Vitamin E and Selenium supplements may increase risk of cancer

With this increasing obsession with fitness and health the use of supplements such as vitamins, minerals, and herbal has increased exponentially. The increased efforts to stay healthy are good news but the fact that a huge majority of individuals do not even know what supplement to take or not to take, many end up losing any benefit and incur more damage to their health then advantage.

Recent clinical trials have shown that the unnecessary use of certain dietary supplements can lead to far more serious problems then known before. Such a study conducted in the US has shown that the high levels of the mineral Selenium can lead to a 91% increased risk for high grade cancer.
According to the the study leader Dr. Alan Kristal (Fred Hutchinson Cancer Research Centre, Seattle)"These supplements are popular – especially vitamin E – although so far no large, well-designed and well-conducted study has shown any benefits for preventing major chronic disease.
"Men using these supplements should stop, period. Neither selenium nor vitamin E supplementation confers any known benefits, only risks."

This adverse effect appeared only when men with already high levels took the selenium supplement and not in men who originally had low levels. It was also noted that Vitamin E also increased the risk of cancer almost doubling it in men who had low level of selenium.

This study was a follow-up of Select (selenium and vitamin E cancer prevention trial), which originally recruited more than 35,000 men to see if the supplements could help prevent prostate cancer. The main goal of the trial was to prove whether selenium and vitamin E supplements actually prevented prostrate cancer. It was concluded "SELECT was initially planned for a minimum of seven years and a maximum of 12 years of participants taking supplements, plus follow-up observation after the men finished taking their supplements. However, the independent Data and Safety Monitoring Committee (DSMC) for the trial met on September 15, 2008, to review SELECT study data and found that selenium and vitamin E, taken alone or together did not prevent prostate cancer. The committee also determined that it was unlikely selenium and vitamin E supplementation would ever produce a 25 percent reduction in prostate cancer incidence, as the study was designed to show. Based on their recommendation, with SWOG and NCI agreement, SELECT participants were told in October 2008 to stop taking their study supplements." (National Cancer Institute)

The Select trial suggested that Vitamin E intake may have more detrimental effects then initially thought, whereas the outcome of overuse of selenium was still disputed hence the follow up study.     "In 2011, data showed that men taking vitamin E alone had a significantly increased risk of prostate cancer, but men taking vitamin E plus selenium did not.  If men had low selenium levels at the start of the trial, the selenium supplement may have counteracted a negative effect of the vitamin E supplement." (Select study - NCI)

The results of this follow-up study have shown a clear relation between selenium and vitamin E supplements and the increased risk of prostrate cancer.
"In an analysis published in 2014, men who had high levels of selenium at the start of the trial, as assessed by measures of selenium in their toenail clippings, had almost double the chance of developing a high-grade prostate cancer if they took the selenium supplement compared to men with low levels of selenium at the start of the trial.  This finding was unexpected, as previous studies had shown that men with low levels of selenium had an increased risk of prostate cancer that was reduced with supplements (11, 12).  Additionally, men with low levels of selenium at the start of the trial had double the chance of developing a high-grade prostate cancer if they took the vitamin E supplement."
(National Cancer Institute)

A detailed article on the latest results was published on February 21st 2014 in The Guardian, titled

Some vitamin supplements raise risk of cancer in men, research shows.

P.S:

References:

Selenium and Vitamin E Cancer Prevention Trial (SELECT) (National Cancer Institute)
Some vitamin supplements raise risk of cancer in men, research shows. (The Guardian)

Cancer on the rise in the world

Since the release of the  World Cancer Report 2014 by the WHO, we have been seeing headlines like 'Cancer 'tidal wave' on horizon, warns WHO' (BBC World) and for good reason.

The stats in the report have gotten everyone's attention. It suggests that the number of cancer cases might reach 24 million by 2035. It also points out that world health issues such as smoking, drinking, and obesity must be effectively dealt with to reduce that number. 

The International Agency for Research on Cancer (WHO) press release states:

Global battle against cancer won’t be won with treatment alone.

Effective prevention measures urgently needed to prevent cancer crisis.

Based on the latest statistics on trends in cancer incidence and mortality worldwide, this new book reveals how the cancer burden is growing at an alarming pace and emphasizes the need for urgent implementation of efficient prevention strategies to curb the disease.
Despite exciting advances, this Report shows that we cannot treat our way out of the cancer  problem,” states Dr Christopher Wild, Director of IARC and co-editor of the book. “More commitment to prevention and early detection is desperately needed in order to complement improved treatments and address the alarming rise in cancer burden globally.”

In 2012, the worldwide burden of cancer rose to an estimated 14 million newcases per year, a figure

expected to rise to 22 million annually within the next two decades. Over the same period, cancer deaths are predicted to rise from an estimated 8.2 million annually to 13 million per year.

According to the report globally the highest number of diagnosed cancers were lung cancer, breast cancer and cancer of the large bowel. The highest number of cancer deaths were caused by cancer of the lungs, followed by cancers of the liver and stomach.

This World Cancer Report 2014 highlights the presence of a cancer divide.

As a consequence of growing and ageing populations, developing countries are disproportionately affected by the increasing numbers of cancers. More than 60% of the world’s total cases occur in Africa, Asia, and Central and South America, and these regions account for about 70% of the world’s cancer deaths, a situation that is made worse by the lack of early detection and access to treatment.

 Many of the cancers seen in developing countries are high infection related cancers (cancer of liver, cervix and stomach) or are cancer known to be associated with the industrialized lifestyles (cancer of lungs, breast and large bowel). Therefore high mortality from cancer in these countries could be significantly reduced if they have access to effective and affordable cancer treatments but also by implementation of vaccination programs (Hep B and HPV) and preventive efforts towards the spread of tobacco.
The rising number of cancer cases is proving to be detrimental to the economy of even the richest countries. According to the report 'In 2010, the total annual economic cost of cancer was estimated to reach approximately US$ 1.16 trillion. Yet about half of all cancers could be avoided if current knowledge was adequately implemented.'

Last but not least the report stresses on the need for widespread efforts towards early detection and treatment and the promotion of adequate legislation to reduce exposure and risk behaviours.



P.S:

Cancer 'tidal wave' on horizon, warns WHO (BBC World February 4th 2014)
International Agency for Research Cancer  
World Cancer Research Fund International 

A Survey for all parents of teenagers : Monitoring the Future 2013 Survey Results

I am sharing some informational posters on NIDA ( National Institute on Drug Abuse) to help all parents better understand the degree to which our kids are exposed to drugs and how prevalent the use of illicit drugs in youngsters is. Knowledge and information are power, the more we understand the seriousness of this problem, the less likely we will be to support such crazy legislation as the legalization of Marijuana. Please if you come across this post, do share it with your teenagers and middle schoolers.

Description: Monitoring the Future is an annual survey of 8th, 10th, and 12th-graders conducted by researchers at the University of Michigan, Ann Arbor, under a grant from the National Institute on Drug Abuse, part of the National Institutes of Health. Since 1975, the survey has measured drug, alcohol, and cigarette use and related attitudes in 12th-graders nationwide. Eighth and 10th graders were added to the survey in 1991. Overall, 41,675 students from 389 public and private schools participated in the 2013 survey.

Description: Last Two Decades of Alcohol, Cigarette, and Illicit Drug Use*
*Past 30 day use.
This graphic illustrates past 30 day alcohol, cigarette, and illicit drug use among 8th, 10th, and 12th graders from 1993 through 2013. In general, alcohol and cigarette use has decreased, and illicit drug use, which declined in the late 1990s and early 2000s, has been increasing in recent years.

Description: Marijuana: As Perceived Harm Drops, Use Goes Up
* Past-year use in 12th graders.
Three points in time are shown—1993, 2003, 2013— for marijuana use and the perception of risk (saw great risk in smoking marijuana occasionally) among 12th graders.

 Description: 60% of high school seniors do not view regular marijuana use as harmful, which is nearly double from 20 years ago. The potency of marijuana, as measured by THC content, has steadily increased over the last few years, which means that daily use of today’s marijuana may have greater health consequences than use of marijuana from 10 to 20 years ago.

Description: Prescription/Over-the-Counter vs. Illicit Drugs
After marijuana, prescription and over-the-counter medications account for most of the top drugs abused by 12th graders in the past year.

Description: Abuse of Some Synthetic Drugs is Down.
These are substances that are chemically similar to and/or mimic the effects of illicit drugs. This year, 7.9% of high school seniors reported past-year use of K2/Spice (sometimes called synthetic marijuana), down from last year’s number of 11.3%. Past-year use of the substances called “bath salts” was low for all three grades - at or below 1%.

P.S:Monitoring the Future 2013 Survey Results(NIDA)

The truth about addiction; ruthless, honest, and extremely insightful....

"The mind of a heroin addict: the struggle to get clean and stay sober" on The Guardian is a collection of comments by recovering sober addicts and some using addicts on how they struggle and how Philip Seymour Hoffman's death from heroin overdose after 23 years of sobriety affected them. 

As I read this post, I was not only shocked and troubled by the very truthful and blatantly honest responses but also got a better understanding of how they struggle or relapse and how terribly hard it is to fight the addict inside them. I am not totally unaware of what goes into rehabilitation, I worked with addicts during my one year psychiatry job. Yet I found these comments revealing and poignant. 

One of the comments which stood out to me was by Danny from Ireland, who has been ten years sober; "My father died from addiction, we lost a cousin, I myself had numerous overdoses and helped prevent siblings from OD-ing (all of who are now clean thanks to the process of one addict helping another that Russell Brand spoke of). Hearing about Hoffman affects me the same way as if it were a friend. I didnt know he was an addict untill he died, but when I heard of his story and addiction I immediatly identified with him. We work the same way in our minds. I know what happened to him before he picked up. I know how he felt. I'm pretty sure it started the same way most relapses do. "

Read all the responses...

Some drug facts in the US:

According to NIDA ( National Institute on Drug Abuse) "Illicit drug use in America has been increasing. In 2012, an estimated 23.9 million Americans aged 12 or older—or 9.2 percent of the population—had used an illicit drug or abused a psychotherapeutic medication (such as a pain reliever, stimulant, or tranquilizer) in the past month. This is up from 8.3 percent in 2002. The increase mostly reflects a recent rise in the use of marijuana, the most commonly used illicit drug."

 Most people use drugs for the first time when they are teenagers. There were just over 2.8 million new users (initiates) of illicit drugs in 2012, or about 7,898 new users per day. Half (52 per-cent) were under 18.

More than half of new illicit drug users begin with marijuana. Next most common are prescription pain relievers, followed by inhalants (which is most common among younger teens).

In 2009, there were nearly 4.6 million drug-related Hospital Emergency Department (ED) visits nationwide. These visits included reports of drug abuse, adverse reactions to drugs, or other drug-related consequences. Almost 50 percent were attributed to adverse reactions to pharmaceuticals taken as prescribed, and 45 percent involved drug abuse.

The majority of drug-related ED visits were made by patients 21 or older (80.9 percent, or 3,717,030 visits). Of these, slightly less than half involved drug abuse. Patients aged 20 or younger accounted for 19.1 percent (877,802 visits) of all drug-related visits in 2009; about half of these visits involved drug abuse.

In 2009, almost one million visits involved an illicit drug, either alone or in combination with other types of drugs. The rates of ED visits involving cocaine, marijuana, and heroin were higher for males than for females. Rates for cocaine were highest among individuals aged 35–44, rates for heroin were highest among individuals aged 21–24, stimulant use was highest among those 25–29, and marijuana use was highest for those aged 18–20.

 Illicit drug use among teenagers remains high, largely due to increasing popularity of marijuana. Marijuana use by adolescents declined from the late 1990s until the mid-to-late 2000s, but has been on the increase since then. In 2013, 7.0 percent of 8th graders, 18.0 percent of 10th graders, and 22.7 percent of 12th graders used marijuana in the past month, up from 5.8 percent, 13.8 percent, and 19.4 percent in 2008. Daily use has also increased; 6.5 percent of 12th graders now use marijuana every day, compared to 5 percent in the mid-2000s.

P.S:

The mind of a heroin addict: the struggle to get clean and stay sober

Trends and Statistics on Addiction (NIDA)

Millions living with leprosy in spite of being curable

On January 26th The World Day of Leprosy, I saw a video on The Guardian global development news page by Maria Zupello  titled Leprosy in Brazil: Uncovering a hidden disease. Realizing that leprosy is still around was rather disturbing, especially because this is a curable disease and therefore there should be no such thing as living with leprosy in these times, but after doing some research it became apparent that is not the case.

WHO: Leprosy Statistics:

According to the World Health Organization's latest stats on leprosy in the world, there are still around 200,000 reported new cases of leprosy every year in the world. Also known as Hansen's Disease, leprosy is endemic in 91 countries around the world. The highest concentration of reported new cases (at the start of 2012) being in South East Asia (117,147). The majority of which are in India. The second highest incidence is in the Americas (34,801),  of these reported new cases the majority are from Brazil. But because of its long incubation period and the lack of tools to allow early detection leading to late diagnosis, the exact prevalence of Hansen's disease is not clear.

India:
Although the Indian Government declared it has eliminated leprosy in 2005. It has since then become clear that the claim was premature. Of the total leprosy cases in the world 55% are in India, and about 127,000 new cases were reported between 2010-2011. Besides lack of access to basic healthcare services, leprosy patients also suffer socioeconomic isolation as a result of the stigma and discrimination that still exists in India.

Brazil: 
Leprosy is more prevalent in Brazil than in any other country except India. More than 30,000 new cases are diagnosed each year. Despite economic development, expansion of public healthcare, and efforts of the leprosy control program in the past 30 years, this disease has not been eliminated, and new cases are still being detected. The leprosy control program in Brazil distributes free drugs as part of the World Health Organization multidrug regimen for treatment of leprosy. Unfortunately health care services are not available in rural parts of the country. The amazon region of Brazil where leprosy has been endemic for more than a century is almost deprived of such health services.

Leprosy is particularly prevalent among the poorest and most marginalised communities due to their lack of access to healthcare, poor sanitation and congested living spaces. - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

Government statistics under estimate the extent of leprosy according to research organisations, NGOs and some medical personnel who argue that leprosy cases are on the rise - See more at: http://www.tlmindia.org/index.php/about-leprosy/facts#sthash.zlOMnaBW.dpuf

To understand why the stigmatization, socioeconomic isolation, discrimination leading to leprosy communities in countries like India and Brazil is so wrong, here are some basic facts about Leprosy( Hansen's Disease);

What is Leprosy?

Leprosy is a chronic bacterial disease caused by Mycobacterium leprae and Mycobacterium lepromatosis. This infection primarily affects the skin, peripheral nerves and upper airway. It is well known that leprosy is not spread through casual contact. 

About 95% of human beings are naturally immune making leprosy the 'least contagious communicable disease'. The World Health Organization suggests that it is transmitted through moisture from the nose and mouth during frequent and close contact with an untreated leprosy-affected person. It might also happen if you are exposed to other nasal fluids (also known as secretions). Droplets and other secretions can contain the bacteria that cause Hansen’s disease. If you breathe these in, you can become sick with the disease.

According to the CDC,  as incubation period of the bacteria is long , it may take up to 2-10 years for signs and symptoms to appear. The disease mainly affects the skin, nerves and the mucous membranes. Common signs and symptoms include; disfiguring skin sores, lumps, or bumps that do not go away after several weeks or months. The skin sores are pale-colored. Nerve damage can lead to loss of feeling in arms and legs and muscle weakness. Without treatment, leprosy can permanently damage your skin, nerves, arms, legs, feet, and eyes.

Treatment of Leprosy

Leprosy can be cured. In the last two decades, more than 14 million people with leprosy have been cured. The World Health Organization provides free treatment for all people with leprosy.

Treatment depends on the type of leprosy that you have. It is treated with a combination of antibiotics. The treatment may last anywhere from 6 months to 2 years. People with severe leprosy may need to take antibiotics longer. Antibiotics cannot treat the nerve damage.

Anti-inflammatory drugs are used to control swelling related to leprosy. This may include steroids, such as prednisone.

Patients with leprosy may also be given thalidomide, a potent medication that suppresses the body's immune system. It helps treat leprosy skin nodules. Thalidomide is known to cause severe, life-threatening birth defects and should never be taken by pregnant women.

According to the WHO 'Access to information, diagnosis and treatment with multidrug therapy (MDT) remain key elements in the strategy to eliminate the disease as a public health problem, defined as reaching a prevalence of less than 1 leprosy case per 10,000 population. Only a couple of endemic countries have still to achieve this goal at the national level; most are now applying the same elimination strategy at regional, district and sub-district levels. MDT treatment has been made available by WHO free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy.

Most countries that were previously highly endemic for leprosy have achieved elimination at the national level and are intensifying their efforts at regional and district levels.'

Information campaigns about leprosy in high risk areas are crucial so that patients and their families, who were historically ostracized from their communities, are encouraged to come forward and receive treatment. The most effective way of preventing disabilities in leprosy, as well as preventing further transmission of the disease, lies in early diagnosis and treatment with MDT. (WHO)

P.S: 
The Leprosy Mission India 
The Leprosy Mission Canada  
Hansen's Disease (CDC) 
Leprosy (WebMD)
Leprosy Today (WHO) 
National Hansen's Disease Program (HRSA) 
Watch Video: Leprosy in Brazil: Uncovering a hidden disease (The Guardian)

Watch Video: Battling leprosy in Brazil(BBC World)

Watch Video: Leprosy: India's Hidden Disease (The Guardian)

Photo Gallery: Colonia Antonio Alexio - Leprosy community in Manaus, Brazil (Photojournalist: Sharon Steinmann)

High Incidence of Diseases Endemic to the Amazon Region of Brazil, 2001–2006 (CDC)

 

Easy way to lose weight... just turn the heat down

Obesity and the struggle to lose weight is starting to become the plight of our time. Much research  is being done to find effective ways to understand the causes and finding effective ways to win this losing battle. Right now, more than one third of adults in the US are obese or overweight and a little more then a quarter of the adults in UK is obese or overweight.
Amongst all that research work a recent study published in Trends in Endocrinology & Metabolism Journal, suggests that central heating might be another contributing factor to rising number of overweight individuals. As the temperature in homes, offices, hospitals and most places is being kept high our bodies are no longer burning that many calories to keep the body warm. Normally our metabolism rate (BMR) rise in cold weather to produce body heat. About 80% of the energy produced from our food intake is used up by our BMR.

According to the researchers at Maastricht University, a temperature of 66F would suffice to maintain a normal balance. The report also points out that about 90% of people remain mostly indoors while keeping the temperature at maximum comfort levels in turn minimizing caloric use by our bodies to maintain normal body temperature, shifting the balance towards weight gain.

Although lowering the thermostat alone may not lead to weight loss but it will definitely help along with exercise and diet. The report also mentions a study from  Japan in which volunteers showed a decrease in body fat after spending two hours a day in 17C over a period of six weeks.According to BBC World reporter James Gallagher;

Dr Wouter van Marken Lichtenbelt told the BBC: "19C is enough - and not for the whole day.
"Energy increases were in the order of 6% in mild cold, and in the long term that could really make a difference.
"It could be a substantial influence and help in combination with food changes and exercise." 
He said people could "try turning the thermostat down" at home or "go outside".


P.S: 
Central heating may make you fat, say researchers (BBC World) 
Want to lose weight? Try turning your heating down: Being cold is a 'cheap way to get slim' (Daily Mail UK)





 

Shift work clearly detrimental to health

It is a fact that doing the night shift at work is terribly hard. It not only affect our personal and social lives it also throws our whole sleep cycle into chaos. Now scientists at the Sleep Research Center Surrey have found definite proof that night work can lead to long term damage starting at molecular level. Night shift work has been linked to a higher risk of type 2 diabetes, heart attacks and cancer.

According to an article in BBC World News by James Gallagher;
'Experts said the scale, speed and severity of damage caused by being awake at night was a surprise.

The human body has its own natural rhythm or body clock tuned to sleep at night and be active during the day.
It has profound effects on the body, altering everything from hormones and body temperature to athletic ability, mood and brain function.'

Scientists observed 22 individuals as their bodies adjusted from their normal patterns to working the night shift. Preliminary blood test showed that 6% genes had precise daily activity cycles. As the individuals got into a night work routine, these cycles were thrown off. 
The researchers call this 'Chrono-Chaos', here the scientists on the team explain it;

"Over 97% of rhythmic genes become out of sync with mistimed sleep and this really explains why we feel so bad during jet lag, or if we have to work irregular shifts," said Dr Simon Archer, one of the researchers at the University of Surrey.
Fellow researcher Prof Derk-Jan Dijk said every tissue in the body had its own daily rhythm, but with shifts that was lost with the heart running to a different time to the kidneys running to a different time to the brain.
He told the BBC: "It's chrono-chaos. It's like living in a house. There's a clock in every room in the house and in all of those rooms those clocks are now disrupted, which of course leads to chaos in the household."
Prof Dijk added: "We of course know that shift work and jet lag is associated with negative side effects and health consequences.
"They show up after several years of shift work. We believe these changes in rhythmic patterns of gene expression are likely to be related to some of those long-term health consequences."

According to Web MD about 8.6 million people do shift work, meaning either they work the night shift or they rotate shifts during the week.  These include police officers, firefighters, nurses, doctors, pilots, waitresses, truck drivers, and many more professionals. Even a personal trainer who works out at the gym with clients in the early mornings and evenings is a shift worker.
Some of the short term health problems seen more commonly in shift workers are; 

• Gastrointestinal symptoms like upset stomach, nausea, diarrhea, constipation, and heartburn
• Increased risk of injuries and accidents
• Insomnia
• Decreased quality of life
• General feeling of being unwell

Whereas the long term effects on health are harder to measure but there has been compelling proof that shift workers might be more prone to these long term medical problems;

• Cardiovascular disease
• Diabetes and Metabolic Disorder
• Depression and Mood Disorders
• Serious Gastrointestinal Problems
• Obesity
• Problems with Fertility and Pregnancy
• Cancer

 Although most of these long term effects may occur only after decades of disruptive shift work, but some health problems might develop much faster. For many professions shift work is inevitable, hence can not be completely avoided. In those cases, here are some suggestions on the Web MD to help minimize the damage:

• Eat Well and Exercise
• Get enough Sleep
• Change your Schedule
• See your Doctor

P.S:
References

Night work 'throws body into chaos' (BBC World News)

The Health Risks of Shift Work (Web MD)