New data reported in the Journal of the American College of Cardiology found an inverse association between chocolate consumption and total stroke and a trend in the reduction of both hemorrhagic and ischemic stroke. 

The study included 33,372 women enrolled in the Swedish Mammography Cohort. Using a validated food-frequency questionnaire, the researchers evaluated the relationship between chocolate consumption and the risk of stroke. 

The investigators found that women who reported the highest amount of chocolate consumption (equivalent to about 2 chocolate bars a week) had a 20% reduced risk of stroke. 

Chocolate consumption has previously been shown to reduce systolic and diastolic blood pressure in short-term clinical trials, and has been demonstrated to improve the function of blood vessels.  Moreover, flavonoids in chocolate possess strong antioxidant activity and can suppress oxidation of bad cholesterol (LDL). 

However, not all chocolate bars are the same.  Milk-chocolate bars that are high in sugar, fat and calories might be bad to the health and should be consumed in moderation.  Readers are advised to take the dark chocolate bars that are low in sugar and have higher flavonoid content. 

To be healthy, one should also exercise regularly and consume a heart-healthy diet that is rich in fruits and vegetables and low in fats. 

Source: Journal ofAmericanCollegeof Cardiology 2011 

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In the study published in the journal of Diabetes Care, researchers evaluated the effect of omega-3 fatty acids in 1014 diabetic patients aged 60 to 80 years who had had a heart attack within the previous 10 years. 

Patients were assigned to one of the following treatment and were followed for 40 months.

1)     Margarines containing EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) at 400 mg/d

2)     Margarines containing (ALA) α-linolenic acid at 2 g/d

3)     Margarines containing EPA, DHA andALA

4)     Margarines with placebo 

During the 40-month follow-up period, the group that received the combination of all 3 fatty acids has a 72% lower incidence of irregular heart beats and fatal heart attack than the group taking placebo. 

To obtain omega-3 fatty acids, you don’t need to take the pills.  You can also get omega-3 fatty acids from eating fish, vegetables and walnuts. 

Before this study was published, omega-3 fatty acids have also been shown to improve the brain function in babies of mothers who consumed omega-3s. 

Source: Diabetes Care 2011; 34;2515-2520 

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The study randomized hemodialysis patients to receive either 100 ml of pomegranate juice (n = 66) or an equivalent-tasting placebo (n = 35) 3 times a week for 12 months.

At the end of 12 months, all components of the lipid profile (including total cholesterol, LDL, HDL and triglycerides) were improved in the pomegranate juice group but not in the placebo group.

Furthermore, patients who had a baseline systolic pressure of at least 140 mm Hg and drank pomegranate juice experienced a significant reduction in systolic blood pressure.

Last but not the least, more patients in the juice group than in placebo group took fewer antihypertensive drugs at the end of the study. The investigators believed the beneficial effects of pomegranate juice were probably related to the antioxidants (i.e. ascorbic acid and polyphenolic flavonoids) that it contained.

This result is definitely good news for hemodialysis patients. Beside kidney problems, this group of patients also has comorbidities such as hypertension and cholesterol, which increase their risk of heart attack and stroke.

If this study is to continue for another 5 years, it is possible that patients in the pomegranate juice have a fewer incidents of heart attack and stroke.

If you have kidney problems and would like to take pomegranate juice, you might like to inform your dietician and nephrologists first. It is because pomegranate juice contains high level of potassium. Patients with chronic kidney disease and dietary potassium restriction are especially prone to experience potassium overload.

Source: Kidney Week 2011: American Society of Nephrology 44th Annual Meeting. Abstract FR-PO1660. Presented November 11, 2011.

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Currently, there is no cure for it.  Patients with nonalcoholic fatty liver disease might experience fatigue, pain in the upper right abdomen and weight loss.   If not treated, nonalcoholic fatty liver disease might progress from steatosis to nonalcoholic steatohepatitis, cirrhosis or even end-stage liver disease. 

Now, there is hope this group patients!!! 

A combination of vitamin E and alpha lipoic acid (ALA) were found to improve the inflammatory and steatosis scores in patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis.  The results of the study were presented in the American College of Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course.

The study randomized 155 patients with nonalcoholic fatty liver disease or nonalcoholic steatohepatitis to either the antioxidant combination therapy (700IU vitamin E and 300mgALA) or placebo for 6 months.

After 6 months of treatment, the combination therapy resulted in

–         70% improvement in tumor necrosis factors-alpha levels

–         43% improvement in triglyceride levels

–         71% improvement of steatosis scores

–         51% improvement retinol binding protein 4 (RBP4)

–         63% improvement of homeostasis model assessment (HOMA) scores

 A friend of mine who also has non-alcoholic liver disease and has many therapies (including metformin and fibrate) told me that he felt much better after taking the antioxidant combination.  He did not feel the abdominal pain anymore and felt more energetic everyday.

The beauties of this drug regimen are that it is available as an over-the-counter drug, is very inexpensive and should not have any adverse effects.

Source:AmericanCollegeof Gastroenterology (ACG) 2011 Annual Scientific Meeting and Postgraduate Course: Abstract 38. Presented November 3, 2011.

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These chemotherapies damage to the peripheral nervous system and can produce severe pain and gait impairment, and is often a reason for stopping chemotherapy with these agents.  Unfortunately, there is no effective treatment of CHIPN. 

Now, a small pilot study, published in Acupuncture in Medicine, reported that acupuncture may help relieve the severe pain associated with chemotherapy-induced peripheral neuropathy. 

Investigators at theHanseMerkurCenterfor Traditional Chinese Medicine at the University Medical Center Hamburg-Eppendorf,Hamburg,Germanyoffered acupuncture to 11 patients who had developed symptoms of peripheral neuropathy during chemotherapy for a variety of cancers. 

Six patients agreed to receive the treatment and the other five patients declined because the appointments were inconvenient for them. 

The 6 patients were treated with acupuncture for 10 weeks in addition to receiving best medical care, and the 5 patients who declined acupuncture received best medical care but no specific treatment for CIPN. 

During acupuncture treatment, 20 disposable, sterile needles were inserted at prescribed points to a depth of 10 to 30 mm and left in place for 20 minutes during each of the 10 sessions. Needle stimulation techniques were not used. 

The 6 patients in the acupuncture group were examined by nerve conduction studies to assess the signaling speed and intensity of 2 nerves in the same calf before treatment and again 6 months later after the end of treatment. 

The study found that acupuncture improved both the speed and the intensity of the nerve signaling in 5 of the 6 patients. These same patients also reported that their condition had improved.  The other 5 patients who did not receive acupuncture did not experience any improvement in nerve signaling. 

It is possible that acupuncture may increase the blood flow in the limbs and the increased blood flow contribute to nerve repair and relieve of neuropathic pain. 

If you have neuropathic pain due to chemotherapy, you might to consider seeking the help of acupuncturists who is experienced.  Acupuncture is not painful and does not have any major side effects. 

Source: Acupuncture Medicine December 5, 2011. 

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However, only 39% of colorectal cancers are diagnosed at this stage. Untreated patients with metastatic colorectal cancer (mCRC) have median survival duration of only 5– 6 months.  Even after the treated with latest cancer agents such as cetuximab (Erbitux), bevacizumab (Avastin), irinotecan (Camptosar), 5-fluorouracil, oxaliplatin (Eloxatin) and leucovorin, the median survival can be extended to 3-4 years. 

Now, a new agent, regoragenib, developed by Bayer, might be able to further extend the survival of metastatic colorectal cancer patients.  

The trial, known as CORRECT, enrolled 760 patients with mCRC whose disease progressed after approved standard therapies. The study was being conducted at multiple centers inAustralia,China, Europe,Japan, andNorth America. 

All patients received best supportive care and were randomized to receive either regorafenib (an oral multikinase inhibitor) or placebo. Treatment cycles consisted of 160 mg of regorafenib (or matching placebo) given once daily for 3 weeks, followed by a week without therapy. 

The study was stopped early because patients in the regorafenib arm experienced a significant improvement in overall survival.  

The drug has been granted Fast Track designation by the US Food and Drug Administration (FDA) for the treatment of patients with mCRC who have progressed after approved standard therapies. 

In addition, regorafenib had been granted Orphan Drug status by the FDA for use in gastrointestinal stromal tumors (GIST), and was granted Fast Track designation for the treatment of patients with metastatic and/or unresectable GIST whose disease has progressed despite at least imatanib (Gleevec) and sunitinib (Sutent) treatments. 

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A small new study finds that doing yoga might help restore some lost energy. 

In the current study, investigators randomized 31 breast cancer survivors to participate in either two 90-minute Inyengar yoga classes every week or a two-hour health class once a week. 

The group taking the health classes experienced about the same amount of fatigue and energy throughout the study period. However, the group taking the yoga class reported about a 26% drop in fatigue and a 55% increase in energy after the 12-week yoga regimen. 

Furthermore, the women in the yoga group continued to report significant improvements in fatigue levels three months after the classes stopped. 

The investigator postulated that gaining a sense of control over one’s physical body, when one has a disease like breast cancer, might have important benefit. 

It has been well documented that exercise such as yoga is beneficial to improve the well-being of an individual.  Whether you are sick or not, it is smart to keep exercise regularly.

Source: Cancer 2011 

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A study published in the American Journal of Clinical Nutrition looked at the dietary habits (including meat consumption) of close to 500,000U.S.adults age 50 and older and their risk of developing cancer.

The investigators found that people in the top quintile of red meat consumption (about four ounces per day) were 19% more likely to be diagnosed with kidney cancer than those in the bottom quintile that have red meat consumption less than one ounce per day.

When the researchers looked at the most common types of kidney cancers that these people developed, they found that people who eat lots of red meat is at risk of developing papillary cancers.

Furthermore, they also confirmed the previous findings that people who ate the most well-done grilled and barbecued meat (and therefore had the highest exposure to carcinogenic chemicals from the cooking process) also had an extra risk of kidney cancer compared to those who didn’t eat grilled and barbecued meat.

To limit the exposure to meat cooking carcinogenic chemicals, one can avoid direct exposure of meat to an open flame or a hot metal surface, reducing the cooking time, and using a microwave oven to partially cook meat before exposing it to high temperatures.

This study supports the cancer prevention recommendations published by the American Cancer Society, which recommends limiting the intake of red and processed meats and preparing meat by cooking methods such as baking and broiling.

Source: Am J Clin Nutr 2011

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Now, a small study conducted at the University of Western Australia has shown that drinking black tea three cups a day, which provided approximately 400 mg/day of polyphenols, was able to reduce systolic and diastolic blood pressure between 2 to 3 mm Hg. 

In this study, investigators randomized 95 men and women with a daytime systolic blood pressure between 115 and 150 mm Hg to three cups of black tea daily or to placebo. 

At the end of 6 months, individuals who consumed daily black tea had a significantly lower systolic blood pressure (2.0 mmHg lower) and diastolic blood pressure (2.1 mm Hg lower) than patients in the control group. 

This difference in blood pressure translated to a 10% reduction in the prevalence of hypertension and a 7% to 10% reduction in the risk of cardiovascular disease. 

If you have high blood pressure (systolic blood pressure > 140mm Hg) or have prehypertension (systolic blood pressure between 120 and 139 mmHg), you might like to consider drinking daily black tea and perform regular exercise instead of taking blood pressure lowering pills. 

Source: Archives of Internal Medicine, 2012 

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Recently, a study published in the Journal of Clinical Endocrinology & Metabolism indicated that metformin may prevent or delay the development of polycystic ovary syndrome (PCOS) in adolescence. 

The goal of the study was to compare the efficacy of early versus late metformin treatment to prevent adolescent PCOS in girls at high risk of developing PCOS because of a combined history of low(-normal) birth weight (LBW) and precocious pubarche (PP) – the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal. 

In the study, 38 LBW-PP girls were followed-up from 8 years to 15 years of age and were assigned to receive early metformin (age 8 – 12 years) or late metformin (age 13 – 14 years). 

At the end of 7 years, girls randomly assigned to receive early metformin were 4 cm taller at age 15 years than those girls assigned to receive late metformin, and they also had less of a proinflammatory state and less central fat because of reductions in organs and liver fat. 

Compared with early-treated girls, late-treated girls had 2-fold to 8-fold more hirsutism (too much body hair), androgen excess, oligomenorrhea (infrequent menstruation), and PCOS.  

Besides being used to prevent and to treat POS, metformin is also an effective drug to treat diabetes.  In clinical studies, metformin has been shown to lower the risk of cancer in diabetic patients.

If your daughter is at risk of developing PCOS (low birth weight and signs of early puberty), you might like to consult your physicians whether your daughter needs to take metformin to prevent or delay the development of PCOS. 

Source: J Clinical Endocrinology June 2011 

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