“The caffeine derivatives in mate tea not only induced death in human colon cancer cells, they also reduced important markers of inflammation,” said Elvira de Mejia, a U of I associate professor of food chemistry and food toxicology.

That’s important because inflammation can trigger the steps of cancer progression, she said.

In the in vitro study, de Mejia and former graduate student Sirima Puangpraphant isolated, purified, and then treated human colon cancer cells with caffeoylquinic acid (CQA) derivatives from mate tea. As the scientists increased the CQA concentration, cancer cells died as a result of apoptosis.

“Put simply, the cancer cell self-destructs because its DNA has been damaged,” she said.

The ability to induce apoptosis, or cell death, is a promising tactic for therapeutic interventions in all types of cancer, she said.

de Mejia said they were able to identify the mechanism that led to cell death. Certain CQA derivatives dramatically decreased several markers of inflammation, including NF-kappa-B, which regulates many genes that affect the process through the production of important enzymes. Ultimately cancer cells died with the induction of two specific enzymes, caspase-3 and caspase-8, de Mejia said.

“If we can reduce the activity of NF-kappa-B, the important marker that links inflammation and cancer, we’ll be better able to control the transformation of normal cells to cancer cells,” she added.

The results of the study strongly suggest that the caffeine derivatives in mate tea have potential as anti-cancer agents and could also be helpful in other diseases associated with inflammation, she said.

But, because the colon and its microflora play a major role in the absorption and metabolism of caffeine-related compounds, the anti-inflammatory and anti-cancer effects of mate tea may be most useful in the colon.

“We believe there’s ample evidence to support drinking mate tea for its bioactive benefits, especially if you have reason to be concerned about colon cancer. Mate tea bags are available in health food stores and are increasingly available in large supermarkets,” she added.

The scientists have already completed and will soon publish the results of a study that compares the development of colon cancer in rats that drank mate tea as their only source of water with a control group that drank only water.

This in vitro study was published in Molecular Nutrition & Food Research, vol. 55, pp. 1509-1522, in 2011. Co-authors include Sirima Puangpraphant, now an assistant professor at Kasetsart University in Thailand; Greg Potts, an undergraduate student of the U of I; and Mark A. Berhow and Karl Vermillion of the USDA, ARS, National Center for Agricultural Utilization Research in Peoria, Illinois. The work was funded by the U of I Research Board and Puangpraphant’s Royal Thai Government Scholarship.

Source: University of Illinois College of Agricultural, Consumer and Environmental Sciences

Credit: Anne Peery, MD

The study, conducted by researchers at the University of North Carolina at Chapel Hill School of Medicine , found that consuming a diet high in fiber raised, rather than lowered, the risk of developing diverticulosis. The findings also counter the commonly-held belief that constipation increases a person’s risk of the disease.

“Despite the significant morbidity and mortality of symptomatic diverticulosis, it looks like we may have been wrong, for decades, about why diverticula actually form,” said Anne Peery, MD, a fellow in the gastroenterology and hepatology division at UNC and the study’s lead researcher. The study appears in the February 2012 issue of the journal Gastroenterology.

“While it is too early to tell patients what to do differently, these results are exciting for researchers,” said Peery. “Figuring out that we don’t know something gives us the opportunity to look at disease processes in new ways.”

Diverticulosis affects about one-third of adults over age 60 in the United States. Although most cases are asymptomatic, when complications develop they can be severe, resulting in infections, bleeding, intestinal perforations and even death. Health care associated with such complications costs an estimated $2.5 billion per year.

Since the late 1960s, doctors have recommended a high-fiber diet to regulate bowel movements and reduce the risk of diverticulosis. This recommendation is based on the idea that a low fiber diet will cause constipation and in turn generate diverticula as a result of increased pressure in the colon. However, few studies have been conducted to back up that assumption. “Our findings dispute commonly-held beliefs because asymptomatic diverticulosis has never been rigorously studied,” said Peery.

The UNC study is based on data from 2,104 patients aged 30-80 years who underwent outpatient colonoscopy at UNC Hospitals from 1998-2010. Participants were interviewed about their diet, bowel movements and level of physical activity.

“We were surprised to find that a low-fiber diet was not associated with a higher prevalence of asymptomatic diverticulosis,” said Peery. In fact, the study found those with the lowest fiber intake were 30 percent less likely to develop diverticula than those with the highest fiber intake.

The study also found constipation was not a risk factor and that having more frequent bowel movements actually increased a person’s risk. Compared to those with fewer than seven bowel movements per week, individuals with more than 15 bowel movements per week were 70 percent more likely to develop diverticulosis.

The study found no association between diverticulosis and physical inactivity, intake of fat, or intake of red meat. The disease’s causes remain unknown, but the researchers believe gut flora may play a role.

Peery said more research is needed before doctors change dietary recommendations, but the study offers valuable insights on diverticulosis risk factors. “At this time, we cannot predict who will develop a complication, but if we can better understand why asymptomatic diverticula form we can potentially reduce the population at risk for symptomatic disease,” said Peery.

Source: University of North Carolina School of Medicine

These findings are detailed in three studies of 756 patients published online in the Jan. 23 edition of the Archives of Internal Medicine — the first large, randomized controlled trials to show that people can use positive affect and self-affirmation to help them make and sustain behavior change. The research was funded by a $9.5 million contract from the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH) and led by Dr. Mary Charlson, executive director of the Center for Integrative Medicine at Weill Cornell Medical College and the William T. Foley Distinguished Professor of Medicine and professor of integrative medicine at Weill Cornell Medical College. She is also chief of the Division of Clinical Epidemiology and Evaluative Sciences Research in the Department of Medicine at Weill Cornell Medical College.

The same intervention was used in all three studies. Patients were encouraged to think of small things in their lives that make them feel good (such as seeing a beautiful sunset) when they get up in the morning and throughout their day. Patients were also asked to use self-affirmation to help them overcome obstacles to their plan by recalling moments in their lives they are proud of, such as a graduation (see script excerpt below). The script, created by Dr. Charlson, is now in the public domain and free to use.

“This simple approach gives patients the tools that help them fulfill their promise to themselves that they will do what’s needed for their health,” says Dr. Charlson. “For example, if it’s raining and they don’t feel like exercising, these strategies can help them get past this mental block and into their sneakers.”

Excerpt from Positive Affect/Self-Affirmation Script:

First, when you get up in the morning, think about the small things that you said make you feel good, like __________________________ (example: babies in hats, the sunrise…). Then as you go through your day, notice those and other small things that make you feel good and take a moment to enjoy them. Second, when you encounter some difficulties or are in a situation that makes it hard for you (e.g. taking your blood pressure medications or exercising), think about things you enjoy or proud moments in your life, like __________________________ (example: a graduation, success of a child…).

The behavior changes employed in the studies are known to be beneficial — whether it is increased physical activity for coronary artery disease or regularly taking medication for high blood pressure or asthma. “In this way, positive affect made a real difference — patients are better able to follow through on behaviors to improve their health,” Dr. Charlson adds.

Patients were randomly assigned either to the experimental “positive affect” group or to a control group. Both groups made personal contracts to adhere to their behavior plans, were given an educational guide on the importance of their intervention, and received phone calls every two months to check in on their progress. Along with daily use of positive affect, patients in the experimental group received surprise gifts like tote bags prior to the phone sessions. The monetary value of the gifts was unimportant, Dr. Charlson explains; rather, they were symbolic and served to reinforce the intervention.

Results were measured at the completion of the yearlong studies. For coronary artery disease, 55 percent of patients practicing the positive affect/self-affirmations increased their physical activity compared with 37 percent in the control group; the positive affect group walked an average of 3.4 miles a week more than the control group. For high blood pressure (the study focused on African-Americans with the disease), 42 percent of the positive affirmation group adhered to their medication plan compared with 36 percent in the control group. For asthma patients, there was no difference in energy expenditure between the two groups; however, there was some benefit for patients requiring medical care during the trial.

The design of the studies, which simultaneously tested the same intervention for different populations, was one of the first for NIH-funded research, and began with contract awarded to Weill Cornell Medical College in 2002. This intervention development approach is now being more broadly used in the obesity-related behavioral intervention trials (ORBIT) sponsored by the NIH. Dr. Charlson is a recipient of an award titled “SCALE: Small Changes and Lasting Effects” under the ORBIT trials. The findings of the three trials are the basis for “SCALE” for overweight or obese patients.

Source: New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

“The data raises the possibility that we might identify subsets of patients whose tumors may respond to statins,” said Carol Prives of Columbia University. “Of course we can’t make any definitive conclusions until we know more.”

Prives said that a clinical trial of statins in breast cancer based on the mutation status of the tumor suppressor, p53, may be in order. The p53 tumor suppressor acts to regulate many aspects of cell proliferation, generally putting the brake on uncontrolled growth.

More than half of all human cancers carry mutations in the p53 gene. Many of these mutations don’t simply disrupt the normal function of p53, they also endow p53 with new functions that promote, instead of inhibit, cancer formation. Mice lacking p53 develop cancer and die, Prives explained, but mice carrying tumor-derived mutant forms of the p53 gene suffer from more aggressive disease. What these mutant forms of p53 are actually doing is a big question in cancer research.

Prives’ team designed experiments to sort this mystery out. By studying cancer cells grown in an artificial system that resembles the three-dimensional structures in the human breast, the researchers learned that cells carrying mutant p53 grow in a disorganized and invasive manner, characteristic of human breast cancers. When the researchers lowered the levels of mutant p53, the 3D cell cultures grew more normally.

Further studies, led by study first author William Freed-Pastor, traced the structural changes to a cholesterol-building pathway (called the mevalonate pathway). This is the same pathway targeted by cholesterol-lowering statins. When the mutant p53 cells were treated with statins, they stopped their disorganized, invasive growth, and in some cases, even died. Importantly, the effects of the drugs were erased when intermediates of the mevalonate pathway were added back in, additional proof that the drug wasn’t working in some other, off-target way.

With collaborators in Norway, Prives and Freed-Pastor analyzed breast cancer tissue taken from patients to find that mutations in p53 and elevated activity of mevalonate pathway genes tend to go together in human tumors too. While those findings are encouraging that the cell culture findings may have clinical relevance, Prives emphasizes that it will take considerably more work to confirm that.

“It is what it is,” she says. “There are great implications, but nothing clinical yet. Perhaps one could do a clinical trial, and that may support these findings, or it may be more complicated.”

Source: Cell Press

“Mammographic screening confers a substantial relative and absolute reduction in breast cancer mortality risk in the long-term,” said Stephen W. Duffy, M.Sc., professor of cancer screening at Queen Mary, University of London. “For every 1,000 to 1,500 mammograms, one breast cancer death is prevented.”

The Swedish Two-County Trial of mammographic screening was the first breast cancer screening trial to show a reduction in breast cancer mortality from screening with mammography alone. The trial randomized 133,065 women into two groups, one that received an invitation to screening and another that received usual care. At the conclusion of the study, there were 30 percent fewer breast cancer deaths among all women (attenders and non-attenders) in the group invited to undergo screening. The screening phase of the trial lasted approximately seven years. Women between the ages of 40 and 49 were screened, on average, every 24 months, and women age 50 to 74 were screened, on average, every 33 months.

For the current study, nearly three decades after the beginning of the trial, the researchers analyzed the original data and the follow-up data to estimate the long-term effect of mammography screening on breast cancer mortality. At 29 years, this represents the longest recorded follow-up period for a mammography screening trial.

Case status and cause of death were determined by local trial end point committees and, independently, by an external committee. Mortality analysis at follow up showed a reduction in the breast cancer mortality rate in the screening population, similar to the original trial results. But while the relative effect of screening on breast cancer mortality remained stable over the follow-up period, the absolute benefit in terms of lives saved increased with longer follow-up times. At 29 years of follow-up, the estimated number of women needed to undergo screening every 2 or 3 years over a seven-year period to prevent one breast cancer death ranged from 414 to 519.

According to the researchers, evaluation of the full impact of screening mammography requires follow-up times exceeding 15 to 20 years, because the observed number of breast cancer deaths prevented increases with the passage of time.

“Most of the deaths prevented would have occurred more than 10 years after the screening started,” Duffy said. “This indicates that the long-term benefits of screening in terms of deaths prevented are more than double those often quoted for short-term follow-up.”

These new data add to the evidence on the long-term benefits of regular mammography screening, and should be included in the discussions between women and doctors about what to expect from breast cancer screening.

“Unfortunately, we cannot know for certain who will and who will not develop breast cancer,” Duffy said. “But if you undergo a recommended screening regimen, and you are diagnosed with breast cancer at an early stage, chances are very good that it will be successfully treated.”

Source: Radiological Society of North America

There is no question that, on average, very elderly people may be more sensitive to the effects of alcohol (especially those individuals with chronic diseases, lower muscle mass, a poor diet, etc.) It should be made clear, however, that 65-year-olds are healthier than people of that age a generation ago – age-specific disability rates are decreasing, not increasing.

The report also recommends lower “sensible limits” for older people in comparison with younger people The International Forum on Alcohol Research scientific reviewers point out inherent difficulties in providing guidelines for a very non-homogenous group of individuals whose only criterion for inclusion, in this paper, is being above the age of 65 years Such a group includes individuals varying from marathon runners to very sick, frail people.

The report was conspicuously lacking in a discussion of the important role that moderate drinking can play in reducing the risk of coronary heart disease, ischemic stroke, diabetes, dementia, and osteoporosis. Advising healthy people aged 65 years or older who are moderate, responsible drinkers to stop drinking or to markedly reduce their intake would not be in their best health interests, especially in terms of their risk of cardiovascular diseases. Forum reviewers thought that advice to lower limits of drinking for everyone in this age group is not based on reliable research, and would certainly not apply to all in this age group. Of more importance, the absolute risk for cardiovascular diseases increases markedly with age, and therefore the beneficial or protective effect of light to moderate drinking on cardiovascular diseases is greater in the elderly than in younger people.

Evidence is also accumulating that shows that the risk of Alzheimer’s disease and other types of dementia is lower among moderate drinkers than among abstainers. Neurodegenerative disorders are key causes of disability and death among elderly people. Epidemiological studies have suggested that moderate alcohol consumption, may reduce the incidence of certain age-related neurological disorders including Alzheimer’s disease. Regular dietary intake of flavonoid-rich foods and/or beverages has been associated with 50% reduction in the risk of dementia, a preservation of cognitive performance with ageing,a delay in the onset of Alzheimer’s disease and a reduction in the risk of developing Parkinson’s disease.

Further, scientific data are consistent in demonstrating that quality of life is better and total mortality is lower among moderate drinkers than among abstainers. For example, analyses by Simons et al from a large population-based patient population in New South Wales demonstrated clearly that regular moderate alcohol consumption increases life span and quality of life for men up to 80 years of age and for women indefinitely.

In another paper, by Kirchner et al of almost 25,000 American adults over age 65 seen in primary care, those reporting between 8 and 14 drinks/week (A US drink is 14g, against 8g in the UK) did not differ significantly in their characteristics from drinkers consuming 1-7 drinks/week.. Heavier drinkers and binge drinkers did not do as well.

A particular interesting paper by White et al showed a direct dose-response relation between alcohol consumption and risk of death in women aged 16-54 and in men aged 16-34, whereas at older ages the relation is U shaped. These investigators used statistical models relating alcohol consumption to the risk of death from single causes to estimate the all-cause mortality risk for men and women of different ages. The authors state that their data suggest that women should INCREASE their intake to 3 units a day over age 75, and men rise from 3 units a day up to age 54 to 4 units a day up to age 84.

Since the absolute effects of moderate drinking on cardiovascular disease are much greater in older people than in younger adults, the current limitations to intake for the elderly may not be appropriate. Attempting to persuade elderly people who currently drink moderately to decrease their current intake may not be advisable. For healthy moderate and responsible drinkers, advice to reduce or stop all alcoholic beverage intake would not be in the best health interests of such individuals.

Source: Boston University Medical Center

The study*, by researchers at Queen Mary, University of London, shows that the number of deaths that are prevented goes up year after year.

The results are new evidence of the long-term benefits of regular breast screening.

Senior author, Professor Stephen Duffy explained: “Breast cancer can take many years to develop so to tell if screening is effective, we need to see how women fair in the long-term.

“In this study, we’ve continued to monitor women for nearly three decades and we’ve found that the longer we look, the more lives are saved.”

The study included over 130,000 women and was the first to show that screening, with mammography only, led to fewer deaths from breast cancer. It compared a group of women who were invited for regular mammograms with a group who were not. The women have now been followed up for 29 years to see how many died of the disease.

The results showed that 30 per cent fewer women in the screening group died of breast cancer and that this effect persisted year after year.

The study also showed that one cancer death is prevented for approximately every 400 to 500 women in the screening group.

Professor Duffy added: “This suggests that the long-term benefits of screening, in terms of deaths prevented, are more than double those often quoted for short-term follow-up.

“Unfortunately, we cannot know for certain who will and who won’t develop breast cancer. But if you take part in screening and you are diagnosed with breast cancer at an early stage, the chances that it will be successfully treated are very good.”

Source: Queen Mary, University of London

The largest study yet of adult childhood cancer survivors found that the first cancer is just the beginning of a lifelong battle against different forms of the disease for about 10 percent of these survivors.

The research involved 14,358 individuals enrolled in the federally funded Childhood Cancer Survivor Study (CCSS). St. Jude Children’s Research Hospital investigators leading the effort reported that 1,382, or 9.6 percent, of survivors developed new tumors unrelated to their original cancers. About 30 percent of those survivors, 386 individuals, developed third tumors. Four or more tumors were found in 153 survivors in this study. The results appear in the June 27 online edition of the Journal of Clinical Oncology.

“These findings show that when you describe adult survivors of childhood cancer it is not sufficient to describe their risk of a first subsequent cancer, but to acknowledge that some of these patients are at risk for multiple cancers. This is the first study to more fully enumerate that risk,” said Gregory Armstrong, M.D., the study’s principal investigator and an assistant member of the St. Jude Department of Epidemiology and Cancer Control.

The work underscores the importance of cancer screenings for this growing population. “Too often, survivors still are not getting these important cancer screening tests beginning as early or as often as recommended,” Armstrong said. For example, mammograms beginning at age 25 rather than age 40 are recommended for female survivors whose childhood treatment included chest radiation of 20 grays or more. A gray is a measure of absorbed radiation.

An estimated 366,000 Americans alive today are childhood cancer survivors. With overall long-term childhood cancer survival rates now at 80 percent, the ranks of survivors are expected to keep growing. The CCSS was launched in 1994 to identify the challenges facing childhood cancer survivors and to develop new methods to ease or prevent late effects. St. Jude is the study’s central coordinating institution. St. Jude scientists are also focused on using genomics and other tools to develop the next generation of cancer therapies and better match patients with existing therapy to increase cures but decrease the risk of treatment-related toxicities, including second cancers.

In this study, half of the participants had survived at least 23 years since their childhood cancers were found. Their median age was 32 years old, meaning most had yet to reach the age when rates of prostate, breast and other cancers increase sharply in the general population.

Almost 70 percent of study participants received radiation as part of their successful childhood cancer treatment. This study reinforced earlier research that linked radiation therapy with an increased risk of developing additional tumors, malignant and benign, later in life. Female survivors whose childhood cancer treatment included radiation were among those at highest risk for later tumors, particularly breast tumors.

For 735 survivors, the second tumors were malignant and thus life-threatening.

Risks were also associated with benign tumors. Investigators showed survivors whose second tumor was a non-melanoma skin cancer had a 1 in 5 chance of being diagnosed with another, more aggressive cancer within 15 years. The group included 485 survivors with either basal or squamous cell skin cancers. “These survivors are candidates for additional genetic evaluation to look for an underlying genetic propensity for tumor development or an inability to protect healthy cells against the harmful effects of radiation,” Armstrong said.

Of the 176 survivors whose second tumors were found in the breast, 42 women developed multiple tumors. For many, researchers reported that the tumors apparently developed independently in both breasts almost simultaneously. “This finding reinforces previous reports of multiple breast cancers and defines them as a significant risk,” Armstrong said.

This study included survivors whose cancers were found between 1970 and 1986 when they were age 20 or younger. Participants were treated at one of 26 institutions in the United States or Canada and survived at least five years after their cancer diagnosis.

Source: St. Jude Children’s Research Hospital

Since 2005, doctors have been accepting fewer and fewer patients with health insurance, according to a new study published in the June 27th issue of Archives of Internal Medicine. As a result, says Dr. Tara Bishop, assistant professor of public health at Weill Cornell Medical College, and lead author of the study, insured patients could face new obstacles to receiving the medical attention they need, and overall access to health care could actually contract.

Dr. Bishop, who is also a practicing physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, and her fellow investigators looked at survey data from a national survey run by the CDC’s National Center for Health Statistics and found an overall decline in physician acceptance of several types of insurance. First, they noted a modest drop in acceptance of Medicare patients, from 95.5 percent in 2005 to 92.9 percent in 2008. Doctors also turned more and more Medicaid patients away over the four-year period — a phenomenon the authors attribute to Medicaid’s historically low reimbursement rates. But the most surprising decline of all was seen in doctors’ acceptance of new patients with private insurance.

“Given the medical profession’s widely reported dissatisfaction with Medicare, we expected to find hard evidence that Medicare patients were being turned away,” Dr. Bishop says. “Instead, we saw only a modest decline in doctors’ acceptance of patients on Medicare. The survey data showed a more significant decline in their acceptance of patients with private insurance.”

Physician acceptance of patients with traditional fee-for-service private insurance declined from 93.3 percent in 2005 to 87.8 percent in 2008.

This change could be traceable to two major factors, she explains: inadequate reimbursement levels that have not kept pace with medical practice expenditures; and the tangle of administrative issues that go hand in hand with private health insurance.

“At a moment when the country is poised to achieve near-universal coverage, patients’ access to care could be a casualty of the collision between the medical profession and the insurance industry,” says Dr. Bishop.

Source: New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College

Traumatic brain injury is a disruption of normal brain function after a head injury and affects 1.7 million Americans annually, according to the Centers for Disease Control and Prevention. Those struggling with the long-term effects of TBI are at a heightened risk for mental and physical problems. Such problems can significantly inhibit rehabilitation outcomes and are therefore important to address in the context of rehabilitation efforts. And when TBI leaves people feeling stressed, less satisfied with life and functionally dependent on others, rehabilitation is the only option.

“Among healthy adults, religion and spirituality have shown strong association with improved life satisfaction and physical and mental health outcomes,” said Waldron-Perrine. But research about religion’s effect on TBI rehabilitation in particular is lacking.

To fill this void, Waldron-Perrine interviewed and completed neuropsychological tests on 88 individuals diagnosed with TBI victims, most of whom were male, African American Christians. Participants also completed a neuropsychological measure of their cognitive abilities. A significant other of each TBI victim also participated and reported on the injured individual’s functional status.

Waldron-Perrine found that most participants who reported higher levels of religious well-being (a connection to a higher power) had better emotional and physical rehabilitation outcomes. But public religious activities or practice and existential well-being – a sense that life has a purpose apart from any religious reference – did not have such an effect influence on rehabilitation outcome.

This “intriguing” finding, she said, may be due to the fact that TBI victims lack full control of their ability to participate in public religious practice. “They often must rely on others for scheduling and transportation to social events, so their public religious participation does not wholly reflect their true use of religious resources,” she said.

As expected on the basis of previous studies, social support was related to positive physical and mental rehabilitation results. This, Waldron-Perrine said, is consistent with other research studies linking religious social support to positive health outcomes in other populations. But even when Waldron-Perrine adjusted for social support, religious well-being still stood as a unique and strong predictor of positive health outcomes in TBI patients.

“Individuals cope with the tools available to them, and perhaps especially for those with limited means and few alternatives, religion can take on great power as a psychosocial resource,” Waldron-Perrine said.

Waldron-Perrine’s doctoral dissertation, completed in Rapport’s lab, was the foundation of this study. Waldron-Perrine is now a post-doctoral fellow at the Veterans Affairs Ann Arbor Health Care System and University of Michigan’s Department of Psychiatry.

Source: Wayne State University