- Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC
- Blog author, Solai Buchanan is an experienced Registered Dietitian and Certified Diabetes Educator with an MS from Columbia Teachers College. She specializes in treating heart disease, diabetes, hypertension, high cholesterol, polycystic ovarian syndrome,and other chronic diseases. She is a provider at a full-service cardiology practice accepting most insurance and staffed with a primary care MD, pediatrician, and cardiologist. Call: 718.894.7907. NYCC is lead by Interventional Cardiologist Sanjeev Palta, MD, FSCAI, FACC. He trained at Cornell-Columbia Presbyterian Hospital and the State University Hospital of Brooklyn. He currently is an Attending Cardiologist at New York Methodist Hospital and Maimonides Medical Center. He is also an Assistant Clinical Professor in the Department of Medicine at Mount Sinai Medical Center. Having performed over 2000 invasive cardiac procedures Dr. Palta’s patients know they are in trusted hands.
Tuesday, November 14, 2017
The American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF) recently updated information on diet, lifestyle and colon and rectal cancer risk. Their extensive research review of over 100 studies found there is strong evidence of links between lifestyle and colorectal cancer risk. An estimated 47% of American’s colorectal cancers, 63,700 cases, could be prevented each year with lifestyle changes. The 2017 report is the first by the AICR/WCRF to conclude there are substantial benefits to eating more whole grains (such as brown rice and 100% whole-grain bread) for reducing colon cancer risk. Consistent with earlier reviews they found regular physical activity, healthy weight, and not smoking also lower one’s odds of bowel cancers. Alcohol, meat, and particularly processed meats were found to increase risk of colon and rectal cancer.
The AICR/WCRF found that three servings (a serving equals 1 slice of bread or ½ cup of cooked grains) a day of whole grains can lower colorectal cancer by 17%. Other sources of dietary fiber including fruits, vegetables, beans, and nuts, as well as dairy products and calcium supplementation were also deemed beneficial for lowering colon cancer risk. Besides their fiber, plant foods contain a wide variety of substances that have been linked to lower risk for cancer, including carotenoids, selenium, lycopene and many more. Fruits and vegetables rich in vitamin C such as strawberries, oranges, and spinach appear to be especially beneficial. Interestingly, regular intake of garlic was also linked to reduced risk. Exactly how garlic contributes to lower risk is not known but in many laboratory studies, garlic and its components such as allyl sulphur compounds, has shown the ability to slow and stop the formation of colon tumors. The panel also recommended at least 30 minutes of daily physical activity.
As for foods to decrease, AICR/WCRF experts advised limiting intake of all red meat, such as beef or pork, to no more than about 17 ounces (i.e. just over 1 pound) per week. The report also stated it is best to eat little or no processed meats such as ham, hot dogs and bacon because frequent intake of these significantly increases the risk of bowel cancer. Nitrates are added to many processed meats; they contribute to the production of N-nitroso compounds that can damage the lining of the gut.
What to do: Colorectal cancer is one of the most common cancers, yet this report demonstrates healthy diet and lifestyle substantially lowers risk. Maintain a healthy weight with a diet rich in whole grains, fruits, and vegetables. Control portions of meat, opting for fish, chicken, or beans more often. Stay away from processed meats, alcohol, and smoking. Also get screened. The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 and continuing until age 75 years.
Adapted from articles available at:
American Institute for Cancer Research and the World Cancer Research Fund International. Continuous Update Project Report: Diet, Nutrition, Physical Activity and Colorectal Cancer. September 7, 2017. Available at: https://www.wcrf.org/colorectal-cancer-2017.
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 11:49 AM
Saturday, November 11, 2017
A recent study underscores the importance of consistently treating obstructive sleep apnea (OSA). The research trial revealed that when individuals with sleep apnea do not use their continuous positive airway pressure (CPAP) devices, even for just a couple of days, they experience marked increases in blood sugar, stress hormones, and blood pressure. Another recent study concluded that over time untreated sleep apnea increases the build-up of amyloid beta, the plaque-building peptides associated with Alzheimer's disease.
An estimated 25% of adults and 45% of obese adults have obstructive sleep apnea in which one's airway momentarily closes multiple times per hour during sleep. Treatment typically entails wearing a mask that provides air pressure into the throat to keep the airway open during sleep but there are also other less intrusive treatment options that can work in some cases.
"This is one of the first studies to show real-time effects of sleep apnea on metabolism during the night," said study senior author Dr. Jonathan Jun. In the study, researchers monitored 31 obese individuals as they slept. All the subjects had moderate to severe obstructive sleep apnea and were monitored either while using a CPAP device or after not using it for two nights. During the night, researchers measured levels blood fatty acids, insulin, glucose and the stress hormone cortisol. They found that having not worn the CPAP for two previous nights resulted in elevated heart rate and reduced blood oxygen. CPAP withdrawal also increased levels of free fatty acids, glucose, cortisol and blood pressure during sleep. The more severe the OSA, the more these parameters increased.
Another recent report finds that OSA puts elderly at greater risk of developing Alzheimer's disease. Researchers from this study report that biomarkers for amyloid beta, the plaque-building peptides associated with Alzheimer's disease, increase over time in elderly adults with OSA in proportion to OSA severity. Thus, individuals with more apneas per hour had greater accumulation of brain amyloid over time.
What to do: These studies emphasize the importance of treating OSA to prevent its metabolic, cardiovascular, and neurological consequences. Indications one is at increased risk for OSA include obesity, particularly in the upper body and neck, daytime sleepiness, snoring, and waking at night feeling like one cannot breath. Maintain a healthy weight or work on weight loss to minimize your risk for OSA. Screening with a sleep study can reliably diagnose OSA but many diagnosed individuals find it difficult to tolerate wearing their CPAP device. In this case work with a sleep specialist with whom you can explore the various CPAP mask options and potential alternative OSA therapies including implanted devices, dental appliances, and positional therapy.
Adapted from articles available at:
Chopra S, Rathore A, Younas H et al. Obstructive sleep apnea dynamically increases nocturnal plasma free fatty acids, glucose, and cortisol during sleep. The Journal of Clinical Endocrinology & Metabolism, 2017; DOI: 10.1210/jc.2017-00619
Sharma RA, Varga AW, Bubu OM et al. Obstructive sleep apnea severity affects amyloid burden in cognitively normal elderly: A longitudinal study. American Journal of Respiratory and Critical Care Medicine, 2017; DOI: 10.1164/rccm.201704-0704OC
Posted by Solai Buchanan, MS, RD, CDE & Sanjeev Palta, MD, FACC at 2:08 PM