Wednesday, December 30, 2009

Green Tea Drinking in Elderly Linked to Lower Risk for Depression

From Medscape CME Clinical Briefs

News Author: Laurie Barclay, MD
CME Author: Charles P. Vega, MD

December 29, 2009 — More frequent consumption of green tea is associated with a lower prevalence of depressive symptoms in the community-dwelling older population, according to the results of a cross-sectional study reported in the December issue of the American Journal of Clinical Nutrition.

"Green tea is reported to have various beneficial effects (e.g., anti–stress response and anti-inflammatory effects) on human health," write Hideko Takahashi, from Tohoku University Graduate School of Biomedical Engineering in Sendai, Japan, and colleagues. "Although these functions might be associated with the development and progression of depressive symptoms, no studies have investigated the relation between green tea consumption and depressive symptoms in a community-dwelling population."

Drinking green tea is a common social practice in Japan, and many people believe that this tea has salutary effects on the mind and spirit. However, a previous study by Shimbo and colleagues questions this possibility. They examined the effects of green tea consumption on self-perceptions of mental health among 600 Japanese adults. Their results, which were published in the December 2005 issue of Public Health Nutrition, failed to demonstrate a significant independent effect of green tea consumption on the mental health status of men or women. However, greater caffeine intake was associated with higher rates of poor mental health among women.

Mediterranean Diet Linked to Lower Risk for Stomach Cancer

From MedscapeCME Clinical Briefs

News Author: Laurie Barclay, MD
CME Author: Laurie Barclay, MD

December 29, 2009 — Greater adherence to a relative Mediterranean diet is associated with a significantly lower risk for incident gastric adenocarcinoma, according to the results of a prospective cohort study reported online in the December 9 issue of the American Journal of Clinical Nutrition.

"The Mediterranean dietary pattern is believed to protect against cancer, although evidence from cohort studies that have examined particular cancer sites is limited," write Genevieve Buckland, BS, from the Catalan Institute of Oncology, Idibell, in Barcelona, Spain, and colleagues from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort study.

The Mediterranean diet includes a proportionately high intake of fruit, nuts, fiber, seeds, vegetables, olive oil, and a moderate intake of wine. These foods are rich in antioxidants that may help prevent cancer, such as vitamin C, carotenoids, phenols, and flavonoids. In addition, consumption of red and processed meat is relatively low.

Several studies have shown a protective effect of the Mediterranean diet on health and its association with a reduced risk for cancer and other chronic diseases. However, only breast cancer and colorectal cancer risks have been examined separately, and no studies to date have evaluated the association between adherence to a Mediterranean diet and the risk for gastric adenocarcinoma.

Monday, December 21, 2009

Tai Chi Improves Pain in Arthritis Sufferers

From Arthritis Care Research News Alerts

Posted: 12/02/2009; Arthritis Care Research News Alerts © 2009 Wiley InterScience

The results of a new analysis have provided good evidence to suggest that Tai Chi is beneficial for arthritis. Specifically, it was shown to decrease pain with trends towards improving overall physical health, level of tension and satisfaction with health status.

Musculoskeletal pain, such as that experienced by people with arthritis, places a severe burden on the patient and community and is recognized as an international health priority. Exercise therapy including such as strengthening, stretching and aerobic programs, have been shown to be effective for arthritic pain.
Tai Chi, is a form of exercise that is regularly practiced in China to improve overall health and well-being. It is usually preformed in a group but is also practiced individually at one’s leisure, which differs from traditional exercise therapy approaches used in the clinic.

Recently, a new study examined the effectiveness of Tai Chi in decreasing pain and disability and improving physical function and quality of life in people with chronic musculoskeletal pain. The study is published in the June issue of Arthritis Care & Research ( Led by Amanda Hall of The George Institute in Sydney, Australia, researchers conducted a systematic review and meta-analysis. They analyzed seven eligible randomized controlled trials that used Tai Chi as the main intervention for patients with musculoskeletal pain. The results demonstrate that Tai Chi improves pain and disability in patients suffering arthritis.

The authors state, “The fact that Tai Chi is inexpensive, convenient, and enjoyable and conveys other psychological and social benefits supports the use this type of intervention for pain conditions such as arthritis.”

“It is of importance to note that the results reported in this systematic review are indicative of the effect of Tai Chi versus minimal intervention (usual health care or health education) or wait list control,” the authors note. Establishing the specific effects of Tai Chi would require a placebo-controlled trial, which has not yet been undertaken.

Article: “The Effectiveness of Tai Chi for Chronic Musculoskeletal Pain Conditions: A Systematic Review and Meta-Analysis,” Amanda Hall, Chris Maher, Jane Latimer, Manuela Ferreira, Arthritis Care & Research, June 2009.


Friday, December 18, 2009

Stay Slim, Active, Smoke-Free: Live Long and Free of CVD

From Heartwire
Shelley Wood

men who smoked, were inactive, and who had a waist girth >94 cm had an overall life expectancy that was 14 years shorter

December 16, 2009 (Chicago, Illinois) — Everyone agrees: smoking, physical inactivity, and abdominal obesity increase the risks of coronary heart disease (CHD), but just how much are risks reduced in those who can claim "none of the above"?

A new study appearing in the December 14-28, 2009 issue of the Archives of Internal Medicine indicates that men with none of these risk factors had a 59% lower risk of CHD events and a 77% lower risk of dying of cardiovascular disease [1]. The authors say their study may be the first to estimate the "combined health benefits" of not smoking, having good cardiorespiratory fitness (measured by max treadmill test), and a normal waist girth.

Dr Chong-Do Lee and colleagues followed 23 657 men age 30 and older for a mean of almost 15 years (348 811 person-years) in the Aerobics Center Longitudinal Study (ACLS).

Over this period, 482 men had a fatal or nonfatal MI, and 1034 died of noncardiac causes. After adjusting for age, year of initial medical examination, and baseline risk factors, Lee et al found that risk of a CHD event or of dying of cardiac or noncardiac causes was inversely related to the presence of "low-risk factors."

Men with a normal waist circumference, who kept physically active, and who didn't smoke were significantly less likely to have a CHD event or die of cardiac causes, as compared with men with none of these low-risk factors. Risk of all-cause mortality was also dramatically lower in this group.
By comparison, men who smoked, were inactive, and who had a waist girth >94 cm had an overall life expectancy that was 14 years shorter.

Investigators underscore a number of limitations in their study: the study cohort comprised mainly white, middle- to upper-class men and importantly, did not address changes in low-risk factors over the follow-up period. But overall, they say, their findings speak to the importance of adhering to healthy behaviors and a healthy weight over the long term.

"The magnitude of having the three low-risk factors is impressive for both population-attributable risk and for longevity and indicates the clinical and public-health importance of these characteristics," Lee et al conclude.

Easier said than done, perhaps. Citing a 2006 paper by Chiuve et al [2], Lee and colleagues point out that "low-risk" Americans, who have a normal weight in combination with a healthy lifestyle, make up just 3% to 4% of the population.


Diagnosing Breast Cancer: Needle Biopsy Best?

From WebMD Health News

Jennifer Warner

December 17, 2009 — A less invasive needle biopsy may be nearly as effective as surgical biopsy at diagnosing breast cancer, and with far fewer side effects.

A new review of more than 80 studies on the two breast cancer screening methods shows breast needle biopsy was able to distinguish between cancerous and noncancerous breast lesions with about the same accuracy as surgical biopsy and less than half the risk of complications.

Women suspected of having breast cancer after initial screening are usually referred for a biopsy to determine whether the lesion is cancerous. In most cases, the lump or lesion is benign or noncancerous and does not require further treatment.

Biopsies may be performed via open surgery on the breast or with a less invasive core-needle biopsy in which a small sample of breast tissue from the affected area is removed through a special needle inserted through the skin.

Researchers say needle biopsy has fewer complications and a shorter recovery time than open surgical biopsy, but some women and doctors may have concerns about the accuracy of the procedure compared with traditional open surgery methods of breast cancer diagnosis.

In the study, published in the Annals of Internal Medicine, researchers reviewed 83 studies on the two methods.

The results showed that core needle biopsies were about as accurate as open surgery at detecting cancerous vs. noncancerous breast lesions.

Needle biopsies also had a much lower rate of complications (less than 1% compared with 2%-10% with open surgery).

In addition, the study showed women initially diagnosed with breast cancer with needle biopsy were more likely to be treated with a single breast cancer surgery than those initially diagnosed by open surgical biopsy.

"Based on currently available evidence, it appears reasonable to substitute core needle biopsy procedures for open surgical biopsy given the comparable sensitivity and lower complication rates," write researcher Wendy Bruening, PhD, of the ECRI Institute Evidence-Based Practices Center in Plymouth Meeting, Pa., and colleagues. They say additional studies are needed to find out what factors affect the accuracy of core-needle breast biopsy.


Bruening, W. Annals of Internal Medicine, published online Dec. 15, 2009.

Monday, December 14, 2009


Question 1: What Behaviors Are Most Likely To Prevent Food Safety Problems?

The behaviors in the home that are most likely to prevent a problem with foodborne illnesses are

Cleaning hands, contact surfaces, and fruits and vegetables (but not meat and poultry, which should not be washed)

Separating raw, cooked and ready-to-eat foods while shopping, preparing, or storing

Cooking foods to a safe temperature

Chilling (refrigerate) perishable foods promptly

Tuesday, December 1, 2009

Aging excellently

Nov 7, 2009

100 is the New 65: Living Longer and Better
By: Greater Good Magazine

100 is the New 65
- Why do some people live to 100? Researchers are trying to find out, reports Meera Lee Sethi, and they’re discovering how we might live better lives, not just longer ones.

Will Clark, 105, recently bought a van for a 5,000-mile road trip across the Midwest with his wife, Lois, who is 102. Elsa Brehm Hoffmann loves bridge and is always ready for a party. Rosa McGee enjoys singing hymns to herself all day long. Will Clark makes a mean spaghetti and meatballs. What connects these three? They belong to the single fastest growing segment of the United States population: people over a hundred years old.

Hoffmann, McGee, Clark, and the nearly 100,000 other centenarians in the U.S. provide inspiration to the rest of us. But they also provide researchers with a tantalizing puzzle: Why do some people live so long? For years, medical researchers have been studying this select group, identifying some key factors to a long life. Now, a growing body of research is suggesting that longevity isn’t just linked to good genes and a healthy lifestyle; it’s also tied to cultivating a positive, resilient attitude toward life. These results validate a simple idea: that centenarians can teach us how to live not just longer lives, but better ones.

At the fore of this research is the New England Centenarian Study (NECS), which has enrolled more than 1,500 centenarians from around the world over the past 15 years. The study’s director, Thomas Perls, says these participants dispel the belief that the older someone gets, the sicker he or she becomes. Instead, he says, “the older you get, the healthier you’ve been.” In other words, people who demonstrate exceptional longevity tend to have had a lifelong history of good health.

Indeed, people who die in their 70s or 80s are plagued by degenerative illnesses in the years before their death; in contrast, Perls has found that nearly two thirds of centenarians either delay the onset of diseases such as heart disease, stroke, and diabetes—or escape them altogether. Plus, a substantial proportion of centenarians who survive such age-related illnesses do so without developing physical disabilities, enabling them to remain socially, mentally, and physically active. As a result, in a culture that romanticizes youth, Perls argues that centenarians embody “a thoroughly optimistic view of aging”—one that shows that prolonging life and enjoying it go hand-in-hand.

How do they do it?

To reach 100, research suggests that it definitely helps to have the right genes. Longevity clusters in families; Perls has documented as many as eight siblings in one generation who lived to 100. He’s also found that the children of centenarians have only one-third the risk of dying from cancer as the rest of us, and one-sixth the risk of dying from heart disease. Although specific genetic mechanisms behind long life are notoriously difficult to prove, there is some evidence that centenarians may be less likely to possess specific genetic variations that predispose people to problems like cardiovascular disease, diabetes, and high cholesterol. Perls is currently studying the entire human genome, searching for genetic variations associated with other diseases that centenarians lack, as well as variations that may actively promote longevity.

But long life isn’t just a lucky break. Scientists’ best estimate, largely based on a landmark Swedish study of identical and fraternal twins, is that genetic factors account for only 20 to 30 percent of a person’s lifespan. Environmental and behavioral factors dictate the other 70 to 80 percent.

Much of what researchers know about how to reach extreme old age sounds like basic public health advocacy: Don’t smoke. Drink in moderation. Eat healthy. Exercise regularly. “What we can do to live longer is no secret,” says Peter Martin, who directs the Gerontology Program at Iowa State University and was a key contributor to a study of centenarians in Georgia, the Georgia Centenarian Study, which ran from 1988 to 2006.

But what is new is the growing evidence that our personalities affect our longevity. It’s easy to know what it takes to stay healthy. More difficult is believing we have the power to control our lifespans, mustering the will to make good choices, and simply loving life enough to make long-term investments in our health. “It’s personality,” says Martin, “that turns these things on.”

Though every centenarian is unique—they vary widely in terms of education, socioeconomic status, religion, and ethnicity—Martin reports that, as a group, they exhibit a distinct constellation of personality traits. For instance, they tend to display relatively high levels of what psychologists label “competence”—the ability to achieve goals—and “conscientiousness,” or self-discipline. These qualities may make it easier to follow through on the healthy habits the rest of us resolve to keep each New Year’s Eve but abandon by the end of January.

“It’s amazing how cognizant they are of the need to exercise and not just leave it to chance or nature,” says Lynn Peters Adler, who runs the National Centenarian Awareness Project, an advocacy group that celebrates the pleasures and accomplishments of aging. “One woman I know walks a mile every morning, no matter the temperature.” This may sound like a strict and dreary regimen, but Adler notes that there’s an exciting reason for it: This woman loves hiking the Grand Canyon, which she has done nearly a dozen times since her 75th birthday.

Martin’s research suggests that centenarians also seem to be more inclined to embrace new skills and experiences, defying the stereotype of the elderly as stuck in their ways. Will Clark is living proof. Now 105, he just acquired his first computer, which he uses to email friends and to research authors and golfers in which he’s interested. He’s even taken to Googling family members. “I can’t believe the things you can call up on this gadget,” chuckles the former dentist and military man.

Elsa Hoffmann, 102, epitomizes two other traits centenarians display at relatively high levels: extraversion and trust. “I love people and I like to find out their interests in life,” she says. “We get to be intimate almost when we meet.” Hoffmann’s schedule includes lunch dates, theater outings, fundraisers, shopping excursions, bridge and gin tournaments, and—every year for the past few years—a cruise with fellow country club members.

Though she derives boundless joy from all this social activity, it also happens to be good for her: A considerable body of epidemiological research has linked low levels of social connection with higher risks for mortality. (See Jill Suttie’s Greater Good article this month for more on the cognitive benefits of social connection.)

But even when life isn’t all about world travel and intellectual discovery, centenarians still seem to have a leg up on the rest of us: Their results on personality tests show that they may be better equipped to handle difficult situations without literally worrying themselves to death. Rosa McGee, for instance, has lived through cancer, the death of her husband of 25 years, and a foot condition that renders her essentially homebound. Yet her daughter Clara Jean describes her personality simply as “sweetness. She never fusses, never argues, never complains. It’s a contentment that is beautiful.”

Indeed, research also shows that centenarians are more likely than younger adults to engage in “cognitive coping,” using mental strategies to tackle difficult situations. Martin says he has seen centenarians take a variety of approaches to combating stress and negative emotions. Some write poetry about the loneliness of old age or the misery of illness; others replace lost physical pursuits with mental ones, like reading, or take comfort in deep religious beliefs.

None of these coping strategies are particularly innovative. But Perls, Martin, and their colleagues argue that they can add up to a lifetime’s worth of healthy stress-management. Centenarian research shows that avoiding anxious or neurotic behavior may not only help us increase our lifespans but better enjoy those extra years.

A higher bar for aging

Given how “fantastically well” he has seen his study participants doing in the later stages of their lives, Perls is frustrated by what he sees as our culture’s obsession with youth. He laments the fact that “we have an entire industry that tries to stop aging—it’s all nonsense.”

Leonard Poon, who heads the Georgia Centenarian Study and is a professor of public health and psychology at the University of Georgia, says it’s not just popular culture but politicians who are short-sighted in this regard. Poon bemoans the lack of congressional support for the fields of gerontology and geriatrics. “The White House Conference on Aging is held every 10 years to get grassroots recommendations,” explains Poon. “In the last one, President Bush did not show up.”

Their lack of political clout is ironic; in his interviews with centenarians, Martin has found that many are acutely interested in politics, and love discussing issues like the national debt. He says this vigorous involvement in community life is a joy that old age shares with youth.

But there are also new joys that take shape as one gets older. There is, for instance, the pleasure of what Martin calls “weaving your own life story and making sense of why we’re here.” It’s a pleasure that McGee clearly enjoys when she talks about her role orchestrating a year’s supply of food for a church in Mexico, and that Hoffmann feels when she fixes broken toys for her great-grandchildren and speaks to elementary schoolchildren about her life’s experiences. And there is, still, the pleasure of exploration. Clark reveled in it recently, when he bought a van and went on a 5,000-mile road trip across the Midwest with his wife, herself 102.

Rising life expectancy rates mean that most of us will live longer than previous generations. What remains in question is the quality of life we’ll have at 80, 90, or 100. Martin contends that the answer lies in the attitude we cultivate in our younger years. “Imagine that you’re 95,” he says. “You can’t see, you can’t hear, you’re lonely and dependent on other people—and it’s because of the anxious, disagreeable attitude you had all your life.”

On the other hand, he says, developing a positive attitude towards life while we’re young, though challenging at times, can set us up to be happy, healthy, and independent in old age.

In other words, aging well isn’t just a project for the elderly. It’s something we can work toward our entire lives.

“For our parents, the standard was aging gracefully,” says Adler. “The bar has been raised. Let’s aspire instead to age excellently.”

– Meera Lee Sethi is a Chicago-based freelance writer who reports on current issues in biomedicine, public health, social psychology, and neuroscience. She is a contributing editor for Copyright Greater Good. Greater Good Magazine, based at UC-Berkeley, is a quarterly magazine that highlights ground breaking scientific research into the roots of compassion and altruism.

Related articles by Greater Good Magazine:

Arts and Smarts: Test Scores and Cognitive Development
Cognitive and Emotional Development Through Play
Mindfulness and Meditation in Schools for Stress Management

Brain Autopilot

Nov 22, 2009

The Brain Advantage: Train your Autopilot…and how to turn it off
By: Madeleine Van Hecke, Ph.D.

Brain-imaging techniques allow researchers to witness the brain’s activity reflected in a rainbow of colors on a computer screen. When brain cells are highly active—working harder—the result shows up as brighter colors on the computer screen. Brilliant reds and yellows indicate brain areas that are most active. In contrast, the blues and greens on a scan show a quieter, less active brain.

What would we expect to find if we examined the brain scans of people with high versus average IQ scores? We might picture the active brain of an Einstein as a hotbed of smoldering colors—but we’d be wrong. Neurologist Richard Restak summarized a UCLA study that compared individuals with high IQs to those with average IQs. Restak wrote, “The researchers started off with the seemingly reasonable idea that ‘smarter’ brains work harder, generate more energy, and consume more glucose. Like light bulbs, the brains of ‘bright’ people were expected to illuminate more intensely than those of ‘dimwits’ with a reduced wattage.” What they discovered instead was exactly the opposite. Higher IQ people had cooler, more subdued brain scans “while their less intellectually gifted counterparts lit up like miniature Christmas trees.” ….

Why would “smarter” brains work less hard? One strong bet is that when we are inexperienced—when we still have a lot to learn—we have to make a conscious effort to think about what we’re doing. But later, after we’ve become more adept, much of what initially took effort becomes automatic.

The good news is that functioning on autopilot allows us to expend less brain energy on the routine aspects of the work. Our expertise allows us to direct our energy elsewhere. For example, novices use different parts of their brains than experts do. This happens in areas as different as playing chess and swinging a golf club.These studies show that less-experienced people think more about carrying out the mechanics of the task and encoding information.Experts, on the other hand, function on automatic pilot in these areas. In fact, experts sometimes falter—flubbing a basketball free throw or a golf putt—when their focus shifts back to the mechanics.

So functioning on autopilot can be a great advantage. But it can also work against us. As mentioned in chapter 1, international rock climber Lynn Hill was preparing to climb a wall in Buoux, France in 1989. She threaded her rope through her harness but then, instead of tying the knot, she stopped to put on her shoes. While tying her shoes, she talked to another woman. “The thought occurred to me that there was something I needed to do before climbing,” she later recalled.29 But Hill “dismissed the thought” and climbed the wall. When she leaned back to rappel to the ground, she fell seventy-two feet. Fortunately, tree branches broke her fall and Hill survived.

Lawrence Gonzales, who tells this story in his book Everyday Survival, points out that more training would not have helped Lynn Hill. “In fact,” as Gonzales writes, “experience contributed to her accident.” She could tie her rope to her harness on autopilot but the similarity between tying shoes and tying the rope “tricked” her brain into thinking she had done what she needed to do.

So there are two sides to our ability to function on autopilot. Doing so can lead to major mistakes, as Lynn Hill’s story illustrates. On the other hand, there are distinct benefits as well. When we are trying to become more expert, in many cases our goal is to get good enough so that we can be on autopilot!

Interesting, but so what?

How can I use this information as a business leader?

Among their many challenges, leaders have two key responsibilities: developing their people and increasing efficiency. Increasing efficiency often involves standardizing, automating or simplifying processes. However, carrying out routines more automatically also has one major drawback. It increases the risk that, like Lynn Hill failing to knot her rope, people will at times implement these procedures “mindlessly.”

In an ideal world, for efficiency’s sake, employees would conduct much of their work on autopilot. Then they would shift off autopilot when the situation required more conscious thought. The key question for business leaders is how to ensure that people stick to autopilot when it’s working well, yet make the shift to more conscious deliberation when it’s needed…

What if …

1. What if business leaders use automated systems to remind them to periodically go off autopilot?

Professionals often step back from recently-completed projects and debrief. They assess how things went and consider what they might do differently next time. Why not extend this practice to well-established routines? Team members could, for example, look at the plans they are creating for carrying out a project. Then they could take some time to discuss questions like “Is this the most efficient possible way to do this?” and “Is there someone else whose perspective we should get on this before we start?”

Similarly, individuals can take a few minutes before they jump into their own work to ask “Is there a better way to do this?” “Would it be better to have someone else do this?”One business leader experimented with sending herself questions like these as instant messages that appeared throughout the day. When one of these “prompts” appeared, it didn’t usually change her behavior immediately because it didn’t apply directly to what she was doing. But over time, she internalized the questions and they started popping into her head at times when they did apply…

In many organizations, quality or continuous improvement reviews are intended to serve a similar purpose. But all too often, the reviews themselves become scripts that are executed with little thought or consideration. Leaders should shift their mindset from thinking of quality or other reviews as administrative tasks and instead approach them as opportunities to turn off autopilot.

– Madeleine Van Hecke, Ph.D., is one of the authors of The Brain Advantage: Become a More Effective Business Leader Using the Latest Brain Research, with Lisa P. Callahan, Brad Kollar and Ken A. Paller, Ph.D. Ms. Van Hecke is a licensed clinical psychologist, speaker, consultant, and author.

Related Articles:

To Think or To Blink
Why Smart Brains Make Stupid Decisions