Healthy Aging: Body, Mind & Spirit

Non-pill solutions for erectile dysfunction

The Food and Drug Administration just approved the first new pill for ED in a decade.   But Stendra, also known as Avanafil, works the same way and is likely to work for the same men as previous pills.

Stendra does have one new selling point: “It acts a little quicker,” often in about 15 minutes, says Wayne Hellstrom, a professor of urology at Tulane University in New Orleans. He worked on clinical studies for drugmaker Vivus Inc.  The other drugs typically take effect in 30 to 60 minutes.  The drugs all increase blood flow to the penis, and men who take any of them can get side effects such as facial flushing, headaches, upset stomachs and stuffy noses.

Still, these heavily marketed pills are not the whole answer to a problem estimated to affect 30 million American men and their partners.

For one thing, they don’t work for everyone: The 40% to 60% of men who get results are likely to have milder ED (they can still get some spontaneous erections), are in stable relationships and do not have a long list of other health problems.   Those health problems — including heart disease, diabetes and obesity.  But many cases of ED could be prevented or improved with the same lifestyle choices that improve overall health, especially heart health.

Experts are developing ED prevention guidelines based on studies showing links with risk factors for cardiovascular disease, including smoking, obesity, lack of exercise and poor diets.  Those links are so strong that doctors now know that a man in his 40s who arrives in a doctor’s office with ED is at high risk for an eventual heart attack and/or stroke, says Stephen Kopecky, a cardiologist at the Mayo Clinic in Rochester, Minn., and president of the American Society for Preventive Cardiology.

“These are different manifestations of the same disease process,” he says. “What causes heart attacks?  A decrease in blood flow to the heart.  What causes erectile dysfunction?  It’s a decrease of blood flow to the penis.” But the effects on the penis show up sooner, he says.

Sometimes, there are other factors.  ED can be caused by certain medications, including drugs for high blood pressure and depression.   Many patients have had surgery for prostate, colon or bladder cancer, and for those men, pills often are less effective than other options, including penile injections and pumping devices.  Blood vessel surgery is an option for some young men with ED caused by pelvic injuries.

Whatever the cause, ED can be made worse by “conflict in the marriage, hurt and anger, depression and performance anxiety,” says Ruth Hutcheson, clinical director of North Shore Center for Marital Therapy in Oakbrook, Ill., and a certified sex therapist with the American Association of Sexuality Educators, Counselors and Therapists.  Sometimes sessions with a therapist may help.

“It’s very important to improve communication,” she says.  When couples do that, they often find that everything works better in the marriage.

Can eating berries help with natural memory decline?

Berries might provide a safe and easy way to boost brain power, a new study suggests.  This study from Harvard researchers shows how eating berries a few times a week can stave off the cognitive decline and memory loss which comes with natural aging.

For the study, researchers looked at data from the long-running Nurses’ Health Study of nearly 122,000 registered nurses between the ages of 30 and 55 who completed health questionnaires starting in 1976.

Every four years the nurses were surveyed on their eating habits and between 1995 and 2001, researchers began testing memory in 16,000 of the nurses who by this time were over 70 years old.

Testing the subjects’ memory in two-year intervals, the researchers found nurses who ate the most blueberries and strawberries delayed their memory decline up to 2.5 years compared with those who did not report eating berries.   These findings are published in the April 26 issue of the Annals of Neurology.

“What makes our study unique is the amount of data we analyzed over such a long period of time.  No other berry study has been conducted on such a large scale,” study author Dr. Elizabeth Devore, a researcher in the Channing Laboratory at Brigham and Women’s Hospital and a professor at Harvard Medical School in Boston.

“Among women who consumed 2 or more servings of strawberries and blueberries each week we saw a modest reduction in memory decline. This effect appears to be attainable with relatively simple dietary modifications.”

So if you’re looking around for something good to get addicted to, make it fresh berries!  Especially this time of year!

How do we get hooked?

There was a wonderfully informative segment on addiction last night on CBS 60 Minutes.  Go see it now!

Or I can give you the highlights here:

First of all, we all need to finally accept that all addictions are medical chronic diseases, and NOT character defects. Any type of addiction (sex, food, drugs, Internet) changes our brains and can be seen in an MRI, even AFTER the addiction has resolved itself.

Addiction is all about dopamine and how it regulates the pleasure centers of our brains.  Without these interactions the human race would not have survived.  We need to react to and remember things like food and sex which give us pleasure.

Our brains react even to images of delicious foods, sex, drugs and alcoholic drinks, which we are now completely surrounded by everyday.   These pictures drive behavior, as all advertisers know, even though much of this behavior is unconscious.  And if we continue to seek out these sources of pleasure, the dopamine receptors in our brains wear out and pleasure decreases.  So then we need ever higher levels of pleasure sources just to feel “Normal.”

Most drugs damage the brain’s ability to resist addictions, so our desire for drugs just keeps increasing resulting in such statistics as:

There were 210 million prescriptions written for opioids in the U.S. last year, leading to over 15,000 deaths from painkiller overdoses!

Increase alcohol consumption to increase your good cholesterol!

I’ve been working on increasing my good cholesterol or HDL levels by losing weight (50 pounds!) and increasing my daily exercise.  Now I find out that I should also be drinking wine!

Heart disease risk is directly associated with elevated total cholesterol, but more specifically with low levels of “good” cholesterol, or HDL, coupled with high levels of “bad” cholesterol, or LDL.

High levels of “good” cholesterol (HDL) reduces your overall risk of heart disease, and according to some studies, alcohol consumption helps to raise these levels in your blood.

The exact mechanism by which this happens is a point of debate, and the benefit of raising HDL via alcohol consumption comes with some negative impact.  With apologies to the American Heart Association, which discourages doctors from telling their patients about the advantages of alcohol: one or two drinks per day can significantly increase HDL levels.   However, more than one or two drinks per day can lead to substantial health problems including heart failure.

Also remember, alcohol contributes a lot of sugar and “empty calories” to your daily diet!

Who has the cleanest air?

The American Lung Association just came out with their list of the cleanest cities in the U.S.

Go check it out and see how your air is doing!

New blood test for ovarian cancer in development

A chemical in the blood could one day help doctors spot early signs of ovarian cancer.

A US team found a marker antibody in the blood of women with ovarian cancer, but not in healthy ones. Ovarian cancer is very difficult to detect at an early stage, which means it can remain hidden until it is advanced and very difficult to treat.

A cancer charity said the early findings were intriguing but required further study.  The work was carried out by a team at Rush University Medical Center in Chicago.

They tested women for antibodies to mesothelin, a substance found on the surface of ovarian cancer cells.  Some of the women had fertility problems (109), ovarian cancer (28), or non-cancerous ovarian growths (24), while the rest (152) were healthy. The antibodies were found in the bloodstream of most of the women with ovarian cancer, as well as women with infertility due to problems with the ovary, the researchers said.  They were not present in healthy women or the women with non-cancerous ovarian tumours.

Lead researcher Dr. Judith Luborsky said: “The finding is extremely important because at present medical tests are unable to detect ovarian cancer in its early stages, which is why death rates from this disease are so high.”

This research is published in the journal Cancer Epidemiology, Biomarkers & Prevention, published by the American Society for Cancer Research.

Some interesting life expectancy news from the UK

The gap between male and female life expectancy is closing, and men could catch up by 2030, according to the UK Office for National Statistics.  The difference between the sexes peaked in the 1970s with life expectancy going up all round now, but the rates for men are increasing faster.  Plummeting smoking rates in men are thought to explain a lot of the change.

Findings show men languishing far behind women for decades, but they are now starting to close in on that of women.  If current trends continue, both sexes could be living on average to the age of 87 in 2030.

“What’s interesting at the moment is that in the last 20 years or so, male life expectancy at 30 has jumped by about six years and if it jumps by the same amount in the next 20 years it will converge with female life expectancy.”

The reason could be because men are living a healthier lifestyle.

New ways to repair severed nerves

A “miniature honeycomb” – or scaffold – could one day be used to encourage damaged nerves to grow and recover, according to an international group of researchers.  The scaffold can channel clusters of nerves through its honeycomb of holes, eventually healing a severed nerve.  The findings of their study on mouse nerves are published in the journal Biofabrication.

Academics hope to one day treat spinal cord injuries with the scaffold.  When nerves are severed, such as in car accidents, it can result in a loss of feeling and movement.  Repairing this damage can be a challenge – but nerves outside of the brain and spinal cord can repair themselves, if only over short distances.

One technique to improve this repair is to use tubes.  Either end of the severed nerve is placed in a tube and the two ends of the nerve should grow and join in the middle.  Researchers at the University of Sheffield and Laser Zentrum Hannover, Germany, investigated using a honeycomb structure.

Dr Frederik Claeyssens, from the department of materials science and engineering at Sheffield, told the BBC: “That is much more like the structure of the nerve itself.  “The nerve has small regions of ‘cable’ that go through from one end to the other end, you have a whole bunch of little cables inside a larger cable, that’s what we tried to reproduce with this type of scaffold.”

The honeycomb is made from photopolymerizable polylactic acid, which biodegrades once the nerve has repaired.  The researchers showed nerve cells could grow on the scaffold and are now testing it in mice to see if it can fully repair the damage.  Dr Frederik Claeyssens said: “This technology could make a huge difference to patients suffering severe nerve damage.”

Scaffold technology is used in a range of “regenerative medicines”.  Building a scaffold and then coating it with human cells has, for example, been used to give patients new windpipes and bladders.

Lifestyle choices and Alzheimer’s

Alzheimer’s disease already affects 4.5 million Americans, more than twice the number that were affected in 1980–but that number is expected to grow significantly. By the year 2050, it’s estimated that 11.3 million to 16 million Americans may develop the disease, according to the Alzheimer’s Association.

Alzheimer’s disease affects the brain, progressively destroying a person’s ability to learn and reason, make judgments and carry out daily activities. The majority of people with Alzheimer’s are over the age of 65 — an age after which the chances of developing the disease double every five years.  But, of course, just because you age does not mean that you will develop Alzheimer’s, and there are, in fact, known methods to prevent this epidemic disease.

Eat healthy. Your best defense against this disease appears to be in the food you eat.  A recent study published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association found that people who eat the recommended amount of folate have a much lower risk of developing the disease.  Folates are B-vitamins found in leafy green vegetables, oranges, legumes and bananas.

But, “Although folates appear to be more beneficial than other nutrients, the primary message is that an overall healthy diets seems to have an impact on limiting Alzheimer’s disease risk.  Antioxidant-rich foods are also extremely important.

Lead a healthy lifestyle. Things like avoiding tobacco and excess alcohol, exercising and staying socially active all are linked to a healthy brain, according to the Alzheimer’s Association.  “The major way we’ve reduced the death rate from heart disease is through lifestyle changes: eating better, exercising more, smoking less,” said David A. Bennett of Rush University in Chicago. “It would require a lot of people to change the way they live, but there’s no reason to think we can’t have the same impact on Alzheimer’s and other forms of dementia.”

Exercise your body. As mentioned above, regular exercise is important for your brain health.   “Walking 45 minutes three times a week for six months significantly improved mental ability of older adults with no dementia; a randomly selected control group that did stretching and toning had no change,” says Arthur Kramer, a psychologist at the University of Illinois.

Exercise your mind. “Just keeping busy seems to tune the brain,” says neuropsychologist Yaakov Stern of Columbia University College of Physicians and Surgeons.   In a seven-year study of 1,800 older adults, Stern found that the more “leisure pursuits” a person had, the lower their risk of developing Alzheimer’s.  Leisure pursuits included visiting friends, playing cards and going to the movies

The key is to keep your brain engaged as you age.   Try crossword puzzles, games like chess and checkers,reading, attending a lecture, volunteering or taking a class that interests you.

Avoid head injuries. Research has uncovered a strong link between serious head injury and Alzheimer’s.  You can reduce your risk of head injury by always wearing a seat belt while driving, wearing a helmet on a motorcycle or bicycle and making sure to remove tripping hazards around your home.

Try to relax and stay positive. According to the Center for Healthy Minds, elderly people who experience a lot of psychological distress (worrying, feeling insecure or nervous) are more likely to show signs of mental decline.   In fact, one study found that people prone to high levels of distress were twice as likely to develop symptoms of Alzheimer’s disease after five years than those who were prone to low levels of distress.

What exactly is breast cancer?

What we currently call breast cancer should be thought of as ten completely separate diseases, according to an international study which has been described as a “landmark.”

Breaking this disease into separate categories could improve treatment by tailoring drugs for a patient’s exact type of breast cancer, and help predict survival more accurately.

This study in Nature analyzed breast cancers from 2,000 women.  The latest findings give the breast cancer map far more detail, allowing us to find individual types.

At the present moment, breast cancers are classified by what they look like under the microscope with tests for “markers” on the tumors.  Those with “estrogen receptors” should respond to hormone therapies such as tamoxifen; those with a “Her2 receptor” can be treated with Herceptin.   The vast majority of breast cancers, more than 70%, should respond to hormone therapies.   However, their reaction to treatment varies wildly.

This new study looked at frozen breast cancer samples of tumor cells from 2,000 women at hospitals in the UK and Canada, with intensive detail, which genes had been mutated, which genes were working in overdrive, which were being shut down.   The study showed that all the different ways the cells changed when they became cancerous could be grouped into 10 different categories – named IntClust one to 10.

This will change the way we look at breast cancer, with enormous impact in the years to come in how we diagnose and treat it.  But the new breast cancer rulebook could take some time to directly benefit patients.  Researchers need to prove that these ten classifications actually provide benefit to women with breast cancer, before they can be used by doctors.  That process is expected to take three to five years.