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News

Celebrity-based medicine

Male reproductive health and the environment

Nutrition and cancer: a review of the evidence for an anti-cancer diet

Cognitive assessment at 2 ½ years following fish oil supplementation in pregnancy: a randomised controlled trial

Breast-feeding and cognitive development: a meta-analysis

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News

Celebrity-based medicine

The media has a strong influence on the public’s view of complementary and alternative medicine. Articles published during 2005 and 2006 reporting celebrity use of complementary and alternative medicine were utilised.

The authors identified 38 celebrities, including 19 female singers or actors, who were reported to use complementary and alternative medicine. The range of reported complementary and alternative medicine interventions is wide, with some celebrities using several types simultaneously. The most popular modality is homeopathy, followed by acupuncture and Ayurveda.

These data suggest that many celebrities are fond of complementary and alternative medicine. This may partially explain the current popularity of therapies such as homeopathy and acupuncture, as people strive to emulate their idols.

Ernst E and Pittler MH 2006, Celebrity-based medicine, The Medical Journal of Australia, 185 (11/12): 680-681.

Below are the reported uses of complementary and alternative medicine by celebrities:

Male reproductive health and the environment

Australia is one of a long list of nations experiencing a recent and dramatic decline in fertility rate. The reasons behind this trend are complex, recent, and generally appear to be independent of the socioeconomic status of the country.
Deferred childbearing and improved contraceptive use are undoubtedly major factors. However, it is also intriguing that population growth is below replacement rate in several countries such as Sri Lanka, Denmark and Spain, where there have been no obvious increases in abortion rates or contraceptive use. This loss of fertility has affected countries such as Denmark to the point that about 7% of all newborn babies are now being generated by assisted conception. In Australia and New Zealand, the number of babies born as a result of assisted conception procedures has increased threefold over the past 10 years and, despite recent increases, our birth rate is still well below that needed to maintain the population at its present level.

Although it has long been acknowledged that both male and female partners contribute to human infertility, the past 20 years have witnessed a growing awareness of the importance of the male factor in the aetiology of this condition. Indeed, the late Mike Hull and colleagues asserted that defective sperm function is the largest single, defined cause of human infertility. Current estimates suggest that one in 20 Australian men suffer some degree of infertility.
Human semen quality is notoriously poor compared with other mammalian species, and in some major capital cities, such as Paris and Copenhagen, there is evidence that it is getting poorer over time. Whatever factors are responsible for this deterioration in semen quality, they do not appear to be universal, because in other areas, such as Finland or the United States, similar changes have not been found. Nevertheless, at present, 30% of young Danish men seem to have sperm counts that are in the subnormal range according to World Health Organisation guidelines and, in 10% of this population, the semen parameters are indicative of substantially reduced fertility prospects.

It has been proposed that environmental factors are involved in the aetiology of testicular dysgenesis syndrome (TDS) and that these factors have their effect during early foetal life, when the male genital tract is attempting to differentiate away from the default female condition. Whether the outcome of testicular dysgenesis syndrome is impaired spermatogenesis or testicular cancer may depend on the timing and nature of the xenobiotic attack and the genetic background on which these factors are acting. In this context, a key factor will be the patient’s polymorphism profile for proteins involved in detoxification, such as the cytochrome P450s and glutathione-S-transferases.

An important and intriguing feature of the pathologies comprising testicular dysgenesis syndrome is the way in which their incidence varies in different regions of the world. In northern Europe, for example, Denmark has high rates of testicular cancer and low sperm counts, but Finland has the opposite — high sperm counts and low rates of testicular cancer. Such geographical variability, coupled with the rapidity with which male reproductive pathologies are increasing in affected countries, suggests an important contribution from environmental factors, including modern Western lifestyle. This conclusion is supported by analysis of the incidence of testicular cancer in the offspring of Nordic parents who have migrated to Sweden, which adjusts to the rate typical of the host country.

A possibility involves paternally mediated toxicity through effects on DNA integrity in the male germ line. Once male germ cells have completed meiosis, they lose their capacity for DNA repair, discard their cytoplasm (containing the defensive enzymes that protect most cell types from oxidative stress) and eventually become separated from the Sertoli cells that have nursed and protected them throughout their differentiation into spermatozoa. In this isolated state, spermatozoa must spend a week or so journeying through the male reproductive tract and, uniquely in our species, a further period (up to 3 or 4 days) in the female tract waiting for an egg. During this period of isolation, sperm DNA is vulnerable to damage by both xenobiotics and electromagnetic radiation. Such DNA damage is associated with male infertility, and its aberrant repair in the fertilised egg may result in mutations in the embryo with the potential to either induce abortion or impair the health and fertility of the offspring.

In conclusion, male infertility is a common condition that affects one in 20 Australian men. That exposure to environmental chemicals can impair semen quality is clearly plausible and, in some heavily polluted environments of Europe, such effects are clearly evident.

Aitken RJ, Skakkebaek NE and Shaun D Roman SD 2006, Male reproductive health and the environment, The Medical Journal of Australia, 185 (8): 414-415.

Nutrition and cancer: a review of the evidence for an anti-cancer diet

It has been estimated that 30–40 percent of all cancers can be prevented by lifestyle and dietary measures alone. Obesity, nutrient sparse foods such as concentrated sugars and refined flour products that contribute to impaired glucose metabolism (which leads to diabetes), low fibre intake, consumption of red meat, and imbalance of omega 3 and omega 6 fats all contribute to excess cancer risk. Intake of flax seed, especially its lignan fraction, and abundant portions of fruits and vegetables will lower cancer risk. Allium and cruciferous vegetables are especially beneficial, with broccoli sprouts being the densest source of sulforophane. Protective elements in a cancer prevention diet include selenium, folic acid, vitamin B-12, vitamin D, chlorophyll, and antioxidants such as the carotenoids (α-carotene, β-carotene, lycopene, lutein, cryptoxanthin). Ascorbic acid has limited benefits orally, but could be very beneficial intravenously. Supplementary use of oral digestive enzymes and probiotics also has merit as anticancer dietary measures. When a diet is compiled according to the guidelines here it is likely that there would be at least a 60–70 percent decrease in breast, colorectal, and prostate cancers, and even a 40–50 percent decrease in lung cancer, along with similar reductions in cancers at other sites.

Over Consumption of Energy (Calories)
Eating too much food is one of the main risk factors for cancer. This can be shown two ways: (1) by the additional risks of malignancies caused by obesity, and (2) by the protective effect of eating less food.

It was estimated in a recent study, from a prospective cancer prevention cohort, that overweight and obesity accounted for 14 percent of all cancer deaths in men and 20 percent of those in women. Significant positive associations were found between obesity and higher death rates for the following cancers: oesophagus, colon and rectum, liver, gallbladder, pancreas, kidney, stomach (in men), prostate, breast, uterus, cervix, and ovary. The authors estimated that over 90,000 cancer deaths per year could be avoided if the adult population all maintained a normal weight (BMI < 25.0). Clearly, obesity is a major risk factor for cancer.

Flax seed
Flax seed provides all of the nutrients from this small brown or golden hard-coated seed. It is an excellent source of dietary fibre, omega 3 fat (as alpha-linolenic acid), and lignans. The lignans in flax seed are metabolised in the digestive tract to enterodiol and enterolactone, which have estrogenic activity. In fact, flax seed is a more potent source of phytoestrogens than soy products, as flax seed intake caused a bigger change in the excretion of 2-hydroxyestrone compared to soy protein.

Fruits and Vegetables
One of the most important messages of modern nutrition research is that a diet rich in fruits and vegetables protects against cancer. (The greatest message is that this same diet protects against almost all other diseases, too, including cardiovascular disease and diabetes.) There are many mechanisms by which fruits and vegetables are protective, and an enormous body of research supports the recommendation for people to eat more fruits and vegetables.

Donaldson MS 2004, Nutrition and cancer: a review of the evidence for an anti-cancer diet, Nutr J, Oct 20; 3:19-39.

Cognitive assessment at 2 ½ years following fish oil supplementation in pregnancy: a randomised controlled trial

A double blind randomised placebo controlled trial was conducted to assess the effects of antenatal omega 3 long chain polyunsaturated fatty acid (n-3 LC PUFA) on cognitive development in a cohort of children whose mothers received high dose fish oil in pregnancy.
Pregnant women (n=98) received the supplementation from 20 weeks gestation until delivery. Their infants (n=72) were assessed at 2 ½ years of age in Perth, Western Australia.

Fish oil (2.2g docosahexaenoic acid (DHA) plus 1.1g eicosapentaenoic acid (EPA)/day) or olive oil from 20 weeks gestation until delivery.

Children in the fish oil supplemented group (n= 33) attained a significantly higher score for eye-hand coordination (mean score 114 SD 10.2) than the placebo group (n=39, mean score 108, SD 11.3) (P=0.021, adjusted P=0.008).
Eye-hand coordination scores correlated with n-3 PUFA levels in cord blood erythrocytes (EPA: r=0.320, P=0.007 and DHA: r=0.308, P=0.009) and inversely correlated with n-6 PUFA (arachidonic acid; 20:4n-6: r= -0.331, P=0.005).
Growth measurements in the two groups were similar at 2 1/2 years of age.

The conclusions were that maternal fish oil supplementation during pregnancy is safe for the foetus and infant, and may have potentially beneficial effects on the child’s eye and hand coordination. Further studies are needed to determine the significance of this finding.

(Dunstan JA, Simmer K, Dixon G, and Prescott SL 2006, Cognitive assessment at 2 ½ years following fish oil supplementation in pregnancy: a randomized controlled trial, Arch. Dis. Child. Fetal Neonatal Ed., Dec, doi:10.1136/adc.2006.099085.)

Breast-feeding and cognitive development: a meta-analysis

Since the report of Hoefer and Hardy in 1929, many studies have reported that children who are breast-fed score higher on tests of cognitive development than do children who are formula fed.
The cognitive development of an infant is a complex process influenced by multiple genetic and environmental factors that interact with one another.

Most studies were conducted in the United Kingdom (10 reports) and the United States (5 reports), with others from Australia, Germany, New Zealand, and Spain. All studies included males and females. Although sex was frequently included as a covariate in analyses, insufficient information was reported to provide reliable estimates separately for males and females. The age at which cognitive evaluation took place ranged from 6 months to 16 years. Five studies reported results separately for low-birth-weight children. Of the 20 studies, 18 used prospective designs.

This meta-analysis of 20 controlled studies indicated that breast-feeding was associated with a 3.2-point higher cognitive development score than was formula feeding after adjustment for key cofactors. These results were homogeneous and significant (P < 0.001). Enhanced cognitive development of breast-fed compared with formula-fed children was manifested early in development and was sustained through childhood and adolescence. Increasing duration of breast-feeding was accompanied by a gradual increase in cognitive developmental benefit. Our analysis supports data reported in individual studies.

Low-birth-weight infants derived greater benefits from breast-feeding than did normal-weight infants. The analysis suggests that normal-birth-weight infants who are breast-fed rather than formula fed have a cognitive developmental advantage of 2.66 points (P < 0.001) whereas low-birth-weight infants have an advantage of 5.18 points (P < 0.001) compared with formula-fed infants matched for birth weight. These observations support the results of comparisons made in individual studies.

If breast-feeding is accompanied by more rapid or better development of neurologic function, it may be because breast milk provides nutrients required for rapid development of the immature brain. Human breast milk may support neurologic development by providing long-chain polyunsaturated fatty acids (LCPUFAs) such as docosahexaenoic acid (DHA; 22:6n-3) and arachidonic acid (AA; 20:4n-6). Structural lipid comprises 60% of the human brain, and DHA and AA are major lipid components.
Premature infants are denied the intrauterine supply of DHA and AA and, having no fat stores of these basic LCPUFAs, do not have adequate DHA and AA for retinal and cortical brain development. Breast milk provides these critical LCPUFAs, whereas formulas available in the United States do not provide DHA or AA. In 1979, Sanders and Naismith noted that blood DHA concentrations were higher in breast-fed than in formula-fed infants. Research in primates and humans indicates that breast-fed infants have higher brain concentrations of DHA than do formula-fed infants studied after accidental death. Makrides et al also noted that the DHA content of the brain cortex of infants increased significantly with duration of breast-feeding. Furthermore, erythrocyte DHA was significantly correlated with brain cortex DHA content in human infants, as reported previously in animal studies.

In conclusion, this meta-analysis of controlled studies indicates that breast-feeding is associated with a 3.16-point higher score for cognitive development compared with formula feeding after adjustment for significant covariates. This difference between breast-fed and formula-fed children was observed as early as 6 months and was sustained through 15 years of age, the last time of reliable measurement. Longer duration of breast-feeding was accompanied by greater differences in cognitive development between breast-fed and formula-fed children. Whereas normal-weight infants showed a 2.66-point difference, low-birth-weight infants showed a 5.18-point difference in IQ compared with weight-matched, formula-fed infants. These studies suggest that nutrients present in breast milk may have a significant effect on neurologic development in premature and term infants.

(Anderson JW, Johnstone BM and Remley DT 1999, Breast-feeding and cognitive development: a meta-analysis, American Journal of Clinical Nutrition, Vol. 70, No. 4, 525-535.)

This information is presented for your personal educational purposes only. It does not replace or substitute medical advice, nor is it intended to diagnose or treat, and should not be used so. Always consult a health care professional. Use only as directed. If symptoms do persist, or if you are unsure, consult your Health Care Professional. Please read labels carefully. Do not stop taking your medications. Speak to your doctor.