Category Archives: Obesity Prevention

Cardiovascular Disease (CVD) on the New Spotlight

It’s Black Friday, Cyber Monday, or Holiday shopping time. I’m fascinated by some new, popular products on the market. They seamlessly integrate into our daily lives or functions, through hand-free and hassle-free items or other products that make routine tasks more effortless, efficient, and enjoyable.

Equally fascinated by emerging technologies in medical science, I’d love to share some tremendous discoveries and developments that have transformed clinical landscape of therapeutics. But first off, critically important is putting cardiovascular diseases (CVD) on the spotlight. Why?

Based on the World Heart Federation, CVD is the world’s number one killer, causing over 20.5 million deaths each year (resulting from heart attack, stroke, and heart failure). However, there is hope—80% of premature deaths from CVD are preventable! Not to say, medical breakthroughs make CVD and some of its risk factors treatable.

Here I’d focuses on the conditions that are harmful to your heart, but sometimes overlooked.

1. Obesity

Overweight and obesity affects more than 70% of US adults and more than 50% of people worldwide, contributing to numerous health consequences. Overweight and obesity are independently associated with an increased risk of CV events. This holds true after excess weight-associated cardiometabolic risk factors (such as hypertension, dyslipidemia, and type 2 diabetes) are accounted for (Khera et al., 2023; Lincoff et al., 2023; Drozdz et al., 2021).

Whether obesity as a disease that individuals are predisposed to develop as a result of genetics, biology and the living environment or as a condition due to complex factors, it’s important to double our awareness and effort to prevent or treat obesity for tackling CVD. For those who want to understand more about it, I’d recommend a Weight and Health video from New England Journal of Medicine. It eloquently and effectively delves into obesity from pathophysiology and the impact of weight bias or stigma, to therapy including benefits and risks of promising new medications.

Since weight gain usually takes place gradually, weight loss unlikely occurs quickly. So, monitor this significant risk factor closely, make small lifestyle modifications consistently, and seek medical treatment if needed.

Having emphasized on overweight and obesity, by no means I diminish or minimize other common risk factors or detrimental conditions such as high blood pressure, high cholesterol, high blood sugar, smoking, alcoholism, poor diet, physical inactivity, and stress, in addition to the uncontrollable (age and genetics). It’s very possible that an individual may have multiple risk factors as these conditions are often interlinked and interact. All of that make regular check-up, lifestyle modifications, and early intervention crucial for the prevention of CVD.

2. Climate change coupled dual threats—extreme heat and poor air quality

Global climate change affected environmental disaster is real! As we all see, extreme heat events are becoming more frequent, more intense, and longer. High temperatures stress the CV system by making the heart work harder and by putting extra strain on vital organs like lungs and kidneys. Exposure to poor air quality, especially to high concentrations of fine particulate matter smaller than 2.5 µm (PM2.5) is also independently associated with CV morbidity and mortality. When inhaled deep into the lungs, these fine particulates can irritate the lungs and blood vessels around the heart.

Recent findings showed that co-exposure to extreme heat and poor air quality synergistically increase the risk of fatal heart attack. In an analysis of 202,678 heart attack deaths between 2015–2020 in Jiangsu province of China, up to 2.8% of heart attack deaths were attributed to combination of extreme heat and high levels of PM2.5 (exceeding WHO target value of 37.5 µg/m³). Women and older adults were more vulnerable to the greater risk.

3. “Athlete’s Heart” and exercise intensely

In January, the Bills’ 25-year-old Damar Hamlin suffered cardiac arrest on the field during Monday Night Football, which captured the national spotlight. Sudden cardiac arrest is the leading cause of death in young athletes. According to Rakesh Gopinathannair, MD, specialized in clinical cardiac electrophysiology, intensive endurance training can cause a distinct pattern of functional and structural changes of the CV system, including heart muscle thickening and ECG changes. This results in so-called “athlete’s heart”. So, it reminds us to be more attentive to heart health among young athletes and ensure the readiness of life-saving equipment and teams involved.

I would also expand this issue to the non-athletic population, in particular a small percent of “fitness-fanatics” who exercise excessively. Without doubt, exercise reduces your risk of CVD, cancer, and all-cause mortality. However, excessive exercise or rigorous yet unproven fitness routines can negatively impact your heart health.

Most commonly seen is atrial fibrillation (AFib; a heart condition of an irregular rhythm and often abnormally fast rate). This is because strenuous exercises put extra demands on the heart and cause damage to the CV system. It has been proven not only by scientific/medical research but also by people in real life. I know some folks—a family member, a neighbor, and a few doctors including cardiologist who admitted their heart problems were the fault of their own (i.e., exercised in extreme intensity, volume, and frequency when they were young). It all comes down to the benefits’ gain from proper exercises without overdoing it when the risk kicks in. A 30-minute walk is just as good as 30-minute intense cycling, depending on an individual. Adequate exercise is always better than none. If you have any concerns about your heart health, don’t hesitate to consult with your doctor or a healthcare professional.

The bottom line is—in the holiday season and the years ahead, don’t just indulge in hand-free, hassle-free gadgets to satisfy your convenience, do pay attention to your heart and keep it “hazard-free” for your wellbeing and life.

Image credits: Pixabay; Andres Ramos / Vecteezy

Rethink Obesity and Reshape Your Health

By Hui Xie-Zukauskas

I had a conversation with a friend regarding the pandemic and weight among other topics. My question is—How is your weight affecting you physically, emotionally, or medically?

If this sounds relevant to you, read on.

First, I’m highlighting three quick facts about obesity:

The prevalence of obesity in U.S. adults reaches 42.4% (pre-COVID), based on the CDC.
The obesity rate of young adults aged 20-39 is 40%.
Obesity is an established risk for chronic diseases (e.g. heart disease, some cancers, diabetes, stroke, etc.), and has been linked to severe complications and clinical outcomes of COVID-19.

Now combine the reality of the pandemic. The lockdowns or self-quarantine and teleworking—by less exercise and more stress—exacerbate obesity epidemic, at least weight gain becomes increasingly common among many folks.

Let’s focus on one of the weight control solutions right at your home.

If you have been living in a confined world, getting less active in the outdoors or gaining “lockdown pounds”, you may wish to create your own “little paradise” in your garden.

The health benefits are abundantly clear, just mentioning some of them:

More movement to get physically active for weight control
Family activity to prevent the kids from overweight and obesity
Stress relief and mood enhancer
Close contact with soil that benefits the gut microbiome.
Eat nourishing veggies or fruits of your own without chemical toxins.
Connect with nature and enjoy your surroundings.

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Let me add a critical note on gut microbiome.

We know that the gut microbiota can contribute to human metabolism, immune defense and so on. Disturbances of gut microbiota not only disrupt your gut barrier and immune function but also have an impact on your weight and obesity.

Due to a modern lifestyle, most of us leave behind the contact with soil (plainly the “dirt”), hence causing the loss of diversity of beneficial microbiota in the human gut, which has led to some negative health consequences including obesity and diabetes. In contrast, research showed that our ancestors had the highest richness of the gut microbiome because of their hunting-gathering lifestyle.

So, what actions can you take to reshape your health?

In August to early fall, you still have time to plan something green and healthy, with benefits of getting physical activity, fresh air, and the gut microbiome as players in your team.

Whether you have a big or small backyard garden, you have many ways to do so including but not limited to the following:

Select your favorite seasonal veggies, fruits or flowers and plant them.
Use elevated / raised garden beds or planter boxes , if you need more space or more variety. They look fantastic and this site offers a lot of great information too!
Add other varieties such as a little fountain or water flow, providing serenity.
Include a bird feeder or bath for bird watching, which is really joyful and meditative. As an article in New York Times puts it—“The birds are not on lockdown, and more people are watching them.” Certainly, you can also adore eBird.
Any other favorites, lawn chairs, a table under a tent, etc.?

Now that I threw a few ideas based on my “playing with dirt” and experience, but I’m not in any way near a gardener. So, if you ask a Pro gardener, you’ll get an ocean of suggestions or options for sure.

But the point is —

Whether you’re planting veggies, fruits and flowers or watching birds chanting and water flowing at your backyard, you are in touch with nature, thereby escaping from the pandemic anxiety or quarantine fatigue to enhance your well-being.

Not only can you indulge in your “little paradise” anytime, but you keep moving because gardening is not one-time labor.

So, take a few minutes from your busy or demanding life, appreciate nature, the tranquility, the beauty of greens or colors, the sound of water, the singing birds, along with healthy weight, beyond harvesting nutritious crops.

Is it a small joy of your life? I bet it’s the unique rewards of your “little paradise”!

P.S. If you don’t have your own garden, participate in nearby community garden.

Image credits: Aaron’s Homestead , Pixabay

Stop Childhood Obesity or Dangerous Risks Persist

By Hui Xie-Zukauskas

We are at the end of September, as you probably know that this is the month for national awareness of childhood obesity. But the problem doesn’t stop in September.

Childhood obesity is a continuous yet urgent issue that needs to be addressed and worked on every day.

1 in 5 children in the US are obese, and this obesity epidemic in children deserves our attention.

The good news is—childhood obesity can be prevented!

Before I talk about how to work towards a solution, let me outline what impacts childhood obesity.

Childhood obesity is influenced by many factors, including

- poor diet (esp. fast foods, sugar-sweetened beverages or sugary soft drinks),

- sedentary behaviors or physical inactivity,

- metabolic elements,

- genetics,

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- family dynamics or house environment, and

- community and social impacts.

Importantly, parental lifestyle plays a crucial role in a child’s health outcome. Research shows that high pre-pregnancy BMI is an important contributor to excess adiposity, insulin resistance, and cardiovascular or metabolic disease risk in the offspring during childhood.

Stopping childhood obesity is critical because the persistence of obesity into one’s adulthood has been associated with increased chronic illnesses and premature deaths.

Sure, there is no simple solution for this problem, but there are many ways to keep kids healthy. Here are eight key strategies and immediate actions:

Prevention of childhood obesity starts with a healthy diet at home. Have regular family meals and model healthy eating for your kids.
Pack nutrient-rich and fiber-rich snacks for your children.
Let the kids participate in age-appropriate grocery shopping and cooking activity, in order to cultivate their knowledge or interests in healthy foods and beneficial diet habits.
Encourage the kids get more physically active and exercise regularly. Do it with them too. Modern technologies provide too much sitting time or screen time for children.
Dink safe and filtered water instead of Coke and sugar-sweetened beverages.
Ensure your kids to have sufficient sleep. Shorter sleep period is linked to childhood obesity. So, take necessary measures to limit their screen time at night and remove the mobile devices from their bedrooms.
Take care of children’s emotional health and help them with social issues.
Execute early intervention and prevention at various fronts as early as prenatal period, if not earlier. This can provide the greatest protective effect on your kid’s early development and later life.

In brief, childhood obesity is a serious and urgent public health problem. Family interventions are the key strategy in our efforts to tackle this problem. Parental healthy lifestyle passing on to the next generation is an invaluable gift for children’s well-being.

What Holiday-Indulging and Junk-Eating Have in Common

By Hui Xie-Zukauskas

Have you ever thought or said “I only eat this much around the holidays”?

Well, I confess it first.

Often many of us gave ourselves excuses for holiday indulging, especially when eating healthy all year long. Yes, it’s OK to indulge occasionally. Occasional indulging may not have a long-term impact on your health as long as you live a healthy lifestyle with well-balanced diet and regular exercise.

However, I’d also like to remind you that overeating does matter, particularly for those who adore heavy holiday eating or drinking, because delightful drinks, delicious foods have a dark side in hiding. There is no big gap between regular junk foods and loaded festive meals, in terms of harm to your health.

The damage could be different in a time-fashion, a diet with junk foods contributes to various chronic illness such as heart disease, diabetes and cancer, whereas holiday heavy eating or drinking may trigger unforeseen heart attack or heart failure. So, do you see a grave consequence they share?

You can also examine what festive meals and junk foods have clearly in common. Both

contain food with high fats, high sugar and high salt, and sugary drinks as well.
mix up with alcohol over-consumption.
accompanied by stress-eating.
implicate extra calories intake resulting in weight gain. Then for some folks, those pounds are not easily shedded off.

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Time after time, holidays after holidays, a gradual weight gain becomes considerable weight gain, overweight or obesity. Obesity mostly comes in an accumulative way, but it is a major risk for diabetes, cardiovascular disease and cancer.

Now consider if you are having a health issue or an unhealthy eater, then imagine how unfortunate the cost would be to over-indulge during holidays.

Briefly, overindulging (alcohol, junk foods or festive meals) is never good. Overindulging, even overindulging chocolate – which contains some health values – is not worthy, either.

The bottom line is –

Holiday indulging is not trivial. To get more health benefits from food and family time, make it easier just by being mindful when you eat and joyful when you move.

Equally important as smart eating is – blissful when you gather, and peaceful when you rest. After all, it’s the most wonderful time of the year – as we sing the song.

Image credit: oxfordinternationalenglish.com

Go Beyond Knowing Obesity Is Bad (Part 2)

By Hui Xie-Zukauskas

What comes to your mind when you hear “Belly fat”?

Call it “Belly fat” as you like, but what I’m specifically talking about is visceral fat, the fat stored deeply inside your abdominal cavity and around your organs – unlike subcutaneous fat (under your skin) that’s visible and pinchable. (Image Credit: FitWeightCare)

Fat on Visceral Organs (i.e. intra-abdominal fat)

Everybody likely has visceral fat whether knowing it or not. but how much is too much?

Although visceral fat can only be measured by CT and MRI now, if you or your loved ones have an overhanging belly and large waist, that’s a warning sign of dangerous fat inside. That said, it doesn’t exclude relatively lean (with normal waistline) folks.

So, how dangerous is visceral fat exactly?

Visceral fat has deleterious effects on a variety of your organs and their functions. Clearly, it is attributed to increased inflammation by provoking inflammatory pathways and releasing pro-inflammatory chemicals. Also, extra visceral fat is strongly linked to insulin resistance and metabolic diseases, and to an elevated risk of death, even for people who have a normal body mass index (BMI).

Carrying around excess visceral fat increases a risk for a long list of chronic conditions or diseases including, but not limited to –

Coronary artery disease, heart attack, stroke
Cancer
High blood pressure, high blood cholesterol, and high blood glucose
Obesity – making it hard to lose weight
Type 2 diabetes – due to insulin resistance
Dementia
Depression and mood problems
Sleep disorders (e.g. sleep apnea)
Endocrinal, sexual dysfunction
Arthritis

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Here, I want to lay emphasize on cancer, as cancer’s impact on public health is increasingly prevalent. Excess visceral fat is a risk factor for several cancers of the gastrointestinal system, particularly esophageal, stomach, small intestine, colorectal, pancreatic, liver and gallbladder cancers. This is because overloaded adiposity is associated with fat tissue-derived inflammation, alterations in insulin signaling and sexual hormones’ pathways, then turning normal cells into cancerous ones. Moreover, visceral obesity is greatly associated with breast cancer.

Fat’s Influence on Other Vital Organs (e.g. brain)

Just because visceral fat is wrapped around abdominal organs such as the pancreas, liver and kidneys, it doesn’t mean that its damaging effects are local. For instance, liver fat may have a direct association with brain aging or shrinking. What’s more, greater visceral fat is correlated with a smaller total brain volume, which has been linked to neurodegenerative processes, and used as one of predictors for dementia.

Excessive visceral fat results from a combination of hormonal, dietary, lifestyle (i.e. sedentary), and genetic factors. Now you can see how any big belly and large waistline are unhealthy.

Obesity and Aging

As we get older, we store more visceral fat, because changes in body composition occur and co-morbidities accumulate. However, hopefully by now, you’ve come to the realization – simply accepting a growing midsection as an unavoidable product of aging may ignore or tone down your health risks.

On issues of aging and obesity, it’s inevitable not to touch on the gut microbiome, the microbial communities inhabiting the human body and containing a diverse array of microbes (in trillions).

The gut microbiota has emerged as a crucial regulator between how our food interacts with our body. They modulate how we balance levels of blood sugar and how we store fat, as well as how we respond to hormones. They play a key role in obesity.

As we age, altered gut microbiota in their composition and metabolites (called Dysbiosis) occurs. Science reveals that our gut microbiota undergoes the most prominent changes during infancy and old age, and profoundly, our immune health is also in its weakest and most unstable state during these two critical stages of life, indicating that the gut microbiota and immune function develop hand-in-hand with age.

Sure enough, with aging, levels of inflammatory mediators in the blood rise, and hence age-associated inflammation becomes a strong risk factor for morbidity and mortality in elders. It turns out that the gut microbiota may act as invisible yet important players in chronic inflammation.

Aging-associated dysbiosis can promote intestinal barrier’s broken-down, systemic inflammation and immune dysfunction, which all contribute to the pathogenesis and progression of various diseases commonly seen in old people such as obesity-related disorders, liver diseases, cardiovascular diseases and cancer. Age-related changes in the gut microbiota have also been associated with various neurological and neurodegenerative disorders due to disturbed gut-brain communication.

Clearly, the gut microbiota can have a potent impact on human health and diseases. But to date, there is no knowledge on “Which” gut microbe is doing “What”, “Why” and “How”. Without doubt, we can anticipate to learn more soon as a remarkable pace of scientific research is going on.

The Key Point Is –

If fats deposit where they should not be or more than they should be, then that will change a physiological condition to a pathological one through the effects of inflammatory chemicals. Excess body fat is like an inflammation-pumping machine.

For this reason, any extra fat – from both body and diet – any big belly or larger waistline poses a hidden risk. With obesity, people carry not only fat or weight but pain and health consequences.

Obesity is serious, regardless of the debate whether obesity is a disease or a condition. Obesity is just as significant as high blood pressure and high cholesterol – while none of them are actual diseases (but symptoms), all need to be medically treated lest they lead to termed “diseases”.

Indeed, causes of obesity are multifactorial and complex. However, for some, obesity is caused by genetic factor(s) and could be a life-long condition, which needs to be medically treated and individually managed.

Doses of Wisdom for Prevention

Obesity, in most cases, is a modifiable and preventable. Lifestyle, diet and physical activity are key factors to prevent, ease or slow down obesity even with aging.

So, please don’t see obesity as a death sentence, because it’s not.

Nutritional and physical approaches, that are within your control, can prevent dangerous fat buildup, and thus lower a risk for obesity as well as chronic diseases such as heart disease, diabetes and cancer.

Furthermore, getting a good night sleep and reducing stress are also beneficial for a healthy weight, because the stress cortisol can increase the amount of visceral fat your body stores.

Ultimately, consider to recruit your hidden microbial players, keeping them in harmony and happy, which could help your weight control.

Bonus: Valuable Principle on Diet

An optimal diet to manage obesity should be individual-focused and ensure a long-term maintenance of weight loss, along with the diet that’s safe, efficient, nutritionally adequate, culturally acceptable and economically affordable.

Critically important and specifically effective are diet plans including low-fat, low-carbohydrate, low-calorie but high-protein, high-fiber diet, and Mediterranean diet. Without fail, go for fiber-rich foods (e.g. fruits, vegetables and whole grains), because they are essential to boost growth and activity of beneficial gut microbiota.

Remember low-sugar diet too, as research findings indicate that a high-sugar diet increases visceral fat in humans and animals.

References (including Pt. 1 & Pt. 2) Click here

Image Credit: by FitWeightCare, CPD

Go Beyond Knowing Obesity Is Bad (Part 1)

By Hui Xie-Zukauskas

As you no doubt know, obesity is a condition of abnormal or excessive fat accumulation that may impair health. The condition results from genetic, behavioral, and environmental factors. Virtually everybody knows that obesity is bad for you; but in this post, I want to elaborate further. In particular, I’m going to emphasize FAT, the adipose tissue in our bodies.

Adipose tissue is not only an inert fat-storage tissue, but an active endocrine organ, being accountable for synthesizing and secreting several hormones and inflammatory substances – from angiotensin, leptin, TNF-alpha and IL-6 to adiponectin, just to name a few.

Let’s take one of them, angiotensin, as an example to explain the link between obesity and hypertension.

Fat tissue has a local renin-angiotensin system (RAS), which is well-known as an important regulator of blood pressure and a determinant of cardiovascular homeostasis. One of the components is angiotensin II (Ang II) generated from angiotensinogen (AGT). Ang II causes vasoconstriction, reducing the lumen of blood vessels, leading to elevated blood pressure.

Yiannikouris et al’s study (2012) provided compelling evidence that fat-derived AGT contributes to circulating AGT levels and blood pressure regulation.

Under normal condition, while most AGT in the blood comes from the liver, AGT produced by fat cells contributes significantly (~26%) to the circulating pool of AGT. Noticeably, in obese state, fat mass increases fat-derived AGT, which may become a major source of circulating AGT, leading to stimulated RAS, increased Ang II and elevated blood pressure. So, you can see how obesity is linked to hypertension through fat-derived AGT.

Now, what needs to be addressed is how fat mass is expanded. Well, increased caloric intake, a sedentary lifestyle, and/or various endocrine disorders can all promote the development of fat mass, leading to an increase in AGT gene expression and a high level of circulating AGT in obesity. Furthermore, with an increase in fat tissue and circulating AGT, increased Ang II initiates fat cell growth and thus enlarges fat mass. On the whole, RAS activation results in not only hypertension but also weight gain.

Next, let’s look at how the presence of fat on various tissues and organs impacts your health.

Fat on/around Blood Vessels

Under physiological condition, vascular endothelial cells, the inner lining of blood vessels, synthesize and release endothelium-derived nitric oxide (NO) and/or other relaxing factors that induce endothelium-dependent vasodilation, increase blood flow, and play a critical role in the regulating blood pressure. We now know that functional changes in endothelial cells and vascular smooth muscle cells contribute to the initiation and progression of cardiovascular diseases like atherosclerosis.

There is also fat tissue that structurally and functionally surrounds blood vessels.
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How could fat be involved in pathological changes?

Fat tissue around blood vessels can produce inflammation-promoting chemicals, subsequently promoting vascular diseases. Under conditions of hypercholesterolemia, high levels of reactive oxygen species (ROS, i.e. free radicals) can rapidly destroy NO and impair endothelium-dependent vasodilation; the abnormality is evident in various disorders such as diabetes, coronary artery disease and hypertension.

After feeding mice with a high-fat diet for 2 weeks, researchers found a reduction in anti-inflammatory factors and an increase in pro-inflammatory chemicals in fat tissue around blood vessels (i.e. perivascular fat), but not fat surrounding abdominal organs (i.e. visceral fat) and under the skin (i.e. subcutaneous fat) in these animals. Consistent with functional studies, these data suggest that pro-inflammatory factors derived from perivascular fat play a key role in the development of vascular dysfunction, and vascular dysfunction is likely an early sign of cardiovascular diseases.

High fat mass can also raise your LDL (i.e. bad cholesterol) and blood pressure, and cause insulin resistance – a risk for type-2 diabetes. My research has demonstrated that bad cholesterol (especially its oxidized form) can cause endothelial dysfunction and reduced blood flow in small brain arteries. Other researchers have also found that fat diet, together with overexpression of oxidized LDL’s receptor, can cause vascular dysfunction in small mesenteric arteries.

It is worth mentioning that obesity reduces adiponectin, a substance that is secreted from fat tissue and protects blood vessels against endothelial dysfunction. Clinical data show that lower levels of blood adiponectin are correlated to an increased risk of cardiovascular diseases.

How about fat inside blood vessels?

You have probably heard about the “plaque”, a combination of cholesterol, fat, calcium and other substances. In atherosclerosis, plaque builds up inside your arteries, grows larger due to chronic inflammation, and can eventually rupture. When this takes place, blood clots clog up the lumen of arteries, blocking blood flow and depriving oxygen supply. Consequently, heart attack and stroke may occur, depending on a clot’s location in the coronary or brain arteries.

Overall, as fat expansion outside and inside blood vessels, increased oxidative stress and chronic inflammation promote cardiovascular aging and diseases.

Please stay tuned to learn hidden fat on intra-abdominal and vital organs (Part 2).

References (including Pt. 1 & Pt. 2) Click here

Image by CPD

Emerging New Evidence on Pancreatic Cancer Risks

By Hui Xie-Zukauskas

This is a key topic on my editorial calendar this year due to the striking statistics of the increasing incidence and lethality of pancreatic cancer. For 2017, an estimated 53,670 people will be diagnosed with pancreatic cancer, and over 43,000 deaths resulting from it are expected in the U.S. alone (source: American Cancer Society).

Pancreatic cancer still has a very poor prognosis, with an overall survival of 5% over five years. The disease is remarkably aggressive, rarely diagnosed at an early stage, and difficult to treat due to its resistance to radiotherapy and chemotherapy. Therefore, the cancer’s cruelty creates a tremendous emotional burden for both patients and their loved ones. Even for survivors, the battles and treatments are brutal.

This does not mean we can do nothing.

To treat this horrible disease early and save more lives, identifying risk factors of pancreatic cancer and targeting high-risk people for effective screening are crucial. Therefore, steps to help prevent pancreatic cancer need everybody’s attention. A better understanding of the factors associated with pancreatic cancer can pinpoint preventive strategies to reduce its incidence.

Through literature review, I’ve compiled a list of risk factors for pancreatic cancer from research findings and emerging new evidence over the last 10 years. Here I share them with you in three categories.

First – Established risk factors

Cigarette smoking: It is consistently associated with a two-fold increase in pancreatic cancer risk. Cancer-causing agents (i.e., carcinogens) existing in tobacco products cause DNA damage, which lead to abnormal cell growth.
Obesity: Obesity produces an inflammatory state. Specifically, visceral obesity (i.e. belly fat) is linked to an increased risk for pancreatic and other cancers, independent of general obesity measured by body mass index (BMI).
Chronic inflammatory conditions: such as chronic pancreatitis, liver cirrhosis.
Diabetes: Particularly, type 2 diabetes is among a cluster of metabolic syndromes including hypertension, dyslipidemia, insulin resistance, and obesity.
Age (55+): The risk of developing pancreatic cancer increases with age.
Gender: Men are more likely to develop pancreatic cancer.
Inherited genetic mutation: Genetic factors accounts for ~10% pancreatic cancer.

Second – Emerging risk factors

Environmental risk: Exposure to mutagenic nitrosamines, organ-chlorinated compounds, or heavy metals is involved in the initiating phase of pancreatic cancer.

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Gut microbiota: The role of the microbiota in the development of pancreatic diseases is increasingly accepted. Gut bacteria translocation and small intestine bacterial overgrowth have been found in acute pancreatitis and chronic pancreatitis, respectively.
Infection: Helicobacter pylori (H. pylori) infection.
Ionizing radiation: Most relevant evidence comes from studies done on workers due to occupational exposure.

Let me add a bit more on invisible microbiota. Imbalance in gut microbiota is also related to other risk factors for pancreatic cancer (such as smoking, diabetes, and obesity). Furthermore, oral microbiota change in periodontitis is associated with an increased risk of developing pancreatic cancer.

Third – Preventable or modifiable risk factors

Sedentary behavior: Physical inactivity is directly and independently linked to multiple types of cancer.
Smoking: Smoking is the biggest preventable cause of cancer.
Excess alcohol intake
Dietary factors: A diet high in red and processed meats, fat, calories, and fructose may increase cancer risk. In contrast, a diet rich in whole wheat or whole grains, fiber, vegetables, and fruits is associated with reduced cancer risk.
Obesity: Obesity is a significant risk factor for more than 10 types of cancer, severe morbidities, and premature death; it is also considered the major modifiable risk factor for multiple cancers and chronic diseases.

Each cancer is different. Sadly, pancreatic cancer has struck individuals who were healthy, non-smokers, athletes, or as young as age 30-40.

In summary

Fighting against pancreatic cancer starts with learning about its risk factors so as to save preventable deaths in the larger population.

Meanwhile, there is hope – thanks to advanced research and technology that deliver better treatments or promising therapeutic options. So, let’s also remember HOPE.

Image credit: http://fatfplatform.org/risk-assessment/

22 Proactive Things You Can Do on World Cancer Day and Beyond

By Hui Xie-Zukauskas

February 4^th each year is designated as World Cancer Day. This day is significant because it

kicks off a drive to expand awareness of cancer and its prevention;
offers a chance to discover risk factors for cancer and take protective measures;
provides a time to reflect on what you can do to make a difference in the fight against cancer;
embraces people around the globe to fulfill whatever needs to be done to control this deadly disease; and
presents an opportunity to spread a message – We Can Save Millions of People from Preventable Deaths Each Year!

Lifestyle-centered cancer prevention is evidence-based and it’s science. It’s no longer a theory or hypothesis, or breaking news. Healthy lifestyle measures provide powerful ways to lower the risk for many types of cancer.

The theme of World Cancer Day for the current three years (2016-2018) is “We Can. I Can.” Surely, each of us can do something, no matter how small. So, I have compiled a list of actions you can take for World Cancer Day and every day after:

Set a “Cancer Patients First” agenda: Whether from a note, gift, prayer, or—best of all—a visit, let your friend battling cancer know you are with him or her in this fight.
Pack a tool kit for cancer awareness or a thoughtful kit for cancer care.
Remind your loved one to get a cancer screening. Early detection saves lives.
Change one unhealthy behavior, e.g., harmful sun exposure, intentional tanning, alcohol abuse, or tobacco smoking (smokeless tobacco causes cancer too). Importantly, stay on the right course.
Do something about early childhood weight management, especially control obesity in childhood cancer survivors. Unhealthy behaviors and overweight that develop early in life and persist over time can increase not only the risk for some types of cancer but also cancer-related mortality.
Host a Veggies/Vegetarian party or gathering (the size doesn’t matter). Alternatively, go on a Mediterranean diet. The point is to replace Western diet components, which are rich in refined grains, animal fats, excessive sugar, and processed meat but poor in fruits, vegetables, legumes, and whole wheat or whole grains. A substantial body of evidence has linked the Mediterranean diet to increased cardiovascular benefits and prevention of some chronic diseases.
Make a “Cancer Prevention” family dinner, or make a “Cancer Prevention Salad.” Family meals can be a cost-effective intervention for weight management. Evidence suggests that regular family meals protect against unhealthy eating and obesity in children. If time or schedule is challenging, get your teens and/or other family members involved.
Start or improve your weight management plan and actions. Make sure to have a balanced diet and exercise regime.
Enjoy an “Exercise Day” or “Move Day,” and at least, consider taking a 30-minute walk.
Take a “NO JUNK FOOD Day,” and limit red meats. Then do it often.
Drink filtered tap water at home. Drink plenty of filtered water away from home too.
Drink tea to replace sugar-rich beverages.
Better: Have a “Triple Combat” day, by combining three intensive but joyful actions together.
Give your unexplained pain some TLC by paying attention to it, tracking its duration, frequency or pattern, and scheduling a visit to your doctor.
Give cancer caregivers a token of love to honor their labor of love.
Write or speak to your local/national legislator or lawmaker about a policy idea to make food systems safer or make the environment safer.
Speak out or stand up against any external source that potentially promotes cancer.
Volunteer for a cancer fundraising or a cancer care center.
Support the great cause of fighting cancer in any form you can.
Parents and teachers: Advise your girls and boys to vaccinate against HPV. Recommended vaccination starts at age 11 or 12.
Go along with proven strategies to prevent cardiovascular disease (CVD). Why? Because doing whatever is practical or plausible to lower your risk of CVD will enhance your potential to reduce the risk of cancer. For instance, research findings indicate that proven preventive measures for CVD are identical to preventive actions for prostate cancer.
Take pancreatic cancer seriously. Based on the proposed “pancreatic injury−inflammation−cancer” pathway, it’s critical to avoid risk factors such as smoking, chronic pancreatitis, diabetes, and obesity. Pancreatic cancer remains a complex, lethal malignancy with the worst prognosis, and a lack of early diagnostic symptoms. It’s also resistant to conventional chemo- and radiation therapies. The rate of its incidence is slowly increasing.

The list can go on and on…

By now, you likely see a clearly centered theme—prevention, which is the most cost-effective implement to fight cancer.

Remember: Cancer doesn’t develop overnight. It’s vitally essential to stick to a healthy lifestyle. Take protective measures such as enjoying a balanced diet, regular physical activity, and a healthy weight now and far beyond World Cancer Day.

And yes, every single small step counts! It’s a life-course approach.

Image credit: Designer at <a href=”http://www.freepik.com/free-photos-vectors/medical”>Medical vector designed by Ibrandify – Freepik.com</a>

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Links between Obesity, Diabetes, and Colon Cancer

By Hui Xie-Zukauskas

Colorectal cancer remains the 3^rd most common cancer and is the 2^nd leading cause of cancer-related deaths in the United States.

The causes of colon cancer are multi-factorial. They include cellular, molecular, and genetic factors, as well as dietary and lifestyle factors. Today, I’m going to focus on one significant yet modifiable risk factor, obesity.

We start with a glimpse at the numbers.

The incidence rate of obesity is alarmingly high among U.S. adults based on CDC data. Rates for different age groups include middle-aged (40.2%), older (37.0%), and younger (32.3%). Also, about 17% of children and adolescents (age 2-19) are obese.

More than 29 million adults and children in the U.S. have diabetes. 86 million Americans have pre-diabetes, a condition that can lead to type-2 diabetes. Note that an estimated one in two seniors has pre-diabetes.

Obesity may be a factor in approximately 300,000 deaths each year. Diabetes will cause an estimated 75,578 deaths and colorectal cancer, an expected 49,190 deaths in 2016.

A look beyond the numbers

Obesity is a leading cause of diabetes, a disease for which the body fails to control blood sugar levels. High blood sugar levels are characteristic of both obesity and diabetes. What is less well known is that diabetes and obesity are also linked to an increase in cancer risk.

In fact, obesity is linked to many types of cancer (colon, esophageal, thyroid, breast, prostate, uterine, kidney, pancreas, gallbladder and non-Hodgkins lymphoma) and, needless to say, heart disease, stroke, and other chronic illnesses.

Research shows that obesity and diabetes are associated with an increased risk of developing colon cancer.

Intrinsic links between obesity, diabetes, and colon cancer are vastly complicated. One clear tie is sugar. High levels of blood sugar are a characteristic in both obesity and diabetes. High blood sugar also makes us predisposed to cancer by increasing the activity of a gene involved in cancer progression. Apparently, dietary sugar is a link tying together obesity, diabetes, and colon cancer, and thus excess sugar has an impact on our risk for cancer.
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Certainly, other links play a causal role. For instance, chronic inflammation is a central process that likely leads obese individuals to an elevated risk of diabetes and colon cancer, which all three conditions share a common inflammatory loop participated by multiple cell signaling molecules, growth and nuclear factors.

Highlighted Call for Actions

1. Colon Cancer screening

If you or your loved ones turn 50, you all should begin screening for colorectal cancer and then continue getting screened at regular intervals. This is because colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Colorectal polyps can be found by screening and then removed before they develop into cancers. Plus, any developing cancer can be found earlier by screening when treatment works best.

2. Diabetes Control

Early intervention is critical to preventing or delaying the onset of type-2 diabetes. Good news for our nation’s seniors is that Medicare will extend coverage for pre-diabetes care. Check out the National Diabetes Prevention Program, a preventive health initiative via the Center for Medicare & Medicaid Innovation.

3. Healthy Weight Management

Nutrition and balance diet, weight loss, daily physical activity and healthy lifestyle are all beneficial for keeping weight down. Look for further details in CancerPreventionDaily earlier posts.

In brief, obese people are at a higher risk for developing cancer. Also, an obese condition is often resistant to chemotherapy regimens. The bottom line is that obesity prevention is a key life-saving approach.

Image source: CancerPreventionDaily

How do you integrate vascular health and cancer prevention?

By Hui Xie-Zukauskas

For those who may be unaware of what cancer and heart disease share in common, today I wish to remind you of why I talk about cardiovascular diseases. When I started this website, with its focus on cancer prevention, I had a well thought-out approach to maximize your benefits for heart health as well. To put it simply, there are many practices that will help you “kill two birds with one stone”—both cancer and heart disease.

So today, let me elaborate on cardiovascular risk factors that a cancer-prevention lifestyle can help allay.

First, let me ask you, Do you know if you have peripheral vascular diseases (PVD) or not? About 20 million of people in the United States are suffering from PVD, yet they don’t even know it. What does that have to do with cancer prevention? Please read on.

What is PVD, and what is PAD?

Almost everyone knows about atherosclerosis. Well, PVD is one of the major clinical complications of atherosclerosis. It affects blood vessels outside of the heart and brain, e.g. those of your body’s extremities.

When PVD only develops in the arteries, it is usually called peripheral arterial disease (PAD), which results in reduced blood flow to the lower extremities. PAD is predominantly caused by the buildup of fatty plaque in small arteries, resulting in the narrowing of those arteries, blocking blood flow from the heart to the legs. Consequently, the hallmark of PAD is extreme pain or painful cramping in the legs.

However, many folks with PAD experience no symptoms. That is why it is important to raise public awareness.

PAD and aging

PAD is neither a men’s nor a women’s disease—it is more of an aging disease. According to the NIH and CDC, one in every 20 Americans over age 50 has PAD, and approximately 12-20% of people older than age 60 have it. By age 80, 20-25% of Americans have PAD.

What are the risk factors for PAD?

So far, we have covered two already:

Atherosclerosis
Aging

Other risk factors include:

Smoking
Diabetes
High blood pressure
High cholesterol or abnormal cholesterol – too much “bad” LDL cholesterol and too little “good” HDL cholesterol
Being overweight or obese
Family history of high cholesterol, high blood pressure, or cardiovascular disease (stroke, coronary artery disease, or PVD).
Stress

What does learning about PAD have to do with cancer prevention?

The table below shows the risk factors that cancer and PAD have in common.

Risk Factors	Cancer	PAD
Aging	√	√
Tobacco use / Smoking	√	√
Obesity	√	√
Being physically inactive	√	√
Inflammation	√	√ indirectly, because it’s linked to atherosclerosis
Stress	√	√
Diabetes	√	√
Junk diet (high fats, high sugar, excessive salt)	√	may lead to other risk factors above
Hormonal imbalance	√

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Without distracting from today’s focus, I have addressed each of risk factors in previous CancerPreventionDaily Summer Health Education Series, and you can learn more by visiting CancerPreventionDaily.com

What’s the take-away message?

PAD is under-diagnosed and lacking in public awareness, yet its incidence increases with age disturbingly.
Make a cancer-prevention lifestyle your priority. Lifestyle modification is one of the keys to controlling and preventing PAD as well as cancer.
Take action using the “Five Seconds Rule”—meaning that whether you consult with your physician or change one unhealthy lifestyle habit, take one small step at a time and do it now!

Image credit: CDC

Cancer Prevention Daily

Lifestyle for Staying Cancer-free & Solutions to Cancer Prevention

Category Archives: Obesity Prevention

Cardiovascular Disease (CVD) on the New Spotlight

Rethink Obesity and Reshape Your Health

Stop Childhood Obesity or Dangerous Risks Persist

What Holiday-Indulging and Junk-Eating Have in Common

Go Beyond Knowing Obesity Is Bad (Part 2)

Go Beyond Knowing Obesity Is Bad (Part 1)

Emerging New Evidence on Pancreatic Cancer Risks

22 Proactive Things You Can Do on World Cancer Day and Beyond

Links between Obesity, Diabetes, and Colon Cancer

How do you integrate vascular health and cancer prevention?