge-eating
Dr John Beaver

The researchers showed people pictures of highly appetizing foods (eg chocolate cakes), bland foods (eg broccoli), and disgusting foods (eg rotten meat).

At the same time, they measured brain activity using a sophisticated fMRI scanner.

After testing, the study participants completed a questionnaire that assessed their general desire to pursue rewarding items or goals.

The results showed that the participant's scores on the reward sensitivity questionnaire predicted the extent to which the appetizing food images activated their brain's reward network.

False assumptions

Lead researcher Dr John Beaver said: "Previous studies in this area have assumed that brain activation patterns are similar in all healthy individuals.

"But the new findings demonstrate that, even in healthy individuals, some people's brain reward centres are more sensitive to appetizing food cues.

We need to move away from a position of simply blaming patients
Dr Ian Campbell

"This helps explain why some individuals are more vulnerable to developing certain disorders like binge-eating.

"This is particularly pertinent in understanding the rapidly increasing prevalence of obesity, as people are constantly bombarded with images of appetizing food items in order to promote food intake through television advertising, vending machines, or product packaging."

According to Dr Beaver the findings may also have broader implications for understanding vulnerability to multiple forms of addiction and compulsive behaviours.

He said: "Research demonstrates that an individual's reward sensitivity may also relate to their vulnerability to substance abuse, and the brain network we have identified is hyper-responsive to drug cues in addicts."

Industry responsibility

Dr Ian Campbell, an expert in obesity from Nottingham and medical director of the charity Weight Concern, said appetite control was notoriously difficult and most dieters regularly fail to control their food intake.

"This research this shows that it's not simply explained by a loss of will power or greed. It's much more complicated.

"An involuntary exaggerated neurophysiological response to pictures of desirable food presented through clever advertising makes it incredibly difficult for some affected individuals to resist.

"The message is clear. While individuals must retain a responsibility to do their best to control their intake of high fat high sugar foods this responsibility must be shared by the food manufacturers and advertisers.

"We need to move away from a position of simply blaming patients to one of greater understanding, and support."

Grapefruit link to breast cancer

Eating too much grapefruit could increase risks of breast cancer
Eating grapefruit every day could raise the risk of developing breast cancer by almost a third, US scientists say.

A study of 50,000 post-menopausal women found eating just a quarter of a grapefruit daily raised the risk by up to 30%.

The fruit is thought to boost levels of oestrogen - the hormone associated with a higher risk of the disease, the British Journal of Cancer reported.

But the researchers and other experts said more research was still needed.

This is an interesting study, but is simply a piece of the jigsaw that will eventually help us to understand how our diets affect our health
Dr Joanne Lunn

The women had to fill in questionnaires saying how often they ate grapefruit and how big their portions were.

Oestrogen important

The researchers, at the universities of Southern California and Hawaii, found that women who ate one quarter of a grapefruit or more every day had a higher risk of breast cancer than those who did not eat the fruit at all.

Previous studies have shown that a molecule called cytochrome P450 3A4 (CYP3A4) is involved in metabolising oestrogen hormones.

And grapefruit may boost blood oestrogen levels by inhibiting this molecule, allowing the hormones to build up.

The researchers found that in women who ate at least a quarter of a grapefruit daily, levels of oestrogen were higher.

They said: "It is well established that oestrogen is associated with breast cancer risk.

"Therefore, if grapefruit intake affects oestrogen metabolism leading to higher circulating levels, then it is biologically plausible that regular intake of grapefruit would increase a woman's risk of breast cancer."

More research

And they said this was the first time a commonly eaten food had been linked to an increased risk of breast cancer in older women.

However, they warned that more research was needed to confirm the findings which may have been affected because they only took into account intake of the fruit, but not grapefruit juice.

Breast cancer accounts for almost a third of all cancers in women, and previous lifestyle factors linked to the disease include drinking alcohol and being overweight.

Dr Joanne Lunn, a nutrition scientist at the British Nutrition Foundation said: "This is an interesting study of a large group of post-menopausal women whose diet and health have been followed for many years.

"However, this study is simply a piece of the jigsaw that will eventually help us to understand how our diets affect our health.

"Although we are beginning to get a better awareness of how our diets can modify the risk of diseases such as cancer, we are still a long way from identifying particular foods that might specifically increase or decrease risk."

However, she said that some dietary patterns are associated with a reduced risk of certain cancers and that a diet rich in a variety of different fruits and vegetables could help reduce the risk of heart disease and some cancers.

From the New York Times, The Consumer

An Old Cholesterol Remedy Is New Again

Published: January 23, 2007

Perhaps you heard it? The wail last month from the labs of heart researchers and the offices of Wall Street analysts?

Pfizer Inc., the pharmaceutical giant, halted late-stage trials of a cholesterol drug called torcetrapib after investigators discovered that it increased heart problems — and death rates — in the test population.

Torcetrapib wasn’t just another scientific misfire; the drug was to have been a blockbuster heralding the transformation of cardiovascular care. Statin drugs like simvastatin (sold as Zocor) and atorvastatin (Lipitor) lower blood levels of LDL, the so-called bad cholesterol, thereby slowing the buildup of plaque in the arteries.

But torcetrapib worked primarily by increasing HDL, or good cholesterol. Among other functions, HDL carries dangerous forms of cholesterol from artery walls to the liver for excretion. The process, called reverse cholesterol transport, is thought to be crucial to preventing clogged arteries.

Many scientists still believe that a statin combined with a drug that raises HDL would mark a significant advance in the treatment of heart disease. But for patients now at high risk of heart attack or stroke, the news is better than it sounds. An effective HDL booster already exists.

It is niacin, the ordinary B vitamin.

In its therapeutic form, nicotinic acid, niacin can increase HDL as much as 35 percent when taken in high doses, usually about 2,000 milligrams per day. It also lowers LDL, though not as sharply as statins do, and it has been shown to reduce serum levels of artery-clogging triglycerides as much as 50 percent. Its principal side effect is an irritating flush caused by the vitamin’s dilation of blood vessels.

Despite its effectiveness, niacin has been the ugly duckling of heart medications, an old remedy that few scientists cared to examine. But that seems likely to change.

“There’s a great unfilled need for something that raises HDL,” said Dr. Steven E. Nissen, a cardiologist at the Cleveland Clinic and president of the American College of Cardiology. “Right now, in the wake of the failure of torcetrapib, niacin is really it. Nothing else available is that effective.”

In 1975, long before statins, a landmark study of 8,341 men who had suffered heart attacks found that niacin was the only treatment among five tested that prevented second heart attacks. Compared with men on placebos, those on niacin had a 26 percent reduction in heart attacks and a 27 percent reduction in strokes. Fifteen years later, the mortality rate among the men on niacin was 11 percent lower than among those who had received placebos.

“Here you have a drug that was about as effective as the early statins, and it just never caught on,” said Dr. B. Greg Brown, professor of medicine at the University of Washington in Seattle. “It’s a mystery to me. But if you’re a drug company, I guess you can’t make money on a vitamin.”

By and large, research was focused on lowering LDL, and the statins proved to be remarkably effective. The drugs can slow the progress of cardiovascular disease, reducing the risk of heart attack or other adverse outcomes by 25 percent to 35 percent.

But recent studies suggest that the addition of an HDL booster like niacin may afford still greater protection.

After analyzing data from more than 83,000 heart patients who participated in 23 different clinical trials, researchers at the University of Washington calculated this month that a regimen that increased HDL by 30 percent and lowered LDL by 40 percent in the average patient would reduce the risk of heart attack or stroke by 70 percent. That is far more than can be achieved by reducing LDL alone.

Other small studies have produced similarly encouraging results, but some experts caution that the data on increased HDL and heart disease are preliminary.

Researchers at 72 sites in the United States and Canada are recruiting 3,300 heart patients for a study, led by Dr. Brown and financed by the National Institutes of Health, comparing those who take niacin and a statin with those who take only a statin. This large head-on comparison should answer many questions about the benefits of combination therapy.

Many cardiologists see no reason to wait for the results. But niacin can be a bitter pill; in rare instances, the vitamin can cause liver damage and can impair the body’s use of glucose. High doses should be taken only under a doctor’s supervision.

A more frequent side effect is flushing. It becomes less pronounced with time, and often it can be avoided by taking the pills before bed with a bit of food. Doctors also recommend starting with small doses and working up to larger ones.

Extended-release formulations of the vitamin, taken once daily, are now available by prescription, and in many patients they produce fewer side effects. And a new Merck drug to counteract niacin-induced flushing is being tested in Britain. If it works, the company plans to bundle the drug with its own extended-release niacin and with Zocor, its popular statin.

Until then, consider this: If it means preventing a heart attack, maybe it is better to put up with flushing than to wait for the next blockbuster.

“If you can just get patients to take niacin, HDL goes up substantially,” said Dr. Nissen of the Cleveland Clinic. “Most of the evidence suggests they’ll get a benefit from that.”

From BBC Health News

Vitamin pill for prostate cancer

Prostate cancer cell
Prostate cancer is a major killer
Scientists have developed a vitamin D pill to treat advanced prostate cancer.

Exposure to Vitamin D from sunlight is known to improve the prognosis of certain cancers.

US drug company Novacea has produced a pill which delivers a concentrated dose of the vitamin without running the risk of side-effects from an overdose.

Chemistry and Industry magazine reports that if clinical trials of the drug - Asentar (DN-101) - are successful it could be available by 2009.

This drug has shown potential in early trials
Dr Julie Sharp
Cancer Research UK

The drug would be given to patients in the advanced stages of the disease, along with chemotherapy drugs.

Professor Nick James, a cancer expert at the University of Birmingham, said the drug had produced impressive results in preliminary phase two trials.

He said patients taking the drug lived for an average of an extra nine months longer than those taking another chemotherapy drug - taxotere - alone.

Professor James said: "On average, patients in the advanced stage of the disease survive about 18 months, so an extension of nine months would be very significant in my view."

Asentar provides levels of vitamin D 50 to 100 times higher than normal.

Patients would be expected to take one tablet once a week with their weekly regime of taxotere for three weeks out of every four.

No guarantees

However, Professor James said it was far from certain that the phase three trials would repeat the success of the earlier tests.

The phase II trial used a less than optimal taxotere regime so the survival rate may have been artificially inflated.

Professor James said vitamin D was known to play a key role in the regulation of several tissues, including the prostate and breast.

He said laboratory work had shown that cancer cells had lost the ability to respond in the normal way to vitamin D, and carried on dividing in an uncontrolled fashion.

Data shows that rates of prostate cancer are higher in countries further away from the equator, where there is less exposure to sunlight.

Professor James said it was possible that the new drug helped to increase the sensitivity of cancer cells to the effect of other chemotherapy drugs.

Dr Julie Sharp, of the charity Cancer Research UK, said: "We would welcome any improvements in the treatment for men with advanced prostate cancer and this drug has shown potential in early trials.

"But the results of the much larger study are needed to fully establish if this treatment is both effective and safe."

Prostate cancer is the second leading cause of cancer death in men. It kills one man every hour in the UK.

From Reuters Health News:

Cola consumption linked to weaker bones in women

Tue Oct 10, 1:55 PM ET

Women who want to keep their bones strong may want to keep their cola consumption to a minimum, a new study suggests.

In a study of more than 2,500 adults, Dr. Katherine L. Tucker of Tufts University in Boston and colleagues found that women who consumed cola daily had lower bone mineral density (BMD) in their hips than those who drank less than one serving of cola a month.

"Because BMD is strongly linked with fracture risk, and because cola is a popular beverage, this is of considerable public health importance," the authors write in the American Journal of Clinical Nutrition.

Studies in teen girls have tied heavy soft drink consumption to fractures and lower BMD, the researchers note, but it is not clear if this is because they're drinking less milk, or if it is due to any harmful effects of soda itself.

To investigate this question in adults, the researchers measured BMD in the spine and at three points on the hips in 1,413 women and 1,125 men participating in a study of the bone-thinning disease osteoporosis.

While there was no association between soft drinks in general and BMD, the researchers found that women who drank the most cola had significantly less dense bones in their hips. The greater their intake, the thinner the bones, and the relationship was seen for diet, regular, and non-caffeinated colas.

Cola consumption had no effect on BMD in men.

Women who drank more cola did not drink less milk, but they did consume less calcium and had lower intakes of phosphorus in relation to calcium. Cola contains phosphoric acid, the researchers note, which impairs calcium absorption and increases excretion of the mineral. Caffeine has also been linked to osteoporosis, they add.

"No evidence exists that occasional use of carbonated beverages, including cola, is detrimental to bone," they note. "However, unless additional evidence rules out an effect, women who are concerned about osteoporosis may want to avoid the regular use of cola beverages."

SOURCE: American Journal of Clinical Nutrition, October 2006.

Vitamin D halves pancreatic cancer risk

Wed Sep 13, 8:06 AM ET

People who take vitamin D tablets are half as likely to get deadly pancreatic cancer as people who do not, U.S. researchers reported on Wednesday.

Now they are checking to see if getting the vitamin from food or sunlight also cuts the risk.

The study suggests one easy way to reduce the risk of pancreatic cancer, the fourth-leading cause of death from cancer in the United States. This year, the American Cancer Society estimates that 32,000 new cases of cancer will be diagnosed, and only 5 percent of patients will survive more than five years.

"Because there is no effective screening for pancreatic cancer, identifying controllable risk factors for the disease is essential for developing strategies that can prevent cancer," Halcyon Skinner of Northwestern University in Chicago, who helped lead the study, said in a statement.

"Vitamin D has shown strong potential for preventing and treating prostate cancer, and areas with greater sunlight exposure have lower incidence and mortality for prostate, breast, and colon cancers, leading us to investigate a role for Vitamin D in pancreatic cancer risk."

Working with colleagues at Harvard University, Skinner's team examined data from two large, long-term health surveys involving 46,771 men aged 40 to 75 and 75,427 women aged 38 to 65.

They found that people who took the U.S. Recommended Daily Allowance of Vitamin D, 400 IU a day, had a 43 percent lower risk of pancreatic cancer.

Those who took doses of less than 150 IU per day had a 22 percent reduced risk of cancer.

Writing in the journal Cancer Epidemiology Biomarkers & Prevention, the researchers said taking more than 400 IU a day did not reduce the risk further.

Vitamin D is produced by the body when sunlight hits the skin, but most Americans do not get enough sunlight to produce the needed amount. Milk, both dairy and soy, is fortified with the vitamin. Some foods such as fish, eggs and liver also contain vitamin D.

"In concert with laboratory results suggesting anti-tumor effects of Vitamin D, our results point to a possible role for Vitamin D in the prevention and possible reduction in mortality of pancreatic cancer," Skinner said.

"Since no other environmental or dietary factor showed this risk relationship, more study of Vitamin D's role is warranted."

Pomegranate juice may be cancer weapon

By Lisa RichwineSat Jul 1, 11:41 AM ET

A daily glass of pomegranate juice showed potential for slowing the growth of prostate cancer in a small study but more evidence is needed before doctors recommend it, U.S. scientists said on Saturday.

A study funded by a juice maker found men who drank the beverage had a longer time until doubling of their blood levels of PSA -- a protein that indicates the presence of prostate cancer. Patients with short doubling times are more likely to die from the cancer.

In the study, the time until PSA doubling after treatment extended to 54 months on average when the men started drinking eight ounces of pomegranate juice a day. Before drinking the juice, PSA doubled in an average of 15 months.

"That's a very big difference. ... It's an indicator of how quickly the cancer is growing," said Dr. Allan Pantuck, a urologist at UCLA Jonsson Cancer Center and the study's lead author.

Each of the 50 men who took part had radiation, surgery or other treatment for prostate cancer before enrolling in the study. No major side effects were reported from drinking the juice.

"It's too early to tell people with prostate cancer they should drink pomegranate juice" because the evidence is preliminary, Pantuck said in an interview.

A larger study is under way to try to confirm the findings, with results expected in two years, he said.

While he does not expect pomegranate juice to cure prostate cancer, Pantuck said it could delay or prevent the need for other therapies with harsh side effects including hot flashes, fatigue, depression and impotence.

Pomegranate juice "is a very non-toxic treatment that, if it really did have that effect on doubling time, could prevent many people from going on to metastatic disease and hopefully from dying of prostate cancer," he said.

The research team said substances known as polyphenols or other ingredients in the fruit juice may be able to fight prostate cancer, but exactly how is unclear. The benefits probably come from a combination of ingredients, they said.

The findings were published in the peer-reviewed journal Clinical Cancer Research and funded by a trust established by the owners of Pom Wonderful, a brand of pomegranate juice. Pom Wonderful supplied the juice used in the study. 

Click here to go to our Pomegranate Juice Concentrate -

From BBC Health News:

A daily drink 'only good for men'

Drinking alcohol every day protects against heart disease in men but not in women, Danish research shows.

A study of 50,000 people found that men who drank daily had a 41% reduced risk of coronary heart disease compared with a 7% drop in men who drank once a week. In women, the risk of heart disease fell by a third with a weekly drink but did not fall further in daily drinkers. Experts warned the results, published in the British Medical Journal, should not be used to justify heavy drinking.

Previous research has shown that moderate alcohol intake is associated with a lower risk of heart disease, but up until now most studies have been in men. Men and women aged 50-65 who took part in this study were questioned on their drinking behaviour and then followed for an average of six years.

"One or two drinks in men or one drink a day in women would be sufficient for heart disease - you wouldn't get any more beneficial effects from drinking more" - Professor Morten Gronbaek, Study leader

Women drank an average of five and a half drinks a week, and men consumed 11. In men, the risk of heart disease fell significantly with increased frequency of drinking - with men who drank a little every day having the lowest risk. But for women, although drinking on at least one day a week was associated with a 36% reduced risk of heart disease compared to those who drank more rarely, the risk was the same whether women had one drink a week or drank moderately each day. The researchers said how much women drank may be more important for protection against heart disease than how often they drank.

Gender difference
The researchers said there could be several explanations for the differences found between men and women. It may be hormonal, or related to the type of alcohol consumed or there may be differences in the way men and women's bodies process alcohol.

Lead researcher Professor Morten Gronbaek from the National Institute of Public Health in Denmark said: "It has been shown that frequency of drinking has a larger role than amount but this points towards the fact there is a gender difference." He added that the benefits of alcohol had to be weighed against the increased risk of cancer and liver damage. "One or two drinks in men, or one drink a day in women, would be sufficient for heart disease - you wouldn't get any more beneficial effects from drinking more."

In an accompanying editorial, Dr Annie Britton, senior lecturer at University College London warned that the study participants had a high risk of heart disease because of their age, and added that the study had a low response rate and so may not have been fully representative. She said: "We do not yet know whether cardioprotective effects accrue over a lifetime or whether, purely from a health perspective, we should defer drinking alcohol until older age, when heart disease is manifest."

Judy O'Sullivan, medical spokesperson for the British Heart Foundation (BHF) said: "This study does not change the fact that alcohol should be enjoyed in moderation only, both by men and women. "If you are teetotal you should not start consuming alcohol in order to reduce your risk of developing coronary heart disease. However, if you enjoy alcohol you should be aware that the risks of drinking large quantities significantly outweigh any potential benefits."

Small changes 'add years to life'

Blair (PA)

Making small changes to your lifestyle can have a significant impact on how long you will live, research has shown.

The Cambridge University study looked at over 25,000 people. It found that stopping smoking, exercising more and eating better could give you the life expectancy of a person 11 to 12 years younger. The government is backing the research, and launching an initiative to encourage people to make small changes to improve their health.

This is about showing people that there are everyday, simple choices they can make in their lives which will have a direct impact on their health
- Caroline Flint, Health minister

The study, carried out in Norfolk, is part of the European Prospective Investigation and Nutrition (Epic) study, involving over half a million people in 10 European countries. The UK arm of the study is following 25,663 men and women aged between 45 and 79 years old since 1993, looking at their diet, environment, lifestyle and health. The participants have regularly filled in questionnaires about their diet, lifestyle and health and had periodic check-ups from nurses.

These latest results from the study showed eating five portions of fruit and vegetables a day can give you the life expectancy of someone three years younger. Not smoking turned the clock back by four to five years. Even increasing exercise by a moderate amount can take up to three years off.

But the amount of exercise someone would need to do to achieve that depends on their job. An office worker would need to do one hour of exercise, such as swimming or jogging, every day, while a person with a moderately active job, such as a hairdresser, would need to take 30 minutes exercise a day. People with active jobs, including nurses and bricklayers, do not need to do any extra exercise - as their work is strenuous enough.

'Daunting prospect'

Professor Kay-Tee Khaw, who led the study, said: "Many of us find it difficult to change our usual lifestyle. "However, there is increasing evidence that even relatively small changes can make a big difference to our health and well being." Government ministers highlighted the research as they launched an initiative called Small Change Big Difference, aimed at showing people how to improve their health by making small easily available changed to lifestyle.

Prime Minister Tony Blair has vowed to make lifestyle changes such as using the stairs instead of the lift, visiting the gym more often and boosting his intake of fruit and vegetables. Public Health Minister Caroline Flint said: "We all know that we should eat more fruit and veg and get more exercise to improve our health, but sometimes improving our own health can be daunting. "This is about showing people that there are everyday, simple choices they can make in their lives which will have a direct impact on their health. "Eating an extra piece of fruit or walking up the stairs can help people add years to their lives." James Johnson, chairman of the British Medical Association, said: "Today's campaign is to be welcomed. "But we would also like to see funding questions urgently addressed if the agenda is to make a sustained difference to the health of our communities."

Obesity is on the rise across the developed world

Scientists believe it could be possible to treat obesity by altering levels of fatty acids in a key area of the brain. They found reducing fatty acid levels in the hypothalamus caused rats to overeat and become obese. The study, by a team at Albert Einstein College of Medicine in New York, was featured in Nature Neuroscience. It suggests that a therapy which restores fatty acid levels in the hypothalamus may be a promising way to treat obesity. However, UK experts warned that appetite regulation was a complex area.

"Work like this does help to increase our understanding of obesity, and does help us work towards new treatments" Dr Ian Campbell

Obesity is a growing problem across the developed world. In the UK, it is thought that 40% of men, and a third of women are either obese or overweight. Carrying too much weight is linked to a range of health problems, including a greater risk of heart disease and cancer.

The hypothalamus keeps track of the body's nutritional status by monitoring the blood levels of several different hormones and nutrients. Taking this information into account, it regulates both appetite, and the speed at which the body breaks down nutrients.

Injected virus

The Einstein team had already shown that glucose is one of the substances closely tracked by the hypothalamus. Now they have found that fatty acids too are on the organ's checklist. The researchers focused on a particular fatty acid molecule called malonyl CoA. They injected a virus on to which was attached an enzyme known to break down malonyl CoA into the hypothalamus of lab rats. The injections caused a drop in malonyl CoA levels, which led to the rats gorging themselves. The effect lasted for at least four months. Lead researcher Dr Luciano Rossetti said: "We showed in this study that disrupting malonyl-CoA levels in this region of the brain impairs the nutrient-sensing mechanism by which the hypothalamus modulates food intake to maintain normal weight. Figuring out a way to re-adjust malonyl-CoA levels in the human hypothalamus could lead to innovative therapies not only to treat obesity but to help prevent diabetes and other consequences of being overweight."

Complex issue

Dr Ian Campbell, a weight management expert and former chairman of the UK National Obesity Forum, told the BBC News website that research of this kind underlined just what a complex issue obesity was. "It is not just about greed and laziness," he said. "There seem to be many underlying physiological factors. Clearly we are a long way off being able to prescribe a drug based on this research. "But work like this does help to increase our understanding of obesity, and does help us work towards new treatments." Dr Campbell stressed that the best way to combat obesity was to control one's weight through exercise and a sensible diet.

Professor Ian MacDonald, of the University of Nottingham, agreed that it was simplistic to draw too many conclusions from one piece of research. He said it would be difficult to produce a drug that targeted its effect specifically at the hypothalamus, and that any effect on human appetite that could be produced was likely to be minimal.

Exercise now to cut dementia risk

The exercise should be enough to make you sweaty and breathless. Exercising for half an hour at least twice a week during midlife can significantly cut a person's risk of dementia later, say researchers. People in their late 40s and early 50s who do this could reduce their risk of dementia by about 50%, according to a study reported in Lancet Neurology. Those who are genetically prone to Alzheimer's disease could see a reduction of about 60%, it adds. The Swedish team said the findings had large disease prevention implications.

Protective effect

"If an individual adopts an active lifestyle in youth and at midlife, this may increase their probability of enjoying both physically and cognitively vital years in later life," they said. Past studies have also suggested regular exercise might guard against dementia, however, this is one of the first to look at the effects over a long time scale - about two decades. The authors say this is important because dementia takes many years to develop and is typically quite advanced when it is diagnosed.

The study involved nearly 1,500 men and women, of whom nearly 200 developed dementia or Alzheimer's disease between the ages of 65 and 79. The researchers looked back at how physically active the study participants had been up to 21 years earlier, when they would have been in their late 40s and early 50s. Those who developed Alzheimer's disease or another form of dementia were far less likely to have been active when they were middle-aged than those who remained free of dementia.

Good for the brain

The amount of exercise that appeared to be necessary to be protective was physical activity which lasted 20-30 minutes at least twice a week and which was enough to cause breathlessness and sweating. People are generally recommended to take moderate aerobic exercise for 20-30 minutes three to five times a week for a healthy heart and lungs. Dr Miia Kivipelto and colleagues said there were many reasons why exercise might be good for the brain as well as the rest of the body. For example, regular exercise could help keep the small blood vessels of the brain healthy as well as protecting against other conditions that might make dementia more likely, such as high blood pressure and diabetes.


Exercise might also reduce the amount of the protein amyloid that builds up in the brain in Alzheimer's disease. Physical activity also affects genes and compounds important for maintaining good cognition and memory. It might be that people who exercise tend to live healthier lifestyles in general, such as drinking less alcohol and refraining from smoking, they said. However, when they took into account such health risk factors, the findings remained the same, suggesting that exercise per se is beneficial for the brain. A spokeswoman from the Alzheimer's Research Trust said: "This study backs up the evidence so far. "Studies seem to suggest that leading a healthy lifestyle - exercising regularly and eating a balanced diet - helps protect against dementia." She said more research was needed, particularly as the condition was becoming increasingly common since the proportion of older people in society was increasing.

A few cigarettes a day 'deadly'

Doctors warn that any amount of smoking is dangerous

Smoking just one to four cigarettes a day almost triples a person's risk of dying of heart disease, according to Norwegian researchers. Their work suggests the health impact is stronger for women and that even "light" smokers face similar diseases to heavier smokers, including cancer. The team tracked the health and death rates of almost 43,000 men and women from the mid 1970s up to 2002. Their findings appear in the journal Tobacco Control.

Lung cancer

Compared with those who had never smoked, the men and women who smoked between one and four cigarettes a day were almost three times as likely to die of coronary artery disease. Among women, smoking one to four cigarettes daily increased the chance of dying from lung cancer almost five times. Men who smoked this amount were almost three times as likely to be killed by lung cancer. However, due to the relatively small number of men that this applied to in the study sample, this finding could have been due to chance.

"There is no safe level of smoking" Amanda Sandford from ASH

So-called "light" smokers were also found to have a significantly higher risk of dying from any cause - 1.5 times higher generally - than those who had never smoked, when researchers looked at deaths among those studied over the duration of the research. Death rates from all causes rose as the number of cigarettes smoked every day increased.

Sporadic smoking

The researchers believe their conclusions are accurate, even though they had to estimate the projected impact of smoking one to four cigarettes for five years in those light smokers who had smoked for less time. This indicated that the risk of death from coronary artery disease for both sexes would have been 7% higher, and the risk of lung cancer would have been 47% higher in women. A significant proportion of the light smokers had also increased their daily consumption over the period of the study. However, this had not exceeded nine cigarettes a day.

"The only way to protect smokers from heart disease, cancer and other killer diseases is to quit completely" A spokesman from the British Medical Association

Author Dr Kjell Bjartveit also pointed out that it was not possible to tell from the findings what impact sporadic smoking - such as a few cigarettes on a Saturday night out - might have on health. Dr Ken Denson of the Thame Thrombosis and Haemostasis Research Foundation questioned the validity of the figures. He said other large studies had not found that smoking fewer than 10 cigarettes daily increased the risk of heart disease.

'No safe level'

Amanda Sandford from Action on Smoking and Health said the conclusions were clear. "This study should dispel the myth once and for all that smoking just a few cigarettes a day won't do you any harm. "Quite simply, there is no safe level of smoking."

A spokesman from the British Medical Association said: "All smokers are putting their health on the line when they smoke - even if they only define themselves as social smokers. "The only way to protect smokers from heart disease, cancer and other killer diseases is to quit completely." The Department of Health estimates 106,000 people die every year in the UK as a direct result of smoking. It said quitting was the only way to avoid the serious health risks. Jean King of Cancer Research UK said: "Although more research is needed, this study suggests that the health implications for 'light smokers' are much more serious than previously thought. "This is particularly worrying as a third of smokers in the UK - an estimated 3.7 million people - smoke less than 10 cigarettes a day."