HOW TO PREVENT CANCERS

It seems everywhere you turn, someone is touting a new herbal supplement or extract as the solution to what ails you – prevent cancer, lose weight, reduce cholesterol, boost immunity. You name it, someone is probably selling an herbal concoction to fix it. And often, these claims seem to be backed by scientific research. So what’s the problem?

Unfortunately, there are many:

1. Quality. As detailed in today’s Wall Street Journal, when supplements are submitted to quality testing, about 25% have problems like contamination or mislabeled dosage. In some cases, that contamination can be quite dangerous such as with lead.
2. Safety. Herbal supplements aren’t subject to the same kind of testing that pharmaceutical drugs have to go through. This often means unsubstantiated claims and little information about risks associated with long term or high dosage use.
3. Research quality. Many of the claims made about supplements are backed by research. Unfortunately, the fine print often reveals the research was funded by the supplement maker. The potency of plants can often vary as well – so the variety tested in the research study may not be the one included in the supplement you buy.  In many instances, the studies are also very small or not well designed, which makes for less reliable results, something often missing from the scientific pedigree supplement makers list in their ads or on their websites.  That many people who write about the benefits of these supplements don't have a great understanding of the research process, and what may seem in an article to be rock solid health benefits of a supplement, may be little more than anecdotal evidence.
4. Reductionism.  Reductionism is when a single component of a whole food found to have health benefits is put into a supplement and assumed to have the same (or greater) health benefits of the whole foods.  The food is "reduced" to a single component, usually with mixed results.  The classic example is beta-carotene.  Studies had found that individuals who consumed higher amounts of fruits and vegetables had lower rates of lung cancer. Researchers hypothesized that this was due to the antioxidants (like beta-carotene) found in fruits and vegetables and began randomized controlled trials to see if these individual components had any health benefits in smokers.  The results were surprising.  Lung cancer rates were HIGHER in the groups taking beta-carotene. These results don’t mean you should go off and eat Twinkies instead of carrots, but they do suggest that extracting one component from a food doesn’t always lead to the desired result.
5. Extrapolation. Extrapolation is taking a narrow set of results and applying it to broader populations.  It's a common practice, particularly in health news stories, and while it makes for great headlines, it often results in over-reaching.  Supplement makers do the same.  A small study in mice or cells in a petri dish can have seemingly astounding results - but the problems is that these studies are in....mice and cells.  Animal and cell studies are just a starting point in the research process, and more often than not the results don't pan out in good studies in humans.  It is also important to note that the doses of supplements and extracts applied to animals and cells in the laboratory often exceed those that humans would (or could) consume. The big concern here is that these extracts and compounds, tested in labs, will result in the same unanticipated consequences that beta-carotene did on lung cancer when tested in humans. Of course, there is also the possibility that they will have benefit, but until they are evaluated, we just don’t know.

It might seem that we're anti-supplement here at CNiC.  But that's certainly not true.  For a very long time, we've recommended a daily multivitamin as a great nutrition insurance policy for most people. A daily multivitamin with folate can provide added protection against certain cancers and other chronic diseases. Folate is a B vitamin that has been shown to lower the risk of colon cancer, as well as breast cancer in women who regularly drink alcohol. The calcium and vitamin D in most multivitamins may also help provide added protection against colon cancer.

What we worry about are the health claims many supplement makers and other proponents make that over-reach (often by a great deal) what the science has to say about both the effectiveness and the safety of their products.

In this day of ever-growing health care costs and tight budgets, it's only natural that we want to take control over our health, and turning to supplements can seem like an easy route to take.  But, it's important to know about some of the potential pitfalls with supplements so you can make good, informed decisions about your health.  Most of the time, the best choice is to keep those supplements on the store shelves and go for a good walk instead. Focus on fruits, vegetables, and whole grains, trying to get a wide variety of each. A single 100% RDA daily multivitamin is also a good nutrition insurance policy for most people.

Second hand smoke exposure in the US was thoroughly documented last week in the CDC report noted in many media stories.

The report evaluated national data from 1999 through 2008, and estimates that 88 million non smokers greater than age 3 were exposed to second hand smoke. The authors note that the decline in exposure within the US has slowed pointing to the tapering off in our national public health efforts to control cigarette smoking.

Despite the increasing attention paid to obesity and the economic burden on society due to obesity, tobacco remains a leading cause of premature mortality, cancer onset. lost productivity, and health care expenditures. Continued efforts at smoking cessation and state-wide comprehensive laws to limit exposure in work places and public places can help avoid serious health effects.

The health effects of second hand smoke are are well documented.
  

• Lung cancer 
• Heart disease

• Sudden infant death syndrome
• Reduced lung function
• Asthma
• Respiratory infections
• Ear infections in children

 The good news is that many of tobacco’s harmful effects can be reduced by smoking cessation, and benefits of quitting can be seen almost immediately.  Quitting smoking is the single best thing that smokers can do to improve their health, and over 46 million Americans have successfully quit.

More news from Alvin J. Siteman Cancer Center showing significant nicotine exposure from cigarette smoke in restaurant and bar workers. It is time for regulations to protect workers. We can cut the health impact of smoking now.  See story 

There is a fascinating little study out this week in the journal Appetite, which was also highlighted in a piece in The Economist.  What the study found was that dieters, when they felt they were given a larger piece of pizza than other people were for lunch (pieces were actually the same),  were more likely to eat more cookies afterward than the others were.  While it's hard to pin a motivation on exactly why this was, one explanation is that the dieters felt the perceived larger piece of pizza pushed them off their dieting program, which then opened the "might as well" flood gates when it came to eating cookies afterward.

There are a number of possible conclusions to draw from this study when it comes to battling the current obesity epidemic -- all of which would be little more than conjecture.  But, it does highlight the very complex problem we're dealing with it comes to weight gain and weight loss and the important role that external influences can have on our internal cues to eat.

With the food industry spending millions to get us to eat more and more food (most of which is unhealthy), it's important to do what we can to listen to our bodies and understand when we're truly hungry and when we've eaten enough to feel satisfied but not bursting.  It seems like a simple thing but this small study and the growing numbers of people who are overweight and obese tell us its not.

Try these simple steps to get in touch with your internal cues and keep your weight in check:

• Exercise, exercise, exercise.  Being active is one of the best ways of controlling weight.
• Go Mediterranean.  A diet rich in fruits, vegetables, whole grains, and healthy oils (like olive oil) can make you feel full,  help regulate your appetite, and actually taste really good
• Choose smaller portions and eat more slowly.  Slow down and give your body a chance to feel full before you move on to seconds.
• Be a mindful eater.  Food is big business, and their main goal is to get you to eat.  Try to listen to what  your body is telling you, not what the food business wants you to hear.  

This week marks one of my favorite times of the year - the US Open. The New York Times had a couple of articles this week that got me thinking about how competition can fuel (or harm) health. The first was a great photojournalism article in the Sunday Magazine about how much harder the women are hitting than in years past. I love seeing a discussion about how increasing strength is pushing women to do more. Strength training has lots of benefits and we're seeing more and more discussion of them (the Times also covered the role of strength training in aging-related muscle loss). The need to keep or get a competitive edge is pushing women to start strength training at younger ages -- I remember this being a really novel part of our pre-season soccer training when I played in high school (aka, the old days). However, we didn't get any instruction on proper form or how to progress safety and not injure our growing bodies. It is nice to see so many programs now for youth addressing these issues.

The other article is about a "friendly" wager (of $10,000!) between Andy Roddick and Justin Gimelstob as to whether Gimelstob can complete the New York City Marathon this November. Gimelstob's motivation isn't health - it is competition with Roddick - who isn't even running! Lots of sites that offer tips for getting healthy and starting (or maintaining) exercise programs suggest friendly competitions or reward systems to keep you motivated. Gimelstob and Roddick have pushed it a bit beyond this, with friends and family worrying that Gimelstob has progressed to a significant risk of injuring himself. It got me thinking about whether friendly wagers and competitions can help or do they push us past where we should go in our pursuit of health?

What do you think? Do you use rewards or competition to motivate yourself to get active?