January 2014 Health Pearls

1.  Many of us often wonder: Is it too late to start exercising as we reach middle age?  We look at women like Jane Fonda or Diane Nyad and wish we were active like them in our younger days.  Could we have had toned arms like Fonda, or swam a hundred miles like Nyad, if we had not sat in front of our TV sets watching NFL games eating buttery popcorn? Gretchen Reynolds of NYT wrote an excellent article citing several large studies in different parts of the world showing that it is never too late to start exercising.  She cited a study from Australia with 12,000 men between 65-83.  Men who participated in 30 minutes of exercise five times weekly were much healthier and significantly more likely than those who did not exercise to be alive 11 years after the start of the study.  Many variables such as smoking, higher education and body mass index were adjusted in this study. 

Another study cited by Reynolds was from the British Journal of Sports Medicine, involving tens of thousands of British citizens through many decades of life. This very well and carefully conducted study of aging and health shows how late-in life exercisers aged almost as successfully as those who had maintained a healthy life styles all along.  Unlike those who remained sedentary all their lives, those who started exercising after reaching middle age had about a seven-fold risk reduction in becoming ill or infirmed after eight years.  

 A third study, released in 2009, according to Reynolds, of 2,000 middle-aged men, showed how regular exercising, even when started after 50 years of age, reduces their likelyhood of death in the next 35 years compared to those who lived a sedentary life. 

The obvious conclusion from the above studies?  It is never too late to start exercising!  We might never look like Jane Fonda, but hopefully we will live a longer and more healthy life.

2.  High intake of fruits and vegetables may reduce the risk of bladder cancer in women.

This multi-ethnic study, started in 1996, had 185,000 participants, between the ages of 45 and 75, who were followed for 12.5 years. The study showed that women who had the highest intake of certain fruits and vegetables, such as yellow-orange vegetables, cruciferous vegetables and citrus fruits, had a reductions in the risk of bladder cancer of up to 52%.  High consumption of vitamin A and C, alpha and beta-carotene, lutein, and beta-cryptoxanthin, as found in fruits and vegetables, have been found to reduce bladder cancer risk in women.

Interestingly, the same risk reduction in bladder cancer was not seen in men!  When it comes to smoking history, however, high intake of fruits and vegetables was found to reduce bladder cancer risk by 60% in men who currently smoke, but not former smokers or those who never smoked. 

I found the results in men puzzling, and hope there will be future studies to see why gender would make a difference in bladder cancer reduction risk  and a high consumption of fruits and vegetables.

3. Taking Proton-Pump Inhibitors (PPIs) or heartburn medications, by prescriptions or over-the-counter, is linked to Vitamin B12 Deficiency. Archives of Internal Medicine, December 2013.

Vitamin B12 deficiency has been found to cause nerve damage, anemia, risk of dementia and susceptibility of C. Difficile, an infection which can cause severe diarrhea and sometimes even death.

In this study, 25,956 adults with B12 deficiency in California between January 1997-June 2011 were compared to 184.199 adults without vitamin B12 deficiency.  Those who took PPI medications for more than two years had a 65% increased risk of B12 deficiency.  PPI medications include Nexum, Prevacid and Prilosec.  H2As medication such as Zantac, have less effect on B12.

Unfortunately, according to Dr. Michael Katz, director of the San Francisco Department of Public health, 60 to 70% of prescription or over-the-counter PPIs or H2As were consumed needlessly! There were 157 million prescriptions written and millions of over-the-counter purchases of these medications in 2012 alone.

If you are one of the patients who are taking PPIs or H2As, if in doubt, be sure to consult with a gastroenterologist.  Are you taking these medications unnessarily? It is important to discuss with your doctors about vitamin B12 deficiency if you have been on these medications for a long time.