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.
It's the same advice that mothers everywhere have been giving for years, but now there's science to back it up: Eating veggies is good for the eyes. A new study from the University of Wisconsin confirmed that women who have a healthy diet, exercised regularly and didn't smoke were less likely to suffer macular degeneration as they got older. Macular degeneration is the leading cause of vision problems in older people in the United States, researchers said.
The study of 1,313 women from Oregon, Iowa and Wisconsin is the first to look at several lifestyle factors that influenced age-related macular degeneration (AMD), according to a release from the university. These findings show a healthy lifestyle can improve the chances of good eyesight for those who inherit the condition, according to Dr. Julie Mares of the UW School of Medicine and Public Health.
According to the study, 18 percent of women deemed to have unhealthy lifestyles developed early AMD while just 6 percent of women in the healthy-lifestyle group developed the condition. Researchers found that the association of healthy eyes and healthy overall diets was stronger than what they observed for any single nutrient. Women whose diet score was the in top 20 percent had a 50 percent lower prevalence of early stages of macular degeneration than woman with the lowest percent for healthy diet scores. Higher scores were given to those with more leafy green and orange vegetables, fruits, dairy, grains and legumes, according to the release.
Mares said this was the first study where researchers found higher levels of physical activity lowered the likelihood of early macular degeneration. However, this study didn't show obesity was related to AMD, but obese women were more likely to have more macular degeneration. That trend was explained by a poor diet and low physical activity, according to the university. The study also confirmed other studies that smoking played a role in eye disease.
The university said the study is being published online in the Archives of Ophthalmology, a journal of the American Medical Association. The research was funded by the National Institutes of Health, National Eye Institute. It was also supported by the Research to Prevent Blindness and the Retina Research Foundation.
Experts have suggested that an intensive lifestyle intervention helps individuals with type 2 diabetes lose weight and keep it off, along with improving fitness, control of blood glucose levels and risk factors for cardiovascular disease. Improving blood glucose control and cardiovascular risk factors in patients with type 2 diabetes is critical in preventing long-term complications of the disease.
The Look AHEAD (Action for Health in Diabetes) Research Group conducted a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention to diabetes support and education among 5,145 overweight individuals with type 2 diabetes.
Of these, 2,570 were assigned to the lifestyle intervention, a combination of diet modification and physical activity designed to induce a 7 percent weight loss in the first year and maintain it in subsequent years. The 2,575 individuals assigned to the diabetes support and education group were invited to three group sessions each year. On average, across the four-year period, individuals in the lifestyle intervention group lost a significantly larger percentage of their weight than did those in the diabetes support group.
They also experienced greater improvements in fitness, hemoglobin A1c level (a measure of blood glucose), blood pressure and levels of high-density lipoprotein. Individuals in the diabetes support group, on the other hand, experienced greater reductions in low-density lipoprotein, owing to greater use of cholesterol-lowering medications in this group.
The report was published in the September 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Researchers have long speculated that the diet may help explain why nations in the Mediterranean region have historically had lower rates of heart disease and some cancers, including breast cancer, compared with other European countries and the U.S.
Until now, only two other studies have looked at the relationship between Mediterranean-style eating and the risk of breast cancer, both done in the U.S. Each found a connection between the diet and lower breast cancer risk, although in one the link was limited to breast cancers that lack receptors for the hormone estrogen — which account for about one-quarter of breast tumors.
The current study focused on women in Greece, as it is the “cradle” of the Mediterranean diet, and a large segment of the population still adheres to it, Dr. Dimitrios Trichopoulos, the senior researcher on the work, told Reuters Health by email.
At the outset, the study participants completed detailed dietary questionnaires and gave information on their lifestyle habits and demographics. Each woman was given a Mediterranean diet score, ranging from 0 to 9, based on how often they consumed vegetables, legumes, fruit and nuts, whole grains, fish and olive oil or other sources of monounsaturated fats; they also won points by limiting meat and dairy.
Of the 14,800 women included, 240 were diagnosed with breast cancer over an average follow-up of 10 years.
Overall, postmenopausal women whose Mediterranean diet scores were in the 6-to-9 range were 22 percent less likely to develop breast cancer than their counterparts with scores between 0 and 3. That was with factors such as age, education, smoking history, weight and exercise habits taken into account.
The findings show an association between Mediterranean eating and lower breast cancer risk, but do not prove cause-and-effect, according to Trichopoulos, who is with the Harvard School of Public Health in Boston and the Bureau of Epidemiologic Research at the Academy of Athens in Greece.
Further studies are needed to confirm the results, he said.
However, other evidence suggests ways the Mediterranean diet might curb cancer risk.
Research has found, for instance, that women who closely follow the diet tend to have lower levels of estrogen, which fuels the growth of the majority of breast cancers, than other women do. Other studies in the lab suggest that the fats found in the Mediterranean diet — both olive oil and the omega-3 fats in oily fish — may slow the growth of cancer cells.
The diet is also typically rich in antioxidants, which protect body cells from damage that can eventually lead to disease, including cancer. Trichopoulos said that if the Mediterranean diet does have a protective effect against cancer, it is “likely” to involve that antioxidant component.
It also makes sense, said the researcher, that the diet could affect the risk of postmenopausal, but not premenopausal, breast cancer.
Younger women who develop breast cancer, he explained, often have a genetic vulnerability to the disease, whereas in older women, lifestyle and environmental exposures may be relatively more important contributors to risk.
Based on their findings, Trichopoulos and his colleagues write, the association between the Mediterranean diet and breast cancer is of “modest, but not negligible, strength.”
In the U.S., a woman's chance of being diagnosed with breast cancer rises from about a half a percent, or one in 233, during her 30s, to about four percent, or one in 27, during her 60s.
Established risk factors for breast cancer include older age and having had a first-degree relative diagnosed with the disease. Research has also linked obesity, sedentary lifestyle, use of hormone replacement therapy and high alcohol intake to an increased risk.
SOURCE: Journal of Clinical Nutrition
Artinian and her co-authors analyzed 74 studies conducted among U.S. adults between January 1997 and May 2007. The studies measured the effects of behavioral change on blood pressure and cholesterol levels; physical activity and aerobic fitness; and diet, including reduced calorie, fat, cholesterol and salt intake, and increased fruit, vegetable and fiber consumption.
Cardiovascular disease (CVD) is the leading cause of death in the United States. According to American Heart Association statistics, about 81.1 million adults, or one out of every three people in America, have at least one type of CVD, such as heart attack, stroke or heart failure. If cardiovascular diseases were completely eradicated, life expectancy could increase by nearly seven years.
“Lifestyle change is never easy and often under-emphasized in clinical encounters with our patients. This statement shows what types of programs work and supports the increased need for counseling and goal setting to improve healthy cardiovascular habits,” said Ralph Sacco, M.D., president of the American Heart Association. “We need to find more effective ways to make lifestyle change programs available, especially to the groups at highest risk for cardiovascular diseases – older Americans, African-Americans and people of Hispanic origin.”
Sacco added that the first step in making a change is to know your health status, “because a lot of people don't realize they're at risk for heart disease and stroke. The American Heart Association's My Life Check can help identify your risk level and offers simple steps to get started on the path to ideal cardiovascular health.”
Although obesity, physical inactivity and poor diet are well recognized as major risk factors for cardiovascular disease, it's often difficult for doctors and nurses to help patients reduce their risk for an extended period. They are faced with numerous obstacles, including time constraints, reimbursement problems and insufficient training in behavioral-change techniques, the statement authors write.
Despite these difficulties, Artinian said policy changes will eventually make critical interventions more readily available.
Federal health reform legislation includes provisions that would improve access to preventive services and help Americans make healthier food choices to control risk factors for heart disease and stroke. For example, the new law requires calorie information on restaurant menus and vending machine products and eliminates co-pays for certain preventive services under Medicare and new private health plans. The legislation also includes funding to support public health interventions at the state and local levels aimed at lowering risk factors for chronic disease.
“I'm looking forward to the future when we will have a healthcare system that gives more weight to the importance of prevention and changing lifestyle behaviors to help people stay healthy and reduce cardiovascular risk,” Artinian said.
Diets that encourage and promise rapid weight loss often lead to weight being regained just as quickly. Australian women spend over $400 million per year in a fruitless quest to be slim, with 95% of people who go on weight loss diets regaining everything they have lost plus more within two years.
Not only are many popular diets ineffective, but they are also a health risk. Research into popular diet books has found that only one in four diets reviewed met current nutrition guidelines with many eliminating important, nutritious foods.
The Dietitians Association recommends weight loss diets that:
- Meet individual nutritional and health needs
- Fit with individual lifestylesInclude a wide variety of foods from all food groups
- Promote physical activity
- Focus on realistic life-long changes to eating and exercise habits.
The Dietitians Association does not recommend weight loss diets that:
- Cut out entire food groups or specific nutritious foods
- Promote and promise rapid weight loss without the supervision of a dietitian and doctor
- Focus on short-term changes to eating and exercise habits
- Recommend unusual foods or eating patterns
- Encourage miracle pills and potions.
There is no one magic or ‘ideal’ weight loss diet. It is possible to lose weight while meeting individual nutrition and lifestyle needs through a variety of approaches.
To lose weight and keep it off see an Accredited Practising Dietitian (APD) like Nastaran. Nastaran can help you get off the dieting merry go round by developing a lifestyle plan that’s right for you and can be followed for life.
A referral to Nastaran Habibi should be made when your patient needs more intensive dietary, nutritional and lifestyle behavior education than you can provide in your office environment. Nastaran can help particularly when the patient is in the preparation, action or relapse stages of change.
A consultation generally includes a diet and lifestyle assessment, and nutrition education and counselling. Nastaran will review your patient’s medical and social status, including biochemistry and othe relevant test results, dietary and family history and home environment. In addition she will take anthropometric measurements and collect information on the patient’s individual food preferences and cultural, socio-economic and lifestyle needs. Taking into account the patient’s own goals, knowledge, skills and access to resources, Nastaran will custom design a program for your patient based on the principles of Medical Nutrition Therapy. She integrates self-management training regarding information on nutrient content, food choices, and meal preparation based on each patient’s particular and unique circumstances. Initial appointments are more than 1 hour.
What happens next:
- You will receive a formal report assessing your patient’s nutritional, physical activity and lifestyle status including Nastaran’s recommendations for improvement, possible barriers to success and guidelines for evaluating progress.
- During the 45-90 minute follow-up visits, Nastaran will review your patient’s progress, provide further education, encourage continued adherence to the plan and identify any obstacles to success.
In order for your patient to qualify for a Medicare rebate, referral must be through an Enhanced Care Plan. Referrals outside Medicare will still qualify for a Health Fund rebate.
Nastaran’s individually-designed client plans:
- Provide early diagnosis of nutrition-related health problems
- Facilitate better management of chronic conditions through diet and lifestyle change
- Lead to fewer nutrition-related secondary complications such as neuropathies from diabetes
- Dispel myths regarding fad diets
- Teach patients how to take personal responsibility for their own health status
- Raise awareness regarding nutrition-related problems like high cholesterol, diabetes and hypertension
Placement in Practitioner’s Office
Some practitioners would prefer their patients receive all medical services in their own offices. Nastaran is available for scheduled placement in your office to meet with patients you believe would benefit from professional nutrition services. From once a month, to once a week, Nastaran can accommodate your office and patient needs.
Lunch & Learn
Recognizing how quickly nutritional information changes, Nastaran offers free lunchtime programs in your office, specifically tailored to your patient base and staffing needs.
- Eating for thyroid disorder
- Celiac disease
- Chronic fatigue
- Supplement protocols
- Diabetes care and prevention
- General Nutrition
- Pediatric Nutrition
Please contact Nastaran directly with any questions regarding any of our services.