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Well, since we've started a thread here on the "General Health and Longevity" forum dedicated to Colon Cancer Prevention, I figured we might as well have one for prostate cancer too, particularly since CR practitioners are overwhelmingly male, and because among US men, prostate cancer is the most common cancer and second leading cancer killer based on CDC Statistics. Plus, there is a new study  showing how good my favorite diet (vegan) is for prostate cancer prevention. The study followed ~26,000 men (obviously) who are participating in the famous Adventist Health Study-2, and recruited between 2002 and 2007. It found that men eating a vegan diet were 35% less likely to develop prostate cancer (HR: 0.65; 95% CI: 0.49, 0.85) relative to omnivores during the mean follow-up period of 7.8 year, even after adjusting for age, race, family history of prostate cancer, education, screening for prostate cancer, calorie intake, and BMI. The last is significant because it shows that it wasn't just a result of the vegans being thinner than the omnivores that protected them from prostate cancer. Interestingly, and distinctively from other studies of this population where health benefits relative to omnivores have been observed among all the categories of vegetarians, the benefits observed here for prostate cancer avoidance were entirely restricted to the vegan diet group. Below is the summary table of relative risks for the different diet groups, broken down by race. Looking at data for white men I've highlighted. None of the other vegetarian categories have even a hint of reduction in prostate cancer risk relative to omnivores, not even the pesky pesco-vegetarians - only the vegans: So if you want to avoid the most common form of cancer among men in the US, and the second leading cause of cancer death, go vegan! --Dean --------------  Am J Clin Nutr. 2015 Nov 11. pii: ajcn106450. [Epub ahead of print] Are strict vegetarians protected against prostate cancer? Tantamango-Bartley Y(1), Knutsen SF(2), Knutsen R(2), Jacobsen BK(3), Fan J(2), Beeson WL(2), Sabate J(2), Hadley D(4), Jaceldo-Siegl K(2), Penniecook J(2), Herring P(2), Butler T(2), Bennett H(2), Fraser G(2). BACKGROUND: According to the American Cancer Society, prostate cancer accounts for ∼27% of all incident cancer cases among men and is the second most common (noncutaneous) cancer among men. The relation between diet and prostate cancer is still unclear. Because people do not consume individual foods but rather foods in combination, the assessment of dietary patterns may offer valuable information when determining associations between diet and prostate cancer risk. OBJECTIVE: This study aimed to examine the association between dietary patterns (nonvegetarian, lacto-ovo-vegetarian, pesco-vegetarian, vegan, and semi-vegetarian) and prostate cancer incidence among 26,346 male participants of the Adventist Health Study-2. DESIGN: In this prospective cohort study, cancer cases were identified by matching to cancer registries. Cox proportional hazards regression analysis was performed to estimate HRs by using age as the time variable. RESULTS: In total, 1079 incident prostate cancer cases were identified. Around 8% of the study population reported adherence to the vegan diet. Vegan diets showed a statistically significant protective association with prostate cancer risk (HR: 0.65; 95% CI: 0.49, 0.85). After stratifying by race, the statistically significant association with a vegan diet remained only for the whites (HR: 0.63; 95% CI: 0.46, 0.86), but the multivariate HR for black vegans showed a similar but nonsignificant point estimate (HR: 0.69; 95% CI: 0.41, 1.18). CONCLUSION: Vegan diets may confer a lower risk of prostate cancer. This lower estimated risk is seen in both white and black vegan subjects, although in the latter, the CI is wider and includes the null. © 2016 American Society for Nutrition. PMID: 26561618
Antibiotic Use Linked to Higher Diabetes Risk Note: I'm starting a new generic thread about diabetes prevention with a rather narrowly focused post about diabetes and antibiotics, because I thought the study was interesting and suggested a link I hadn't heard about before. Over time I hope we'll build up posts on this thread dealing with other means of avoiding this important cause of morbidity and mortality. With that background, I thought this recent observational study  of a possible link between antibiotic use and subsequent development of type 2 diabetes was quite interesting and potentially relevant for CR Practitioners. It found quite a clear and dramatic dose-response relationship between the number of antibiotic prescriptions a person fills, and their subsequent risk of developing type 2 diabetes, among 5.6 million Danish people tracked for 12 years. Here is the kicker graph from the full text of the paper: As you can see from the graph, 2-4 courses of an antibiotic raised one's risk of developing diabetes by about 20%, and 5-8 courses raised it by about 40%. The authors suggest (warn) that there are two possible ways to interpret this association: There are two competing interpretations of our findings: 1) patients with type 2 diabetes are more prone to develop infections many years before they become diagnosed with type 2 diabetes and therefore have increased demand for antibiotics and 2) antibiotics increase the risk of type 2 diabetes. They suggest it may be a combination of both, but that there is definitely evidence that messing up one's gut microbiome via antibiotics can lead to weight gain, glucose intolerance, etc. So a causal link that goes as follows: antibiotics -> gut dysbiosis -> metabolic syndrome -> Type 2 diabetes seems quite plausible. I'm personally thankful that I haven't needed antibiotics in many, many years, and would be reluctant to take them now unless there was a significant danger of serious health consequences from not doing so. --Dean ----------  J Clin Endocrinol Metab. 2015 Oct;100(10):3633-40. doi: 10.1210/jc.2015-2696. Epub 2015 Aug 27. Use of Antibiotics and Risk of Type 2 Diabetes: A Population-Based Case-Control Study. Mikkelsen KH(1), Knop FK(1), Frost M(1), Hallas J(1), Pottegård A(1). CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics. METHODS: We conducted a population-based case-control study of incident type 2 diabetes cases in Denmark (population 5.6 million) between January 1, 2000, and December 31, 2012. Data from the Danish National Registry of Patients, the Danish National Prescription Registry, and the Danish Person Registry were combined. RESULTS: The odds ratio (OR) associating type 2 diabetes with exposure to antibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) with redemption of more than or equal to 5 versus 0-1 prescriptions. Although no individual group of antibiotics was specifically associated with type 2 diabetes risk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum and bactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum and bacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A clear dose-response effect was seen with increasing cumulative load of antibiotics. The increased use of antibiotics in patients with type 2 diabetes was found up to 15 years before diagnosis of type 2 diabetes as well as after the diagnosis. CONCLUSIONS: Our results could support the possibility that antibiotics exposure increases type 2 diabetes risk. However, the findings may also represent an increased demand for antibiotics from increased risk of infections in patients with yet-undiagnosed diabetes. PMCID: PMC4596043 PMID: 26312581
Diet & Colon Cancer Prevention While researching the Adventists diet study for prostate cancer prevention, Al Pater kindly pointed me to a similar study  of diet and colon cancer risk among the Adventists in the AHS-2 study by the same authors (thanks Al!). It followed 96,000 Adventists of both genders for an average follow-up time of 7.3 years to see which diets were associated with a reduced risk of colon cancer. As expected, all vegetarians combined were 22% less likely than omnivores to develop any form of colon cancer during the follow-up (HR 0.78: 95% CI, 0.64-0.95). Here is the breakdown of colon cancer risk by various types of vegetarian diets, again relative to omnivores: Vegans 0.84 (95% CI, 0.59-1.19); lacto-ovo vegetarians 0.82 (95% CI, 0.65-1.02); pescovegetarians, 0.57 (95% CI, 0.40-0.82) semivegetarians, 0.92 (95% CI, 0.62-1.37) For colon cancer, it appears to be the pesky pesco-vegetarians who have the lowest risk of colon cancer. But vegans win overall, at least among this healthy Adventist population relative to all cancers (not just prostate or colon cancer), according to . From the abstract: ... vegan diets showed statistically significant protection for overall cancer incidence (HR, 0.84; 95% CI, 0.72-0.99) in both genders combined. Here is the diagram from  comparing the overall cancer risk for different forms of vegetarian diets, relative to omnivores: If we look at the male & female line (first highlight) or the male-only line (second highlight) in the fully adjusted model (including adjusting for BMI), it is only the vegan dietary pattern that reaches the level of 0.05 significance, and is P < 0.05 for the combined gender group. The other vegetarian subgroups failed to show a statistically significant lower overall risk of cancer relative to omnivores. Go ahead - call my Dr. Greger. But thems the data... --Dean -----------  JAMA Intern Med. 2015 May;175(5):767-76. doi: 10.1001/jamainternmed.2015.59. Vegetarian dietary patterns and the risk of colorectal cancers. Orlich MJ(1), Singh PN(2), Sabaté J(1), Fan J(2), Sveen L(2), Bennett H(2), Knutsen SF(1), Beeson WL(2), Jaceldo-Siegl K(1), Butler TL(2), Herring RP(2), Fraser GE(1). IMPORTANCE: Colorectal cancers are a leading cause of cancer mortality, and their primary prevention by diet is highly desirable. The relationship of vegetarian dietary patterns to colorectal cancer risk is not well established. OBJECTIVE: To evaluate the association between vegetarian dietary patterns and incident colorectal cancers. DESIGN, SETTING, AND PARTICIPANTS: The Adventist Health Study 2 (AHS-2) is a large, prospective, North American cohort trial including 96,354 Seventh-Day Adventist men and women recruited between January 1, 2002, and December 31, 2007. Follow-up varied by state and was indicated by the cancer registry linkage dates. Of these participants, an analytic sample of 77,659 remained after exclusions. Analysis was conducted using Cox proportional hazards regression, controlling for important demographic and lifestyle confounders. The analysis was conducted between June 1, 2014, and October 20, 2014. EXPOSURES: Diet was assessed at baseline by a validated quantitative food frequency questionnaire and categorized into 4 vegetarian dietary patterns (vegan, lacto-ovo vegetarian, pescovegetarian, and semivegetarian) and a nonvegetarian dietary pattern. MAIN OUTCOMES AND MEASURES: The relationship between dietary patterns and incident cancers of the colon and rectum; colorectal cancer cases were identified primarily by state cancer registry linkages. RESULTS: During a mean follow-up of 7.3 years, 380 cases of colon cancer and 110 cases of rectal cancer were documented. The adjusted hazard ratios (HRs) in all vegetarians combined vs nonvegetarians were 0.78 (95% CI, 0.64-0.95) for all colorectal cancers, 0.81 (95% CI, 0.65-1.00) for colon cancer, and 0.71 (95% CI, 0.47-1.06) for rectal cancer. The adjusted HR for colorectal cancer in vegans was 0.84 (95% CI, 0.59-1.19); in lacto-ovo vegetarians, 0.82 (95% CI, 0.65-1.02); in pescovegetarians, 0.57 (95% CI, 0.40-0.82); and in semivegetarians, 0.92 (95% CI, 0.62-1.37) compared with nonvegetarians. Effect estimates were similar for men and women and for black and nonblack individuals. CONCLUSIONS AND RELEVANCE: Vegetarian diets are associated with an overall lower incidence of colorectal cancers. Pescovegetarians in particular have a much lower risk compared with nonvegetarians. If such associations are causal, they may be important for primary prevention of colorectal cancers. PMCID: PMC4420687 PMID: 25751512 ------------  Cancer Epidemiol Biomarkers Prev. 2013 Feb;22(2):286-94. doi: 10.1158/1055-9965.EPI-12-1060. Epub 2012 Nov 20. Vegetarian diets and the incidence of cancer in a low-risk population. Tantamango-Bartley Y(1), Jaceldo-Siegl K, Fan J, Fraser G. Author information: (1)Department of Epidemiology and Biostatistics, Loma Linda University, School of Public Health, Loma Linda, CA 92350, USA. firstname.lastname@example.org BACKGROUND: Cancer is the second leading cause of death in the United States. Dietary factors account for at least 30% of all cancers in Western countries. As people do not consume individual foods but rather combinations of them, the assessment of dietary patterns may offer valuable information when determining associations between diet and cancer risk. METHODS: We examined the association between dietary patterns (non-vegetarians, lacto, pesco, vegan, and semi-vegetarian) and the overall cancer incidence among 69,120 participants of the Adventist Health Study-2. Cancer cases were identified by matching to cancer registries. Cox proportional hazard regression analysis was conducted to estimate hazard ratios, with "attained age" as the time variable. RESULTS: A total of 2,939 incident cancer cases were identified. The multivariate HR of overall cancer risk among vegetarians compared with non-vegetarians was statistically significant [hr, 0.92; 95% confidence interval (CI), 0.85-0.99] for both genders combined. Also, a statistically significant association was found between vegetarian diet and cancers of the gastrointestinal tract (HR, 0.76; 95% CI, 0.63-0.90). When analyzing the association of specific vegetarian dietary patterns, vegan diets showed statistically significant protection for overall cancer incidence (HR, 0.84; 95% CI, 0.72-0.99) in both genders combined and for female-specific cancers (HR, 0.66; 95% CI, 0.47-0.92). Lacto-ovo-vegetarians appeared to be associated with decreased risk of cancers of the gastrointestinal system (HR, 0.75; 95% CI, 0.60-0.92). CONCLUSION: Vegetarian diets seem to confer protection against cancer. IMPACT: Vegan diet seems to confer lower risk for overall and female-specific cancer than other dietary patterns. The lacto-ovo-vegetarian diets seem to confer protection from cancers of the gastrointestinal tract. PMCID: PMC3565018 PMID: 23169929