Concord Grape Juice Improves Memory

“A critical weekly review of important new research findings for health-conscious readers…”

By, Robert A. Wascher, MD, FACS

Updated:  01/31/2010

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.

Welcome to Weekly Health Update

“A critical weekly review of important new research findings for health-conscious readers”

CONCORD GRAPE JUICE IMPROVES MEMORY

Polyphenols are plant-based dietary compounds with known antioxidant and anti-inflammatory properties. These biological properties of polyphenols reduce the ongoing damage to the DNA in our cells that results from the toxic byproducts of metabolism, including free radicals. Polyphenols have, therefore, been the subject of intense research as potential prevention agents for a variety of human ailments, including cardiovascular disease, dementia, and cancer. (The evidence-based role of dietary polyphenols in cancer prevention is discussed in great detail in my soon-to-be-published book, “A Cancer Prevention Guide for the Human Race.”)

Foods that are naturally rich in polyphenols include most blue and red berries, grapes (including red wine), pomegranates, walnuts, peanuts, olive oil, green tea, dark chocolate and cocoa, coffee, and beer (as well as other fruits and vegetables).

Recent animal research has suggested that polyphenols derived from grape seeds can reduce the development of plaques in the brain (at least in mice) that are associated with the development of Alzheimer’s disease. Now, a newly published prospective, randomized, double-blind clinical research study suggests that Concord grape juice, which is rich in polyphenols, may be able to improve early memory decline in older adults.

In this small study, which has been published in the British Journal of Nutrition, 12 elderly adults with declining memory were divided into two groups. The “experimental group” received daily Concord grape juice supplements for a period of 12 weeks. The second group, the “control group,” received placebo supplements that were identical in appearance to Concord grape juice, but which contained no juice. Neither the 12 patient volunteers nor the research assistants were aware of which patients received grape juice and which patients received the placebo while the study was being conducted.

Standardized, validated tests of memory, and other aspects of cognitive function, were administered to all 12 patient volunteers participating in this study. These cognitive function tests revealed statistically significant improvements in verbal learning skills among the patients who received 12 weeks of Concord grape juice (when compared to the placebo group). Although not statistically significant, improvements were also noted in both verbal and spatial recall among the patient volunteers who received the grape juice supplements in this small clinical study with a brief duration of patient follow-up.

While larger studies, with a longer duration of follow-up, will be required to confirm the findings of this small pilot study, the prospective, randomized, placebo-controlled, double-blind nature of this small study does give it considerably more predictive power than the much larger dietary survey-based epidemiological studies that are more commonly used in disease prevention research.

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Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity

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Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author

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For a somewhat lighter perspective on Dr. Wascher, please click on the following YouTube link:

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(Anticipated Publication Date:  May 2010)

(Click above image for TV36 interview of Dr. Wascher)

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Send your feedback to Dr. Wascher at:

rwascher@doctorwascher.net

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Dr. Wascher’s Biography

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Links to Other Health & Wellness Sites

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Copyright 2007 – 2010

Robert A. Wascher, MD, FACS

All rights reserved

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Dr. Wascher’s Archives:

1-24-2010: Mozart, Music, Babies & Health

1-17-2010: Breast Cancer, Physical Therapy & Lymphedema

1-10-2010: Prevention of Surgical Site Infections (SSIs) after Surgery

1-3-2010: Ginkgo Biloba, Memory & Cognitive Health

12-20-2009: CT Scans & Cancer Risk

12-13-2009: Soy Isoflavones Decrease Breast Cancer Recurrence Risk

12-6-2009: Salt (Sodium) Intake, Stroke & Cardiovascular Disease

11-29-2009: Exercise & Prostate Cancer Risk

11-22-2009: Genistein (Soy Isoflavone) & Prostate Cancer

11-15-2009: Breast Cancer Treatment & Chronic Pain

1-8-2009: Vitamin D & Breast Cancer Risk

11-1-2009: Exercise & Prostate Cancer Risk

10-25-2009: HPV Virus & Risk of Breast Cancer

10-18-2009: Post-Cholecystectomy Syndrome (Symptoms after Gallbladder Surgery)

10-11-2009: Vitamin D & Falls in the Elderly

10-4-2009: Surgery, NSQIP, Complications & Death

9-27-2009 Stress, Heart Disease, Exercise & Death

9-20-2009: Vitamin D & Colorectal Cancer Survival

9-13-2009: H1N1 Swine Flu Update

9-7-2009: Green Tea, Aging & Lifespan

8-30-2009: Irritable Bowel Syndrome (IBS), Diet & Fiber

8-23-2009: Update on Prostate Cancer and Cryotherapy

8-16-2009: Exercise Improves Lymphedema Symptoms in Breast Cancer Survivors

8-9-2009: Breast Cancer Recurrence, Death & Vitamin D

8-2-2009: Honesty, Dishonesty & Brain Function

7-26-2009: Coronary Artery CT Scans & Cancer Risk

7-19-2009: Hormone Replacement Therapy (HRT) & Ovarian Cancer

7-12-2009: Breast Cancer & Metformin (Glucophage)

7-5-2009: Prostate Cancer & Green Tea

6-28-2009: Air Pollution & the Risk of Deep Venous Thrombosis (DVT)

6-21-2009: Red Yeast Rice, Statins & Cholesterol

6-14-2009: Bone Marrow Stem Cell Transplant & Congestive Heart Failure (CHF)

6-7-2009: Diet, Soy & Breast Cancer Risk

5-31-2009: Diet and Prostate Cancer Risk

5-24-2009: Diabetes, Glucose Control & Death

5-17-2009: Drug Company Marketing & Physician Prescribing Bias

5-10-2009: Hemorrhoids & Surgery

5-3-2009: Statin Drugs & Blood Clots (Thromboembolism)

4-26-2009: Are We Really Losing the War on Cancer?

4-19-2009: Exercise in Middle Age & Risk of Death

4-12-2009: Can Chronic Stress Harm Your Heart?

4-5-2009: Does PSA Testing for Prostate Cancer Save Lives?

3-22-2009: CABG Surgery vs. PCI in Diabetics with Coronary Artery Disease; Sweetened Beverages and Coronary Artery Disease

3-15-2009: Depression, Stress, Anger & Heart Disease

3-8-2009: Coronary Artery Disease: CABG vs. Stents?; Swimming Lessons & Drowning Risk in Children

3-1-2009: Aspirin & Colorectal Cancer Prevention; Fish Oil & Respiratory Infections in Children

2-22-2009: Health Differences Between Americans & Europeans; Lycopene & Prostate Cancer

2-15-2009: Statin Drugs & Death Rates; Physical Activity, Breast Cancer & Sex Hormones

2-8-2009: Hormone Replacement Therapy (HRT) & Breast Cancer; Stool DNA Testing & Cancer of the Colon & Rectum

2-1-2009: Obesity and the Complications of Diverticulosis (Diverticulitis & Bleeding); Obesity, Weight Loss & Urinary Incontinence

1-25-2009: Prostate Cancer, Fatigue & Exercise; Does your Surgeon “Warm-up” Before Surgery?

1-18-2009: Cancer and Vitamins; Teenagers, MySpace and Risky Behaviors

1-11-2009: Exercise Reverses Some Effects of Fatty Meals; Vitamin C and Blood Pressure

1-4-2009: Secondhand Smoke & Heart Attack Risk; Poor Physical Fitness During Childhood & Heart Disease Risk During Adulthood

12-28-2008: Stress & Your Risk of Heart Attack; Vitamin D & the Prevention of Colon & Rectal Polyps

12-21-2008: Breast Cancer Incidence & Hormone Replacement Therapy; Circumcision & the Risk of HPV & HIV Infection

12-14-2008: Vitamin E, Vitamin C and Selenium Do Not Prevent Cancer; Postscript: A Possible Cure for Down’s Syndrome

12-7-2008: Generic vs. Brand-Name Drugs, Stress & Breast Cancer Survival

11-30-2008: A Possible Cure for Down’s Syndrome?; Smoking & Cognitive Decline; Calcium & Vitamin D & Breast Cancer Risk

11-23-2008:  Breast Cancer & Fish Oil; Lymphedema after Breast Cancer Treatment; Vasectomy & Prostate Cancer Risk

11-16-2008:  Vitamin E & Vitamin C: No Impact on Cardiovascular Disease Risk; Does Lack of Sleep Increase Stroke & Heart Attack Risk in Hypertensive Patients?

11-9-2008: Statins Cut Heart Attack Risk Even with Normal Cholesterol Levels; Statins & PSA Level

11-2-2008: Radiation Treatment of Prostate Cancer & Second Cancers; Sexual Content on TV & Teen Pregnancy Risk

10-26-2008:  Smoking & Quality of Life

10-19-2008:  Agent Orange & Prostate Cancer

10-12-2008:  Pomegranate Juice & Prostate Cancer

10-5-2008: Central Obesity & Dementia; Diet, Vitamin D, Calcium, & Colon Cancer

9-28-2008: Publication & Citation Bias in Favor of Industry-Funded Research?

9-21-2008: Does Tylenol® (Acetaminophen) Cause Asthma?

9-14-208:   Arthroscopic Knee Surgery- No Better than Placebo?; A Healthy Lifestyle Prevents Stroke

8-23-2008:  Alcohol Abuse Before & After Military Deployment; Running & Age; Running & Your Testicles

8-12-2008:  Green Tea & Diabetes; Breastfeeding & Adult Cholesterol Levels; Fish Oil & Senile Macular Degeneration

8-3-2008:   Exercise & Weight Loss; Green Tea, Folic Acid & Breast Cancer Risk; Foreign Language Interpreters & ICU Patients

7-26-2008:  Viagra & Sexual Function in Women; Patient-Reported Adverse Hospital Events; Curcumin & Pancreatic Cancer

7-13-2008:  Erectile Dysfunction & Frequency of Sex; Muscle Strength & Mortality in Men; Cryoablation for Prostate Cancer

7-6-2008:  Sleep, Melatonin & Breast Cancer Risk; Mediterranean Diet & Cancer Risk; New Treatment for Varicose Veins

6-29-2008:  Bone Marrow Stem Cells & Liver Failure; Vitamin D & Colorectal Cancer Survival; Green Tea & Colorectal Cancer

6-22-2008:  Obesity, Lifestyle & Heart Disease; Effects of Lifestyle & Nutrition on Prostate Cancer; Ginkgo Biloba, Ulcerative Colitis & Colorectal Cancer

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down’s Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology’s Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer– Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer

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CENTRAL OBESITY & DEMENTIA

We are, quite plainly, the heaviest society in the recorded history of mankind.  More than 60% of adult Americans are overweight, and one-fourth of the U.S. population is frankly obese. 

There is ample clinical evidence showing that obesity is associated with an increased risk of high blood pressure (hypertension), diabetes, heart disease, stroke, arthritis and premature death.  Some cancers also appear to be more common among obese patents, including cancers of the breast, pancreas, esophagus, stomach, colon, rectum, uterus and kidney. 

Although generalized obesity is a risk factor for all of the life-threatening diseases that I have described, the accumulation of excess body fat within and around the abdomen (central obesity) appears to be linked with an especially high risk of obesity-associated illnesses.  Now, a new research study, just published in the journal Neurology, suggests that dementia may also be more common among patients with central obesity.  This study was conducted by the Kaiser Permanente Division of Research in Oakland, California, in collaboration with Göteborg University in Sweden, the University of California in San Diego, the University of Michigan, and the University of California in San Francisco.

In this study, more than 6,500 patients within the Kaiser Permanente Northern California system participated in this study.  Between 1964 and 1973, these patients had their abdominal diameters measured (sagittal abdominal diameter), and were then followed, for an average of 36 years, through clinical records of their subsequent visits for medical care at Kaiser Permanente healthcare facilities.  In addition to the incidence of dementia in this large group of patients, the researchers also considered the following patient factors: gender, age, ethnic background, level of formal education, marital status, and the presence or absence of diabetes, hypertension, elevated cholesterol (hyperlipidemia), stroke and heart disease.

Out of the approximately 6,600 patients evaluated in this long-term study, 1,049 (16%) were ultimately diagnosed with dementia.  When these patients with dementia were further analyzed, it was determined that the patients with the greatest abdominal diameter had nearly 3 times the risk of developing dementia when compared to patients with the smallest abdominal diameter.  Because both diabetes and hypertension also increase the risk of dementia, the researchers in this study adjusted their analysis to account for these two other dementia risk factors.  However, following this adjustment, the nearly three-fold incidence of dementia associated with central obesity persisted.

To summarize, this long-term analysis of a very large group of patients enrolled in a comprehensive healthcare maintenance organization (HMO) appeared to show that central obesity was, by itself, a significant risk factor for dementia.  As this study was not designed to assess the mechanism, or mechanisms, whereby central obesity might be increasing the risk of dementia, it will be necessary to follow-up the findings of this study with a more focused clinical research trial in order to gain a better understanding of how central obesity affects the risk of dementia.  However, the results of this study offer additional and compelling data that obesity, and central obesity in particular, appears to be associated with an increased risk of dementia, in addition to the increased risk of other life-threatening illnesses that have previously been identified.

 

DIET, VITAMIN D, CALCIUM & COLON CANCER

Regular readers of this column already know that I have a very strong interest in disease prevention, particularly through lifestyle modifications.  These modifiable lifestyle factors include, principally, diet, natural products and dietary supplements, and physical activity levels.  It has been estimated by cancer epidemiology experts that somewhere between 60 and 80% of all cancers could be eliminated through relatively moderate lifestyle modifications, although this conclusion receives shockingly little emphasis within our current healthcare system.  (A forthcoming book of mine, “A Cancer Prevention Guide for the Human Race,” extensively covers the currently available scientific and clinical evidence supporting specific lifestyle modifications that appear to reduce the risk of the most common causes of cancer-related death.)

The scientific evidence related to dietary factors and colorectal cancer risk remains a bit unclear at the present time.  Indeed, some recent research studies have called into question a few longstanding and conventional assumptions about diet and colorectal cancer risk.  For example, for decades, we’ve been telling our patients that a high-fiber diet will reduce their risk of developing colorectal cancer.  However, recently published clinical research has suggested that there may not be a significant relationship between the amount of fiber in your diet and the risk of developing pre-cancerous polyps (adenomas) of the colon and rectum.  To complicate matters further, however, other recent clinical studies have suggested that at least certain types of dietary fiber may actually reduce the risk of adenoma formation in the colon and rectum.  So, the jury would appear to still be out on the issue of dietary fiber as a possible colorectal cancer prevention strategy (although there are many other documented health benefits to eating a diet rich in natural high-fiber foods!).

The role of Vitamin D and calcium in preventing colorectal cancer has also been an area of intense study, lately.  Once again, as is unfortunately often the case with clinical research, there is a considerable amount of contradictory research data with respect to the effectiveness, if any, of Vitamin D and calcium in the prevention of colorectal cancer.  However, several high quality epidemiological studies in recent years have suggested at least a moderate protective effect against colorectal cancer associated with higher levels of Vitamin D and calcium in the blood (blood levels of calcium are primarily controlled by Vitamin D, in the diet, and parathyroid hormone, which is secreted by small glands located near the thyroid gland in the neck).

A newly published research study in the journal Cancer Research takes a further look at potentially adverse health effects associated with the typical highly-processed, high-fat, low-fiber “western diet.”  (Most nutrition experts consider the typical western diet to be deficient in fruits and vegetables, fiber, and other important nutrients, including Vitamin D and calcium.)  This study was conducted by researchers at Cornell University, Rutgers University, Stony Brook University and the Albert Einstein College of Medicine.    

In this study, laboratory mice were fed the “rodent-equivalent” of a western diet for most of their lifespan (an average of 2 years).  The researchers noted that a long-term western diet was associated with an increased risk of colon tumors in these mice, when compared to mice that were fed standard “mouse chow.”  Seeking to learn more about the exact causes of the observed increase in colon tumors associated with a prolonged western diet, the scientists then supplemented the western diet of these laboratory mice with individual nutrients known to be deficient in the human western diet.

When the researchers added Vitamin D and calcium supplements, the increased incidence of colon cancer previously observed in the mice that received the western diet essentially disappeared.  However, supplements of fiber, folate (Vitamin B-9), choline and methionine, all of which are deficient in the human western diet, failed to reverse the increased incidence of colon cancer observed in these laboratory mice that were fed a western diet.

The scientists then studied the function of genes known to be associated with the development of colorectal cancer.  Specifically, the effects of a prolonged western diet on these cancer-associated genes were evaluated, and with rather startling findings.  Gene expression studies revealed that a prolonged western diet, in laboratory mice, was associated with changes in cancer-associated gene function that is more typically observed in patients who inherit a gene mutation (the APC gene) that is associated with a very high risk of developing a hereditary form of colorectal cancer.  Among those mice that received supplements of Vitamin D and calcium, in addition to a western diet, these cancer-associated genetic changes were not observed in the cells lining the animals’ colons.

To briefly summarize, an animal model of colon cancer was developed in this research study, using laboratory mice that were fed a “western-diet-equivalent” throughout most of their lifespan.  The animals placed on a western diet experienced an increased incidence of colon tumors, although Vitamin D and calcium supplements appeared to reverse this increased risk.  At the level of genetic changes known to be associated with colorectal cancer development, a western diet appeared to be associated with a high level of cancer-associated changes in gene expression.  Once again, however, these cancer-associated genetic changes appeared to be prevented by adding Vitamin D and calcium supplements to the animals’ diet.

A few caveats before you run out to the drugstore and load up on Vitamin D and calcium pills.  First, as always, it is important to remember that what works in laboratory mice and rats doesn’t always carry over to human physiology.  There have been numerous research studies of treatments that have shown dramatic effects in laboratory animals, but have then gone on to fail in human clinical trials.  So, this animal study, including the cancer-associated gene expression studies, will have to be replicated in human clinical studies before the findings of the animal study can be confirmed in humans as well.  Secondly, there have already been several human studies that have looked at blood levels of Vitamin D and calcium, as well as clinical studies that incorporated supplements of these nutrients.  Some of these studies have shown no apparent protective effects against colorectal cancer by these nutrients, while other studies have shown a modest-to-moderate protective effect, at best. 

On the whole, a considerable number of well-designed and well-executed human clinical research studies suggest that vitamin D and calcium may have a modest-to-moderate protective effect against colorectal cancer.  However, none of these human studies have shown as dramatic a protective effect with Vitamin D and calcium as was observed in this laboratory animal study.  Once again, the methodology used in this animal study will need to be translated into a human clinical trial before anyone can definitively say that Vitamin D and calcium supplements are highly effective in the prevention of colorectal cancer.  For now, however, it is prudent to ensure that your diet is at least sufficient in these two very important nutrients.             

 

Dr. Wascher is an oncologic surgeon, professor of surgery, a widely published author, and the Director of the Division of Surgical Oncology at Newark Beth Israel Medical Center:

 http://www.sbhcs.com/hospitals/newark_beth_israel/mservices/oncology/surgical.html

Send your feedback to Dr. Wascher at:  rwascher@doctorwascher.net
 

To read more of Dr. Wascher’s Health Report columns, please visit his

website at:  http://www.doctorwascher.com

Copyright 2008.  Robert A. Wascher, MD, FACS.  

All rights reserved.

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Drinking coffee soon after a heart attack is often discouraged by cardiologists and internists, out of concern that caffeine, which is present in coffee in moderate levels, and which acts as a cardiovascular stimulant, may increase the risk of additional cardiac strain or heart attack. For coffee lovers, however, the thought of discontinuing consumption of their favorite beverage after experiencing a heart attack may be disconcerting. Unfortunately, although coffee consumption has been studied rather extensively regarding its possible association with the development of heart disease, there is not a great deal of evidence out there in terms of its safety in patients who already have heart disease, and who have recently experienced a heart attack.

A new Italian public health study, just published in the journal Circulation , evaluated more than 11,000 adults who reported a heart attack within the previous three months, and assessed their intake of coffee throughout the duration of the study. Coffee consumption was categorized as follows: never/almost never, less than 2 cups per day, 2 to 4 cups per day, and more than 4 cups per day. After an average of more than three years of follow-up, the risk of heart attack, death due to heart attack, and stroke was calculated according to the level of coffee consumption in this population of adults with a history of recent heart attack.

Coffee lovers will be relieved to know that, in this study, there appeared to be no association between coffee consumption and the subsequent risk of additional heart attacks, death due to heart attacks, or stroke. This reassuring data follows multiple prior studies suggesting that moderate coffee consumption may also decrease the risk of diabetes, as well.

Despite the reassuring results of this epidemiological study, all patients with a history of coronary artery disease (including recent heart attack) should discuss the routine use of dietary stimulants, such as coffee and tea, with the physician who is managing their cardiac disease.

IMPACT OF DIVORCE ON THE ENVIRONMENT

Certainly, the enormous social and economic consequences of divorce have already been extensively studied and reported upon. A new study in the Proceedings of the National Academy of Sciences , however, puts a new spin on the consequences of divorce in our society. In this study, statistics related to divorced and non-divorced households in 12 countries around the world were analyzed, and the impact of divorce on the environment was assessed, with some rather interesting findings.

First of all, and not really surprisingly, divorced households were smaller than married households (27 to 41% smaller, in fact, among the various countries studied). Somewhat counter-intuitively, however, in the United States, divorced households spent 46% more on electricity, and 56% more on water, than married households; and divorced households also tended to have more rooms-per-person than their married household counterparts. Looking at the United States in particular, the authors of this study calculated that if the number of rooms-per-person, water usage, and electricity usage among the divorced households had been on par with married households then, more than 38 million rooms, 74 billion kilowatt-hours of electricity, and 627 billion gallons of water could have been conserved in 2005 alone, based upon the prevalence of divorce in the US that year!

While divorced households used 42 to 61% more resources per person than married households, remarriage within divorced households appeared to reduce per person resource usage back to the levels associated with the never-divorced married households. The authors, therefore, conclude that divorce leads to a resource-inefficient lifestyle, which can be rectified either by avoiding divorce or by remarrying. One might therefore assume that maintaining the integrity of marriage and the nuclear family is, in general, an environmentally sound method of conserving precious natural resources.

HIGH BLOOD PRESSURE & THE RISK OF DEMENTIA

The role of chronic high blood pressure on brain function is an area of intense study. There is a great deal of research showing that poorly-controlled hypertension can lead to mini-strokes that, over time, can produce significant dementia or other milder forms of cognitive impairment. The relationship between ongoing hypertension and the risk of developing Alzheimers disease, the most common cause of severe dementia, is less clear based upon published research findings.

Mild cognitive impairment, which is considered an intermediate stage of dementia, may be one of the earliest signs of impending Alzheimers disease. A new study in the Archives of Neurology followed 918 adults for nearly 5 years, and assessed the relationship between chronic hypertension and the development of mild cognitive impairment. All of these study volunteers were free of signs of cognitive impairment when they initially volunteered for this clinical research study.

In this study, the presence of hypertension was associated with a 40% relative increase in the risk of mild cognitive impairment, after adjusting for age, sex, and other factors thought to be related to the risk of developing mild cognitive impairment. Interestingly, the type of cognitive dysfunction that appeared to be associated with chronic hypertension was in the area of so-called executive ability, which is believed to include temporary memory that is set aside in the brain for decision-making, planning, troubleshooting complex or dangerous situations, and responding to situations that are either novel or that involve habitual behaviors. Chronic hypertension did not, however, appear to be linked to increased difficulties with memory formation or retrieval, or with language capability, in this study. The studys authors conclude that the prevention, or aggressive treatment, of hypertension may subsequently reduce the risk of mild cognitive impairment.

EMOTIONAL VITALITY & THE RISK OF HEART DISEASE

Much has been written about the risk of heart disease as a function of personality type. The classic Type A personality, which is associated with traits such as impatience, a constant sense of urgency, and a highly goal-oriented lifestyle, has been linked to an increased risk of cardiovascular disease when compared to the more patient and relaxed Type B personalities among us. A new study in the Archives of General Psychiatry looks at the impact of emotional vitality on the incidence of coronary artery disease among more than 6,000 adult men and women who participated in the National Health & Nutrition Examination Survey.

Emotional vitality is defined as a collection of generally positive psycho-emotional traits that includes a sense of positive well-being, a sense of personal energy, and a tendency to confront stimuli (both good and bad) with appropriate and measured emotional responses. The participants in this public health observational study were followed for an average of 15 years after completing the initial survey. Based upon hospital records and death certificates, the authors found that those individuals who scored highly in terms of emotional vitality were 19% less likely, in terms of relative risk, to be diagnosed with coronary artery disease when compared to subjects who scored poorly in terms of their level of emotional vitality. While the authors found that higher levels of emotional vitality were also associated with increased levels of heart-healthy behaviors, the favorable effect of emotional vitality on cardiac health persisted even when the effects of heart-healthy behaviors (or the lack thereof) were controlled for.

There is a growing body of research linking emotional and psychological health with the functions of critical body systems, including the immune system, the GI tract, and the heart. It may well be that our sense of personal well-being is associated with hormonal and immunological factors which may help to maintain our hearts in a healthy state, while negative emotional factors may send destructive signals to our heart and other vital organs. Mind and body, it appears, are more closely connected than was previously thought to be the case.

Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity.

Dr. Robert Wascher is an oncologic surgeon, professor of surgery, and a widely published author. He is the Director of the Division of Surgical Oncology at Newark Beth Israel Medical Center. Send your feedback to Dr. Wascher at rwascher@doctorwascher.net

http://doctorwascher.com

Beth Israel Hospital

Copyright 2007. Robert A. Wascher, MD, FACS. All rights reserved .

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