Health for life

In a large prospective study published online in the British Journal of Cancer, researchers looked at the association between nut consumption and risk of pancreatic cancer among 75,680 women in the Nurses Health Study, with no previous history of cancer. Consumption of nuts, including tree nuts (such as almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts), was inversely associated with risk of pancreatic cancer, independent of other potential risk factors for pancreatic cancer.

Women who consumed a one-ounce serving of nuts two or more times per week had a significantly reduced risk of pancreatic cancer (RR, 0.65; 95% CI, 0.47-0.92; P=0.007) compared to those who largely abstained from nuts. "This reduction in risk was independent of established or suspected risk factors for pancreatic cancer including age, height, obesity, physical activity, smoking, diabetes and dietary factors," stated lead author, Ying Bao, MD, ScD, from the Department of Medicine, Brigham and Womens Hospital and Harvard Medical School, Boston, MA.

Pancreatic cancer is the fourth most common cause for cancer-related mortality in the U.S., yet very few modifiable risk factors have been identified. According to the 2009 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) report, aside from cigarette smoking, body fatness was the only convincing modifiable risk factor for pancreatic cancer.

While there may be concern that frequent nut consumption may result in weight gain and thereby increase the risk of developing pancreatic cancer, the opposite seems to be true. "In our cohort women who consumed the most nuts tended to weigh less," reported Dr. Bao. Moreover, in a recent analysis of this same cohort, higher nut consumption was associated with a slightly lower risk of weight gain and obesity.

Nut intake has also been associated with a reduced risk of diabetes mellitus, which is a risk factor for pancreatic cancer. "Nuts contain a variety of important vitamins, minerals and phytochemicals," states Maureen Ternus, M.S., R.D., Executive Director of the International Tree Nut Council Nutrition Research & Education Foundation (INC NREF). "This exciting, new study provides yet another reason to encourage people to eat a handful—or 1/3 cup—of tree nuts every day."

In a study published today in the New England Journal of Medicine, researchers looked at the association of nut consumption with total and cause-specific mortality among 76,464 women in the Nurses Health Study and 42,498 men in the Health Professionals Follow-up Study. Consumption of nuts, including tree nuts (such as almonds, Brazil nuts, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios and walnuts), was inversely associated with total mortality in both men and women, independent of other predictors for death. In addition, there were significant inverse associations for deaths due to cancer, heart disease and respiratory disease.

"Compared with those who did not eat nuts, individuals who consumed nuts (serving size of one ounce) seven or more times per week had a 20% lower death rate and this association was dose-dependent," stated lead author, Ying Bao, MD, ScD, from the Department of Medicine, Brigham and Womens Hospital and Harvard Medical School, Boston, MA. "Those who consumed more nuts were also leaner, and tended to have a healthy lifestyle, such as smoking less and exercising more," added Dr. Bao.

This is the largest study to date to examine the relation between nut consumption and total mortality, and the results are consistent with previous studies, according to senior author, Charles Fuchs, MD, MPH, from the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. "The findings from our study and others suggest a potential benefit of nut consumption for promoting health and longevity," reported Dr. Fuchs.

Nuts contain important nutrients such as unsaturated fats, high quality protein, vitamins (i.e., vitamin E, folate and niacin) minerals (i.e., magnesium, calcium and potassium) and phytochemicals—all of which may offer cardioprotective, anticarcinogenic, anti-inflammatory and antioxidant properties. "With current nut consumption well below the recommended 1.5 ounces of nuts per day (in the FDA qualified health claim for nuts and heart disease) we need to continue to encourage people to have a handful of nuts every day," recommends Maureen Ternus, M.S., R.D., Executive Director of the International Tree Nut Council Nutrition Research & Education Foundation (INC NREF).

People who take statins to reduce their risk of cardiovascular disease are less likely to be diagnosed with the most common form of glaucoma, according to a nationwide study of more than 300,000 patients. A University of Michigan School of Medicine research team, directed by Joshua Stein, MD, MS, found that the risk for glaucoma was reduced by eight percent in patients who took statins continuously for two years, compared with patients who did not take statins. The study, the largest to date on the topic, is published in the October issue of Ophthalmology, the journal of the American Academy of Ophthalmology.

Dr. Steins study was sparked by growing evidence that statin use may protect the optic nerve and retinal nerve fibers, structures that are essential to good vision and are damaged by glaucoma. His team used healthcare claims data for a diverse population of Americans aged 60 and older who took statins to control high blood levels of unhealthy fats, a condition known as hyperlipidemia, between 2001 and 2009, The researchers assessed patients risk for open-angle glaucoma (OAG). Unlike earlier studies, their analysis adjusted for patients who also had diabetes and/or hypertension to prevent distortion of the results.

Several of the studys findings suggest that statin use may be most important before glaucoma is diagnosed, or in the early stages of the disease. Dr. Steins research may lead to new preventive treatments that could especially benefit groups at increased risk, including African-Americans, Hispanics and those with a family history of glaucoma.

Glaucoma affects more than 2.7 million Americans age 40 and older . If untreated, glaucoma causes vision loss or blindness by damaging the eyes optic nerve. The optic nerve sends signals from the retina — a layer of light-sensitive tissue at the back of the eye — to the brain, where these signals are interpreted as the images we see. Only about half of the people who have glaucoma know it, since symptoms are rarely noticed in the early stages and vision loss is very gradual in most cases.

"Statins apparent ability to reduce glaucoma risk may be due to several factors, including improved blood flow to the optic nerve and retinal nerve cells and enhanced outflow of the aqueous fluid, which may reduce intraocular pressure," said Dr. Stein. "While more research is needed, we hope our results may contribute to saving the sight of thousands who are predisposed to glaucoma."

Dr. Stein cautioned that the study results apply only to patients with hyperlipidemia, and that further study is needed to determine whether statins also protect patients who dont have this diagnosis or have other characteristics that differ from the study population.

Achieving and maintaining a healthy body weight, staying physically active and maintaining a healthy diet improved survival after cancer diagnosis in an elderly female cancer survivor population, according to data presented at the 11th Annual AACR International Conference on Frontiers in Cancer Prevention Research, held here Oct. 16-19, 2012.

Researchers examined cancer survivors adherence to the 2007 World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines for body weight, physical activity and diet.

"Elderly female cancer survivors who achieve and maintain an ideal body weight, stay physically active and eat a healthy diet have an almost 40 percent lower risk for death compared with women who do not follow these recommendations," said Maki Inoue-Choi, Ph.D., R.D., research associate in the Division of Epidemiology and Community Health in the School of Public Health at the University of Minnesota.

Study participants included 2,080 women from the Iowa Womens Health Study who had a confirmed cancer diagnosis between 1986 and 2002 and who completed a follow-up questionnaire in 2004. Women provided information on body weight, physical activity level, dietary intake and other demographic and lifestyle factors.

Through annual linkage with the State of Health Registry of Iowa and the National Death Index, researchers identified 495 deaths from 2004 to 2009, including 197 from cancer and 153 from cardiovascular disease. Researchers adjusted for age, number of comorbid conditions, general health, smoking, type and stage of cancer, current cancer treatment and subsequent cancer diagnosis. They found all-cause mortality was 37 percent lower for women with the highest (6 to 8) versus the lowest (0 to 4) adherence scores.

Reaching the WCRF/AICR physical activity recommendation was also associated with lower risk for death from any cause, from cardiovascular disease or from cancer after the researchers adjusted for dietary and body weight recommendation adherence scores and other covariates.

However, reaching the dietary recommendations was not associated with mortality following adjustment for body weight and physical activity recommendation adherence scores.

A new study from Denmark found that people who regularly used statins to lower cholesterol and then received a cancer diagnosis were 15% less likely to die from cancer or any other cause than cancer patients who had never used statins.

Statins are the most commonly prescribed drug for lowering cholesterol and reducing the risk of heart disease.

The researchers, from the University of Copenhagen, write about their findings in the 8 November early online issue of the New England Journal of Medicine.

They decided to look at the link between statin use and cancer death because, as cholesterol is necessary for cell growth, it has been suggested that reducing it may limit the cellular proliferation required for cancer growth and spread.

They did not look at whether taking statins affected peoples risk for developing cancer.

For the study, the researchers used Danish national databases to find all patients who had received a diagnosis of cancer between 1995 and 2007, with follow-up until end of 2009.

This yielded data on a total of 295,925 patients aged 40 and over, of whom 18,721 had used statins regularly before their cancer diagnosis and 277,204 had never used statins.

When they analyzed the data statistically using hazard ratios, the researchers found among patients who had regularly taken statins, deaths from cancer were reduced by 15%, as were deaths from all causes.

Eric Jacobs, Strategic Director of Pharmacoepidemiology at the American Cancer Society, says in a statement about the study that while the findings are "exciting":

"... it does not mean people with cancer should start using statins in the hopes of improving their progress."

He says other factors could be behind the lowered rates of death. For example, it may be that some of the people taking statins could also have been taking aspirin, which some studies published recently have linked to improved survival from cancer (in August 2012 Jacobs and his team carried out a review of such evidence).

Jacobs also points out that randomized trials of people taking statins to reduced risk of developing heart disease did not show benefits against cancer - and yet they should have, according to the findings from this Danish study.

He suggests further research is now needed to "clarify if and how statins might influence survival in cancer patients".