Successful Weight Control

A recent article in the New York Times showed that people who succeeded in losing large amounts of weight – say from 430 pounds to 190 – were rarely able to stay at their new weights. Most of the dieters in the New York Times article had lost large amounts of weight rapidly, as contestants in The Biggest Loser television program.  When they began dieting they had normal metabolisms for their body size.  When they had lost weight, their metabolisms had slowed radically and their bodies were not burning enough calories to maintain their thinner sizes.  As the years went by their metabolisms did not recover, so they kept gaining back weight.  It seemed that their bodies were working to pull the dieters back to their original weights.  Investigators also found that the dieters had very low levels of leptin, a hormone made by fat cells that inhibits hunger.  They were unable to detect satiety (feeling full). 

This is discouraging news to people who want to lose weight for health reasons, such as having diabetes or certain kinds of heart disease.  Research is ongoing on ways to improve this situation. 

Are there other models of weight loss that would be more effective in the long term?  We will look at the National Weight Control Registry for ideas.  This organization was started by researchers from Brown Medical School and the University of Colorado, to look at people who have lost weight (at least 30 pounds) and kept it off for a year or more.  People enroll voluntarily; 80% are women, and 20% men.  On the average, weight loss has been 66 pounds, kept off for 5.5 years.  Most people report maintaining a low calorie, low fat diet (25% fat) and doing high levels of physical activity.  78% eat breakfast daily; 75% weigh themselves at least once a week; 62% watch less than 10 hours of TV per week; 90% exercise, on average, about 1 hour per day. Changing beverage consumption to low/no calorie sweetened drinks is felt to be very important for weight loss and maintenance by the participants. People in the registry varied in the amount of exercise they did, and in their dietary plans.  There was no ‘one size fits all’ formula being followed. 

Dr. Barbara Rolls at Penn State University has written several popular books on making weight loss easier.  Her latest is The Ultimate Volumetrics Diet.  She has looked at ways to change the amount of water in foods, thereby adding weight and volume but no calories. This is done by adding vegetables to each recipe, and making sure the food is tasty. The result, found in careful studies, was that people reduced their calorie intake by about 25%. In a trial of 700 people, she found that when people ate a diet that was less calorie dense (more vegetables included) they were eating significantly more food – about a pound more food a day – yet they were eating fewer calories and easily losing more weight. She has many good ideas, backed by research, that keep people healthy while losing weight slowly.  Read this book if you are frustrated about your weight.  Aim to lose weight slowly, so that your metabolism can adjust more easily,  And, whenever possible, keep moving! 

Sadja Greenwood, MD,MPH  back issues on this blog, including a column on Dr. Rolls & volumetrics,

Does Exercise Impact Your Cancer Risk? Some Recent Studies

Scientists at the National Cancer Institute, Harvard Medical School and other centers published a paper last week in JAMA Internal Medicine, showing that exercise appears to substantially reduce the risk of developing 13 different varieties of cancer.  The benefits seem to hold true even if someone is overweight.  The researchers looked at 12 large studies, pooled together, involving 1.44 million men and women.

They focused on specific information for each of those 1.44 million people about whether they exercised, how vigorously and how often. They also zeroed in on whether and when, after each study’s start, the participant had been diagnosed with any type of cancer. People who reported exercising moderately, even if the time that they spent exercising was slight, had significantly less risk of developing 13 different types of cancer than people who were sedentary. The researchers found a reduced risk of breast, lung and colon cancers, which had been reported in earlier research. But they also found a lower risk of tumors in the liver, esophagus, kidney, stomach, uterus, blood, bone marrow, head and neck, rectum and bladder. When the researchers compared the top 10 percent of exercisers, meaning those who spent the most time each week engaging in moderate or vigorous workouts, to the 10 percent who were the least active, the exercisers were as much as 20 percent less likely to develop most of the cancers in the study.

On the other hand, they found an increased risk of two types of malignancies — melanoma and slow-growing prostate tumors — among people who exercised the most. Those findings can most likely be explained by certain characteristics of active people, said Steven Moore, an investigator at the National Cancer Institute who led the study. “People who exercise generally go in for more checkups” than sedentary people, he said, resulting in more screenings for conditions such as so-called indolent prostate cancers. (There was no discernible association, positive or negative, between exercise and aggressive prostate tumors.) “They also often exercise outside,” he continued, “and are more prone to sunburns” than people who rarely work out, potentially contributing to a greater risk for melanoma.

Encouragingly, the associations between exercise and reduced cancer risks held true even when the researchers factored in body mass. People who were overweight or obese but exercised had a much lower risk of developing most cancers than overweight people who did not move much.

The authors cautioned that this was an observational study, so it cannot directly prove that exercise reduces cancer risks, only that there is an association between more exercise and less disease. It also relied on participants’ memories of exercise, which can be unreliable.  But even with those limitations, the findings sturdily suggest that exercise may help to reduce the risk of many types of cancer. Here in West Marin we have walking and hiking trails, dirt roads, gyms in Stinson and Point Reyes, tennis courts, classes at the community centers, and the ocean!  Let’s keep moving.

Sadja Greenwood MD, MPH  back issues on this blog

The Latest about Your Spleen

Here are three things you should know about your spleen:  it filters your blood and holds a reserve of red blood cells in case of emergency; it is an important part of your immune system, and it is connected directly with the vagus nerve from the brain.

The spleen is an organ in the upper left part of the abdomen, left of the stomach, and protected by the rib cage. Think of it as fist shaped and about4 inches long.  It is the largest lymph node in the body.

Blood filtering:  as blood passes through the spleen old red cells are removed; their hemoglobin is broken down into amino acids and their heme (a molecule containing iron) is metabolized into bilirubin, removed by the liver and excreted in bile, feces and urine.  Iron is returned to the bone marrow, where new red cells are made. The spleen holds a reserve of red blood cells , used in pregnancy and in case of serious bleeding.  It also stores platelets, used for blood clotting, and white blood cells.

The spleen’s role in the Immune system: as blood flows through the spleen, it detects infectious particles such as bacteria and viruses.  Along with your other lymph nodes, the spleen puts out lymphocytes, a type of white blood cell that can produce antibodies to neutralize bacteria and viruses, and other substances toxic to the invading cells.  The spleen stores half the body’s supply of monocytes – another kind of white blood cell that moves to injured tissue and promotes healing.

The spleen’s connection with the central nervous system (the brain): the spleen is an important connection between the brain and the immune system.  In 2008, for the first time, fibers of the vagus nerve were found in the spleen.  The vagus nerve supplies parasympathetic fibers to most organs in the body and influences heart rate, digestive processes, sweating, speech and other functions.  In contrast to sympathetic nerve fibers (think fight or flight, excitement, anger), the parasympathetic branch of the nervous system is associated with relaxation, a slower heart rate,  lower blood pressure, and feelings of calm. Research is ongoing on vagus nerve stimulation in people with severe seizures, depression and severe pain.  Activation of the parasympathetic nervous system is also associated with decreased inflammation in the body. In situations of severe septic infections, stimulation of the vagus nerve gives increased survival in laboratory animals.

Long slow breathing, preferably through the nose, is one of the simple ways that you can derive the benefits of vagus nerve stimulation.  Most ways of meditation use this kind of breathing.   Establishing a daily practice of relaxation can lower blood pressure, help digestive disorders, decrease anxiety and possibly improve your immune system.  Research is ongoing in this area.

Take care of your spleen:  Most trauma to the spleen occurs in serious auto accidents.  Sometimes the spleen has to be removed as a result.  You can live without a spleen, but not as well.  Drive cautiously and defensively, banish road rage, wear your seat belt, and forget texting while you drive.  A healthy, intact spleen is worth the effort.

Sadja Greenwood, MD, MPH   back issues on this blog

Benefits of Steaming Vegetables, and News about “Roundup”

The April issue of the Tufts University Health and Nutrition Letter has an article on the benefits of steaming vegetables. They cite research from the University of Illinois on different ways of cooking broccoli.  Broccoli (like other cruciferous vegetables) contains a plant compound called sulforaphane, which has shown ant-cancer action in laboratory tests. But for sulforaphane to form, another broccoli compound must be present—an enzyme called myrosinase.

The University of Illinois scientists found that only when broccoli is steamed, for as long as five minutes, did it retain the myrosinase necessary to form the cancer-fighting sulforaphane. Boiling and microwaving broccoli, even for just one minute, destroyed the enzyme.

Those findings follow a 2008 study published in the Journal of Agricultural and Food Chemistry, which reported that steaming was the only cooking method to preserve glucosinolates—a group of cancer-fighting compounds in broccoli and other cruciferous vegetables In fact, steaming actually increased total glucosinolates by 30% compared to raw broccoli. Boiling and frying both led to substantial degradation of glucosinolates, with frying causing an 84% loss of these healthy compounds.  To clarify – glucosinolate is a precursor to sulforaphane – they are basically the same compound.

Sulforaphane is being studied in the Brassica Chemoprotection Laboratory at Johns Hopkins. This unique laboratory is exclusively dedicated to identifying edible plants that are particularly rich in protective enzyme-inducer activity.  This lab has an amazing story, to be revealed in a future column.

Another study found that steaming spinach and broccoli better preserved levels of folate, an important B vitamin. Even after nearly five minutes of steaming spinach and 15 minutes steaming broccoli, folate loss was negligible. Boiling the same vegetables, however, lost more than half the folate in each.

A 2009 Chinese study found that only steaming preserved the chlorophyll, vitamin C, soluble proteins and soluble sugars in broccoli that were lost in microwaving, boiling, and stir-frying.

Some nutrients, such as water-soluble vitamin C and most B vitamins, are rapidly lost to boiling; steaming retains more of these vitamins because the food comes into less contact with the water

Heat destroys vitamin C by speeding the rate at which the vitamin reacts with oxygen in the air, so raw vegetables typically have more vitamin C than steamed ones. But since vitamin C is so prevalent in fruits and vegetables, cooking is often worth the trade-off.

Many nutrients are fat-soluble, including vitamin A, vitamin D, vitamin E, vitamin K and carotenoids like beta-carotene and lycopene. So even if you steam your food to minimize the loss of these nutrients, tossing steamed vegetables in a little oil will help your body absorb these fat-soluble nutrients.

For easy and effective steaming, use a steamer that keeps the food out of the water. You can add herbs, spices or aromatic ingredients like garlic or onions to the steaming water, or replace the water entirely with broth. 

Testing for Glyphosate (Roundup) in Food: The U.S. Food and Drug Administration has confirmed that it would begin testing for residues of the controversial herbicide glyphosate on foods sold in the U.S. for the first time this year. Glyphosate, the active ingredient in Roundup, is widely sprayed on American farms, and is the most-used agricultural chemical in the world. It has been labeled “probably carcinogenic to humans” by the United Nations’ International Agency for Research on Cancer, though a European food safety agency has disputed those claims.

The FDA says it didn’t test food for glyphosate in the past because the “available methods” would have been “very cost- and labor-intensive to implement.” The FDA has recently developed streamlined methods to test for the chemical. “The agency is now preparing plans for Fiscal Year 2016 to measure glyphosate in soybeans, corn, milk, and eggs, among other potential foods.   Stay tuned for more on this topic, including what is going on in the Senate  - attempts to block the Vermont law to mandate GMO labeling on all foods, due to go into effect July first.  GMO foods are sprayed with glyphosate. 

Sadja Greenwood, MD, MPH  back columns on this blog

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Garlic: the hope and the current studies

Garlic is known to have been used for 7,000 years in cooking and as a medicine.  It is one of the first plants cultivated by humans.  Garlic has a long history of medicinal uses – including its use by grave diggers during the terrible episodes of bubonic plague in the 14^th and 15^th centuries that killed half of human populations in areas where it struck.   Grave diggers drank wine with crushed garlic to prevent catching the plague – perhaps their skin odor repelled the fleas that transmitted plague from infected rats.  Perhaps this was hype, and hope.  However, there are numerous current studies on the medicinal properties of garlic that are promising,

Garlic as an antioxidant: Studies from the National Research Council of Canada have shown that allicin, which gives garlic its aroma and flavor, acts as an extremely powerful antioxidant.   Garlic does not have a substantial amount of the compounds responsible for antioxidant activity in green tea or grapes.  The researchers found that a decomposition product of allicin, called sulfenic acid, acts rapidly when in contact with free radicals.  The author wrote ‘The reaction between the sulfenic acid and radicals is as fast as it can get, limited only by the time it takes for the two molecules to come in contact.  No one has ever seen compounds, natural or synthetic, react this quickly as antioxidants.’  While onions, leeks and shallots have a compound similar to allicin, they do not have the same medicinal properties, due to a slower rate of decomposition of allicin.

Cystic Fibrosis: this is an inherited lung disease that causes lung infections and limits the ability to breath. It is usually diagnosed in childhood and may be fatal. A group of infectious bacteria in cystic fibrosis are resistant to most antibiotics.  The chemical known as allicin produced by garlic bulbs may be helpful in the future to kill resistant bacteria.  Research is being done at the University of Edinburgh’s School of Chemistry.  Research on garlic’s antibiotic actions is also going on at the University of Copenhagen and many other centers. More effective antibiotics are desperately needed.

Brain protection:  Researchers at the University of Missouri have found a nutrient in garlic that protects brain cells against the kind of cell damage that promotes  cognitive problems, Parkinson’s disease and stroke.  This garlic nutrient, which they call FruArg,,  promotes the production of antioxidants which offer protective and healing benefits to brain cells,  Research is ongoing.

Reduction of “soft plaque” in arteries: Research at UCLA Medical Center has shown that patients at risk of heart attack benefited from using aged garlic extract.  ‘Soft plaque’ in the linings of arteries is composed mainly of white blood cells, which when released promote blood clotting.  Researchers studied 55 patients who had been diagnosed with ‘metabolic syndrome’ (obesity, high blood pressure, and other cardiac risk factors). After a workup that measured the plaque in their coronary arteries, they were given either a placebo or a dose of 2,400 mg of Aged Garlic Extract daily.  A year later those who had taken the garlic extract showed slowed total plaque accumulation by 80%. 

Cancer protection: Several population studies show an association between increased intake of garlic and reduced risk of certain cancers, including cancers of the stomach, colon, esophagus, pancreas, and breast. An analysis of data from seven population studies showed that the higher the amount of raw and cooked garlic consumed, the lower the risk of stomach and colorectal cancer.  These studies are from Europe, the U.S. and China.  Chinese studies also show a decreased risk of prostate cancer with greater intake of garlic and scallions.

Garlic as a ‘blood thinner’:  Garlic has an anticoagulant effect.  Many doctors advise stopping high doses of garlic 10 days before surgery.  If you are on an anticoagulant medicine, discuss this with your doctor.   Usual doses of garlic in cooking should not be a problem.

There is a restaurant in San Francisco called The Stinking Rose, which features garlic in every course.  If any reader wants to organize a trip there, count me in!

Sadja Greenwood MD, MPH  past issues on this blog

Caution – Nexium, Prilosec and Similar Meds Are Associated with Dementia, and Other Problems

A recent study of drugs to reduce stomach acidity is causing doctors and patients to reevaluate their use.  These drugs are known as proton pump inhibitors (PPIs); they are commonly used to reduce the discomfort of ‘heartburn’, a form of indigestion felt as a burning sensation in the chest, caused by acid regurgitation into the esophagus.  PPIs can be very important in cases of stomach ulcers or precancerous changes in the esophagus.  However, heartburn can be treated in other ways, as explained below.

Increased risk of Dementia: Here is a summary of the recent study that has raised awareness about the dangerous side effects of PPI drugs.  Older adults who use PPIs may be at increased risk for developing dementia, according to an observational study in JAMA Neurology.

Using claims from a large German health insurer, researchers studied nearly 74,000 adults aged 75 and older without dementia in 2004. By 2011, roughly 40% were diagnosed with dementia. Overall, 4% of participants used PPIs regularly during at least one 12-to-18-month interval during the study period.

After adjustment for confounders, including age, other drugs used, stroke, and depression, PPI use was associated with a 44% increased risk for incident dementia.

As potential mechanisms of action, the authors cite evidence suggesting that some PPIs can cross the blood-brain barrier and affect brain enzyme levels. They call for randomized trials to confirm their observational findings.

Other risks : Prolonged use of PPIs has been associated with iron and vitamin B12 deficiencies, low blood magnesium, osteoporosis-related fractures, small intestinal bacterial overgrowth, and community-acquired pneumonia.  These effects are believed to be related to changes in the intestinal bacteria (the microbiome) due to acid suppression. In the case of pneumonia, it may be due to growth of bacteria in the stomach and lungs because of insufficient stomach acidity. Whether less potent acid inhibitors like histamine H2 antagonists, cause similar changes to the microbiome is unknown. These drugs, such as Tagamet, Pepsid, or Xantac, act within an hour or less to decrease stomach acidity, and wear off within 12 hours.  They can be used intermittently, as needed, whereas PPIs are commonly used long term.

Home Remedies for heartburn

• Eat smaller portions at meals • Consume less fat • Avoid lying down for at least 2 hours after eating (avoid late-night snacks) • Wear loose fitting clothing • Elevate the head of the bed about 6 inches (this is best done by placing a block under the headboard, rather than stacking pillows) • Use a ‘bedlounger pillow’ or sleep in a reclining chair. Lose weight if needed (as little as 5 to 10 pounds may help) • Avoid alcohol, tobacco and foods that trigger symptoms, Chew gum (xylitol gum – available at the People’s store or online as Spry) is helpful when heartburn strikes.  Sip an ounce or two of water with added baking soda.

Because PPIs are among the most widely sold drugs in the world, the news about increased dementia risk and other complications is very important.  Be sure to talk to your doctor, nurse practitioner or physician’s assistant about your questions.  Here’s to a healthier you!

Sadja Greenwood, MD, MPH

Ginger – Medicinal Uses for its Peppery Zing

Ginger has long been known to help with nausea, from motion sickness to pregnancy.  A recent study from the University of Rochester showed that ginger capsules significantly reduced nausea severity due to chemotherapy, and that anticipatory nausea was a key factor in the severity of the problem for patients. 

Working with mice, researchers in Taiwan found that an extract of ginger blocked the toxin responsible for diarrhea caused by toxic strains of E. coli, which causes millions of cases of diarrhea worldwide each year, and many infant deaths in poor countries.

If confirmed by further studies, the findings could lead to an inexpensive, easy-to-obtain alternative to drug therapy for the condition, the researchers say. Additional studies are needed to determine the effective doses of ginger needed and whether it is safe for infants, who may experience unexpected side effects from large doses.

 Researchers at Columbia University shows purified components of ginger may have properties that help asthma patients breathe more easily. Asthma is characterized by bronchoconstriction, a tightening of the bronchial tubes that carry air into and out of the lungs. Bronchodilating medications (beta-agonists) work by relaxing the airway’s smooth muscle tissues. This study looked at whether specific components of ginger could help enhance the relaxing effects of bronchodilators. They found that ginger constituents 6-gingerol, 8-gingerol and 6-shogaol act synergistically with the β-agonist in relaxing the airway’s smooth muscles. The researchers at Columbia plan future studies to get a better understanding of the cellular mechanisms involved and to determine whether aerosol delivery of purified constituents of ginger may have therapeutic benefit in asthma and other bronchoconstrictive diseases.

For centuries, ginger root has been used as a folk remedy for a variety of ailments such as colds and upset stomachs. But now, researchers at the University of Georgia have found that daily ginger consumption also reduces muscle pain caused by exercise. Researchers directed two studies examining the effects of 11 days of raw and heat-treated ginger supplementation on muscle pain. Participants in the studies, 34 and 40 volunteers, respectively, consumed capsules containing two grams of either raw or heat-treated ginger or a placebo for 11 consecutive days. On the eighth day they performed 18 extensions of the elbow flexors with a heavy weight to induce moderate muscle injury to the arm. Arm function, inflammation, pain and a biochemical involved in pain were assessed prior to and for three days after exercise. The studies showed that daily ginger use reduced the exercise-induced pain by 25 percent, and this effect was not enhanced by heat-treating the ginger.

News from Women on Web

Since abortion is totally illegal in Poland, Women on Web people in Germany are sending medical abortion pills across the border by drone.  Apparently the senders and receivers are in visual contact.  In Brazil, and other Latin American countries where abortion is illegal and/or inaccessible, Women on Web is making medical abortion pills available – by mail – at greatly reduced rates or free if necessary.  Many pregnant women are terrified by the problem of microcephaly due to the zika virus.  Medical abortions must be done in the first 9 weeks.  You can support the work of Women on Web or Women on Waves if you are so inclined.  They give accurate information and have saved many women from dangerous, do-it-yourself abortion attempts.

Sadja Greenwood, MD, MPH

Cinnamon - Some Unexpected Findings

Cinnamon has been used since remote antiquity as a spice, a food preservative and a medicine. The kind we usually buy is Cassia Cinnamon - the bark of a tree grown mainly in China and Indonesia.  Cinnamon from Sri Lanka – so called Ceylon Cinnamon, is more expensive; it is prized for its flavor and its low content of a substance called coumarin.  Coumarin is a fragrant chemical compound found in many plants.  In high doses it may be toxic to the liver, and may have anticoagulant properties.  Cassia cinnamon has more coumarin, while Ceylon cinnamon has very little.  This is not a problem for most people, using cinnamon as a flavoring in the kitchen.  People with liver disease or on anticogulants should not use large amounts of Cassia cinnamon as a medicine.

Colorectal Cancer – in mice:  Adding cinnamaldehyde, the compound that gives cinnamon its distinctive flavor and smell, to the diet of mice, scientists at the University of Arizona found that mice were protected against colorectal cancer. In response to cinnamaldehyde, the animals' cells acquired the ability to protect themselves against exposure to a carcinogen through detoxification and repair.  The study appeared in Cancer Prevention Research in 2015.

The next step in the research is to test whether cinnamon, as opposed to cinnamaldehyde, prevents cancer using this same cancer model. Human studies have not been reported

Polycystic Ovary Syndrome: Women with this problem have enlarged ovaries with multiple cysts, infrequent menstrual periods, excess hair growth and sometimes obesity.  Previous research has shown that the use of cinnamon can reduce insulin resistance in women with PCOS.  Researchers from Columbia University enrolled 45 women with PCOS into a 6 month trial; those who received cinnamon had more regular menstrual cycles than women who were given placebo. The cinnamon group had 3.82 menstrual cycles during the 6 month trial, while women in the control group only had 2.2 cycles. Two of the women in the treatment group reported spontaneous pregnancies during the trial. "Though small, this rather elegant study shows that cinnamon may be an effective and inexpensive treatment for PCOS patients," said Steven T. Nakajima, MD, President of the Society for Reproductive Endocrinology and Infertility.  He is currently at Stanford.

Parkinson’s Disease – Study in mice: Scientist at Rush University Medical Center used cinnamon to treat the brain changes in mice with Parkinson’s disease (Journal of Neuroimmune Pharmacology, 2014). The study, supported by grants from National Institutes of Health, found that after oral feeding, ground Ceylon cinnamon was metabolized into sodium benzoate, which entered the brain, stopped the loss of important neurons, normalized neurotransmitter levels, and improved motor functions in mice with PD.  The researchers hope to translate their findings into human studies.

Cinnamon in type 2 Diabetes: Cinnamon has been said to lower blood sugar levels, but studies showing this effect have been small, with conflicting results.  Researchers at the College of Pharmacy, Western University of Health Sciences, looked at all published studies in a systematic review of cinnamon’s effect on blood sugar and lipid levels.  They found that the consumption of cinnamon in various trials resulted in a statistically significant decrease in levels of fasting plasma glucose, total cholesterol, LDL-C, and triglyceride levels, and an increase in HDL-C levels; however, no significant effect on hemoglobin A1c was found. They concluded that the variability found in these studies may limit the ability to apply these results to patient care, because the preferred dose and duration of therapy are unclear.

Writing this column made me want to investigate the properties of Ceylon cinnamon.  It is available for about $15 on the internet – for ½ pound, which should last a long time.  You can find 2 ounces for less than $5.  Whichever kind you use, think of the long past history of this spice –Egyptians used it for enbalming in 2000 BCE; Nero burned it on the pyre of his second wife to atone for his role in her death; Arab traders brought it to Europe, Portuguese and Dutch traders fought over Ceylon. 

Sadja Greenwood MD, MPH - back issues on this blog

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Update on the Benefits of Coffee, Fiber and Oregano

In a study from the Harvard School of Public Health, people who regularly drank moderate amounts of coffee daily --less than 5 cups per day -- experienced a lower risk of deaths from cardiovascular disease, neurological diseases, Type 2 diabetes and suicide.  The benefit held true for caffeinated and decaffeinated coffee, suggesting it's not just the caffeine providing health perks but possibly the naturally occurring chemical compounds in the coffee beans. The findings are based on data from three large ongoing studies: 74,890 women in the Nurses' Health Study; 93,054 women in the Nurses' Health Study 2; and 40,557 men in the Health Professionals Follow-up Study.  The study’ first author, Dr. Ming Ding, wrote that bioactive compounds in coffee reduce insulin resistance and systematic inflammation. In general, people who frequently drank coffee were more likely to smoke and drink alcohol. To separate the effects of coffee from smoking, researchers repeated their analysis among never-smokers, and found that the protective benefits of coffee on deaths became even more evident.  The researchers warned that some people should be cautious about their caffeine intake, such as children and pregnant women

Women who eat more high-fiber foods during adolescence and young adulthood--especially lots of fruits and vegetables--may have significantly lower breast cancer risk than those who eat less dietary fiber when young, according to a new large-scale study led by Maryam Farvid at Harvard School of Public Health. Among all the women, there was a strong inverse association between fiber intake and breast cancer incidence. For each additional 10 grams of fiber intake daily--for example, about one apple and two slices of whole wheat bread, or about half a cup each of cooked kidney beans and cooked cauliflower or squash--during early adulthood, breast cancer risk dropped by 13%. The greatest apparent benefit came from fruit and vegetable fiber. The authors speculated that eating more fiber-rich foods may lessen breast cancer risk partly by helping to reduce high estrogen levels in the blood, which are strongly linked with breast cancer development.

Fiber intake is also associated with longevity – studies show a reduced risk of cardiovascular, respiratory and infectious diseases.  Fiber intake also lessens the risk of type 2 diabetes and obesity; intestinal bacteria (the microbiome again!) ferment dietary fiber and reduce the amount of glucose absorbed into the blood.

Oregano: Dr. Supriya Bavadekar, at Long Island University, is currently testing carvacrol, a constituent of oregano, on prostate cancer cells. The results of her study demonstrate that the compound induces apoptosis (cancer cell death) in these cells. Dr. Bavadekar and her group are presently trying to determine the signaling pathways that the compound employs to bring about cancer cell suicide. "We know that oregano possesses anti-bacterial as well as anti-inflammatory properties, but its effects on cancer cells really elevate the spice to the level of a super-spice like turmeric," said Dr. Bavadekar. "Some researchers have previously shown that eating pizza may cut down cancer risk. This effect has been mostly attributed to lycopene, a substance found in tomato sauce, but we now feel that even the oregano seasoning may play a role," stated Dr. Bavadekar. More work is needed on this promising finding.   Recent studies also indicate that oregano may inhibit liver cancer, breast cancer and foodborne bacteria.   

 Many herbs have an anti-inflammatory effect that make them helpful against a variety of health problems.  Tune in next week for an update on turmeric, cinnamon, ginger and coriander. 

Sadja Greenwood, MD, MPH back issues on this blog

New Year's Resolution #3 - Find an Enjoyable Way to Move Your Body

Here are some suggestions from the experts:

*If you haven’t been exercising, check in with the clinic to make sure your plan is safe and right for you.

*While 30 minutes a day is widely recommended for dedicated exercise, this can be broken into shorter times. In a study conducted at the University of Virginia, exercise physiologist Glenn Gaesser, PhD, asked men and women to complete 15 10-minute exercise routines a week. After just 21 days, the volunteers' aerobic fitness was equal to that of people 10 to 15 years younger. Their strength, muscular endurance, and flexibility were equal to those of people up to 20 years their junior. "It would be useful for people to get out of the all-or-nothing mind-set that unless they exercise for 30 minutes, they're wasting their time," says Gaesser.

*From a wise website called Zen Habits: when you make an exercise plan:

*write it down, and post it up.  

*Set an easy goal – like 5 minutes of exercise a day.  

*You can build a habit, and gradually increase it.  

*Be specific about what you are going to do, and when.  

*Have a trigger – such as breakfast – always exercise after breakfast – or any other daily event.

*Know exactly what your goal is – walk around one block, do 5 pushups from the sink, dance for 10 minutes to your favorite music.  *Stick to your goal for a month, before changing it.  

*Log your daily habit right after you do it.  

*Report it to others in your friendship group or family, by phone, email or just plain talk. Arrange in advance that this person will expect a daily report from you.  Reward yourself for your progress with something you love, like a great movie, or a dinner with friends (make it healthy!).

*Here are some ways to exercise that work for me:  I ride my stationary bike while I watch television or a movie.  I’m slow, but I can bike 6-8 miles without noticing it, and I feel great afterwards.  I keep 4 pound weights by my bedside, and do arm exercises while listening to music.  I dance to the California Cajun Orchestra – an easy Cajun line dance step I’m happy to teach anyone who give me a call (868-0493).  I walk the shaded streets of Bolinas to clear my mind. 

Sadja Greenwood: MD, MPH

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