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Moms and Smoking; Apple
Juice and Colon Cancer; Green Tea and Skin Cancer
August 15, 2005
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by Robert A. Wascher, M.D., F.A.C.S.
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THE POWER OF NICOTINE: SMOKING MOM-TO-BE
The British Medial Journal: By now, everyone knows (or
should know) that nicotine is enormously addictive, and that
smoking is the single greatest cause of preventable disease
and death in the world. It is also common knowledge that
smoking during pregnancy subjects a mother’s unborn baby to
the very same genetic mutations that are known to arise in
smokers. Moreover, other complications now known to be
associated with smoking by pregnant mothers include abnormal
development of the placenta, low birth-weight, cleft palate
and cleft lip, and a doubling of the risk of babies dying
from Sudden Infant Death Syndrome (SIDS). Asthma, learning
disabilities and behavioral disorders are among the other
long-term ailments that have also been strongly linked to
smoking during pregnancy, and smoking following delivery.
In view of these seemingly incontrovertible facts, I am
always stunned and, I must confess, angry when I see an
obviously pregnant woman smoking (i.e., as opposed to my
baseline sense of astonishment whenever I see anyone,
pregnant or not, smoking…). Although I certainly understand
the potent addictive qualities of nicotine, the obvious and
profound conflict between maternal instinct and drug
addiction (the arbitrary legality of tobacco in no way
detracts from the fact that nicotine is an addictive drug
that makes people “feel good”) is so stark, in my mind, that
I never fail to become upset when I see a mom-to-be puffing
away.
In the face of this enormous conflict between smoking and
pregnancy, an interesting new study has looked at the impact
of in-home motivational counseling on tobacco cessation
among expectant mothers who smoke. A group of 762 pregnant
smokers were randomly divided into two groups for the
purposes of this study. All of the women received standard
health counseling during their prenatal visits, while the
351 women in the intervention group also received regular
in-home motivational counseling visits from specially
trained midwives. In addition to serially interviewing all
of the 762 women regarding their progress with smoking
cessation, all of the women also had blood or saliva
collected to measure the concentration of a metabolic
breakdown product of nicotine.
In this group of smokers who, one would think, should be
among the most motivated to quit, only 4.8% in the
intervention group quit, while essentially the same number
in the control group (4.6%) quit. Thus, in this group of
pregnant women, intensive in-home motivational counseling
had absolutely no discernible impact on smoking cessation.
As surprising as this disappointing outcome might be to some
people, the results of this study mirror my own experiences
as a physician over nearly two decades now. Smokers subject
not only themselves to the well-known health risks of
smoking, in order to continue their nicotine addiction, but
many of them also choose to subject their children (born and
unborn) to the same severe health risks as well….
APPLE JUICE & COLON CANCER PREVENTION
Carcinogenesis: There is a great deal of research underway
at this time, looking at how dietary and supplemental
products might help to prevent disease, including cancer.
Unfortunately, most of this research has either not found
significant health benefits for such products, or the
apparent benefits observed in a culture dish in a lab, or in
mice, have not been successfully reproduced in humans as of
yet. (Indeed, this area of research is so confusing, and
seemingly contradictory, to most people, that I am currently
writing a book on the subject: “What You Don't Know Can Kill
You: A Clinically Proven Plan to Reduce Your Risk of Dying
from Cancer!”) Because of these factors, it is wise to
approach each new research paper with a healthy bit of
skepticism. However, studies that look into the biochemical
effects of products and substances thought to have
anticancer effects are of special concern to me, as much of
the clinical literature looking at cancer prevention in
humans is survey-based and, consequently, the results of
such studies are not very compelling, scientifically.
Unfiltered apple juice, containing more of the solid
components of apple pulp than filtered, or clear, apple
juice, was tested in rats in an effort to identify any
anticancer properties in the colons of these animals. Rats
were randomized to receive drinking water alone, clear
filtered apple juice, or unfiltered cloudy apple juice,
while receiving injections of a chemical known to cause
colon cancer in rodents. After 7 weeks, microscopic
examination of the animals’ colonic lining was undertaken.
Under the microscope, specific precancerous changes in the
cells of the rats’ colons were significantly less common in
the animals that had consumed the unfiltered cloudy apple
juice when compared to the animals that had consumed plain
water or clear filtered apple juice. At the same time, other
specific premalignant changes were less common in all of the
animals that received apple juice, both filtered and
unfiltered. This is an interesting finding, as both filtered
and unfiltered apple juice are rich in compounds known as
polyphenols, which are thought to have anticancer activity.
The findings of this study, therefore, suggest that there
may be other important compounds within the pulp of apples
that, likewise, possess potential anticancer properties.
Although the findings of this study are a very long way from
proving that apple juice, whether filtered or unfiltered,
might reduce a person’s risk of developing colon cancer, it
is still a very interesting little study, and additional
similar studies should be undertaken with human volunteers.
GREEN TEA & CAFFEINE MAY REDUCE SKIN CANCER RISK
Carcinogenesis: Another dietary supplement that has garnered
considerable attention within the cancer prevention
community is green tea, which, like apples, is also known to
be rich in polyphenols. A new study, involving mice, looked
at the effects of green tea, and caffeine, on the prevention
of early precancerous changes in the skin of mice subjected
to intense ultraviolet light (UVL) skin exposure. Mice were
treated, alternatively, with oral green tea or oral caffeine
solution during the period of UVL irradiation, and their
irradiated skin was then analyzed under a microscope,
looking for characteristic mutations in a protein known as
p53, which is an early event in the development of UVL-induced
skin cancer. This study found that, compared to a group of
mice that received only water, the mice that consumed either
green tea or caffeine experienced a 40% reduction in the
number of precancerous patches within UVL-exposed skin. Once
again, this is an interesting laboratory study in nonhuman
animals, and the findings of this elegant little study may
not effectively translate into humans. Still, the results of
this experiment raise the possibility that oral green tea or
caffeine supplements might reduce the early precancerous
changes in UVL-exposed skin when taken at the time of
exposure. As always, however, avoidance of the sun’s rays,
particularly during peak UVL periods, between 9 AM and 4 PM,
is the best method of preventing UVL-induced skin cancer,
especially in fair-skinned individuals.
SECONDHAND SMOKE EXPOSURE IN CHILDREN: ANOTHER RISK FACTOR
FOR DIABETES AND HEART DISEASE?
Circulation: The so-called Metabolic Syndrome refers to a
constellation of abnormalities that include obesity,
abnormal cholesterol levels, high blood pressure, and
elevated sugar in the blood (sometimes also referred to as
“insulin resistance,” or “pre-diabetes”). Following the
recent explosion in both adult and childhood obesity in the
United States, the prevalence of the Metabolic Syndrome in
both populations is the subject of much concern within the
public health community. This syndrome is associated with a
very high incidence of subsequent cardiovascular disease, to
include stroke, as well as diabetes, high blood pressure,
and early death.
A new study, involving 2,273 adolescent subjects ages 12 to
19, evaluated the presence or absence of household smokers,
the self-reporting of smoking by the adolescent subjects,
and the measured blood levels of nicotine byproducts in the
blood of the adolescents. Among the adolescents with no
tobacco exposure (either firsthand or secondhand), 1.2% met
the criteria for Metabolic Syndrome. Among the kids exposed
to secondhand smoke alone, 5.4% met the criteria for
Metabolic Syndrome. Among the subjects that smoked
themselves, 8.7% met the criteria for Metabolic Syndrome.
Following statistical analysis to balance other risk factors
(e.g., diet, level of exercise, family history of
cardiovascular disease or diabetes, etc.), adolescents who
were chronically exposed to secondhand smoke were found to
have nearly 5 times the risk of developing Metabolic
Syndrome when compared to kids who were not exposed to
tobacco smoke in any form, while adolescents who actively
smoked themselves were at more than 6 times the risk of
developing Metabolic Syndrome.
Given that smoking and obesity are the two leading causes of
preventable death in the United States, the finding that
exposure to tobacco smoke, both firsthand and secondhand, is
associated with an increased risk of the Metabolic Syndrome
is ominous, indeed….
Dr. Robert A. Wascher
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