Wednesday, August 27, 2008
People with diverticular disease, a common digestive disorder, are typically told to avoid eating popcorn, nuts, seeds and corn so they don't get painful attacks.
But, a new study calls into question that conventional wisdom. The study of more than 47,000 men found that eating those foods did not seem to increase the risk of diverticulosis or diverticular complications.
"We found, contrary to current recommendations, that actually, consumption of these foods did not increase the risk of diverticulitis or diverticular bleeding and didn't appear to increase the risk of developing diverticulosis or its complications," said study lead author Dr. Lisa Strate, an assistant professor of medicine at the University of Washington School of Medicine, in Seattle.
The findings are published in the Aug. 27 issue of the Journal of the American Medical Association.
Diverticular disease affects the colon, the part of the large intestine that discards waste. Diverticulosis occurs when pouches -- called diverticula -- form in the colon. Stool or bacteria can lodge in the pouches. Diverticulitis occurs when the pouches get inflamed; symptoms can include bleeding, infection or a blockage of the digestive system.
One third of U.S. adults have diverticulosis by age 60, although most do not experience serious problems. By age 85, two-thirds of people have come down with the condition, according to the U.S. National Institutes of Health.
The exact cause isn't known, although many experts blame a low-fiber diet. Muscle strain during defecation may cause the pouches to form.
The advice to avoid nuts, seeds, popcorn and corn comes from the belief that these foods may be more likely to become lodged within the pouches. But there's been no proof demonstrating such a link.
And Strate's study failed to find a link, either. Evaluating data from the long-running Health Professionals Follow-up Study, a cohort of men followed from 1986 to 2004, she and her colleagues looked at medical records every two years and dietary information for every four years. The men ranged in age from 40 to 75.
At the study start, all were free of diverticulosis or complications. Eighteen years later, 801 had experienced diverticulitis, and 383 had diverticular bleeding.
When the study authors compared men with the highest intake of foods such as nuts with those with the lowest, they found that those who ate the most nuts were actually 20 percent less likely to get diverticulitis than those who ate the least. And those men who ate the most popcorn were 28 percent less likely to get diverticulitis than those eating the least.
No association was found for corn.
Strate thinks the longstanding dietary recommendations should be reconsidered, but she cautioned that hers was just one study. She believes the findings would probably apply to women, too.
Dr. Anthony Starpoli, an attending gastroenterologist at Lenox Hill Hospital in New York City, who is familiar with the new findings, said that even though the study numbers were large, the results may not apply to everyone. "There are probably going to be a subset of people where perhaps a more restrictive diet does benefit them," he said.
Starpoli said that, while the recommendation to avoid nuts, popcorn and seeds isn't based on scientific studies, there are people who do experience distress when they eat those foods.
"If you are a patient with known diverticular disease, and you have had the experience of eating seeds, nuts and popcorn and developed diverticular pain as assessed by your doctor, you should probably not have those foods."
But, a new study calls into question that conventional wisdom. The study of more than 47,000 men found that eating those foods did not seem to increase the risk of diverticulosis or diverticular complications.
"We found, contrary to current recommendations, that actually, consumption of these foods did not increase the risk of diverticulitis or diverticular bleeding and didn't appear to increase the risk of developing diverticulosis or its complications," said study lead author Dr. Lisa Strate, an assistant professor of medicine at the University of Washington School of Medicine, in Seattle.
The findings are published in the Aug. 27 issue of the Journal of the American Medical Association.
Diverticular disease affects the colon, the part of the large intestine that discards waste. Diverticulosis occurs when pouches -- called diverticula -- form in the colon. Stool or bacteria can lodge in the pouches. Diverticulitis occurs when the pouches get inflamed; symptoms can include bleeding, infection or a blockage of the digestive system.
One third of U.S. adults have diverticulosis by age 60, although most do not experience serious problems. By age 85, two-thirds of people have come down with the condition, according to the U.S. National Institutes of Health.
The exact cause isn't known, although many experts blame a low-fiber diet. Muscle strain during defecation may cause the pouches to form.
The advice to avoid nuts, seeds, popcorn and corn comes from the belief that these foods may be more likely to become lodged within the pouches. But there's been no proof demonstrating such a link.
And Strate's study failed to find a link, either. Evaluating data from the long-running Health Professionals Follow-up Study, a cohort of men followed from 1986 to 2004, she and her colleagues looked at medical records every two years and dietary information for every four years. The men ranged in age from 40 to 75.
At the study start, all were free of diverticulosis or complications. Eighteen years later, 801 had experienced diverticulitis, and 383 had diverticular bleeding.
When the study authors compared men with the highest intake of foods such as nuts with those with the lowest, they found that those who ate the most nuts were actually 20 percent less likely to get diverticulitis than those who ate the least. And those men who ate the most popcorn were 28 percent less likely to get diverticulitis than those eating the least.
No association was found for corn.
Strate thinks the longstanding dietary recommendations should be reconsidered, but she cautioned that hers was just one study. She believes the findings would probably apply to women, too.
Dr. Anthony Starpoli, an attending gastroenterologist at Lenox Hill Hospital in New York City, who is familiar with the new findings, said that even though the study numbers were large, the results may not apply to everyone. "There are probably going to be a subset of people where perhaps a more restrictive diet does benefit them," he said.
Starpoli said that, while the recommendation to avoid nuts, popcorn and seeds isn't based on scientific studies, there are people who do experience distress when they eat those foods.
"If you are a patient with known diverticular disease, and you have had the experience of eating seeds, nuts and popcorn and developed diverticular pain as assessed by your doctor, you should probably not have those foods."
Tuesday, August 19, 2008
A mathematical model to find blood biomarkers that can help doctors estimate the size of cancer tumors has been developed by researchers at Stanford University.
The team says its work may help guide development of new tests to improve early detection of cancer. Currently, there's no reliable method of using the results of blood-screening tests to gauge tumor size.
The Stanford researchers developed their mathematical model using two common blood biomarkers: prostate specific antigen (PSA), which is often elevated in prostate cancer, and CA125, used as a marker for follow-up therapy in ovarian cancer patients.
Using this model, the researchers found that the minimum tumor sizes predicted by their calculations were close to what was actually seen in clinical practice.
"We're pretty happy that we came up with rather realistic tumor sizes. Although this is a very basic model, it should give researchers a tool to use when deciding if a particular secreted protein would be a good biomarker," radiologist Dr. Amelie Lutz said in a Stanford news release.
"Early cancer detection is a very challenging but important goal for the cancer field. This modeling work enables a very deep understanding of the problems that will have to be solved for blood-based cancer biomarkers to be successful in this effort," study senior author Dr. Sanjiv Sam Gambhir, a professor of radiology, said in the news release.
The team says its work may help guide development of new tests to improve early detection of cancer. Currently, there's no reliable method of using the results of blood-screening tests to gauge tumor size.
The Stanford researchers developed their mathematical model using two common blood biomarkers: prostate specific antigen (PSA), which is often elevated in prostate cancer, and CA125, used as a marker for follow-up therapy in ovarian cancer patients.
Using this model, the researchers found that the minimum tumor sizes predicted by their calculations were close to what was actually seen in clinical practice.
"We're pretty happy that we came up with rather realistic tumor sizes. Although this is a very basic model, it should give researchers a tool to use when deciding if a particular secreted protein would be a good biomarker," radiologist Dr. Amelie Lutz said in a Stanford news release.
"Early cancer detection is a very challenging but important goal for the cancer field. This modeling work enables a very deep understanding of the problems that will have to be solved for blood-based cancer biomarkers to be successful in this effort," study senior author Dr. Sanjiv Sam Gambhir, a professor of radiology, said in the news release.
Monday, August 11, 2008
Lymphedema is a public health issue "deserving greater attention," doctors from Australia wrote in a recently published paper.
Among 287 women with breast cancer, 190 took part in all assessments during 18 months of followup after surgery and arm swelling developed in 62 (33 percent) of them during that time, Dr. Sandra C. Hayes and colleagues from Queensland University of Technology in Kelvin Grove found.
Roughly 60 percent of these women had fleeting symptoms, whereby the lymphedema dissipated with or without treatment. However, 40 percent of women experienced long-term arm swelling lasting more than 3 months, with or without intermittent periods of relief.
Women with lymphedema, Hayes told Reuters Health, "were twice as likely to have poorer upper-body function when compared with women who had not developed arm swelling. Poor upper body function is associated with reduced quality of life," she noted.
More extensive breast surgery increased the odds of lymphedema six-fold and having more than 20 cancerous lymph nodes removed increased odds four-fold.
Hayes noted that two identified risk factors for arm swelling post-surgery -- insufficient physical activity and not using the affected arm -- "are amenable to interventions and should be investigated for their preventive and therapeutic effects among women after treatment for breast cancer."
"It was found that use of the treated side likely decreases risk of developing lymphedema," Hayes said.
Among 287 women with breast cancer, 190 took part in all assessments during 18 months of followup after surgery and arm swelling developed in 62 (33 percent) of them during that time, Dr. Sandra C. Hayes and colleagues from Queensland University of Technology in Kelvin Grove found.
Roughly 60 percent of these women had fleeting symptoms, whereby the lymphedema dissipated with or without treatment. However, 40 percent of women experienced long-term arm swelling lasting more than 3 months, with or without intermittent periods of relief.
Women with lymphedema, Hayes told Reuters Health, "were twice as likely to have poorer upper-body function when compared with women who had not developed arm swelling. Poor upper body function is associated with reduced quality of life," she noted.
More extensive breast surgery increased the odds of lymphedema six-fold and having more than 20 cancerous lymph nodes removed increased odds four-fold.
Hayes noted that two identified risk factors for arm swelling post-surgery -- insufficient physical activity and not using the affected arm -- "are amenable to interventions and should be investigated for their preventive and therapeutic effects among women after treatment for breast cancer."
"It was found that use of the treated side likely decreases risk of developing lymphedema," Hayes said.
