Men should not stop using Avodart because of heart attack fears! Life Extension’s Rebuttle

Life Extension’s rebuttal by William Faloon in reference to published clinical study in Thursday’s New England Journal of Medicine on Avodart and increased risk for sudden myocardial infarction.

I suspect none of the study participants where using testosterone creams, even though they were ALL likely to be testosterone deficient. You will soon read the findings of an internal study we did on Life Extension Foundation members that found 86% of men have less than optimal testosterone levels.

The significance of this is that testosterone deficiency predisposes a man to heart failure. By taking a drug like Avodart when in a testosterone deficient state, the heart muscle will be robbed completely of this vital anabolic hormone. That may be why this study showed higher heart failure rates in the Avodart group.

 Those with prostate cancer often intentionally suppress their testosterone levels and have to be extra vigilant in protecting against heart attack. Log on to http://www.lef.org/magazine/mag2009/mag2009_05.htm for information on how to protect against multiple risk factors underlying coronary atherosclerosis.

 Aging men (without prostate cancer) should do whatever is necessary to maintain free testosterone blood levels of 20-25 pg/mL, while keeping DHT blood levels at the very low end of the reference range.

This provides the heart, brain and other vital parts their testosterone requirements while protecting the prostate gland against the adverse effects of excess DHT.

 The Avodart study exposes the flaws in so many of these single agent trials. We know, for example, that 25-hydroxyvitamin D serum levels strongly predict prostate cancer risk. If this potent confounding factor was not accounted for, then the results shown with Avodart have little meaning.

If, for example the placebo group’s median 25-hydoxyvitamin D level was 35 ng/mL, and the Avodart group was only 25 ng/mL, this would skew the results in a way to show Avodart less effective than it may really be. Dietary intakes of cruciferous vegetables would have an equally significant confounding effect.

 Bill Faloon

Greater soy consumption associated with lower breast cancer risk in women

Greater soy consumption associated with lower breast cancer risk in women

An article published in the latest issue of the journal Nutrition and Cancer (volume 60, issue 5) revealed the finding of Korean researchers of a protective effect of soy on the risk of developing breast cancer. The study’s conclusion supports that of previous research concerning soy’s effect on breast cancer risk.

Scientists at Hanyang University in Seoul, Korea compared 362 women diagnosed with breast cancer with an equal number of healthy women matched for age and menopausal status. Participants were interviewed concerning their diets, which included tofu, soybean paste, boiled soybeans and soy milk. Total soy protein intake was used as a measure of total soy food consumption.

Compared with women who did not have breast cancer, those who were diagnosed with the disease were likelier to consume more carbohydrates and less likely to drink alcohol or use multivitamin supplements. Women with breast cancer also had fewer children. High soy protein intake was associated with a reduced risk of breast cancer. Among premenopausal women whose intake of soy protein was among the top 20 percent of participants, there was a 61 percent lower adjusted risk of breast cancer compared with those in the lowest 20 percent. For postmenopausal women, the risk experienced by the highest soy protein intake group was 78 percent lower, although the dose-response relationship observed in premenopausal women was not noted in this group. When tofu consumption was separately analyzed, it emerged as protective for premenopausal women only, with those in the top fifth of tofu intake having a 77 percent lower risk of breast cancer than those in the lowest.

Isoflavones contained in soy may effect the development of breast cancer by competing with the body’s own estrogens in binding to estrogen receptors. They may also lower breast cancer risk by increasing sex hormone binding globulin, which reduces blood estrogen levels. Additionally, research suggests that soy isoflavones may inhibit the aromatization of circulating androgens to estrogens in postmenopausal women. Furthermore, there is evidence that soy protein (without isoflavones) can suppress the development of mammary cancer in an animal model. Isoflavones may work in conjunction with soy protein to exert the benefits associated with soy intake.

The researchers recommend their results be interpreted with caution, due to the controversy that exists concerning soy’s possible effects on breast cancer. Nevertheless, the present study’s findings could help support the use of soy as one component of a health-promoting diet. “Our findings, if confirmed, can provide a dietary guideline for the prevention of breast cancer,” the authors conclude.

Higher vitamin C levels associated with lower blood pressure in young women

Higher vitamin C levels associated with lower blood pressure in young women

In an article published online on December 17, 2008 in Nutrition Journal, Gladys Block of the University of California, Berkeley and her associates report that young women who have higher plasma levels of vitamin C have lower systolic and diastolic blood pressure as well as a reduced increase in blood pressure over a one year period compared with those whose levels of the vitamin are low.

The current analysis included 242 African-American and Caucasian participants in the National Heart, Lung and Blood Institute Growth and Health Study, a ten year longitudinal study designed to evaluate the development of obesity in adolescent girls aged 8 to 11 upon enrollment. Blood pressure was measured at the ninth and tenth annual follow-up visit, and blood samples obtained at the tenth visit were analyzed for plasma ascorbic acid (vitamin C) levels.

Following adjustment for body mass index and other factors, the research team found that women whose plasma vitamin C levels were among the top 25 percent had systolic blood pressure that averaged 4.66 mmHg lower and diastolic blood pressure that averaged 6.04 mmHg lower than women whose vitamin C was in the lowest 25 percent. When blood pressure readings from the tenth year of the study were compared with those of the ninth year, women with plasma vitamin C in the lowest 25 percent were found to have experienced an average diastolic increase of 5.97 mmHg, while those whose vitamin C levels were highest had only a 0.23 mmHg increase. A similar effect was observed for systolic blood pressure.

In their discussion of the findings, the authors remark that the antioxidant effect of vitamin C helps protect against oxidative mechanisms involved in the development of hypertension. Additionally, in a clinical trial conducted by Dr Block and colleagues, vitamin C was shown to reduce C-reactive protein, a marker of inflammation, which is associated with endothelial dysfunction and high blood pressure. “Thus, vitamin C may have a beneficial effect on blood pressure by mitigating the adverse effects of inflammation and oxidative stress,” they write.

The authors note that their results were comparable in magnitude to those of the Dietary Approaches to Stop Hypertension (DASH) trial, which found a 5.5 mmHg average reduction in systolic blood pressure and a 3.0 mmHg average diastolic reduction in participants who consumed the DASH diet. They suggest that increasing plasma vitamin C to levels comparable with those of participants in the top one-fourth of the current study might achieve a similar effect.

“The findings suggest the possibility that vitamin C may influence blood pressure in healthy young adults,” the authors conclude. “Since lower blood pressure in young adulthood may lead to lower blood pressure and decreased incidence of age-associated vascular events in older adults, further investigation of treatment effects of vitamin C on blood pressure regulation in young adults is warranted.”

Vitamin D deficiency: emerging cardiovascular disease risk factor

emerging cardiovascular disease risk factor

A review published in the December 9, 2008 issue of the Journal of the American College of Cardiology describes the involvement of deficient vitamin D levels in common risk factors for cardiovascular disease (including high blood pressure, diabetes, and obesity) and in cardiovascular events.

Vitamin D deficiency is estimated to affect up to half of all adults and 30 percent of children in the United States. While the vitamin’s role in bone health has long been known, a flurry of recent studies have uncovered associations between deficient levels of the vitamin and a number of diseases, including cardiovascular disease. In their review, Michael F. Holick, MD, PhD and colleagues note that insufficient levels of vitamin D activate the renin-angiotensin-aldosterone system, which can lead to hypertension and thickening of the heart and blood vessel walls. Altered hormone levels related to a deficiency of vitamin D (which is also a hormone) increase the risk of diabetes, which is a well known risk factor for the development of cardiovascular disease. In 15,088 subjects from the NHANES III national cohort registry, higher vitamin D levels were related to a lower risk of diabetes as well as hypertension, high triglycerides, and obesity. And among Framingham Heart Study participants who had levels of vitamin D of less than 15 nanograms per milliliter upon enrollment, the risk of subsequent cardiovascular events was twice as great as the risk experienced by those with higher levels of the vitamin.

Chronic vitamin D deficiency is associated with secondary hyperparathyroidism, which increases the risk of inflammation and cardiovascular events. Elevated parathyroid levels were associated with an increased risk of death among older individuals compared to those with normal levels over the course of follow-up in a recent observational study.

“We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight,” stated review coauthor James H. O’Keefe, MD, who is a cardiologist and director of Preventive Cardiology at the Mid America Heart Institute in Kansas City, Missouri. The authors’ strategy for restoring vitamin D to optimal levels in cardiovascular disease patients includes initial treatment with 50,000 international units (IU) vitamin D2 or D3 weekly for 8 to 12 weeks followed by maintenance with 1,000 to 2,000 IU daily. They also suggest limited sun exposure as a means of increasing vitamin D. They observe that supplementation with vitamin D is safe and that such effects as elevated calcium levels and kidney stone development have only rarely been observed among individuals who consume 20,000 IU per day or more.

“Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated,” stated Dr O’Keefe. “Vitamin D is easy to assess, and supplementation is simple, safe and inexpensive.”

“Restoring vitamin D levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis,” Dr. O’Keefe concluded. “We need large randomized controlled trials to determine whether or not vitamin D supplementation can actually reduce future heart disease and deaths.”

Western diet accountable for nearly a third of the world’s heart attack risk

Western diet accountable for nearly a third of the world’s heart attack risk

An article published online on October 21, 2008 in Circulation: Journal of the American Heart Association estimates that the diet typically consumed in Western countries, consisting of high amounts of meat, fried foods, and salty snacks, is responsible for approximately 30 percent of heart attack risk worldwide.

Salim Yusuf, DPhil and colleagues analyzed data from the INTERHEART study of heart attack risk factors among 16,000 participants in 52 countries. Five thousand seven hundred sixty-one participants diagnosed with heart attack were compared to 10,646 participants without known heart disease. The subjects were interviewed concerning dietary intake, including healthy as well as unhealthy food consumption. The researchers identified three dietary patterns, which they labeled as Oriental, prudent or Western. Oriental diets were characterized by a higher intake of tofu, soy, and other sauces, the prudent pattern contained a greater intake of fruit and vegetables, and the Western diet included an increased amount of meat, eggs, salty snacks and fried foods.

While followers of a “prudent” diet had a 30 percent lower average heart attack risk compared with people who consumed few fruits and vegetables, those who reported a Western dietary pattern experienced a 35 percent greater risk of heart attack than those who consumed few or no fried foods or meat.

The Oriental pattern showed no effect on heart attack risk. While some components of an Oriental diet appear to help protect the heart, the researchers suggest that the diet’s high sodium content could modify this benefit.

“A simple dietary score, which included both good and bad foods with the higher score indicating a worse diet, showed that 30 percent of the risk of heart disease in a population could be related to poor diet,” concluded lead author Romania Iqbal.

“The objective of this study was to understand the modifiable risk factors of heart attacks at a global level,” stated Dr Yusuf, who is a professor of medicine at McMaster University and director of the Population Health Research Institute at Hamilton Health Sciences in Ontario, Canada. “This study indicates that the same relationships that are observed in Western countries exist in different regions of the world.”

Supplemental vitamins C and E reduce post-heart attack deaths in diabetics

Supplemental vitamins C and E reduce post-heart attack deaths in diabetics

In a communication published online on August 12, 2008 in the journal Cardiology, researchers at Grochowski Hospital and the Polish Academy of Sciences in Warsaw report the results of a preliminary study which found that supplementing diabetic patients with vitamins C and E significantly reduced mortality over a thirty day period following acute myocardial infarction (heart attack). The presence of diabetes is known to adversely affect heart attack outcome.

The study included 800 participants in the Myocardial Infarction and Vitamins (MIVIT) study, a placebo-controlled clinical trial designed to assess the safety and outcome of the antioxidant vitamins C and E in heart attack patients. Subjects were randomized to receive a 12 hour intravenous infusion of one gram vitamin C followed by 400 milligrams vitamin C plus 200 milligrams vitamin E administered orally three times per day, or a placebo regimen.

The researchers compared 30-day cardiac mortality among those who received the vitamins with that of subjects who received the placebo. Although deaths were the same for the treatment and placebo groups in nondiabetic subjects, among the 122 diabetics, mortality was 68 percent lower in those who received the antioxidant vitamins.

The authors remark that the vitamins have synergistic activity, resulting in a reduction in reactive oxygen species formation in heart attack patients. In diabetics, elevated blood sugar significantly increases reactive oxygen species, leading to increased endothelial damage and endothelium-derived nitric oxide inactivation. Additionally, these free radicals play a role in the development of diabetes.

“Early administration of appropriate doses of antioxidant vitamins C and E in diabetic patients with AMI seems to be particularly reasonable in view of increased reactive oxygen species formation in these patients,” the authors conclude. “This may explain the beneficial effects of antioxidant vitamins observed in our study.”

Disability rates may not increase with very old age

Disability rates may not increase with very old age

A report published online this week in the Proceedings of the National Academy of Sciences confirmed that increasing rates of disability may not be inevitable among the very old, who are the fastest growing population segment in the Western world. In an article entitled, “Exceptional longevity does not result in exceptional levels of disability,” researchers in Denmark and at the Max Planck Institute in Germany conclude that the concern regarding an increased burden of care-giving associated with more people joining the ranks of the very old may be unfounded.

Kaare Christensen at the Danish Aging Research Center at the University of Southern Denmark and colleagues studied 2,262 Danish men and women born in 1905. The subjects were surveyed in 1998, and in 2000, 2003, and 2005 to evaluate physical functioning, cognitive function, and depression levels.

At the beginning of the study, 39 percent of the subjects were classified as independent: defined as being able to perform activities of daily living without assistance and having adequate cognitive function. This percentage declined by an additional 6 percent by 2005 among the 166 surviving participants, an amount considered “modest”.

The authors write that with improved medical treatment and education, as well as a reduction in the number of those who smoke among those entering the oldest-old population, a decrease in disability among this age group can be expected.

“It has been postulated that life extension would provide only increased chances of being frail and existing in a vegetative state, with huge personal and societal costs,” the authors write. “Our study does not support this grim prediction. On the contrary, our findings suggest that the characteristics of a cohort do not change much in an age range from 92 to 100 years in central domains such as physical and cognitive functions and depression symptomatology.”

“Our finding also suggests that individuals who survive into the highest ages have a health profile that is similar in many aspects to that of individuals who are 7 or 8 years younger,” they conclude. “This suggests that most individuals can expect to experience physical decline before they die, but the postponement of this individual decline makes it possible for us to live into the fourth age.”