Dr Christine Cheng

Malignant melanomas account for more than 75% of deaths from skin cancer. Some cases are missed because of common myths regarding the disease.

1) Non-Caucasians can develop malignant melanoma with excessive sun exposure
2) Atypical melanomas can be mis-diagnosed as benign (not all melanomas have variation in colour, asymmetrical borders or size greater than 6mm)
3) Some hair-bearing moles can be cancerous

Caucasians are 10 times more likely to develop melanoma than other races.

African-Americans often develop melanoma in non-sun-exposed parts of the body: nails, soles of feet, palms of hand, mouth, nasal passages and genitals!

Only 33% of African Americans develop melanoma in sun-exposed areas!

The development of melanoma in non-exposed areas of the body results in spread of the cancer before diagnosis, and a high fatality rate. One American dies of skin cancer every 65 minutes. Appropriate lifestyle behaviour and vigilance plays a large part in the prevention and early detection of this disease.

Source: PR Inside

International obsession with health and weight management has led to a reduction of salt and fat in processed foods.

Low fat foods are guilty of having a high sugar content. The high glycaemic index and high level of processing is already contributing to escalating obesity.

Now even “healthy” foods have much more sugar in them than original recipes! Breakfast cereals, soups and wholemeal bread have up to twice as much sugar as 30 years ago!

A high sugar intake contributes to tooth decay and insulin resistance. Insulin resistance, if not controlled, results in type 2 diabetes mellitus. Type 2 diabetes is linked to heart disease and obesity.

Sugar Content: 1978 vs 2007

I’m astounded that Kellog’s Special K now has 17g sugar/100g compared to a mere 9.6g/100g in 1978. If the sugar content is that high, I’ll have an ice cream for breakfast, thank you!

I’ve always regarded cereals, wholemeal breads and tomato soup as healthy diet options. I guess we can’t trust anything that’s processed nowadays. And it’s not just the additives and trans fats that we need to worry about.

Source: Daily Mail

Wearing sunprotective clothes and a hat and reducing sun exposure to a minimum should be preferred to sunscreens.

Often this solution is deemed to be unacceptable and sunscreens are usually the predominant mode of sun protection.
Sunscreens had been shown to protect against sunburn and less serious forms of skin cancer, said the experts. However, there was no conclusive proof that they prevented the potentially deadly melanoma skin cancer.

Nina Goad, of the British Association of Dermatologists, said: “Sunscreen is an effective tool, but it should not be used as the single method of sun protection.

Researchers have revealed that adequate protective clothing is more reliable at protecting against melanoma than sunblock alone.

Many people are lulled into a false sense of security and abuse low SPF sun protection during periods of sun exposure. The sensible use of sun block includes:

1. Choosing the right SPF level for the sun exposure level. SPF 15-30 is needed for normal indoor use.
2. Application 15-30 minutes before sun exposure.
3. Liberal even application over all sun exposed areas.
4. UV-A and UV-B protection. UV-B rays cause burning, but it is UV-A rays that cause skin cancers and premature ageing.
5. Reapply if exposure is prolonged and if you sweat or swim.
6. Choose a product that you can apply with ease. There are some that are non-greasy, absorb easily and smell wonderful!

Physical protection used in conjunction with a good sun block is ideal. Once again, sensible barrier choices are essential. I had a client who wore hats everywhere and was convinced she was protecting herself against the sun. However, the hats she preferred either had tiny rims so most of her face was not covered, or had large holes in the rim. Very pretty, but useless as far as sun protection is concerned.

Clothes can offer protection too. Again, clothes made of tightly weaved material is a more sensible choice.

Ultimately, common sense is essential. Some exposure with adequate protection and avoidance of prolonged exposure, particularly at the hottest times of day are vital.

Source: Telegraph.co.uk

Healthy older people who take regular aspirin to prevent stroke may actually be increasing their risk. A UK study has revealed that the number of strokes associated with blood-thinning drugs such as aspirin or warfarin has risen seven-fold in the last 25 years.

An article in The Lancet reports that the risk is particularly high in the over 75s and aspirin may do more harm than good in healthy older people.

Researchers at the University of Oxford compared figures on intracerebral haemorrhagic stroke - a type of stroke caused by bleeding in the brain - from 1981-85 and 2002-06.

They found that the number of strokes caused by high blood pressure had fallen by 65%, which in the under 75s meant the overall rate of strokes had halved.

But in the over 75s the stroke rate remained the same over the 25-year period. There has been an increase in the number of strokes in patients taking blood thinning drugs: the proportion of patients on antithrombotic drugs was 4% in the initial study period, but two decades later this had risen to 40%.

People with cardiovascular disease, who have a high risk of blood clot, are prescribed drugs like aspirin to thin the blood and reduce the risk of a heart attack or stroke. But many healthy older people also take a regular aspirin in an attempt to ward off a stroke.

Study leader, Professor Peter Rothwell, said the increasing use of drugs such as aspirin may soon take over high blood pressure as the leading cause of intracerebral haemorrhagic stroke in the over 75s. He warned than in healthy older adults the risks of taking aspirin may outweigh any benefits.

“GPs have been treating high blood pressure very aggressively and that is bringing dividends but there are other causes of stroke in the elderly which have become important.

“There are good reasons for taking aspirin or warfarin but there are elderly who take aspirin as a lifestyle choice and in that situation the trials have shown there’s no benefit.

“And what our study suggests is that, particularly in the very elderly, the risks of aspirin outweigh the benefits,” he said.

This new evidence indicates that if you are healthy and have a low risk of heart disease or stroke and unless advised by your GP to take aspirin on a daily basis then the increased risks from the side effects of aspirin are likely to outweigh the benefits of preventing a stroke.

People can lower their risk of stroke by having regular blood pressure checks, eating a healthy diet, quitting smoking, drinking alcohol in moderation, reducing salt intake and taking regular exercise.

It might be time to get a little more natural light in your life as researchers suggest that vitamin D, which is produced by sun exposure, has a number of profound health benefits.

U.S. researchers have found a direct link between vitamin D and cancer prevention. Their four-year clinical trial found that women taking the vitamin had a 60-per-cent reduction in cancer incidence compared to those not taking it.

Reports that vitamin D deficiency have been linked to cancer, multiple sclerosis, juvenile diabetes and osteoporosis should have people rushing to change their lifestyle. Supplementation is particularly important in temperate climates.

Optimise Your Vitamin D Levels:

1) Have a blood test to determine, then monitor, your vitamin D levels three or four times a year. Check for 25 Hydroxy Vitamin D levels, which should be between 125 and 150 nanomoles per litre.

2) Sunlight is the best source of vitamin D. How long you should stay outside depends on how much sun block your skin creates naturally. Fair-skinned people, especially blonds and redheads, need only about 20 minutes a day to produce the recommended levels. Those with darker skin could need five to 10 times longer. Never allow the skin to burn, Dr. Cannell advises. Vitamin D production is maximized before skin turns pink, and further exposure does not increase levels.

3) Only a few foods have naturally occurring levels of vitamin D, and usually in insignificant quantities. An adult would have to drink about 40 glasses of milk a day to get the recommended dose of vitamin D. Milk is a more adequate source for children.

Fatty fish like salmon, sardines and herring contain vitamin D, as do egg yolks, shiitake mushrooms and reindeer meat. Some juice and cheese companies also fortify their products with vitamin D. It is more effective for adults to go outside than to modify their diet.

4) Vitamin D3 cholecalciferol pills are available over the counter in most pharmacies and health-food stores. Take 2,000 international units of the supplement per day, and no more. It is possible to have too much vitamin D.

Drinking alcohol, even moderate amounts, is a well-established risk factor for breast cancer in women. A recent study found that 60 percent of breast cancer cases in women worldwide were attributable to alcohol consumption. But the mechanism(s) of alcohol-induced breast cancer are poorly understood.

Drinking just two alcoholic drinks a day when you have breast cancer fuels the growth of tumours. Cancer patients are often just told to moderate drinking.

A University of Mississippi team found giving mice the equivalent of two to four drinks a day doubled the normal growth of a tumour after four weeks. The growth and progression of breast cancer by fueling the development of new blood vessels — a process called “angiogenesis.” It does this by boosting expression of a key growth factor known as vascular endothelial growth factor or VEGF.

Dr. Jian-Wei Gu and colleagues from the University of Mississippi Medical Center in Jackson examined the effects of alcohol on tumor growth and progression of breast cancer in mice.

For 4 weeks, 6-week old female mice consumed regular drinking water or water containing 1 percent alcohol, which is equivalent to about 2 to 4 drinks in humans. In week 2, the animals were inoculated with mouse breast cancer cells.

“We found after about 4 weeks that breast tumor size almost doubled in mice that drank alcohol compared to control mice given plain water,” Gu noted in a telephone interview with Reuters Health. Moderate alcohol intake also caused a noteworthy increase in tumor blood vessels compared with no alcohol intake.

The team also observed a significant increase in VEGF levels in the tumors of mice consuming alcohol compared to the tumors of control mice.

Lead researcher Jian-Wei Gu said: “The vast majority of tumours result from over expressed VEGF. Every day, we produce a lot of cancer cells, but they don’t become bigger. But if the cells establish blood vessels, the tumour grows and strengthens, a process known as angiogenesis. Alcohol can induce tumour angiogenesis.”

Over the past 18 months, evidence has emerged suggesting that vitamin D may reduce the risk for colorectal cancer, breast cancer, prostate cancer, non-Hodgkin’s lymphoma, multiple myeloma and other diseases such as multiple sclerosis.

Many cancers, in particular breast cancer, prostate cancer and bowel cancer, that correlate with latitude. This corresponds with the amount of Vitamin D produced naturally in response to sun exposure.

Since exposure to the sun carries risks for skin cancer, cataract formation and premature ageing, people need to take a moderate, balanced approach, and not trade cancers for cancer. A moderate, balanced approach is essential.

Some limited exposure unprotected may in fact reduce your risk of disease, but people should still follow sun sense guidelines, such as not overexposing themselves between 11 a.m. and 4 p.m., and wearing sunscreen when the UV index is higher than three.

How much sun people need depends on age, skin colour, where you live, and the intensity of the sun — factors that influence how quickly vitamin D is produced.

Most experts believe the current recommendation of 400 units of vitamin D a day for people up to age 50, and 600 units daily for those over 70, is probably too low. Somewhere between 400 units and the upper safe limit of 2,000 units a day is optimal.

People may also increase their dietary intake by eating foods naturally high in vitamin D such as fatty fish like salmon, and eggs. Cow’s milk is fortified with vitamin D in Canada, and some cheeses and yogurt contain vitamin D.

US scientists have devised a drug that can switch on a gene to burn body fat, offering hope of an exercise pill. This exercise pill tricks cells into thinking they are undergoing serious exertion and so helps the body burn extra fat.

Mice given the drug burned off fat, even when they did not exercise, and were resistant to weight gain despite a high-fat diet.

The ultimate use would be to treat people at risk of obesity-related diseases like diabetes, rather than offer a “no-work six-pack” pill. This radical new potential treatment for obesity may allow fat people to use drugs to slim down rather than dieting or exercising. The drug, a synthetic form of fat, has only been tested on animals. It appears to work by flicking a master switch within cells that regulates the storage or burning of fat.

Ronald Evans, the researcher who created the drug, told the Experimental Biology conference in Washington DC over the weekend that such drugs could lead to new treatments for human metabolic syndrome. Sometimes called syndromeX, this consists of obesity and its consequences, such as high blood pressure, elevated levels of fat in the blood, heart disease, diabetes and resistance to insulin.

Dr Evans, of the Salk Institute, in San Diego, California, found the drug activated the same fat-burning process that occurs during exercise, increasing the amount of calories burnt with no apparent effort. This made the mice resistant to weight gain even on a high-fat diet. The drug mimics normal fat and chemically triggers a gene switch called PPAR-delta. Turning on this switch activates the same fat-burning process that occurs during exercise.

The potential of chemical metabolic engineering is extremely promising, particularly since we live in a society where too few people get an ideal amount of exercise.

Such a drug could reduce fatty tissue, lower amounts of fat circulating in the blood, cut blood glucose levels and reduce resistance to insulin, limiting the risks of heart disease and diabetes. Type 2 diabetes is linked to obesity, and experts believe up to half of all cases could be prevented through changes to diet and exercise.

There are already a range of anti-fat drugs on the market, but they are criticised by nutrition researchers, who point out that people who take such drugs may lose weight at first, but without appropriate lifestyle changes, inevitably pile it back on soon after.

UK expert Dr Fredrik Karpe, from the Oxford Centre for Diabetes, Endocrinology and Metabolism, is hoping to start human testing of this drug in the near future.

Commenting on the work, he said: “There has never been a method to ‘medically’ switch on fat burning before.

“The finding that PPAR-delta co-ordinates this process, not only by switching on fat burning, but also to rebuild the muscle in a way making it more fit for fat burning, is of major interest, not least as a completely novel approach for the treatment of the metabolic derangements accompanying obesity.”

But he cautioned; “Although this might become an ‘exercise pill’, it is unlikely to provide all the other benefits of real physical exercise.”

An industry-funded study presented Monday at the Experimental Biology meeting in Washington, D.C. reported that the consumption of pistachios could reduce cholesterol levels.

“Pistachio amounts of 1.5 ounces and three ounces (per day) — one to two handfuls — reduced risk for cardiovascular disease by significantly reducing LDL (”bad”) cholesterol levels, and the higher dose significantly reducing lipoprotein ratios,” study author Sarah K. Gebauer, a graduate student in integrative biosciences at Penn State.

The multi-week study, funded by the California Pistachio Commission , concluded that three ounces of pistachios a day reduced LDL levels by 11.6 percent, total cholesterol levels by 8.4 percent, and non-high density lipoproteins (non-HDL) by 11.2 percent. Levels of non-HDL are considered predictors of cardiovascular disease (CVD) risk.

A handful of pistachios provide the same antioxidants found in dark, leafy vegetables and brightly-colored fruit.

“Our study has shown that pistachios, eaten with a healthy heart diet, may decrease a person’s CVD risk profile,” said primary investigator Dr. Penny Kris-Etherton, distinguished professor of nutrition at Penn State.

Research has confirmed that eating pistachios may reduce the body’s response to stress. A Penn State study has shown that elevated reactions to stressors can be reduced by the inclusion of pistachios in the daily diet.

“A ten-year follow-up study of young men showed that those who had larger cardiovascular responses to stress in the lab, were more likely to contract hypertension later in life,” says Dr. Sheila G. West, associate professor of biobehavioral health. “Elevated reactions to stressors are partly genetic, but can be changed by diet and exercise. Lifestyle changes can make the biological reactions to stress smaller.”

A randomised controlled study examiniming the effects of pistachios on participants who had high cholesterol, but normal blood pressure. They used a randomized, crossover controlled feeding study plan. All three diets included an equal number of calories.

After a two-week run-in diet containing 35 percent fat and 11 percent saturated fats, each test diet lasted for four weeks during which time participants consumed only foods supplied by the study.

The 3 diets were: a standard heart healthy diet with 25 percent fat and 8 percent saturated fat, a diet containing 1.5 ounces of pistachios with 30 percent total fat and 8 percent saturated fat, and a diet containing 3 ounces of pistachios containing 34 percent fat and 8 percent saturated fat.

At the end of each four-week diet regime, the researchers measured blood pressure and total peripheral vascular resistance at rest and during two stress tests, one physiological and the other physical.

The physical test consisted of putting one foot in a bucket of ice water for 2.5 minutes. The psychological test asked participants to listen to two numbers, add them in their head and say the answer. Then they were asked to pay attention to another number and add it to the second number they heard, not the original sum.

“The ice water is a stimulus for the sympathetic nervous system, but it is very different form the stressors we encounter every day,” says West. “We also wanted to see if the reaction occurred when the stress was nonphysical, so we used the math test.”

The researchers found that both pistachio containing diets reduced the stress effects on blood pressure, but that the 1.5 ounce pistachio diet reduced systolic blood pressure by 4.8 millimeters of mercury while the 3-ounce pistachio diet only reduced systolic blood pressure by 2.4 millimeters of mercury. The diets had no effect on normal, resting blood pressure.

When the researchers examined total peripheral vascular resistance, it was clear that the 3-ounce diet led to greater relaxation of arteries. Because the body strongly controls blood pressure, rather than allowing blood pressure to drop further, the heart compensated by pumping more forcefully.

“The relaxation of blood vessels after the 3-ounce pistachio diet likely reduced the workload on the heart,” says West. “This pattern of change would be beneficial if it is maintained long term. It is possible that other foods that are high in unsaturated fat and antioxidants would have a similar effect.”