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Showing posts with label family history. Show all posts
Showing posts with label family history. Show all posts

Why Women Are More Likely To Suffer Osteoporosis Than Men

November 12, 2013

Chinese_hunchback_woman
A Chinese hunchback woman
Image is courtesy of zhee

Osteoporosis, a silent disease of decreased in bone mass and density, in which the bones become weak, and lead to an increased risk of fracture incident (break bones), especially in the hip, spine, and wrist. Fracture incidents due to osteoporosis, will occur in healthy people, who would not normally break a bone, in both men and women.

According to Nicholas Perricone, M.D.'s book, 7 Secrets to Beauty, Health & Longevity, page 72, there are several unsupported claims, that women are much more likely to suffer from osteoporosis than men. Below I found several studies in Pubmed to explain dr. Perricone's following claims:

Claim: Women have less bone mass than men.

Fact:
True indeed. Compare to women, men is given larger bone size, and greater bone area at all sites. But, according to a study, there is virtually no clinical difference, in bone mineral density (BMD) precision between men and women.

BMD, the amount of mineral per square centimeter of bone, is an important predictor for osteoporosis. The actual BMD, which is usually expressed in grams per milliliter, is measured by X-Ray Absorptiometry, or Tomography. (MeSH)

Recent study by University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA, compared BMD precision, in 180 older men and women, by using a Lunar iDXA densitometer. The study resulted that there is virtually no clinical difference, in BMD precision between men and women. (Krueger D, et al. 2013)

Claim: Women tend to live longer than men.

Fact:
Totally true, but I found no link between extended lifespan with osteoporosis.

According to recent article by The Institute of Healthy Ageing, London, UK, sex differences in lifespan exist worldwide, with women outliving men, by more than a decade in some countries. Although most sexually reproducing species examined had shown sex differences, in patterns of ageing, but a comprehensive explanation does not exist.

The sex steroids, such as androgens and oestrogens, were examined their regulation of biological processes, that can affect ageing and lifespan. The sexes, in which able to respond differently to dietary restriction, and to alter the activity of nutrient sensing pathways, had come up with the conclusion that females was showing a greater capability for extending life. (Regan JC, et al. 2013)

Claim: Women usually consume less calcium than men.

Fact:
The statement is doubtful and unclear.

Healthy diet with a sufficient intake of calcium, and vitamin D will help making the bones strong. People are usually having less than half the calcium, and vitamin D they need. The food sources of calcium include, low fat milk, yogurt, cheese, orange juice, cereals, and breads.

In my previous post, which titled, Dietary Intake of Vitamin D Against Diabetes and Cancer, I had also mentioned two studies, in relating to vitamin D, calcium, and fracture incidence.

A study had resulted that four monthly supplementation, with 100,000 IU oral vitamin D, may prevent fractures without adverse effects in men and women. However, another trial did not support the calcium, and vitamin D supplementation, either alone, or in combination, for the prevention of fractures in elderly people.

Recent study by 1 Institute for Aging Research, Boston, MA, USA, suggested that greater protein intake benefits women especially those with lower calcium intakes. But, protein effects are not significant for short term changes in bone density. In the contrary, in men, higher protein intakes lead to greater bone loss. (Sahni S, et al. 2013)

According to a study by Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan, among 46,465 men, and 64,327 women, aged 40-79 years, who responded to the self administered food frequency questionnaire, men aged 40-49 years had the lowest mean intake levels of calcium, with other vitamins and minerals. While in women aged 70-79 years, had the lowest mean intake levels of calcium, retinol, and vitamins A. (Iso H, et al. 2005) There are not enough studies to support dr. Perricone's claim.

Claim: The rate of bone loss accelerates after menopause, because the female hormone estrogen is needed to keep the bones strong.

Fact:
True indeed. Postmenopausal osteoporosis is a condition associated with low bone mass, resulting from the increased bone resorption, that occurs following a decline in estrogen levels. (Lagari VS, et al. 2013)

Claim: If a woman's ovaries are surgically removed, more rapid bone loss may occur, because estrogen is made in the ovaries.

Fact:
Totally true. Bilateral oophorectomy (ovariectomy, the surgical removal of both ovaries, resulting in surgical menopause) at the time of hysterectomy (a surgical operation to remove all, or part of the uterus) for benign disease, is commonly practiced, in order to prevent the subsequent development of ovarian cancer, or other ovarian pathology, that might require additional surgery.

Estrogen deficiency resulting from pre-menopausal, and post-menopausal oophorectomies, has been associated with higher risks of coronary heart disease, stroke, hip fracture, Parkinsonism, dementia, cognitive impairment, depression and anxiety, in many studies. Nowadays, observational studies suggest, that bilateral oophorectomy may do more harm than good. In women who are not at high risk of developing ovarian, or breast cancer, removing the ovaries at the time of hysterectomy should be approached with caution. (Parker WH, et al. 2009)

Conclusion: Women are much more likely to suffer from osteoporosis than men.

Osteoporosis Risk Factors

According to NIH, there are many risk factors, which can lead to bone loss, and osteoporosis. Several risk factors, you cannot change, but others you can. The following are risk factors you cannot change:

Gender
Women are much more likely to suffer from osteoporosis than men.

Age
The older you are, the greater your risk of osteoporosis.

Body size
Small, thin women are at greater risk of osteoporosis.

Ethnicity
White, Caucasian and Asian women are at highest risk. Black and Hispanic women have a lower risk.

Family history
Osteoporosis tends to run in families. If a family member has osteoporosis, or breaks a bone, there is a greater chance that you will too.

Other risk factors, which you can avoid includes:

Sex hormones
Low estrogen levels due to missing menstrual periods, or having menopause can cause osteoporosis, in women. Low testosterone levels can bring on osteoporosis, in men.

Anorexia nervosa
An eating disorder which can lead to osteoporosis.

Calcium and vitamin D intake
Diet low in calcium and vitamin D, will make you more prone to bone loss.

Activity level
Lack of exercise, or long term bed rest can cause weak bones.

Cigarettes smoking
Smoking impairs muscle, bone, and joint health.

Excessive use of alcohol
Drinking too much alcohol can cause bone loss, and broken bones.

Medication use
Using certain medications to treat rheumatoid arthritis, endocrine disorders, seizure disorders, and gastrointestinal diseases, may have side effects which can damage bone, and lead to osteoporosis.

In his book, dr. Perricone said that glucocorticoids, a class of drugs, a group of steroids, which have metabolic and anti inflammatory effects, have particularly damaging effects on the skeleton.

The following drugs also can cause bone loss:

  • Thyroid hormones.
  • Anticonvulsants.
  • Antacids containing aluminium.
  • Gonadrotopin releasing hormones, used for treatment of endometriosis.
  • Methotrexate, used for cancer treatment.
  • Cyclosporine A, an immunosuppresive drug.
  • Heparin and cholestyramine, used for controlling blood cholesterol levels.


Dr. Perricone's 7 Secrets to Beauty, Health, and Longevity: The Miracle of Cellular Rejuvenation by Nicholas Perricone, M.D.
Dr. Perricone's 7 Secrets to Beauty, Health, and Longevity: The Miracle of Cellular Rejuvenation by Nicholas Perricone, M.D.

The Obesity Epidemic

August 15, 2013

Fat Guys

Obesity and Diabetes

Obesity is often associated with the high risk of having chronic diseases, such as, diabetes mellitus, and cardiovascular diseases. And then, thin people or vegetarians may have a lower risk of diabetes? No. Obesity may not be the main factor.

A healthy lifestyle will determine the quality of human health. Even in a vegetarian, who is also doing regular exercises, may not lower the risk of diabetes, if the main cause is genetic. It is a fact that, human genes, and family history of diabetes, are associate with the risk of diabetes.

Clinical controlled trials had shown solid evidence that type 2 diabetes is a disease of fatness. A five % of weight loss is sufficient to prevent most obese subjects with impaired glucose tolerance, in developing type 2 diabetes. Type 2 diabetes is obesity dependent, and obesity is well understood aetiology (study of causation), as the main cause of type 2 diabetes. (Astrup A, et al. 2000)

However, ask yourself!
How many times you met with an obese Indian, or Chinese?

An update 2012 data, from International Diabetes Federation showed that, there were 33.4 million men, and 29.6 million women with diabetes, in India. Also, there were 51.5 million men, and 40.8 million women with diabetes, in China.

While in my country of Indonesia, from about 300 million population, there were 3.2 million men, and 4.4 million women with diabetes, aged 20 to 79 years. In the US, there were 12.2 million men, and 11.9 million women with diabetes. (IDF)

According to the article published in 2009, by the Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Colorado Denver, the US generations might have a shorter life expectancy than their parents, if the obesity epidemic is not controlled.

Because, 35.1% of adults in the US, were classified as obese. In children, obesity will continue to increase steadily. The study showed that obesity may become the most difficult public health issues in the US. (Catenacci VA, et al. 2009)

Link Between Obesity and Prostate Cancer

The US Health Professionals Followup Study reported an inverse association between obesity, and the risk of developing prostate cancer, in men under 60 years of age, or in those with a family history of prostate cancer. The study found that body mass does not appear to affect the performance of prostate specific antigen as a diagnostic test. But, a lower body mass is associated with a higher cancer detection rate, on a prostate biopsy.

Although, several mechanisms have been proposed to explain the link between obesity and prostate cancer, including, hormonal alterations, hyperinsulinemia (high levels of insulin in the blood), glucose intolerance (inability to metabolize glucose), elevated IGF (insulin-like growth factor, hormone which exert an effect on bone cell metabolism), and leptin (hormone made by fat tissue, that acts on brain to regulate food intake, and body weight) levels, but, the mechanism which explains the association between obesity, and prostate cancer remains unclear. (Amling CL. 2005)

However, an article which published two months earlier, supported the hypothesis, that obesity is inversely associated with prostate cancer risk, in middle aged men. The study used the interviews from 753 men, aged 40 to 64 years, that were diagnosed with prostate cancer between 1993 and 1996. (Porter MP, et al. 2005)

Obesity and Coronary Heart Disease

We cannot control from where we get our genes, and healthy lifestyle may not prevent us from getting diabetes. But, a healthy lifestyle may prevent us from getting coronary heart disease (CHD). High blood cholesterol, high blood pressure, overweight and obesity, are controllable risk factors of CHD.

A healthy diet and having regular exercise, can help maintaining a healthy weight, in which helps to control CHD risk factors. Five to ten % loss of body weight can lower the risk of CHD. Overweight children and teens are associated with the high risk of CHD, and may also have a shorter life expectancy than their parents, if their weight gain rates are not reduced. However, personally reducing calorie diets are not advised, unless approved by a physician. (NHLBI)



Image credit: Shakespeare's Monkey

Link Between Cancer and Family History

August 12, 2013

Butterfly girl with pediatric cancer
Image credit: Tracie Taylor

Cancer, an abnormal and uncontrolled growth of the cells that make up living things, is associated with family medical history. Even in an healthy body, cells could grow into sporadic cancer cells. So, in this case, inside every living things's cells could grow into cancer cells.

Cancer cells may lie dormant for years, or even decades before they grow sporadic and produce the symptoms of disease. Some cancers develop extremly slowly and often escape detection during the life of the patient. Different types of cancer may be caused by many factors, and different combinations of conditions. Also, there is a possibility that the human body immune system might subdue the tumor, or cancer cells without any treatments.

From 6,773.281 million of world population, in 2008, there were 12.6626 million new cancer cases, and 7.5648 million cancer deaths. The risk of getting cancer before the age of 75 years, was 18.6% worldwide. While the risk of dying from cancer before age the 75 years, was 11.1% worldwide.

Denmark was become #1 country with the highest cancer rate, in both men and women. Followed by Ireland in the second, and Australia in the third. The worldwide estimate mortality rate in women was ASR (Age standardised rates) 99.1 people, in 210.8 estimate cancer incidences, per 100,000 people. While in men, the worldwide estimate mortality rate was ASR 139.1 people, in 303.7 estimate cancer incidences, per 100,000 people. (Globocan 2008)

The Worldwide Most Common Cancer

Lung cancer is the most common cancer in the world. Lung cancer contributed 12.7%, or 1,608,055 new cases, in 2008. The death rate was 18,2%, or 1,376,579 cases of cancer death worldwide.

A cohort study involving 71,392 non smokers women, in Shanghai, China, indicated a moderate association of lung cancer risk with a family cancer history in general, and not specifically to a family history of lung cancer. (Zhang Y, et al. 2007)

The data from recent cohort study, such as, clinicopathologic data, tumor genotype, family history of cancer, and specifically family history of lung cancer, from 230 cases of never smokers lung cancer patients, was also supported the earlier study. 57% of the cases had a family history of any common cancers, and only 42 out of 230 cases (18%), was presented a specific family history of lung cancer. (Gaughan EM, et al. 2013)

Inherited Breast Cancer

The second most common cancer worldwide, in which also the world most common cancer in women is breast cancer. Breast cancer in women contributed 10.9%, or 1,384,155 new cases, in 2008. The mortality rate was 6.1%, or 458,503 cases of death worldwide.

The following are breast cancer risk factors:

  • Age and Gender
    Advanced breast cancer cases are found mostly in women aged over 50 years. Although, men are 100 times less likely than women to get breast cancer, there is a chance for men in getting breast cancer.
  • Family History
    A major risk factor for breast cancer, is the family cancer history, in first degree relatives of the disease. The first degree relatives are parents, brothers, sisters, sons and daughters. About 20% to 30% women with breast cancer, have a family history of the disease.
    Benign breast disease (BBD), a common condition marked by benign (non cancerous) changes in breast tissue, especially hyperplasia (an increased cell production in a normal tissue or organ), is also associated with an increased risk of breast cancer.
    In women with a family history of breast cancer, appear to be at increased risk of being diagnosed with BBD, in which is associated with a greatly increased risk of breast cancer. (Webb PM, et al. 2002)
  • Genes
    Human genes play a key role in the development of breast cancers. At least four types of breast cancers have been shown to be inherited, among them, Luminal A, Luminal B, Triple negative/basal-like, and HER2 type.
    Breast cancer may also effect several genes, either by the activation of oncogenes (genes carried by tumor viruses), or the inactivation of tumor suppressor genes (anti-oncogenes). So, genes are involved specifically as causative factors of breast cancer. (Anderson DE. 1992)
  • Menstrual Cycle
    In women who got an early menstrual period, or before the age of 12 years, will have a high risk of breast cancer. Also, in women who went through a late menopause, or above the age of 55 years, will have an increased risk of breast cancer.

Family History and Colorectal Cancer

Colorectal cancer became the third most common cancer worldwide with 9.8%, or 1,235,108 new cases, in 2008. There were 609,051 cases of death have been reported, or 8,1% of the mortality rate worldwide.

Family history is well established to be a risk factor for developing colorectal cancer (CRC). Recent study was aimed to observe the link between family history and survival from colorectal cancer. The study was using the data from 10,937 patients of the National Study of Colorectal Cancer Genetics (NSCCG), to compare with the data from 10,782 patients of the National Cancer Data Repository (NCDR).

Although the study found no differences between those with and without a family history of CRC, age, sex, tumour stage, and the presence of multiple cancers. But, the study managed to provide the evidence that a family history of CRC, is associated with better survival after a diagnosis of CRC. (Morris EJ, et al. 2013)

Family History and Cancer in Children

A study presented five families of paediatric patients suffering from choroid plexus carcinoma, a rare cancer in the ventricles (small cavities or chambers within a body or organ) of the brain. Choroid plexus carcinoma is often found in infants below two years of age.

The study had found that three families met the criteria for germline TP53 (tumor protein p53, a tumor suppressor protein) mutation testing. From those three family, only one familiy conformed to the criteria of Li-Fraumeni syndrome, an inherited cancer syndrome associated with the mutations in TP53 genes.

In the remaining two families, there were no family history of cancers, and the parents were not shown to carry the TP53 genes mutation. (Krutilkova V, et al. 2005)

Although we cannot control from where we get our genes, but, we could control our lifestyle habits to reduce the risk. By keeping a healthy living, and diet will surely minimize the risk of cancer. Just like a quote, What you eat is what you are, being healthy is a choice in life.



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