Multivitamins and cancer

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Observational studies have not shown a consistent decrease in cancer risk with multivitamin use.

• A large randomized trial of multivitamins, involving over 14,000 men has demonstrated a small, statistically-significant reduction in total cancer risk in the multivitamin group (1). The study included male physicians 50 years and older at recruitment. At a mean follow-up of 11.2 years, there was a reduction in total cancer from 18.3 to 17.0 events per 1000 person-years but there was no impact on cancer mortality.

• In the past a systematic review of 38 studies found that neither vitamin C nor vitamin E supplementation was beneficial for prevention of cancers (2).

• A 2006 NIH consensus concluded that “present evidence is insufficient to recommend either for or against the use of multivitamin supplements by the American public to prevent chronic disease” (3).

• A long-term randomized trial in women found no evidence that supplementation with vitamin C, E, or beta-carotene decreased cancer incidence or mortality (4).

• Two long term observational studies found no association between multivitamin use and risk of cancer. (5,6)

Currently it has not been established that multivitamin and mineral supplements provide added benefit to a balanced, healthful diet for most individuals.

References

1. Gaziano JM, Sesso HD, Christen WG, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2012;308:1871.

2. Coulter ID, Hardy ML, Morton SC, et al. Antioxidants vitamin C and vitamin e for the prevention and treatment of cancer. J Gen Intern Med 2006;21:735.

3. NIH State-of-the-Science Panel. National Institutes of Health State-of-the-science conference statement: multivitamin/mineral supplements and chronic disease prevention. Ann Intern Med 2006; 145:364.

4. Lin J, Cook NR, Albert C, et al. Vitamins C and E and beta carotene supplementation and cancer risk: a randomized controlled trial. J Natl Cancer Inst 2009;101:14.

5. Neuhouser ML, Wassertheil-Smoller S, Thomson C, et al. Multivitamin use and risk of cancer and cardiovascular disease in the Women’s Health Initiative cohorts. Arch Intern Med 2009;169:294.

6. Park SY, Murphy SP, Wilkens LR, et al. Multivitamin use and the risk of mortality and cancer incidence: the multiethnic cohort study. Am J Epidemiol 2011;173:906.

Hepatitis A, E and Typhoid are the hygiene markers of a city

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It is diseases such as jaundice with hepatitis A in children and E in adults, typhoid, cholera and gastroenteritis that reflect the hygiene status of a city and not the occurrence of dengue and malaria.

Food and water–borne diseases can be eradicated by the following public awareness formula: When in doubt follow the principle, “heat it, boil it, cook it, peel it or forget it”. In an unhygienic environment, one can eat an orange or a banana but not tomato or apple. Other steps are:

  • Do not take salad that has been left open for more than 2 hours even if it is washed properly.
  • Do not take cooked food that has been left on the table for more than two hours.
  • Vegetables grown under the ground or over the surface of the ground should be washed properly before eating them raw. They may be the biggest source of worm infection in the brain, a condition called neurocysticercosis.
  • Boiled water is the safest water to drink.
  • Ice made from unhygienic water can be the source of most water–borne diseases.
  • It is our duty to keep our home and city as clean as possible. We must regard our city as our extended home, a garden as our farmhouse and roads as our personal walking tracks.

Most food and water-borne diseases are self–inflicted and can be managed by a simple step of washing hands before and after using the toilet and before and after consuming any food.

Restricting salt in diet can lower heart disease risk

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Restricting salt in the diet can lower the risk of developing heart disease by 25 percent and the risk of dying from heart disease by 20 percent.

Dietary intake of sodium among Indians is excessively high. Quoting a Harvard Medical School study published in British Medical Journal, Dr Aggarwal said that among hypertensive individuals, lowering sodium is quite well established to lower blood pressure, but now it has been shown that reducing salt also has an effect on cardiovascular disease.

When people with pre hypertension (blood pressure more than 120/80 and lower than 140/90), reduced their salt intake by about 25 to 35%, they were 25% less likely to develop cardiovascular disease 10 to 15 years after the trial ended. There was also a 20 percent lower death rate from cardiovascular disease among those who cut their salt consumption.

Salt restriction is best achieved by avoiding salted, salt cured and salt smoked foods such as lunch meat, hot dogs, ham, olives, pickles and regular salted canned foods, and other prepared foods, which often use more salt than homemade equivalents. Foods we would never think of as salty, such as breakfast cereals, cookies, and even some soft drinks, often contain copious additions of sodium.

WHO recommends limiting the salt intake to less than 5 grams per day.

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