Obese Colon Cancer Survivors Face Poorer Prognosis
Colon cancer survivors who are moderately or severely obese face tougher survival odds following treatment compared with their normal-weight peers, a new study reveals.
The finding builds on prior research that established that being obese raises the risk for developing colon cancer in the first place.
“Previous studies have shown that obesity does influence the risk of developing colon cancer, but this study takes it one step further,” said study author Dr. Frank A. Sinicrope, a professor of medicine and oncology at the Mayo Clinic in Rochester, Minn. “Because now we know that if you’re obese, you have a higher risk of cancer recurrence or death for patients who have established colon cancer.”
Sinicrope and his colleagues, whose work was funded in part by the U.S. National Cancer Institute, report their findings in the March 15 issue of Clinical Cancer Research.
The American Cancer Society estimates that last year more than 106,000 Americans were newly diagnosed with colon cancer, while nearly 50,000 men and women died from the disease.
To explore a potential connection between obesity and colon cancer survival, the authors analyzed data concerning 4,381 men and women who had been diagnosed with either stage II or stage III colon cancer. All of the patients had undergone both surgical removal of their cancer and subsequent chemotherapy.
Based on body mass index (BMI), which is a measurement that takes into account weight and height, the researchers determined that approximately 20 percent of the patients were obese (above 30 on the BMI chart). Among that group, about seven in 10 patients were classified as “moderately obese” (BMI between 30 and 34.9), while slightly more than one-quarter were “very obese” (BMI of 35 and up).
About 37 percent of the patients were normal weight (BMI of 20 to 24.9), while a similar number were deemed overweight (BMI of 25 to 29.9). Six percent were classified as underweight (BMI under 20).
Tracking all the cancer survivors for an average of eight years, Sinicrope and his associates observed that 36 percent went on to experience cancer recurrence, while 42 percent ultimately died.
Furthermore, the researchers found that, taken as a group, being either moderately or very obese was associated on average with a 19 percent increase in the risk for death, when compared with normal-weight cancer patients.
Although the pool of underweight patients was considerably smaller, the researchers found that the underweight group also had a much poorer survival rate than normal-weight patients. And while overweight patients actually seemed to fare slightly better (by 6 percent) than normal-weight survivors, Sinicrope indicated that more sophisticated obesity measurements that take into account muscle-mass ratios (not revealed by BMI) could yield slightly different results.
Gender differences were also apparent.
With a patient pool that was more or less evenly divided between men and women, the authors found that taken on their own, the most severely obese men faced the highest risk for cancer recurrence and death — tagged as a 35 percent increase, relative to normal-weight patients.
However, women on the lowest end of the obesity scale were linked to a 24 percent increased risk for death — a risk that actually dropped down to 11 percent as obesity rose.
“For now, we don’t really have a clear explanation for why the moderately obese women did worse than the very obese women,” said Sinicrope. “Menopausal status and hormone replacement therapy — which could be protective against colon cancer — could both be factors. But we don’t know which women were pre- or postmenopausal and which were taking this medication.”
As for what general underlying cause accounts for the obesity-survival risk connection, Sinicrope said the question remains unanswered. But he speculated that the association might result from the presence of higher insulin and insulin-like growth-factor-1 hormone levels in obese patients.
“We know the obese patients have higher levels of both these hormones, which have been associated with both obesity and colon cancer risk in the past,” he noted. “So we think that could be playing a role in this risk.”
A number of variables could explain the findings, said Dr. Joseph Martz, chief of the division of colorectal surgery at Beth Israel Medical Center in New York City.
“Obesity is often associated with a higher likelihood for diabetes and other diseases, and overall secondary immune dysfunction. And since colon cancer is somewhat of an immune disease, that is going to be a driving factor,” he noted.
“There is also a good deal of data already regarding the supportive benefit of exercise and activity after colon cancer treatment in terms of prognosis,” Martz added. “So I think that goes along with the concept that obese individuals are less likely to be in shape. Also, there may be some inherent surgical limitations that could compromise the technical ability to achieve complete removal of the cancer and the potentially affected lymph node tissues when operating on an obese person. All of this may play a role.”
On a related front, a separate study published this week in the Journal of the National Cancer Institute provides fresh evidence that being obese does appear to be linked to a higher risk for colon cancer.
However, the research team — led by Peter T. Campbell of the epidemiology research program at the American Cancer Society — also found that the obesity-survival link does not seem to hold for all tumors, but only for those that are so-called “microsatellite stable.” Obese patients who had this common type of tumor had lower five-year survival rates than obese patients with “microsatellite-high” tumors, suggesting that obesity has a varying impact on prognosis, depending on the kind of colon cancer at hand. By Alan Mozes, Yahoo Daily News
Americans Want Government’s Help Putting Healthy Foods On Their Dinner Table
New survey finds out what Americans are really paying attention to when choosing foods
Americans recognize things need to change in the grocery aisle, and they support Uncle Sam’s efforts to overhaul what is included in their food and on the packages. The majority also believe they are individually responsible for making the right food choices to avoid obesity, but will readily accept the government’s help to be successful, according to a new survey by FoodMinds.
“In light of all the recent attention around food labeling and nutrition guidance programs, we wanted to get a sense of what the consumer actually thought,” said Grant Prentice, FoodMinds’ director of Strategic Insights. “We heard clearly they believe things need to change – and that it makes sense for the government to lead that charge.”
Americans Want Uncle Sam…
…Involved in Food Labels
* Eighty-six percent of consumers are interested in the government implementing objective front-of-pack labeling that calls out calories and beneficial nutrients such as vitamin D or fiber
* Seventy-seven percent of shoppers are interested in front-of-package labels designed to warn them of products with high calories, low nutrients
- And, 64 percent said if their favorite food had a warning label on it, they would either eat less or stop buying the product entirely
…To Help Educate, Mitigate and Motivate
* Seventy-four percent favor government-sponsored nutrition education programs to help them better identify the “good” versus the “bad” foods
* Fifty-eight percent support the government banning advertising of “unhealthy” foods to children and young adults
* Half are in favor of the government allowing employers to reward healthier employees while levying higher costs or fines to punish those who engage in unhealthy behaviors
…But Not His Taxes
* Rejected by 65 percent of shoppers are proposed taxes on soft drinks and foods high in sugar and calories, but low in nutritional value
Just the (Nutrition) Facts, Ma’am
Consumers love food-related information – and want more of it, in particular basic, factual data.
* The Nutrition Facts panel ranks first with 93 percent of shoppers saying it’s a very or somewhat useful tool, followed by front-of-pack information (low fat, high in fiber, etc.) at 88 percent
* Not quite as popular are marketing-oriented claims such as “helps lose weight,” “helps build strong bones,” with 71 percent of shoppers finding them useful
* Three quarters of shoppers like seeing where their food comes from (“organic,” “natural” and “sustainable farming practices”)
Not It! Significant Minority Believes Others Responsible for Individuals’ Eating Habits
* When asked who holds the primary responsibility to make sure the public makes right food choices to avoid obesity, 38 percent chose: 14 percent said food companies, 12 percent said the government, nine percent said the health care system and three percent pointed to the educational systems
About the Food Temperance Survey
Created by the FoodMinds Strategic Insights department, the Food Temperance survey was conducted through Greenfield Online’s Omnibus service on January 18, 2010. The sample of 1045 adults is balanced on age, gender and region of the U.S. Sub-samples of 869 primary grocery shoppers and 182 Opinion Leader Shoppers were screened from the overall adult sample. The MOE is +/- 3% for primary grocery shoppers and +/- 7% for the opinion leader shoppers. redOrbit
Warning Over Salt Levels In Soup
Many soups sold in high street cafes and supermarkets may not offer the healthy option customers are seeking, a pressure group has warned.
Consensus Action on Salt and Health (Cash) said 25% of 575 types of soup it analysed failed to meet Food Standards Agency targets on salt content.
However, it said there had been a 17% drop in the amount of salt in ready-to-eat ranges since its 2007 survey.
Experts say high salt intake raises blood pressure and the risk of strokes.
For its survey, carried out between December and February, Cash tested soups from a number of supermarkets and high street chains.
The Food Standards Agency’s target for soup is that each 100g portion should contain no more than 0.6g of salt.
Its recommended maximum daily intake of salt for an adult is 6g.
Among the worst offenders highlighted by Cash was cafe chain Eat’s 907g Bold Thai Green Chicken Curry soup, which Cash said contained more than 8g of salt.
Even Eat’s smallest 340g-sized portion had 2.8g of salt, nearly half the daily recommendation and more than a Big Mac and fries, Cash said.
Eat, which has 98 shops nationwide, said it had reduced salt in all its soup stocks and would continue to do so, but said it needed to happen gradually for people’s tastes to adjust.
Brand director Faith MacArthur said its largest sized soup was often shared and represented a tiny part of soup sales.
Cash chairman, Professor Graham MacGregor said: “The majority of the food industry is slowly taking out the salt from food, including these soups.
‘Save lives’
“We commend the progress so far, however they haven’t gone far enough if we are to save the maximum number of lives.”
Spokeswoman Katharine Jenner added: “People tend to think salt is only in crisps, snacks and ready meals. But this survey shows huge amounts of salt can be hidden in seemingly healthy choices such as soup.
“We urge manufacturers to reduce their salt content immediately.”
Cash said among supermarket-own brands it tested, 93% met 2010 FSA salt targets, compared with 66% of branded products.
Among products on sale in supermarkets, 23 contained 2g or more salt per portion, Cash said. Of these, 18 were from brands including Heinz and New Covent Garden.
When it came to fresh supermarket soups, Cash said, the highest in salt content was New Covent Garden’s Scotch Broth at 2.4g of salt a portion – six times higher than the lowest, Tideford Organics Moroccan vegetable at 0.44g.
Prof MacGregor urged consumers to boycott products high in salt.
The New Covent Garden Food Company said it had consistently reduced salt levels across its range over recent years and had beaten the Food Standards Agency’s average target for soup.
“We also feature the government-approved FSA traffic light labelling system, which clearly shows all our soups fall within either green or amber classifications for salt,” a spokesman said.
Heinz said its entire soup range was already within average targets and its work to cut salt further continued in line with consumer taste. BBC News
Happiness Helps When It Comes To The Heart
You’ve heard it before: to avoid a heart attack don’t smoke, eat right and exercise. But it also may help to be happy, a new study says.
Even if you’re grumpy by nature, just try to be cheerful.
Researchers at Columbia University rated the happiness levels of more than 1,700 adults in Canada with no heart problems in 1995.
After a decade, they examined the 145 people who developed a heart problem and found happier people were less likely to have had one.
The study was published online Thursday in the European Heart Journal.
“If you aren’t naturally a happy person, just try acting like one,” said Dr. Karina Davidson of Columbia University Medical Center, the paper’s lead author. “It could help your heart.”
Davidson and colleagues used a five-point scale to measure people’s happiness. They then statistically adjusted to account for things like age, gender, and smoking.
For every point on the happiness scale, people were 22 percent less likely to have a heart problem. The study was paid for by the U.S. National Institutes of Health and others.
Davidson said happy people were more likely to have a healthier lifestyle.
It could also be there is an unknown genetic trait that predisposes people to be happy and have less heart disease.
Other experts said happiness itself could result in a healthier heart compared to other emotions such as stress or depression.
Stress often releases hormones that can damage heart muscle. Stress can also cause blood vessels to open too wide, allowing plaque buildups to break off and clog the arteries, according to Joep Perk, a professor of health sciences at Sweden’s Kalmar University and spokesman for the European Society of Cardiology. Perk was not linked to the study.
“I often tell my patients not to get too depressed because it’s bad for your heart,” Perk said. “You need time to recharge your batteries or else your heart won’t be able to take it.”
Depression has long been noted as a risk factor for heart problems. Davidson said it was premature to draft guidelines recommending patients boost their happiness levels just to protect their hearts, even if it might help, until broader studies now under way are completed. But she does recommend trying to be happy for other reasons, like better mental health.
“Anything that patients can do to increase the amount of (happiness) in their lives will be helpful,” she said, adding there was a slight proviso. “No smoking, eating unhealthy food, not exercising or anything potentially damaging,” she said. “That’s the only trick.” By Maria Cheng, The Press Democrat
Inexpensive Bathroom Makeover
You don’t have to spend a lot of money to decorate in your bathroom. Just add some cheap candlesticks, vases, and seashells, dishes with stones, candles or whatever you are drawn to. Even just these smalls’ touches will make your bathroom feel cozier and more decorative. Next, give your bathroom a new face lift with a fresh coat of paint. Painting is one of the least expensive home improvement projects you can do, but it will make an enormous impact. Select a bright color to open up a small room, and enhance it with bright white semi-gloss paint trim. This inexpensive bathroom makeover idea not only looks great, but makes the room smell clean and fresh too.
Nevertheless, while there are plenty of choices on the market for Bathroom Suites many elders still prefer soaking in a tub, and finding alternatives to the dangerous bath tub can prevent many falls. Thus, for bathroom remodels, choosing a toilet that is 15 inches or higher will generally provide the height needed on a more permanent basis. Various styles are available and dozens of models of walk-in tubs provide price range and choice. Some distributors provide reasonable installation, which includes removal of the standard tub. For those who simply want to keep the tub and insist on bathing, tub lifts offer a safe and affordable approach.