New data on prostate cancer mortality rates is good information for men to know, but it may not make decisions about treatment any easier. Furthermore, the new research probably won’t end the longstanding debate in the medical community questioning the use of PSA screening for the cancer or whether or not to even treat the disease in some men.

According to the new study, if you have prostate cancer you have about an 11% chance that you’ll die from it. The odds are more likely that’s you’ll die of something else--like cardiovascular disease.

The study authors say their research reinforces the idea that the key to longevity is embracing an overall healthy lifestyle--like eating a balanced diet, managing your weight, getting regular exercise, and not smoking.

Study Details

The study used data from the U.S. Surveillance, Epidemiology, and End Results Program and the Swedish Cancer and Cause of Death registries to analyze the causes of death among more than 700,000 men. The U.S. data was for 1973-2008 and the Swedish data covered 1961-2008.

• Over these periods, 52% of the Swedish men with prostate cancer died and 30% of American men with prostate cancer in the study.
• Of these deaths, only 35% of the Swedish men died directly from prostate cancer and only 16% of American men died from the disease itself, the investigators found.
• As the study continued, fewer men died from prostate cancer while deaths from heart disease remained the same.
• By the last five years of the study, 29% of Swedish men with prostate cancer died from it as did 11% of American men, the researchers calculated.
• Deaths from prostate cancer varied by age and year of diagnosis. The most deaths were among older men and among men diagnosed before screening for PSA began, they added.

Clinical Implications

When doctors were asked to comment on the study findings, opinions varied widely. Some believe the study is justification for screening only high-risk men for prostate cancer, which includes African-American men and men with a family history of prostate cancer. Others like Dr. Durado Brooks, director of prostate and colon cancer at the American Cancer Society, argue against PSA screening saying that it too often "leads down the path of unnecessary treatment."

"Men should understand that not every prostate cancer needs to be found and every prostate cancer that's found does not necessarily need to be treated," he said.

With such diverse opinions in the medical community, it’s easy to see why men need all the information available to make a decision about their health. There just isn’t a clear-cut answer on this issue.

Source:

Health Day

When a recent study reported that calcium may increase your risk of cardiovascular disease, the ensuing wave of concern and controversy was inevitable. For millions of older men and women taking calcium to help maintain bone mass, the study caused undue alarm and a flurry of calls to doctors asking, “Should I stop taking calcium?”

Before you consider tossing your calcium supplements, you should know that there are some serious flaws in the design of this study--even the study authors acknowledge these defects.

Problems with Study Design

As the Council for Responsible Nutrition (CRN) points out, the original study wasn’t designed to measure cardiovascular events. Consequently, confounding factors were not equally distributed across the study groups, which resulted in misleading results.

For example, the calcium supplement group had a population with a greater incidence of high cholesterol at baseline, and also included more smokers who were more likely to smoke for a longer duration. (The association between smoking and heart disease is well-established.)

Also, the data on calcium intakes was incomplete. Study participants did not always provide the supplement brand name or dosage on food questionnaires so calcium intakes from supplements were inaccurate. Also dietary changes over time which affect total calcium consumption were not calculated.

In addition, calcium intake does not equal calcium absorption in the gut. Many factors can affect calcium absorption and utilization—including age, medical conditions and the presence of other nutrients necessary to use calcium in the body. So, drawing any associations between calcium intakes and CVD outcomes without accounting for these factors would be unreliable.

Taken together, these shortcomings in the study design render the association between calcium intake and increased risk of CVD questionable at best.

Inconsistent Results

The flawed study design may explain why the study findings were inconsistent.

Greater dairy calcium intake—that is milk, cheese or ice cream and not supplements—actually had a significantly lower risk of heart attacks. However they found no link between either calcium supplements or food-based calcium intake and strokes or overall cardiovascular disease death. But they did find a link for heart attacks.

Sorting it Out

The bottom line is this: you need calcium at every stage of life, but it is particularly important as you get older as there is a greater risk of falls and fractures due to weak bones. Removing calcium supplements from your diet could put you at an even greater risk for these kinds of problems.

Nutrition experts advise consumers to be aware of how much calcium you get from your diet and then supplement with calcium if needed.

For best utilization, calcium--whether obtained through diet or supplements--should be consumed in small divided doses.

Also, calcium needs other nutrients including vitamins, protein and minerals--primarily magnesium--to be absorbed by your bones. This is why good bone-building supplement formulas contain vitamin D and vitamin K and the correct ratio of calcium to magnesium. The current ratio is 2 to 1 with newer evidence pointing to a 1 to 1 ratio.

If you do take a calcium-only supplement, most medical experts recommend that you take it with meals rather than in isolation.

As with any supplement, speak with your doctor or other healthcare practitioner to determine your own personal needs.

Sources:

Heart

Council for Responsible Nutrition

New Hope 360

Drug Store News

Journal of Clinical Endocrinology and Metabolism

In the last few years you probably noticed an increase in the amount of nutritional information on the front of food packaging. This includes graphics saying “all natural” or “better for you.” Others list the amount of sugar, fiber, and fat in the product. Others are endorsements by a health organization. These front-of-pack labels or “FOP” labels are at the center of a controversy that’s pitting the Food and Drug Administration (FDA) against food manufacturers and associations.

Currently the FDA doesn’t regulate Front of Pack labeling, but they are in the process of attempting to develop standards for them which are now defined by each company or organization.

The federal government became concerned about FOP labeling as their use exploded and the labels became increasingly misleading. With different label criteria and label formats from each company, consumers were bombarded with different and often incomplete information. For example, manufactures can tout “sugar-free” or “all natural” for a food that is loaded with saturated fat and virtually no other redeeming nutrients. In essence, foods can be made to appear healthier than they really are.

Last year the Centers for Disease Control along with the FDA asked the Institute of Medicine (IOM) to step in and review the labeling in use, make recommendations on how to clean up the mess and suggest a standard FOP scheme.

In anticipation of the coming standards, the Grocery Manufacturers Association and the Food Marketing Institute developed the Nutrition Keys or “Facts Up Front” system. It consists of at least four basic icons for calories, saturated fat, sodium and sugars per serving. An optional format includes two “nutrients to encourage” (potassium, fiber, protein, vitamin A, vitamin D, calcium and iron). All of these are either shortfall nutrients or are required to be on the nutrition facts panel. This scheme is already in use now and some charge this was a deliberate attempt to undermine the impending IOM recommendations.

“Facts Up Front” FOP labeling system developed by the Grocery Manufacturers Association and the Food Marketing Institute.

Institute of Medicine Recommendations

Just last month the IOM released the second of two reports which contains their recommendations that any FDA approved FOP scheme:

• Prominently display all information based on serving size
• Include calories per serving
• In addition to calories, allow only three other items in any front-of-package evaluation scheme: 1) saturated and trans fat, 2) sodium and 3) sugars.
• Adopt a point system to evaluate food products based on the levels of those three items. Their sample design uses stars to signify points. The more stars a product has, the better it is for you.

The IOM says their recommendations focus on helping consumers make healthy food choices that address Americans biggest health challenges: obesity, heart disease, and certain types of cancer. The rating system is a fundamental--and some say courageous--change for the FDA. Until now the FDA only provided nutrition facts and left it up to the consumer to interpret that information.

Sample of system proposed by the Institute of Medicine.

Industry Response

The food industry favors their “Facts-up-Front” label as it contains information from the Nutrition Facts label already regulated by the FDA. They oppose any scheme, such as that recommended by the IOM, which includes a rating system. The industry cites its own surveys that indicate consumers don’t want to be told by the government what to eat. They also believe that a system that uses interpretive symbols that rate criteria negatively, but do not include positive criteria are inherently unfair and misleading.

Great Britain’s FOP Labels

In case you’re wondering how are neighbors across the pond are handling this controversy, Great Britain FOP labels use a “traffic light” scheme. It rates products based on four criteria: total fat, saturated fat, sugar and salt per serving. (It does not include calories.) Each criterion is color coded red, yellow, or green to indicate if the amount in the product is too low or high. For example, if the amount of sugar is high by their regulatory standards, the sugar symbol is red.

“Traffic light” FOP system used in Great Britain

Whether consumers will use the information to improve their diets is another matter. According to data from the independent research group HealthFocus, nearly half of American shoppers say they would like to see calories, saturated fat, sodium and trans fat clearly labeled on food packaging to help them avoid unhealthy products. However, they found that only 36 percent of obese shoppers read on-pack nutritional information compared to 55 percent of shoppers overall, and obese shoppers were less likely to say that they paid attention to their diet.

Sources:

Food Navigator

Grocery Manufacturers Association

Food Navigator

Facts Up Front