Beshear vetoes parts of budget, but health spending is intact

Though Gov. Steve Beshear vetoed 45 parts of the state budget yesterday evening, health-related spending was safe from the cut.

The budget will help reduce caseloads for social workers who investigate child abuse and neglect, funds colon cancer screenings for 4,000 uninsured Kentuckians, substance-abuse treatment for Medicaid recipients and includes funding for an elder abuse registry to protect senior citizens from unscrupulous caretakers.

"This is the most difficult budget I have ever drafted, and it will also be a challenge to implement and manage over the next two years," the governor said in a statement.

In the two-year, $19 billion budget, Beshear voted more than three dozen line-item appropriations, including "portions of the General Fund budget that limited his ability to manage the state's budget or spent money that doesn't exist," reports Beth Musgrave of the Lexington Herald-Leader.

He also cut some earmarks, including $100,000 for Actors Theatre of Louisville and $150,000 for the International Mystery Writers' Festival in Owensboro. "I am vetoing these parts because they identify new spending earmarks yet the General Assembly failed to appropriate additional funds to finance them," Beshear said. (Read more)

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Aspirin tied to lower lung cancer risk in women

In a new study of more than 1,200 Asian women, those who took aspirin at least a couple of times a week had a much lower risk of developing lung cancer -- whether or not they had ever smoked.

The findings, which link regularly taking aspirin to a risk reduction of 50 percent or more, do not prove that aspirin directly protects against lung cancer. There may be other explanations for the connection.

But the study backs up a number of previous ones linking regular aspirin use to lower risks of certain cancers, including colon, prostate and esophageal cancers.

Still, experts say it's too early to recommend widespread aspirin use for cutting cancer risk.

Even low-dose aspirin carries risks, like stomach irritation and ulcers.

"The question about whether aspirin use protects against lung cancer is still open to considerable debate at this point, and the published evidence to date is not conclusive," Dr. Wei-Yen Lim, who led the new study, said in an email.

Avoiding tobacco smoke remains the best way to protect yourself, said Lim, of the National University of Singapore.

Published in the journal Lung Cancer, the study included 398 Chinese women diagnosed with lung cancer and 814 cancer-free women.

Lim's team found that women who had used aspirin regularly -- at least twice a week for one month or longer -- were less likely to have lung cancer.

Among women who'd never smoked, the odds were 50 percent lower for aspirin users versus non-users. And among smokers, aspirin use was tied to a 62 percent lower risk of lung cancer.

The researchers were able to account for some other factors, like the women's age, education and fruit and vegetable intake. But there could still be other differences that would help explain why aspirin users had a lower lung cancer risk, according to Lim.

This type of study, the researcher said, is not designed to show whether taking aspirin cuts cancer risk. That takes a clinical trial, where people are randomly assigned to take aspirin or not.

And the findings do not give an idea of how much risk-reduction there might be.

There was a fairly large relative difference in cancer risk between aspirin users and non-users in the study. But the absolute reduction in any one person's risk, if there is one, might be small.

Other studies have linked regular aspirin use to lower risks of several types of cancer. Most recently, an analysis of past clinical trials found that people given daily low-dose aspirin were less likely to develop cancer after three years of use. (See Reuters story of March 21, 2012.)

Aspirin appeared to prevent about three cases of cancer per 1,000 aspirin users per year.

There are also biological reasons that aspirin might offer protection: it blocks an enzyme called cyclooxygenase-2, or COX-2, which promotes inflammation and cell division and is found in high levels in tumors.

Dr. Andrew T. Chan of Harvard Medical School, who was not involved in the study, said that the evidence on aspirin and lung cancer has been "mixed."

"The number-one thing a person can do to minimize the risk of lung cancer is to not smoke," he said in an interview.

On the other hand, there is stronger evidence that aspirin may be protective against colon cancer, according to Chan, a gastroenterologist who researches colon cancer prevention.

"I don't think the evidence is definitive," Chan said. And it's too soon to recommend that all middle-aged and older adults take a daily aspirin.

But it may be reasonable for people to discuss the pros and cons of low-dose aspirin with their doctors, according to Chan.

"People are usually interested in more than preventing one particular cancer," he noted. "So it's important to view this in the context of a person's overall health."

That includes understanding the risks of aspirin. For many people, gastrointestinal side effects may be "minor," Chan said.

But some people can develop bleeding ulcers. Aspirin is also linked to an increased risk of hemorrhagic stroke -- bleeding in or around the brain.

Many middle-aged and older adults already take daily aspirin for their cardiovascular health.

The U.S. Preventive Services Task Force recommends that men age 45 to 79 take aspirin to prevent heart attacks, as long as their personal benefit is likely to outweigh the risk of bleeding. For women age 55 to 79, aspirin is recommended to prevent ischemic strokes (strokes caused by a blood clot), with the same caveat.

Lim said that if your doctor has recommended aspirin to you, stick with that advice.

"For people who are currently well," the researcher said, "we do not recommend taking aspirin to reduce their risk of lung cancer, as the effect of aspirin on lung cancer is still being evaluated."

SOURCE: http://bit.ly/IzaxsH Lung Cancer, online April 3, 2012.

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This week is National Public Health Week; this year's focus is on prevention and wellness

With a focus on prevention and wellness this year, the Kentucky Department of Public Health is promoting national Public Health Week, which kicked off yesterday and will be observed until Sunday. The prevention theme was chosen to underscore the impact of chronic disease on the American population.

Americans miss 2.5 billion days of work because of diseases like heart disease, cancer and diabetes, which costs the country $1 trillion. Unintentional injuries, such as those stemming from motor vehicle accidents, poisonings and burns, rank within the top 10 causes of death for people 44 and younger, according to a DPH press release.

"Often, these horrible diseases and injuries could have been prevented with more attention to lifestyle choices like physical activity and nutrition or preventive safety measures," said Dr. Steve Davis, acting DPH commissioner. "The health care community — as well as the individual — must work to understand the risk for developing chronic disease and avoiding injury so that we can prevent complications. This is key to improving the health of our state."

Public health is also crucial in emergency response, as witnessed with recent tornadoes that struck the state. "The contribution of public health is tremendous — both on a day-to-day basis and in times of crisis," Davis said. "I encourage everyone to go online to read more about our public health programs; talk to your health care provider about chronic disease and injury prevention; or, better yet, visit your local health department to learn more about how public health can — and does — improve your life." (Read more)

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Norton and UK HealthCare formalize the collaboration they announced almost a year and a half ago

UK HealthCare and Norton Healthcare have formalized the collaboration they announced almost a year and a half ago and will "focus on creating collaborations with hospitals across the state in stroke, cardiovascular and cancer care," Dr. Michael Karpf, executive vice president for health affairs at the University of Kentucky, announced today.

Said Steve Williams, president and CEO of Norton: "Our intent is to bring our combined health care expertise and resources into communities across the commonwealth to improve health-care outcomes."

The partnership will be in the form of a non-profit organization. The board of the Norton-UK HealthCare Partnership for Quality has already approved a budget of $595,000 to grow stroke outreach and education and launch programs to fight heart attacks and cancer, a press release says.

In late 2010, the two systems joined forces to create a statewide collaboration that addresses Kentucky's major health issues, including cancer, stroke and heart disease that stem from high obesity and smoking rates. Some of the accomplishments since the agreement include a transplant program, an effort to increase the number of obstetricians statewide; pharmacy education; and cancer care.

A competing collaboration, between the University of Louisville, Jewish Hospital and the Lexington-based St. Joseph Health System, is again trying to formalize its arrangement following rejection of a merger by state officials on grounds that University Hospital was a public institution that could not be bound by the Catholic system's restrictions on reproductive care.

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Are you getting enough?

Food is the best way to take in the nutrients we need. If you pay attention to your diet, vary the foods you eat, study food labels to glean the nutritional content, then you may not need to worry about suffering any vitamin and mineral deficiencies. However the truth is that most of us have not got the time to be that vigilant.
With hectic modern lifestyles, few of us have the time or knowledge to become our own food scientists. So we are likely to rely on broad advice like eat five portions of fruit and veg a day. Yet the latest national  diet and nutrition survey found that only about a third of the population manages to follow that guidance. In addition, the survey found that intake of oily fish, which is our main source of beneficial omega 3 fatty acids, remains low. That means that most of us could benefit from a little nutritional help, that could protect our long term health from disease and illness like high cholesterol, and cancer.

Ping your blog

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Replacing cigarettes with smokeless tobacco reduces disease risk, says U of L prof who's received tobacco-industry funding

Smokers can greatly reduce their risk of disease if they replace their cigarettes with spit-free smokeless tobacco or electronic cigarettes, University of Louisville professor Brad Rodu, right, said in a presentation at the annual meeting of the American Association for the Advancement of Science last week. It's the same message residents of Owensboro heard in an advertising campaign with which Rodu was involved late last year, one partly funded with grants from the tobacco industry.

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year," Rodu said in a U of L press release. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's 20 years of research has reportedly shown that e-cigs and smokeless tobacco are relatively safe alternatives for smokers who can't or are unwilling to quit nicotine. "Nicotine is addictive, but it is not the cause of any smoking-related disease," he said. "Like caffeine, nicotine can be used safely by consumers."

Research has shown smokeless products are 98 percent safer than cigarettes, the press release states. A 2002 study in the United Kingdom found smokeless tobacco to be up to 1,000 times less hazardous than smoking.

As for whether smokeless tobacco can contribute to mouth cancer, Rodu said the risk "is extremely low." "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to the 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 per year." (Read more)

The Oral Cancer Foundation's website says about 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and cause about 8,000 deaths. The foundation does not support the contention that smokeless tobacco is "safe." "Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers," the website reads. "Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers."

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Rural women are less likely to complete vaccinations for cervical-cancer virus; study finds vaccine does not increase sexual activity

Women living in rural areas of the U.S. were far less likely to return for their follow-up doses after they get the initial injection of the human papillomavirus vaccine, a study in the Journal of Rural Health has found. (Photo by Pete Rodman, Bowling Green Daily News)

The study contrasted the rates of vaccination follow-up by young women recruited from two rural locations and one urban location. "Despite being free, the researchers concluded that uptake of booster doses by rural women was problematic," states an article in the Rural Center for AIDS/STD Prevention's "RAP Time" publication. "This barrier might be resolved by providing the HPV doses at easy-to-access locations in rural communities, such as large grocery stores and area events."

The HPV vaccine requires three doses. The women who went to the rural clinic were seven times less likely to return for at least one follow-up dose.

The vaccine, which has proven to prevent most cervical cancers, has been approved for use in women ages 9 to 26 years, as well as boys. The vaccine is generally given at the age of 11 or 12 and is effective only if administered before a person becomes sexually active. As many as 80 percent of men and women become infected with HPV during their lives, but most do not develop symptoms or illness.

The vaccine has been met with reluctance by parents, some of whom fear it encourages sexual activity, but a study published in the American Journal of Preventive Medicine found girls or women who received the vaccine "were no more likely to be sexually active or have more partners than those not vaccinated."

Last year, just 49 percent of adolescent girls nationwide had received at least the first dose of the vaccine, and only a third had gotten all three. In Kentucky, just 25 percent of adolescent females had gotten the first dose and fewer than 11 percent had received all three doses.

In Kentucky, the annual death rate caused by cervical cancer is 2.9 deaths per 100,000. In the United States, it's 2.4 per 100,000. "The U.S. is remaining stable. Kentucky's is actually falling," gynecologist Dr. Mark Yurchisin told Alyssa Harvey of the Bowling Green Daily News.

The decrease is being attributed to an increase in screenings. "In certain counties in Kentucky there is a high incidence, they implemented outreach clinics because they didn't have clinics where they could get Pap screenings done," Yurchisin said. "They can diagnose it at an earlier and treatable stage." (Read more)

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State health department starts new ad campaign against secondhand smoke, including three 15-second TV commercials

The Kentucky Department for Public Health is launching a new campaign to educate Kentuckians about the dangers of secondhand tobacco smoke and its potential effect. The campaign is funded by $281,000 from the economic stimulus package of 2009 and about $90,000 from the federal Centers for Disease Control and Prevention. This week the department will start running television, billboard and radio advertisements to show the dangers of smoke that comes from the burning end of cigarette, cigar or pipe or the exhaled smoke from a smoker. The ads, which will run statewide, highlight the link between secondhand smoke and dangerous illnesses in both adults and children.



The ads, produced by Louisville-based Doe-Anderson, feature people being unwillingly exposed to secondhand smoke in places such as residences and cars. Each ad carries the tag line, “Secondhand smoke is 100 percent unsafe, 100 percent of the time.”

Kentucky’s smoking rate remains the second highest in the country, with 24.8 percent of the adult population identified as current smokers, and secondhand smoke exposure is equally high. The health department says 39.5 percent of Kentucky children live with someone who smokes – the highest percentage in the country. Secondhand smoke has become a major public health concern because it contains approximately 4,000 chemicals, many of which are known carcinogens, and is responsible for approximately 3,000 cases of lung cancer deaths among nonsmokers each year.



The campaign is another project of the Kentucky Tobacco Prevention and Cessation program. Community interventions for tobacco cessation are available through local health departments staffed with tobacco control specialists, and the program operates a toll-free telephone line, 1-800-QUIT NOW. It also provides technical assistance, with the Kentucky Center for Smoke Free Policy at the University of Kentucky, to assist communities in seeking smoke-free ordinances.

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Smokeless tobacco can help you quit cigarettes, Owensboro-area residents are told (partly with tobacco money)

"Switch and quit" is the theme of an advertising campaign being promoted by a prominent cancer center in Kentucky, in which smokers are advised to lay off the cigarettes in favor of smokeless tobacco such as chew or snuff. "Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do," The Associated Press reports.

AP reports the program is partly funded with grants from the tobacco industry, though program director Brad Rodu, a University of Louisville professor of medicine, said the industry has "absolutely no influence whatsoever." Smokeless tobacco has been linked to oral cancer.

"We need something that works better than what we have," said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which is co-sponsoring the campaign with the university. "This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried."

The campaign is being pushed in Owensboro using print, radio, billboard and other advertising. Residents of Owensboro and the surrounding area reportedly consume about 3 million cigarettes a week. "That amounts to well over a pack for every man, woman and child in the community of about 115,000 people," AP reports.

"The worst that you can say about smokeless tobacco is that it's the lesser of two evils," said Dr. Randall Thomas, an oncologist at the Owensboro Medical Health System. "I don't think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced ... Finding a way to let people have their nicotine that carries less risk, it's the realistic solution."

But there are opponents to the program, including Matthew Myers, president of the Campaign for Tobacco-Free Kids, who called it "a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine." The theme of the program does seem to run counter to warnings by the Centers for Disease Control and the National Cancer Institute at the National Institutes of Health, whose websites say the use of all varieties of tobacco products "should be strongly discouraged" and that there is "no scientific evidence that using smokeless tobacco can help a person quit."

Owensboro is an old tobacco town, and in the face of falling cigarette sales, tobacco companies are marketing more smokeless tobacco and other cigarette alternatives. (Read more)

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Clinic in Greenup will offer free ovarian cancer screenings for Northeast Ky. women

Women in Northeastern Kentucky will be able to receive free ovarian cancer screenings thanks to funding that will set up a clinic in Greenup County.

The clinic is intended for women in Lewis, Carter, Elliott, Greenup and Boyd counties, as well as two counties in Ohio, but "certainly anyone who arrives at the clinic who meets the requirements will be eligible for screening," said Parry Barrows, spokeswoman for Gov. Steve Beshear's office. Eligible women must be age 50 and older or over the age of 25 who have a family history of ovarian cancer.

The clinic will be an expansion of a program that has been in place in Lexington since 1987. As of September, more than 200,000 screenings have been performed on more than 37,000 Kentucky women as part of the program.

To build the clinic, which will be located in the Greenup County Health Department, a $200,000 Appalachian Regional Commission grant will be combined with $45,000 from UK. The health department will contribute $66,600.

"Funding will go toward purchasing required equipment and furnishings, as well as provide program operations for up to 3 years," saysa press release from Beshear's office. "UK will train local ultrasound technicians to facilitate the scans and the UK Markey Cancer Center will read the scans and deliver patient reports."

"Establishing this satellite clinic ... will help save lives by giving women in northeast Kentucky and southern Ohio better access to free ovarian cancer screenings," said Chris Crum, director of the Greenup County Health Department. (Read more)

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Parents, children should discuss HPV vaccine, study indicates

A study at Ohio State University found that college-aged women who have talked to their mothers about the human papillomavirus are more likely to get the vaccine that prevents it, Brandy Reeves, right, a certified sexuality educator and health education coordinator at the University of Kentucky, writes in the Lexington Herald-Leader.

HPV is known to cause cancer, including cervical cancer, oral cancer, vulvar cancer, anal cancer and penile cancer.

There are two vaccines for HPV approved by the Food and Drug Administration: Gardasil and Cervarix. "Because men can carry HPV and transmit it sexually to their partners, the FDA has approved the use of Gardasil in both genders, from ages 9 to 26," Reeves writes. "Parents who are nervous about bringing up the topic can focus on how the vaccine is safe and effective, and that it prevents cancer." (Read more)

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Markey Cancer Center at UK says its patients have higher survival rates than those treated elsewhere in Ky. and the nation

"Patients at the University of Kentucky's Markey Cancer Center who have certain types of cancer have higher rates of survival than patients with the same cancers treated elsewhere in the state or even the nation according to new data released today," Business Lexington reports.

"Markey officials said the data shows that the center's patients have significantly better five-year survival rates than those Kentucky cancer patients who were treated elsewhere for brain, breast, liver, lung, ovarian, pancreatic and prostate cancer, as well as for stage IV colorectal cancer." (Read more)

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Nine breast cancer programs get total of $360,000 from Komen

Nine programs in Central and Eastern Kentucky will share $360,000 for breast cancer screening, treatment, education and patient navigation.

The grants go to breast cancer-specific projects of the Lexington-Fayette County Health Department; the Kentucky Pink Connection; Central Baptist Hospital; St. Joseph Breast Center; King's Daughters Medical Center; Mountain Comprehensive Health Corp.; Our Lady of Bellefonte Hospital; Dayspring Family Health Center; and North Central Area Health Education Center. Programs chosen were determined to have the greatest impact on underserved women in a 58-county service area, the Lexington Herald-Leader reports.

The grants were awarded by the Lexington affiliate of Susan G. Komen for the Cure. Another $100,000 raised in Kentucky went to the Susan G. Komen for the Cure National Grants Program to fund research. (Read more)

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Heartburn on the rise, driven by overeating; avoid minty antacids

As overeating has become more common, Americans have been suffering from a lot more heartburn, the American Gastroenterology Association has found. About 25 million people say they experience daily symptoms of acid reflux, up from 15 million a decade ago, with another 60 million saying they have heartburn once a month.

"Blame stress and an aging population — and above all, experts say, blame Americans' habit of eating too much," reports The Courier-Journal's Anita Creamer.

Though it can occur at any age, acid reflux is most common in middle age. It is caused when acid backwashes into the esophagus while a person is digesting, the result of the sphincter muscle at the top of the stomach being weak. Acid reflux, which can cause heartburn, nausea, coughing and hiccups, can be especially common at night if a person goes to bed with a full stomach. "Anything that increases stomach pressure increases reflux," said Dr. Ronald Hsu, a gastroenterologist at Sutter Roseville (Calif.) Medical Center. "People who are more obese have more symptoms. Pregnant women can have more reflux."

To get relief, avoid mint-flavored antacids. Mint relaxes the valve between the stomach and esophagus, compounding the problem. Losing weight can help. So can avoiding chocolate, citrus fruits, alcohol, caffeine or spicy foods. Over-the-counter medications like Prilosec and Prevacid can block the release of stomach acid and provide relief.

People who regularly have acid reflux are more prone to developing esophageal cancer, which has been relatively rare but is difficult to treat and is quickly becoming more common. Most at risk are middle-age and elderly men who have long suffered from acid reflux and often are obese. (Read more)

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CDC names top 10 public health achievements in past decade, including tobacco control; Ky. still leads nation in tobacco use

The Centers for Disease Control and Prevention have named the top 10 public health achievements of the last decade. They include controlling infectious diseases like AIDS and tuberculosis; fighting tobacco use; improving motor-vehicle safety by having safer vehicles, roads and driving; reducing heart disease and death; and improving public safety preparedness following Sept. 11, 2001.

The 10 were not ranked. "Others include improvements in vaccine-preventable diseases, better maternal and infant health, better cancer prevention, improved occupational safety, and the aggressive steps that have led to fewer childhood lead poisonings," reports Bill Hendrick of WebMD Health News.

"Americans are living longer, healthier and more productive lives than ever before thanks in part to extraordinary achievements in public health over the past decade," CDC Director Thomas R. Frieden said in a press release. "Continued investments in prevention will help us and our children live even longer, healthier and more productive lives while bringing down health care costs."

The report shows the improvements have saved billions of dollars nationwide. Fortifying food with folic acid, which reduced neural tube defects like spina bifida, has alone resulted in a savings of $4.6 billion in the past 10 years. Preventing motor vehicle crashes could save $99 billion in medical and lost work costs each year. Preventing lead exposure in children could save $213 billion each year.

While tobacco control has advanced nationally, and Kentucky's smoking rate has dropped slightly, the state continues to lead the nation in tobacco use, at 25 percent of adults. While about two dozen Kentucky communities have passed smoke-free laws, a statewide ban has never gotten anywhere in the legislature. The number of states with comprehensive smoke-free laws increased from zero in 2000 to 25 states (plus Washington, D.C.) in 2010.

Motor vehicle safety has improved, a trend that has been noted in Kentucky. The number of traffic-related fatalities in Kentucky has decreased for the past six years. In 2010, 759 people died on Kentucky roads compared to 791 the year before. This year so far, 220 people have died in traffic-related accidents compared to 237 last year. Nationwide, the death rate related to motor vehicle accidents went from 14.9 per 100,000 people in 2000 to 11 per 100,000 in 2009. (Read more)

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Alternative ways of treatment

Alternative ways of treating illness and disease such as cancer and heart disease using natural cures.

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There is a cure out there

Ever since I was young I was interested in alternative ways of healing people. In my early days I had a great deal of success in treating my family and friends in a natural way, with minor complaints.
I still think think there are natural cures to yet be discovered in such places as in the Amazon jungle, or in the depths of the oceans.
Some plant, or a fish that heal people with serious illness such as cancer, or heart disease.
The cure may be right in front of us, in our own garden. I eat small amounts of a leaf that is unknown to me, just to see its effect. I do not advise doing this, as some plants, or herbs can be very poisonous.
Holistic cancer cures

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Oltipraz

Oltipraz is a drug that was originally used to treat intestinal worms. It was later found to prevent a broad variety of cancers (1). This was attributed to its ability to upregulate cellular detoxification and repair mechanisms.

Researchers eventually discovered that oltipraz acts by activating Nrf2, the same transcription factor activated by ionizing radiation and polyphenols (2, 3, 4). Nrf2 activation mounts a broad cellular protective response that appears to reduce the risk of multiple health problems.

A recent paper in Diabetologia illustrates this (5). Investigators put mice on a long-term refined high-fat diet, with or without oltipraz. These carefully crafted diets are very unhealthy indeed, and when fed to rodents they rapidly induce fat gain and something that looks similar to human metabolic syndrome (insulin resistance, abdominal adiposity, blood lipid disturbances). Adding oltipraz to the diet prevented the fat gain, insulin resistance and inflammatory changes that occurred in the refined high-fat diet group.

The difference in fasting insulin was remarkable. The mice taking oltipraz had 1/7 the fasting insulin of the refined high-fat diet comparison group, and 1/3 the fasting insulin of the low-fat comparison group! Yet their glucose tolerance was normal, indicating that they were not low on insulin due to pancreatic damage. The low-fat diet they used in this study was also refined, which is why the two control groups (high-fat and low-fat) didn't diverge more in body fatness and other parameters. If they had used a group fed unrefined rodent chow as the comparator, the differences between groups would have been larger.

This shows that in addition to preventing cancer, Nrf2 activation can attenuate the metabolic damage caused by an unhealthy diet in rodents. Oltipraz illustrates the power of the cellular hormesis response. We can exploit this pathway naturally using polyphenols and other chemicals found in whole plant foods.

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Naturopathy can cure disease.

The best natural way to cure disease and illness such as cancer is prevention. You can incorporate naturopathic remedies such as improved nutrition  and vitamin supplements into your recovery strategy.
Various anti-cancer diets share some similar principles: high fibre, low fat, mostly vegan, and avoiding salt and sugar.
Antioxidants are recommended: Beta carotene, found in carrots, high doses of vitamin c and e, and zinc. Grape seed extract, available in supplements is another powerful antioxidant.
Abnormal cervical cells have been linked with a deficiency in folic acid, which is depleted by the pill and smoking.

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Polyphenols, Hormesis and Disease: Part II

In the last post, I explained that the body treats polyphenols as potentially harmful foreign chemicals, or "xenobiotics". How can we reconcile this with the growing evidence that at least a subset of polyphenols have health benefits?

Clues from Ionizing Radiation

One of the more curious things that has been reported in the scientific literature is that although high-dose ionizing radiation (such as X-rays) is clearly harmful, leading to cancer, premature aging and other problems, under some conditions low-dose ionizing radiation can actually decrease cancer risk and increase resistance to other stressors (1, 2, 3, 4, 5). It does so by triggering a protective cellular response, increasing cellular defenses out of proportion to the minor threat posed by the radiation itself. The ability of mild stressors to increase stress resistance is called "hormesis." Exercise is a common example. I've written about this phenomenon in the past (6).

The Case of Resveratrol

Resveratrol is perhaps the most widely known polyphenol, available in supplement stores nationwide. It's seen a lot of hype, being hailed as a "calorie restriction mimetic" and the reason for the "French paradox."* But there is quite a large body of evidence suggesting that resveratrol functions in the same manner as low-dose ionizing radiation and other bioactive polyphenols: by acting as a mild toxin that triggers a hormetic response (7). Just as in the case of radiation, high doses of resveratrol are harmful rather than helpful. This has obvious implications for the supplementation of resveratrol and other polyphenols. A recent review article on polyphenols stated that while dietary polyphenols may be protective, "high-dose fortified foods or dietary supplements are of unproven efficacy and possibly harmful" (8).

The Cellular Response to Oxidants

Although it may not be obvious, radiation and polyphenols activate a cellular response that is similar in many ways. Both activate the transcription factor Nrf2, which activates genes that are involved in detoxification of chemicals and antioxidant defense**(9, 10, 11, 12). This is thought to be due to the fact that polyphenols, just like radiation, may temporarily increase the level of oxidative stress inside cells. Here's a quote from the polyphenol review article quoted above (13):

We have found that [polyphenols] are potentially far more than 'just antioxidants', but that they are probably insignificant players as 'conventional' antioxidants. They appear, under most circumstances, to be just the opposite, i.e. prooxidants, that nevertheless appear to contribute strongly to protection from oxidative stress by inducing cellular endogenous enzymic protective mechanisms. They appear to be able to regulate not only antioxidant gene transcription but also numerous aspects of intracellular signaling cascades involved in the regulation of cell growth, inflammation and many other processes.

It's worth noting that this is essentially the opposite of what you'll hear on the evening news, that polyphenols are direct antioxidants. The scientific cutting edge has largely discarded that hypothesis, but the mainstream has not yet caught on.

Nrf2 is one of the main pathways by which polyphenols increase stress resistance and antioxidant defenses, including the key cellular antioxidant glutathione (14). Nrf2 activity is correlated with longevity across species (15). Inducing Nrf2 activity via polyphenols or by other means substantially reduces the risk of common lifestyle disorders in animal models, including cardiovascular disease, diabetes and cancer (16, 17, 18), although Nrf2 isn't necessarily the only mechanism. The human evidence is broadly consistent with the studies in animals, although not as well developed.

One of the most interesting effects of hormesis is that exposure to one stressor can increase resistance to other stressors. For example, long-term consumption of high-polyphenol chocolate increases sunburn resistance in humans, implying that it induces a hormetic response in skin (19). Polyphenol-rich foods such as green tea reduce sunburn and skin cancer development in animals (20, 21).

Chris Masterjohn first introduced me to Nrf2 and the idea that polyphenols act through hormesis. Chris studies the effects of green tea on health, which seem to be mediated by polyphenols.

A Second Mechanism

There is a place in the body where polyphenols are concentrated enough to be direct antioxidants: in the digestive tract after consuming polyphenol-rich foods. Digestion is a chemically harsh process that readily oxidizes ingested substances such as polyunsaturated fats (22). Oxidized fat is neither healthy when it's formed in the deep fryer, nor when it's formed in the digestive tract (23, 24). Eating polyphenol-rich foods effectively prevents these fats from being oxidized during digestion (25). One consequence of this appears to be better absorption and assimilation of the exceptionally fragile omega-3 polyunsaturated fatty acids (26).

What does it all Mean?

I think that overall, the evidence suggests that polyphenol-rich foods are healthy in moderation, and eating them on a regular basis is generally a good idea. Certain other plant chemicals, such as suforaphane found in cruciferous vegetables, and allicin found in garlic, exhibit similar effects and may also act by hormesis (27). Some of the best-studied polyphenol-rich foods are tea (particularly green tea), blueberries, extra-virgin olive oil, red wine, citrus fruits, hibiscus tea, soy, dark chocolate, coffee, turmeric and other herbs and spices, and a number of traditional medicinal herbs. A good rule of thumb is to "eat the rainbow", choosing foods with a variety of colors.

Supplementing with polyphenols and other plant chemicals in amounts that would not be achievable by eating food is probably not a good idea.


* The "paradox" whereby the French eat a diet rich in saturated fat, yet have a low heart attack risk compared to other affluent Western nations.

** Genes containing an antioxidant response element (ARE) in the promoter region. ARE is also sometimes called the electrophile response element (EpRE).

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