The study was carried out by researchers from University of Otago Medical School, New Zealand. Funding was provided by Genesis Oncology Trust, the Dean’s Bequest Funds of the Dunedin School of Medicine, the Gisborne East Coast Cancer Research Trust and the Director’s Cancer Research Trust. The research was published in the peer-reviewed American Journal of Epidemiology. This was a case-control study in New Zealand that compared a group of adults with bowel cancer, and a group without bowel cancer, and looked at whether they drank milk at school. School milk was freely available in most schools in New Zealand until 1967 when the government programme was stopped. Many schools in the Southland region stopped free milk as long ago as 1950.
Case-control studies are appropriate for looking at whether people with and without a disease have had a particular exposure (milk in this case). The difficulty is in accounting for all potential confounding factors, particularly other health and lifestyle factors, which could be related to both diet and bowel cancer risk, for example regular childhood milk consumption could be a reflection of a ‘healthy’ diet and other healthy lifestyle behaviours that may reduce risk of cancer. In addition, when examining such a specific dietary factor – ie milk consumed in school – it is difficult to account for all possible milk or other dairy products consumed outside of school.
In this case-control study, 562 adults (aged 30 to 69) with newly diagnosed bowel cancer were identified from the New Zealand Cancer Registry in 2007. For a control group, 571 age-matched adults without cancer were randomly selected from the electoral register. All participants were mailed a questionnaire that asked about any previous illness, use of aspirin or dietary supplements in childhood, participation in school milk programmes, other childhood milk consumption, childhood diet (including other milk and dairy), smoking, alcohol consumption prior to 25 years of age, screening tests for bowel cancer, family history of cancer, education and sociodemographic characteristics. Childhood weight and height were not questioned. For school milk consumption they were specifically asked:
- Whether they drank school milk
- How many half-pint bottles they drank a week
- What age they first drank school milk
- When they stopped drinking school milk
Statistical risk associations between school milk participation and cancer were calculated. The calculations took into account several risk factors for bowel cancer risk including age, sex, ethnicity and family history.
What were the basic results?
Data on school milk consumption was available for 552 cases and 569 controls. As expected, people who started school before 1967 were more likely to have had free school milk than those who began school after 1968. Seventy-eight percent of cases participated in the school milk programme compared with 82% of controls. School milk consumption was associated with a 30% reduced risk of developing bowel cancer (odds ratio 0.70, 95% confidence interval 0.51 to 0.96).
When looking at the effect of number of bottles consumed per week they found that compared with no bottles, five bottles per week was associated with 32% significantly decreased risk, and 10 or more bottles with 61% significantly decreased risk. However, there was no significant association with one to four bottles or six to nine bottles. The researchers found a similar trend when the total school consumption of milk was compared with no consumption: 1,200-1,599 bottles was associated with 38% significantly decreased risk; 1,600-1,799 with 43% decreased risk; and 1,800 or more bottles associated with 38% significantly decreased risk. There was no significant association with fewer than 1,200 bottles. The researchers calculated that for every 100 half-pint bottles consumed at school there was a 2.1% reduction in the risk of bowel cancer. Outside of school, there was a significantly reduced risk of bowel cancer with more than 20 dairy products a week compared with none to nine dairy products a week.
The researchers conclude that their national case-control study ‘provides evidence that school milk consumption was associated with a reduction in the risk of adult colorectal cancer in New Zealand. Furthermore, a dose-dependent relation was evident’. This study has strengths in its relatively large size, its reliable and nationally representative identification of cases and controls, and its thorough data collection. However, the conclusion that school milk consumption is associated with a reduced risk of bowel cancer in adulthood must be interpreted in light of a number of considerations:
The analysis took into account established risk factors for bowel cancer including age, sex, ethnicity and family history. However, many other potential confounders were not considered, including diet, physical activity, overweight and obesity, smoking or alcohol consumption. Diet in particular has been implicated in bowel cancer risk, with diets high in saturated fat, red meat and processed foods and low in fibre, fruit and vegetables thought to increase risk. Potentially, any of these lifestyle behaviours could be confounding the relationship between school milk consumption and bowel cancer and regular childhood milk consumption could be a reflection of a ‘healthy’ diet and other healthy lifestyle behaviours that reduce risk of cancer. When looking at the effect of number of bottles consumed per week, the researchers found that, compared with no bottles, five bottles were associated with 32% significantly decreased risk and 10 or more bottles with 61% significantly decreased risk. However, there was no significant association with one to four bottles or six to nine bottles. Therefore, the trend here is not very clear. Particularly as only 16 cases and 31 controls drank 10 or more bottles a week, statistical comparison between such small numbers should be viewed with caution. With many food questionnaires there is the potential for recall bias. For example, adults may have difficulty remembering how many bottles of school milk they drank many years before. When estimating their average weekly amount, it is highly possible that this could be inaccurate or that their consumption varied slightly from week to week and year to year. Particularly when researchers were using this response and combining it with the number of weeks in the school year and their total years at school to give a total number of bottles consumed at school (figures in 100s or 1,000s), there is the possibility of being incorrectly categorised. Hence, there may be less reliability when calculating risk according to the category of total milk bottles consumed. Cancer prevalence, and particularly environmental and lifestyle risk factors for cancer, can vary between countries. These findings in New Zealand may not be represented elsewhere. Of note, the researchers acknowledge that a cohort study in the UK found the opposite: increased childhood dairy consumption was associated with increased risk of bowel cancer. Case-control studies are most appropriate for looking at rare diseases, where you would expect there to be only a small number of cases developing among a large number of people. In the case of bowel cancer, which is common, the slightly more reliable cohort design could have also been used, where children who drank milk at school and those who didn’t were followed over time to see if they developed cancer. However, such a cohort would consequently need extensive long-term follow-up.
The possible association between milk/dairy consumption, or calcium intake, in childhood, or in later years, is worthy of further study. However, from this study alone, it cannot be concluded that school milk prevents bowel cancer later in life.
A new study has found that the leading causes of death are no more infectious diseases but chronic diseases such as cardiovascular disease and cancer – which may be affected by food habits. Researchers investigated eating patterns of over 2500 adults between the ages of 70 and 79 over a ten-year period and found that certain diets were associated with reduced mortality.
By determining the consumption frequency of 108 different food items, researchers were able to group the participants into six different groups as per their food choices:
- Healthy foods- 374 participants
- High-fat dairy products- 332
- Meat, fried foods, and alcohol- 693
- Breakfast cereal-386
- Refined grains-458
- Sweets and desserts-339
‘Healthy foods’ group ate more low-fat dairy products, fruit, whole grains, poultry, fish, and vegetables, and lower consumption of meat, fried foods, sweets, high-calorie drinks, and added fat. ‘High-fat dairy products’ group had higher intake of foods such as ice cream, cheese, and 2 per cent and whole milk and yoghurt, and lower intake of poultry, low-fat dairy products, rice, and pasta.
End results indicated that ‘High-fat dairy products’ group had a 40 per cent higher risk of mortality than the Healthy foods cluster and the ‘Sweets and desserts’ group had a 37 per cent higher risk. No significant differences in risk of mortality were seen between the ‘Healthy foods’ cluster and the ‘Breakfast cereal’ or ‘Refined grains’ clusters.
The “results of this study suggest that older adults who follow a dietary pattern consistent with current guidelines to consume relatively high amounts of vegetables, fruit, whole grains, low-fat dairy products, poultry and fish, may have a lower risk of mortality,” said Amy L. Anderson at Department of Nutrition and Food Science, University of Maryland.
“Because a substantial percentage of older adults in this study followed the ”Healthy foods” dietary pattern, adherence to such a diet appears a feasible and realistic recommendation for potentially improved survival and quality of life in the growing older adult population.” The study will be published in the January 2011 issue of the Journal of the American Dietetic Association .
A new study shows following a Mediterranean style diet rich in vegetables, olive oil, and fish may keep the mind sharp and slow age-related cognitive decline.The diet typified by the Italians, Greeks, and other Mediterranean cultures has already been shown to reduce the risk of heart disease, diabetes, and some types of cancer. But this and other studies are now suggesting that the diet may also have healthy benefits for the mind.
The Mediterranean diet emphasizes fruits and vegetables, fish, legumes, non-refined cereals, olive oil, and moderate wine consumption, usually at meals. Researchers found older adults who followed the diet more closely had slower rates of age-related cognitive decline than those who didn't, even after adjusting for other factors such as educational level. “The more we can incorporate vegetables, olive oil, and fish into our diets and moderate wine consumption, the better for our aging brains and bodies,” says Christy Tangney, PhD, associate professor of clinical nutrition at Rush University, in a news release.
In the study, published in the American Journal of Clinical Nutrition, researchers analyzed information gathered by the ongoing Chicago Health and Aging Project, which follows 3,759 adults over the age of 65 living on the South Side of Chicago. Every three years, the participants took tests of memory and basic math skills and filled out a questionnaire on how often they eat 139 different foods. The study follow-up time was 7.6 years on average.
Researchers looked at how closely the participants followed a Mediterranean diet and then compared it to their scores on age-related cognitive decline. Out of a maximum score of 55 for total adherence to a Mediterranean diet, the average score was 28. The results showed those with higher than average scores had a slower rate of age-related mental decline than those with lower scores. Researchers also looked at how closely the participants followed the Healthy Eating Index-2005, which is based on the 2005 Dietary Guidelines for Americans. They found no relationship between adherence to this type of diet and the rate of age-related cognitive decline.
The American Heart Association has compiled its annual list of the top 10 major advances in heart disease. “We have come far in the past decade, reducing heart disease deaths by more than 27 per cent,” said Ralph Sacco of the University of Miami. “But we know there is still much to be done in improving the lives of heart disease and stroke patients – and more importantly, in preventing these devastating diseases in the first place. Scientific research will help us lead the way,” said Sacco.
The highlights of the top ten advances in cardiovascular research in 2010:
1. Tailoring treatment for people with diabetes to reduce their risk of cardiovascular disease
New research from the ACCORD Study Group offered insight into specific treatments that can reduce their risk of cardiovascular disease (CVD). The first study found that aggressive blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD. In a second study, a combination therapy with a statin plus a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD.
2. New advances for patients who aren't candidates for conventional valve surgery
Two new studies have supported evidence that Transcatheter aortic valve implantation (TAVI) can improve symptoms and outcomes – including quality of life – even over the course of several years. While there are some risks associated with TAVI, including strokes and other major cardiovascular events, the catheter-based procedure offers significant progress in this area.
3. Improving the way we reverse sudden cardiac arrest
Significant studies reported that chest compression only, or ''Hands Only CPR'' for adults by bystander lay rescuers improves survival outcome. Public awareness campaigns resulted in increased use of hands only CPR, as well as improved survival rates. While the new procedure appeared successful in adults, it is important to note that using conventional chest compressions with rescue breathing is still important for children stricken with sudden cardiac arrest.
4. More options for reducing stroke risk in atrial fibrillation
For the first time in more than 20 years there are viable alternatives to the primary prevention of stroke for patients with atrial fibrillation (AF). Warfarin (Coumadin) has long been the standard anti-clotting drug used to reduce the risk of stroke for these patients. But it carries its own complications from bleeding, and managing the dose requires regular blood tests, making it difficult to manage for both patients and doctors. Now, several new drugs have been found to work as well as warfarin – and are simpler for patients to take – offering an important advance in this field.
5. Adjusting pacing therapies can improve outcomes for heart failure patients
New studies showed that adding additional resynchronization pacing to ICD therapy could lead to improved outcomes in an expanded group of heart failure patients. In addition, new types of ICDs (defibrillators without leads, for example) can offer options that reduce some of the risks associated with traditional devices.
6. Hopeful new procedure for infants with congenital heart disease
The Pediatric Heart Network's randomized trial of Norwood shunt types in infants with single-ventricle lesions showed that the type of shunt used makes a difference in outcomes. Better transplantation-free survival at 12 months is a possibility with this new understanding of the better shunt choice for these patients. This was the first large-scale randomized trial in congenital heart surgery, offering an approach that should provide answers to other questions in the future.
7. Finding the right anti-clotting (anti-platelet) therapy
New research from the PLATO investigators has found that ticagrelor may improve outcomes and reduce adverse events better than the current standard, clopidogrel. The CURRENT-OASIS 7 Trial is exploring the optimal dosing of clopidogrel and aspirin in patient undergoing invasive surgery. These studies will help providers better understand the situations where new choices and dosages may improve results for the patient.
8. Basic science findings offer insight into future progress
Several studies this year brought the future of medicine closer to the present with new insight into emerging technologies. Findings from stem cell therapy have shown improved quality of life and survival in several early studies of patients with chronic heart failure and support the development of future cell-based therapeutics. A large animal study defined the basic mechanisms for heart muscle regeneration initiated by specific types of stem cells. The results demonstrated that these stem cells repair scarred myocardium through promotion of the generation of new heart muscle and blood vessel).
9. Using science to support healthy lifestyle behaviours
New science examining lifestyle behaviours in adults and children, with particular emphasis on physical activity and consumption pattern, show that such conditions as obesity and hypertension are positively influenced by a change in diet with decreasing sodium levels. Results from the school setting suggest that the earlier one starts to adopt healthy behaviours the better the effect on health outcomes.
10. Get With The Guidelines participation eliminates disparity gaps in care
Racial and ethnic disparities have been found in the quality of care delivered to patients with cardiovascular disease and achieving equity and addressing disparities has implications for quality, cost, risk management, and community benefit. These findings are the first to show that participating in a quality improvement program, such as Get With The Guidelines-Coronary Artery Disease, can eliminate racial and ethnic disparities of care while increasing the overall use of evidence-based care for heart attack patients.
A new UK research has found that more than a third believe cancer is down to fate and there is nothing they can do to avoid it. Cancer Research UK stated that one in five men and women feared cancer ahead of debt, knife crime, Alzheimer's disease and losing their job whereas 34 percent believed the disease was down to fate, rising to 41 percent of those aged 55 to 64.
The findings come in the midst of growing evidence suggesting lifestyle factors such as losing weight, taking exercise, reducing alcohol consumption and quitting smoking can significantly reduce the risk of developing cancer.
The survey questioned more than 2,000 adults aged 16 and over. Those questioned were asked to choose what they feared most from a list including developing Alzheimer's, being in debt, old age, being the victim of knife crime, cancer, being in a plane crash, motor neurone disease, being in a car accident, having a heart attack, losing your job and losing your home.
More people (20 per cent) overall chose cancer than anything else, followed by 16 per cent who feared Alzheimer's disease the most. Among adults up to the age of 44, cancer was feared most by 25 per cent while 7.5 per cent feared Alzheimer's most. For those aged over 65, Alzheimer's was feared most by 30 per cent while 14 per cent feared cancer most.
John Fyall, Cancer Research UK's spokesman for Scotland, said: “It's absolutely vital for us to get the message out that people can do something to alleviate their emphatic fear of cancer. Cancer is no longer the death sentence people still seem to dread,” the Scotsman quoted, John Fyall, Cancer Research UK's spokesman for Scotland, as saying. “Spotting early signs and symptoms of what could be cancer – but probably isn't – and getting these checked out by a doctor means that the disease can be diagnosed more quickly,” he added.
Teresa Nightingale, general manager of the World Cancer Research Fund, said, “It is a concern that so many people think cancer is a matter of fate, because there is now strong scientific evidence that people can make relatively simple changes to reduce their risk.” “Scientists estimate about a third of the most common cancers in the UK could be prevented just by eating a healthy, plant-based diet, being regularly physically active and maintaining a healthy weight. This includes about 40 per cent of breast and bowel cancer cases,” she added. Nightingale further informed that, “The strong evidence that diet, activity and weight affect our risk, together with other well-known risk factors such as smoking and sunburn, means that cancer is actually a largely preventable disease.” (ANI)
“Fruit and vegetables are all good, but the data significantly show that green leafy vegetables are particularly interesting, so further investigation is warranted,” Carter said. “Green leafy vegetables contain antioxidants, magnesium and omega 3 fatty acids — all of which have been shown to have health benefits”, she added.
Each of the studies that Carter and her colleagues analyzed followed a group of adults over periods of 4-and-a-half to 23 years, recording how many servings of fruits and vegetables each participant ate on a daily basis then examining who was diagnosed with type 2 diabetes.
The researchers found no significant difference in diabetes risk with higher intake of vegetables in general, fruits in general, or combinations of vegetables and fruits.
Green leafy vegetables stood out, however, with an increase of 1.15 servings a day producing a 14 percent decrease in an individual's risk of developing diabetes. Type 2 diabetes is caused by the body's inability to adequately use insulin, a hormone produced by the pancreas, to regulate levels of glucose produced from food. Uncontrolled, the sugar levels rise and can damage the eyes, kidneys, nerves, heart and major arteries.
An estimated 180 million people worldwide have diabetes. The costs of caring for those with the disease are soaring in wealthy nations and becoming an increasing burden in developing countries too. Although there is no cure for diabetes, people with the condition can minimize their chances of getting sicker by being more active and losing weight.
As an example of a picky eater who would not be classified as having an eating disorder, Marcus referenced a woman who spoke on a radio program recently. The woman declared herself “the pickiest eater I've ever met” and explained that the thought of eating any cooked vegetable made her sick, though she didn't mind them raw.
“That is not a disorder,” said Marcus. “She has plenty of other foods to choose from and it's not affecting her health or well-being.”
In her practice at Western Psych, Marcus doesn't see many adults that she would classify as having such a disorder. “I think people don't identify themselves as having an eating disorder and it hasn't been considered an eating disorder,” she said. “They don't come to us.”
At Duke, Zucker encounters adult picky eaters mainly as the parents of children that she is treating for picky eating or other eating disorders.
Adults who are picky tend to like bland foods that are comfortable and colorless, said Marcus, such as plain pasta or french fries.
In both children and adults, picky eating can be caused by “food neophobia,” otherwise known as the fear of new foods, by sensory sensitivity to particular textures, or by traumatic experiences such as forced eating.
Still, the vast universe of picky eaters is poorly defined, Zucker said.
“It's been a pretty poorly operationalized construct — what it means to be a picky eater,” she said. “There's a lot of different definitions floating around. What we'll find is a huge continuum — we all have food quirks.”
Source: Pittsburgh Post-Gazette
“However,” the researcher said, “there is a lack of clinical studies of the effect of vitamin D supplementation for preventing respiratory infections.”
For the current study, Laaksi's team randomly assigned 164 male military recruits to take either 400 international units (IU) of vitamin D or inactive placebo pills every day for six months — from October to March, covering the months when people's vitamin D stores typically decline and when respiratory infections typically peak.
At the end of the study, the researchers found no clear difference between the two groups in the average number of days missed from duty due to a respiratory infection — which included bronchitis, sinus infections, pneumonia, ear infections and sore throat.
On average, men who took vitamin D missed about two days from duty because of a respiratory infection, compared with three days in the placebo group. That difference was not significant in statistical terms.
However, men in the vitamin D group were more likely to have no days missed from work due to a respiratory illness.
Overall, 51 percent remained “healthy” throughout the six-month study, versus 36 percent of the placebo group, the researchers report.
The findings, Laaksi said, offer “some evidence” of a benefit from vitamin D against respiratory infections.
Still, the extent of the benefit was not clear. While recruits in the vitamin group were more likely to have no days missed from duty, they were no less likely to report having cold-like symptoms at some point during the study period.
Moreover, recent studies on the usefulness of vitamin D for warding off respiratory ills have come to conflicting conclusions.
A study of Japanese schoolchildren published earlier this year found that those given 1,200 IU of vitamin D each day during cold and flu season were less likely to contract influenza A. Of 167 children given the supplement, 18 developed the flu, compared with 31 of 167 children given placebo pills.
On the other hand, a recent study of 162 adults found that those who took 2,000 IU of vitamin D everyday for 12 weeks were no less likely to develop respiratory infections than those given placebo pills.
Laaksi said that larger clinical trials looking at different doses of vitamin D are still needed before the vitamin can be recommended for curbing the risk of respiratory infections.
In the U.S., health officials recommend that adults up to the age of 50 get 200 IU of vitamin D each day, while older adults should get 400 to 600 IU. The upper limit is currently set at 2,000 IU per day; higher intakes may raise the risks of side effects.
Symptoms of vitamin D toxicity are often vague and include nausea, vomiting, constipation, poor appetite and weight loss. Excessive vitamin D in the blood can also raise blood pressure or trigger heart rhythm abnormalities.
Some researchers believe that people need more vitamin D than is currently recommended, and that intakes above 2,000 IU per day are safe. However, exactly what the optimal vitamin D intake might be remains under debate.
Food sources of vitamin D include milk, breakfast cereals and orange juice fortified with vitamin D, as well as some fatty fish, like salmon and mackerel. Experts generally recommend vitamin pills for people who do not get enough of the vitamin from food.
SOURCE: Journal of Infectious Diseases
For this study, Chenchen Wang, M.D., M.Sc., and colleagues recruited 40 patients from the greater Boston area with confirmed knee OA who were in otherwise good health. The mean age of participants was 65 years with a mean body mass index of 30.0 kg/m2. Patients were randomly selected and 20 were asked to participate in 60-minute Yang style Tai Chi sessions twice weekly for 12 weeks. Each session included: a 10-minute self-massage and a review of Tai Chi principles; 30 minutes of Tai Chi movement; 10 minutes of breathing technique; and 10 minutes of relaxation.
The remaining 20 participants assigned to the control group attended two 60-minute class sessions per week for 12 weeks. Each control session included 40 minutes of instruction covering OA as a disease, diet and nutrition, therapies to treat OA, or physical and mental health education. The final 20 minutes consisted of stretching exercises involving the upper body, trunk, and lower body, with each stretch being held for 10-15 seconds.
At the end of the 12-week period, patients practicing Tai Chi exhibited a significant decrease in knee pain compared with those in the control group. Using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale, researchers noted a -118.80 reduction in pain from baseline between the Tai Chi and control group. Researchers also observed improved physical function, self-efficacy, depression, and health status for knee OA in subjects in the Tai Chi group. “Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of Tai Chi to extend its benefits to a broader population,” concluded Dr. Wang.
Dr. Nick and his colleagues analyzed epidemiological and health data on 156 CF patients over 40 year of age who receive care at National Jewish Health, the largest adult cystic fibrosis clinic in the nation. In addition, data were analyzed on nearly 3,000 patients from around the nation who were included in the Cystic Fibrosis Foundation Patient Registry from 1992-2007.
The researchers found that the fate of females changes considerably in the older CF population. It has long been recognized that a “gender gap” is present in CF, favoring males. Historically, females have been diagnosed later, had a poorer prognosis, and survived fewer years than males.
Accordingly, Dr. Nick's analysis showed that fewer females diagnosed as children survived to age 40. However, among those diagnosed as adults, females represented a significant majority, accounting for 72 percent of patients in Colorado and 54 percent nationally. Among the adult diagnosed patients, females survived on average 9 to 14 years longer than males.
The complex factors that account for the differential fate of female CF patients is not understood, although Dr. Nick believes it could be a mixture of behavioral and biological factors.
Dr. Nick's findings also indicate that patients diagnosed as adults do not really have milder diseases — as is commonly believed — just a delayed onset of an equally severe form of the disease. Although patients diagnosed as adults live longer than those diagnosed as children, the adult-diagnosed patients lose lung function as rapidly those diagnosed in childhood, and approximately 85% die of respiratory failure or post-transplant complications.
Dr. Nick believes there is a significant number of adults whose CF remains undiagnosed. His analysis indicates that once those patients are accurately diagnosed, proper care can significantly improve their health. Patients diagnosed as adults and subsequently followed at a CF center reversed progressive lung function decline and improved their lung function for at least four years. Older patients commonly do not get specialized CF care. It is generally recognized that the team approach to treatment provided by the 112 CF Foundation-accredited Care Centers results in better clinical outcomes. However, less than half of long-term CF survivors continued to be seen at CF Centers as they pass 40 years, with the fewest among the adult-diagnosed patients.
“In the coming years, more and more cystic fibrosis patients will be living into their 40s, 50s and beyond,” said Dr. Nick. “Our findings concerning the role of gender, in survival, progression of disease, and type of care in current long-term survivors provides important insights that will help us prepare for better treatment of the steadily aging CF population.”