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Bone Fractures, Lung Cancer, and Vitamin B12 Supplements?

The AHA! Team — Fri, 14 Feb 2025 06:21:08 +0000

Michael Greger M.D. FACLM via Nutrition Facts – What do randomized controlled trials of high-dose daily vitamin B12 supplementation show about its effects on cancer risk, death, and longevity? In 2019, “Association of High Intakes of Vitamins B6 and B12 from Food and Supplements with Risk of Hip Fracture Among Postmenopausal Women in the [Harvard] Nurses’ Health Study” was published. Note, though, that only the combined high intake of vitamins B6 (≥35 mg/day) and B12 (≥20 mcg/day) was associated with an increased hip fracture risk. We know that treatment with high doses of vitamin B6 may increase hip fracture risk on its own. After a decade or so, those who had been taking high-dose (40 mg) B6 supplements had about a 40 percent higher hip fracture risk, but not those taking B12, as you can see below and at 0:35 in my video Do Vitamin B12 Supplements Cause Bone Fractures and Lung Cancer?. That’s what the Harvard study found, too. High intake of vitamin B12 alone was not associated with increased risk. In fact, some observational studies suggest a slightly lower fracture risk at high B12 blood levels. What we care about most, though, are interventional studies, where people are randomized to B12 so we can see what happens, and when we look at those, we find there is no increased fracture risk among those given B12. In conclusion, based on randomized controlled trials, high doses of vitamin B12 have not been shown to be associated with the risk of fractures. Okay, but what about this? In 2017, a study found that men taking vitamin B12 supplements appeared to have increased lung cancer risk. Now, the researchers didn’t find any such association in women, and the increased risk was mostly among men who smoked. Could it be that B12 was feeding budding tumors? It’s hard enough imagining a vitamin being carcinogenic on its own, especially if it somehow only affects men and not also women. “Replication of these ﬁndings in additional prospective studies with careful measurement of B vitamin supplement use is warranted.” And, indeed, when you put together all the observational studies, there is no signiﬁcant correlation between lung cancer and levels of B12 in the blood, whether you’ve smoked or not. If anything, most studies seemed to trend towards higher B12 levels being protective, as you can see below and at 2:03 in my video. Then, in 2018, a new study found an association between overall lung cancer risk and higher circulating levels of B12, again appearing to be more of a concern with smokers, as seen here and at 2:16 in my video. Now, this was another observational study. Those with higher B12 levels were just observed to have higher cancer levels. Those of you who have been following my work know the drill: There are two potential issues that arise in observational studies that prevent us from ascribing cause-and-effect: confounding factors, also known as “lurker variables,” and reverse causation. What might be a lurker variable in this case? What might be a third factor associated with both higher B12 levels and cancer that may be the true cause? Well, who has higher levels of B12 circulating in their blood? Those who eat a lot of meat and dairy, which are, in fact, “the most important contributors to serum vitamin B-12,” that is, B12 in our blood. And those who eat more meat do tend to have more lung cancer: “Dose-response analysis showed that consumption of red meat for 120 g per day might increase the risk of lung cancer by 35%, and consumption of processed meat for 50 g per day might increase the risk of lung cancer by 20%.” So, we’re generally talking about 35 percent more risk for every quarter-pound burger eaten each day and about 20 percent increased risk for every breakfast sausage link. It’s no wonder those with higher B12 levels in their blood could have more lung cancer. The B12 could just be a marker for meat intake. And, if you remember, reverse causation is when X may not lead to Y, but, instead, Y may lead to X. So, instead of high B12 blood levels leading to cancer, maybe cancer leads to high blood levels of B12. And, indeed, nearly 75 percent of patients diagnosed with cancer exhibit elevated B12 levels. So, elevated B12 levels may simply be a marker for cancer. Besides taking extra B12, there are all sorts of reasons your levels can rise, such as liver problems, kidney problems, bone marrow problems, and cancer, as you can see below and at 3:50 in my video. So, high B12 levels may just be a marker of brewing, but not yet diagnosed, cancer. What about observational studies specifically linking B12 supplement use to lung cancer, though? Those could also be reverse causation: “The consequence of being at risk for cancer is that patients will engage in healthier behaviors, including taking multivitamins (reverse causality). The well-established causes, such as smoking, chronic obstructive pulmonary disease, and previous cancers, are the real lung cancer risks.” So, we’re left with this “chicken or the egg causality dilemma,” which is why, ideally, we need randomized controlled trials to see if there’s any cause and effect. This became even more urgent with genetic evidence suggesting that those born with higher lifelong levels may be at increased risk. Thankfully, as you can see below and at 4:47 in my video, we do have randomized controlled trials—more than a dozen randomized controlled trials randomizing thousands of people up to 2,000 micrograms of B12 every single day for years, in fact. The findings? “Vitamin B supplementation does not have an effect on cancer incidence, death due to cancer, or total mortality.” And this includes specifically looking at lung cancer, as seen below and at 5:02 in my video. In fact, if anything, vitamin B supplements may actually lower the risk of the most dangerous form of skin cancer. If you missed my previous video, check out Do Vitamin B12 Supplements Cause Acne?. For my other B12 updates, see related posts below. All of these videos can be found in one digital download: Latest Vitamin B12 Recommendations. I’ve also explored vitamin B12’s role in stroke risk. See the related posts below. That series is available for digital download, too: Why Do Vegetarians Have Higher Stroke Risk?. Key Takeaways High intakes of vitamins B6 and B12 together are associated with an increased risk of hip fractures in postmenopausal women, but high B12 alone does not increase this risk. High doses of vitamin B12, based on randomized controlled trials, have not been shown to increase the risk of fractures, unlike high doses of vitamin B6. Some studies suggest that B12 supplementation may be linked to an increased risk of lung cancer in men, particularly smokers, though this association has not been consistently observed. Higher B12 levels in observational studies might be linked to higher meat consumption, which could be the true cause of increased cancer risk, rather than B12 itself. Elevated B12 levels may indicate underlying health issues like cancer, rather than being a direct cause of cancer, highlighting the importance of distinguishing between correlation and causation. To read the original article click here.

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New App Offers Relief for Parents Mourning the Loss of a Child

The AHA! Team — Mon, 10 Feb 2025 06:10:12 +0000

Uppsala University via News-Medical – A new study shows that an app can help parents who are mourning the loss of a child. Parents who used the app for three months reported reduced symptoms of prolonged grief and post-traumatic stress, and also had fewer negative thoughts. Some parents thought the app should be offered early in the mourning process. This is demonstrated in a new study from Uppsala University, published in the scholarly journal Cognitive Behaviour Therapy. In the acute grief following a death, it is natural for family members to think it feels unreal and difficult to accept that the person who has died will not be coming back. For most people, the intense grief diminishes over time. They can accept the grief, live positively and manage to look ahead. However, some people become stuck in acute grief, a condition known as ‘prolonged grief’. They may preserve the child’s room as it was or visit the grave very frequently, even several years after the loss. It becomes a kind of ritual and a duty that they cannot escape. We have investigated whether the app can alleviate symptoms of prolonged grief and of depression and post-traumatic stress as well. In the study, we also investigate whether destructive patterns such as rumination and avoidance can be improved in this way.” Josefin Sveen, Professor of Clinical Psychology and first author of the study There are several apps based on cognitive behavioural therapy for coping with various mental health problems. A common feature of these apps is that they help the user to normalise thoughts, behaviours and feelings that are natural in the various situations they address. Based on previous self-help app In her previous research on the app PTSD Coach, a self-help app for people suffering from PTSD, Sveen discovered that parents whose child has died lack help in managing their grief. She therefore began to develop the new app in the hope that this could help them. Initially, she thought of parents whose child had died of cancer. Later, this group was expanded to include children dying from other causes. The study involved 248 parents (80 per cent of them mothers). All had lost a child in the last 10 years. Almost half of the children had died of cancer and the average age at the time of death was 11. Participation was entirely voluntary. The participants were contacted by letter and via social media hosted by the Swedish Childhood Cancer Fund and Spädbarnsfonden (the Swedish Infant Death Foundation), which also co-financed the study. Half of the participants received access to the app, the other half had to wait three months before being allowed to use it. “Grief meter’ The app has four components. Firstly, learning about grief and prolonged grief, and learning to accept grief. Secondly, help in finding support in your surroundings, for example, from friends, relations or colleagues, and easily accessible contact details to support organisations. Thirdly, practical exercises and strategies, including relaxation and help in writing about your grief and your feelings. One exercise involves writing a letter to the child who has died. It can also involve visiting physical places that you have previously avoided, or looking at photos of the child. The fourth component is a ‘grief meter’ in which the user can rate their own grief and register how strong or weak the feeling of grief has been at different points during the day. “Many participants thought this was particularly useful. Being able to see that their grief changed from day to day, that there are certain times when it is worst, and that they can feel quite all right in between,” Sveen says. She continues: “I am glad we have succeeded in producing an app that parents feel helps them. The feedback we received from them was that they appreciated the variety of functions offered by the app – as they described it, it was helpful to have several types of support in just one place. The self-assessments that they made of their health also show that their prolonged grief symptoms declined thanks to the app. Some parents thought that in future, the app should be offered early in the process of mourning.” Next step young people The study shows that the app can be a first step in providing information about grief and strategies for managing the challenges that grief brings. The next steps will be, firstly, to follow up the study in a year’s time, and secondly, to conduct a similar study with an app for young people who have lost a parent and/or a sister or brother. Source: Uppsala University Journal reference: Sveen, J., et al. (2024). My grief app for prolonged grief in bereaved parents: a randomised waitlist-controlled trial. Cognitive Behaviour Therapy. doi.org/10.1080/16506073.2024.2429068. To read the original article click here.

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US Drug-Related Infant Deaths More Than Doubled from 2018 to 2022

The AHA! Team — Fri, 01 Nov 2024 05:44:39 +0000

Florida Atlantic University via EurekAlert! – A new study by Florida Atlantic University’s Schmidt College of Medicine has uncovered a disturbing trend in drug-related infant deaths in the United States from 2018 to 2022. Infant deaths are those that occur between the time a child is born and age 1. Drug-involved deaths are those in which drugs are either the primary cause of death or a contributing factor and may occur due to maternal drug use, inadvertent or accidental intake of specific prescriptions, illicit or non-medical use of drugs and other incidents where drugs were linked to death. Results of the study, published in the Journal of Perinatal Medicine, show that in the U.S. from 2018 to 2022, drug-involved infant deaths more than doubled (120% increase) from 10.8% in 2018 to 24.4% in 2022. The largest increase was observed between 2019 (16.9%) and 2022 with the greatest proportion of drug-related infant deaths occurring in 2021 (25.8%). Overall, relative to all other causes of infant mortality, drug-involved deaths became more prevalent after 2019. Findings show that drug-involved infant deaths also were higher in the postnatal period, ages 28 to 364 days (81.4%), relative to deaths due to all other causes during the same period (34.6%). The most prevalent underlying causes of death included assault (homicide) by drugs, medicaments and biological substances (35.6%) followed by poisoning from exposure to narcotics and psychodysleptics (hallucinogens) (15.6%), and accidental poisoning from exposure to antiepileptic, sedative-hypnotic, antiparkinsonism and psychotropic drugs (10.8%). The most common multiple causes of drug-involved infant deaths were psychostimulants with abuse potential of synthetic narcotics. In addition, a significant proportion of infants who died from drug-involved causes were born to non-Hispanic white (60.4%) and non-Hispanic Black mothers (28.5%). Furthermore, drug-induced mortality was 56.5% in male infants and 43.7% in female infants, a difference which also was statistically significant. “The differences we observed by race/ethnicity in drug-involved deaths, predominantly among non-Hispanic white and Black infants require a multifaceted approach for clinical and public health interventions,” said Panagiota “Yiota” Kitsantas, Ph.D., corresponding author and professor and chair of the Department of Population Health and Social Medicine, FAU Schmidt College of Medicine. “Addressing the social determinants of health, enhancing access to addiction treatment and implementing culturally sensitive interventions may be important to prevent infant deaths in vulnerable populations. In addition, the underlying causes, which included drug-related assault and various forms of poisoning, also may be areas for clinical and public health interventions.” From 2018 to 2022, drug-involved infant deaths accounted for 1.18% of all infant deaths From 2018 to 2022, drug-involved infant deaths accounted for 1.18% of all infant deaths, a notable rise from the previously reported 0.64% from 2015 to 2017. This increase was particularly pronounced during COVID-19, raising questions that require further studies. During this period, drug overdose mortality also increased substantially among pregnant and postpartum women. The researchers note that during COVID-19 there was reduced access to prenatal care, the emergence of health care deserts and hospital closures, especially in rural areas. These may have contributed, at least in part, to the observed increases in drug-related infant deaths, although more research is warranted. “Given the alarming increase in the number of drug overdose deaths in the general population, especially among pregnant and postpartum women, findings from our study are both important and timely,” said Maria C. Mejia, M.D., senior author and a professor of population health and social medicine, FAU Schmidt College of Medicine. “Drug-involved deaths in infants represent a potentially avoidable cause that should be considered in efforts to reduce infant mortality in the United States. Effective strategies will require collaborative efforts among health providers, public health agencies and community partners, and should focus on preventing and treating maternal substance use disorders, enhancing prenatal care access and addressing broader social and behavioral risk factors.” For the study, researchers used data from the U.S. Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (WONDER) and selected the period of 2018 to 2022 because 2018 was pre-COVID-19 and 2022 represents the most recent data available. Infant deaths were described by year of death, underlying cause and multiple cause of death, age of infant at time of death, gender and maternal race/ethnicity (non-Hispanic white, non-Hispanic Black, non-Hispanic, Hispanic and other race). Study co-authors are Charles H. Hennekens, M.D., Dr.PH, first Sir Richard Doll Professor of Medicine and senior academic advisor; Sebastian Densley and Meera Rao, FAU medical students; Lea Sacca, Ph.D., an assistant professor in the Department of Population Health and Social Medicine; and Robert S. Levine, M.D., affiliate professor of medicine; all within FAU’s Schmidt College of Medicine. Journal Journal of Perinatal Medicine DOI 10.1515/jpm-2024-0067 To read the original article click here.

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Study: 35% of Excess Deaths in Pandemic’s Early Months Tied to Causes Other Than COVID-19

AHA Publisher — Tue, 07 Jul 2020 07:00:42 +0000

Virginia Commonwealth University via EurekAlert – Since COVID-19’s spread to the United States earlier this year, death rates in the U.S. have risen significantly. But deaths attributed to COVID-19 only account for about two-thirds of the increase in March and April, according to a study published Wednesday in the Journal of the American Medical Association. Researchers at Virginia Commonwealth University and Yale University found that, from March 1 to April 25, the U.S. saw 87,001 excess deaths — or deaths above the number that would be expected based on averages from the previous five years. The study, “Excess Deaths from COVID-19 and Other Causes, March-April 2020,” showed that only 65% of the excess deaths that occurred in March and April were attributed to COVID-19, meaning more than one-third were linked to other causes. In 14 states, including two of the most populated — California and Texas — more than half of the excess deaths were tied to an underlying cause other than COVID-19, said lead author Steven Woolf, M.D., director emeritus of VCU’s Center on Society and Health. This data, Woolf said, suggests the COVID-19 death counts reported to the public underestimate the true death toll of the pandemic in the U.S. “There are several potential reasons for this under-count,” said Woolf, a professor in the Department of Family Medicine and Population Health at VCU School of Medicine. “Some of it may reflect under-reporting; it takes awhile for some of these data to come in. Some cases might involve patients with COVID-19 who died from related complications, such as heart disease, and those complications may have been listed as the cause of death rather than COVID-19. “But a third possibility, the one we’re quite concerned about, is indirect mortality — deaths caused by the response to the pandemic,” Woolf said. “People who never had the virus may have died from other causes because of the spillover effects of the pandemic, such as delayed medical care, economic hardship or emotional distress.” Woolf and his team found that deaths from causes other than COVID-19 rose sharply in the states that had the most COVID-19 deaths in March and April. Those states were Massachusetts, Michigan, New Jersey, New York — particularly New York City — and Pennsylvania. At COVID-19’s peak for March and April (the week ending April 11), diabetes deaths in those five states rose 96% above the expected number of deaths when compared to the weekly averages in January and February of 2020. Deaths from heart disease (89%), Alzheimer’s disease (64%) and stroke (35%) in those states also spiked. New York City’s death rates alone rose a staggering 398% from heart disease and 356% from diabetes, the study stated. Woolf said he and his team suspect that some of these were indirect deaths from the pandemic that occurred among people with acute emergencies, such as a heart attack or stroke, who may have been afraid to go to a hospital for fear of getting the virus. Those who did seek emergency care, particularly in the areas hardest hit by the virus, may not have been able to get the treatment they needed, such as ventilator support, if the hospital was overwhelmed by the surge. Others may have died from a chronic health condition, such as diabetes or cancer, that was exacerbated by the effects of the pandemic, said Woolf, VCU’s C. Kenneth and Dianne Wright Distinguished Chair in Population Health and Health Equity. Still others may have struggled to deal with the consequences of job loss or social isolation. “We can’t forget about mental health,” Woolf said. “A number of people struggling with depression, addiction and very difficult economic conditions caused by lockdowns may have become increasingly desperate, and some may have died by suicide. People addicted to opioids and other drugs may have overdosed. All told, what we’re seeing is a death count well beyond what we would normally expect for this time of year, and it’s only partially explained by COVID-19.” Woolf and his co-authors, Derek Chapman, Ph.D., Roy Sabo, Ph.D., and Latoya Hill of VCU, and Daniel M. Weinberger, Ph.D., of Yale University, state that further investigation is needed to determine just how many deaths were from COVID-19 and how many were indirect deaths “caused by disruptions in society that diminished or delayed access to health care and the social determinants of health (e.g., jobs, income, food security).” Woolf, also a family physician, said this paper’s results underscore the need for health systems and public officials to make sure services are available not only for COVID-19 but for other health problems. His study showed what happened in the states that were overwhelmed by cases in March and April. Woolf worries that the same spikes in excess deaths may now be occurring in other states that are being overwhelmed. “The findings from our VCU researchers’ study confirm an alarming trend across the U.S., where community members experiencing a health emergency are staying home — a decision that can have long-term, and sometimes fatal, consequences,” said Peter Buckley, M.D., interim CEO of VCU Health System and interim senior vice president of VCU Health Sciences. “Health systems nationwide need to let patients know it is safe and important to seek care in a health emergency, whether it’s through telehealth or in person.” Woolf, who serves in a community engagement role with the C. Kenneth and Dianne Wright Center for Clinical and Translational Research, said resources should be available for those facing unemployment, loss of income and food and housing insecurity, including help with the mental health challenges, such as depression, anxiety or addiction, that these hardships could present. “Public officials need to be thinking about behavioral health care and ramping up their services for those patients in need,” Woolf said. “The absence of systems to deal with these kinds of other health issues will only increase this number of excess deaths.” To read the original article click here.

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All Sodas Including Diet Increase Risk of Premature Death

AHA Publisher — Thu, 10 Oct 2019 07:00:14 +0000

Angela Betsaida B. Laguipo, BSN via News Medical-Net – Soft drinks are frequently consumed by people of all ages, but whether this consumption is linked with high risk of premature death has not been known, not until now. Do you want to live longer? You may want to ditch drinking soft drinks, a new study says. Drinking carbonated drinks such as soft drinks, sodas and colas has long been dubbed as unhealthy, with all the added sugar they contain. Now, a new study added new information on the bad effects of soft drinks to the health. A team of researchers at the Nutrition and Cancer group of the Catalan Institute of Oncology (ICO) and the Bellvitge Biomedical Research Institute (IDIBELL) found that drinking two or more glasses a day of sugar-sweetened or artificially sweetened soft drinks has been linked to an increased risk of death from all causes. Subsequently, drinking soft drinks more frequently has been associated with deaths from digestive and circulatory diseases. However, the researchers did not find any link between consuming soft drinks and cancer mortality or cancer-related death. None of the participants had diabetes, cancer, stroke, or heart disease before being involved in the study. The study, titled ‘Association Between Soft Drink Consumption and Mortality in 10 European Countries’ and published in JAMA, involved more than 450,000 individuals from ten European countries for about 19 years. It looked at the effects of drinking soda or carbonated drinks on the health. It has been previously known that high blood sugar and taking too much sugar in the diet can impair the gut barrier, leading to a condition called “leaky gut”. As a result, the gut immune system will induce intestinal inflammation, increasing the vulnerability of the person to gut infections. Hence, drinking drinks with added sugars can boost susceptibility to digestive disorders. Aside from cardiovascular and digestive diseases, the increased intake of soft drinks has also been linked to heightened risk of developing Parkinson’s disease, but not with Alzheimer’s disease or cancer. In the study, the researchers defined soft drinks as beverages that fizzy soft drinks like cola and lemonade, fruit squash or cordials, and low-calorie or diet fizzy soft drinks, that are all non-alcoholic concentrated syrups normally mixed with water and sugar. Also, they defined that one glass of soft drink is equivalent to 250 milliliters or 8 fluid ounces. Across the globe, a typical can of soda contains 12 fluid ounces or 355 milliliters of drink. The main results of the study, dubbed as the EPIC study (European Proactive Investigation into Cancer and Nutrition), shows that there were a total of 41,693 deaths in the 16-year follow up. The researchers collected data about soft drink consumption through a nutrition and diet questionnaire between 1992 and 2000. Study Implications The study is important in the society today, since many people are fond of drinking sugary drinks, including soft drinks or soda. Strict regulations should be imposed by health officials on the public, to reduce the consumption of these drinks, especially that many studies have already linked its bad effects to the health. Further, the study findings can help support ongoing public health measures to reduce the consumption of soft drinks. Soft drinks are frequently consumed by people of all ages, but whether this consumption is linked with high risk of premature death has not been known, not until now. The study, however, just like other studies on the link between sugary drink consumption and health risks is observational. It cannot entirely show any cause and effect. The researchers note that there is a major limitation and it’s impossible to determine if the health effect is associated with the use of artificial sweeteners, obesity, diabetes, a type of beverage, or an underlying health condition. How to Cut Back On Sugary Drinks Whether there is an association or not, if you decide to cut back on your soft drink consumption, you can ditch the habit by cutting back correctly. If you find it hard to remove the habit immediately, you can taper the consumption. For instance, you can aim for one drink every other day or drinking just one serving a day. In the long run, you can already remove the habit entirely. There are also fizzy drinks that are not mixed with sugar or artificial sweetener, such as sparkling water or a fruit juice alternative. If you are decided to remove the habit, figure out what the habitual trigger it and replace it with healthier habits. For instance, if you crave for sweets, instead of drinking fizzy sugary drinks, eat a fruit instead. To read the original article click here.

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