Low physical activity increases risk of bladder, kidney cancer

Most of us know that physical activity is good for us. But a new study shows that a chronic lack of physical activity can drastically increase the chance of developing cancer in the bladder and kidneys, and it suggests that engaging in more physical activity may reduce this risk.

New research suggests that chronic sedentarism can increase the risk of bladder and kidney cancer by over 70 percent.

The Centers for Disease Control and Prevention (CDC) report that, every year, almost 57,000 adults have kidney and renal pelvis cancers in the United States. Additionally, almost 14,000 people per year die from these cancers.

Bladder cancer is also widespread. According to the CDC, around 71,000 U.S. individuals developed bladder cancer in 2013, and almost 16,000 people died as a result.

A team of researchers at the Roswell Park Cancer Institute in Buffalo, NY, set out to examine the link between leading a sedentary lifestyle and the risk of developing kidney or bladder cancer.

The findings were published in the journal Cancer Epidemiology.

The researchers were led by Dr. Kirsten Moysich, distinguished professor of oncology in the Departments of Cancer Prevention and Control and Immunology at Roswell Park, and Rikki Cannioto, assistant professor of oncology also in the Department of Cancer Prevention and Control at Roswell Park.

Drs. Moysich and Cannioto, along with their colleagues, analyzed 160 people with renal (kidney) cancer, 208 bladder cancer patients, and 766 healthy controls.

Participants were asked to report on their levels of physical activity - namely, whether or not they took part in any regular or weekly recreational physical activity throughout the course of their lives. Those who said that they had never done so were classified as "physically inactive."

The researchers used unconditional multivariable logistic regression methods to calculate the odds of developing renal and bladder cancer.

Inactivity increases kidney and bladder cancer risks by up to 77 percent

Overall, the authors found "evidence of a positive association between renal and bladder cancer with lifetime recreational physical inactivity."

Specifically, they found that those who were physically inactive were 77 percent more likely to develop renal cancer and 73 percent more likely to develop cancer of the bladder.

A similar risk was found among people with obesity and people with a normal body weight - that is, having a body mass index (BMI) of below 30. This suggests that leading a sedentary lifestyle is an independent factor that influences bladder and renal cancer risk independently of obesity.

This study adds to previous data that have shown the same correlation. Former studies have also indicated a link between chronic physical inactivity and an increased risk of ovarian and cervical cancer.

However, the authors concede that additional, larger-scale, prospective studies are needed to consolidate the findings.

Dr. Moysich comments on the results and urges people to engage in a simple, moderate form of physical activity:

"We hope that findings like ours will motivate inactive people to engage in some form of physical activity. You don't have to run marathons to reduce your cancer risk, but you have to do something - even small adjustments like taking the stairs instead of the elevator, walking around the block a couple of times on your lunch hour, or parking the car far away from the store when you go to the supermarket."

Dr. Cannioto also weighs in on the results, saying that the "findings underscore how important it is to maintain a healthy lifestyle, including getting and staying active. The Department of Health and Human Services recommends 150 minutes each week of moderate physical activity or 75 minutes each week of vigorous physical activity as a way to generate significant, lasting health benefits."

Learn how a type of bladder cancer bears molecular features of breast cancer.

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June 30 Day Step Goal Challenge

This is a very straight forward, yet powerful, challenge. We are giving you a daily step goal (minimum – maximum) and challenging you to complete a daily task. You’ll find the printable checklist below. Walking, jogging, running… it’s up to you to decide how to get your steps in. You also will need a fitness tracker, pedometer […]

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Fitness trackers accurately measure heart rate but not calories burned, study finds

Millions of people wear some kind of wristband activity tracker and use the device to monitor their own exercise and health, often sharing the data with their physician. But is the data accurate?

Such people can take heart in knowing that if the device measures heart rate, it's probably doing a good job, a team of researchers at the Stanford University School of Medicine reports. But if it measures energy expenditure, it's probably off by a significant amount.

An evaluation of seven devices in a diverse group of 60 volunteers showed that six of the devices measured heart rate with an error rate of less than 5 percent. The team evaluated the Apple Watch, Basis Peak, Fitbit Surge, Microsoft Band, Mio Alpha 2, PulseOn and the Samsung Gear S2. Some devices were more accurate than others, and factors such as skin color and body mass index affected the measurements.

In contrast, none of the seven devices measured energy expenditure accurately, the study found. Even the most accurate device was off by an average of 27 percent. And the least accurate was off by 93 percent.

"People are basing life decisions on the data provided by these devices," said Euan Ashley, DPhil, FRCP, professor of cardiovascular medicine, of genetics and of biomedical data science at Stanford. But consumer devices aren't held to the same standards as medical-grade devices, and it's hard for doctors to know what to make of heart-rate data and other data from a patient's wearable device, he said.

A paper reporting the researchers' findings will be published online in the Journal of Personalized Medicine. Ashley is the senior author. Lead authorship is shared by graduate student Anna Shcherbina, visiting assistant professor Mikael Mattsson, PhD, and senior research scientist Daryl Waggott.

Hard for consumers to know device accuracy

Manufacturers may test the accuracy of activity devices extensively, said Ashley, but it's hard for consumers to know how accurate such information is or the process that the manufacturers used in testing the devices. So Ashley and his colleagues set out to independently evaluate activity trackers that met criteria such as measuring both heart rate and energy expenditure and being commercially available.

"For a lay user, in a non-medical setting, we want to keep that error under 10 percent," Shcherbina said.

Sixty volunteers, including 31 women and 29 men, wore the seven devices while walking or running on treadmills or using stationary bicycles. Each volunteer's heart was measured with a medical-grade electrocardiograph. Metabolic rate was estimated with an instrument for measuring the oxygen and carbon dioxide in breath - a good proxy for metabolism and energy expenditure. Results from the wearable devices were then compared to the measurements from the two "gold standard" instruments.

"The heart rate measurements performed far better than we expected," said Ashley, "but the energy expenditure measures were way off the mark. The magnitude of just how bad they were surprised me."

Heart-rate data reliable

The take-home message, he said, is that a user can pretty much rely on a fitness tracker's heart rate measurements. But basing the number of doughnuts you eat on how many calories your device says you burned is a really bad idea, he said.

Neither Ashley nor Shcherbina could be sure why energy-expenditure measures were so far off. Each device uses its own proprietary algorithm for calculating energy expenditure, they said. It's likely the algorithms are making assumptions that don't fit individuals very well, said Shcherbina. "All we can do is see how the devices perform against the gold-standard clinical measures," she said. "My take on this is that it's very hard to train an algorithm that would be accurate across a wide variety of people because energy expenditure is variable based on someone's fitness level, height and weight, etc." Heart rate, she said, is measured directly, whereas energy expenditure must be measured indirectly through proxy calculations.

Ashley's team saw a need to make their evaluations of wearable devices open to the research community, so they created a website that shows their own data. They welcome others to upload data related to device performance at http://ift.tt/2hdgsuf.

The team is already working on the next iteration of their study, in which they are evaluating the devices while volunteers wear them as they go about a normal day, including exercising in the open, instead of walking or running on a laboratory treadmill. "In phase two," said Shcherbina, "we actually want a fully portable study. So volunteers' ECG will be portable and their energy calculation will also be done with a portable machine."

The work is an example of Stanford Medicine's focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.

Stanford's departments of Medicine, of Genetics and of Biomedical Data Science supported the work.

Article: Accuracy in Wrist-Worn, Sensor-Based Measurements of Heart Rate and Energy Expenditure in a Diverse Cohort, Anna Shcherbina, Euan A. Ashley et al., Journal of Personalized Medicine, doi: 10.3390/jpm7020003, published 24 May 2017.

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Lack of sleep increases death risk in people with metabolic syndrome

A recent study, published in the Journal of the American Heart Association, finds that people with a common cluster of heart disease risk factors have a higher risk of dying if they get under 6 hours of sleep each night.

The links between sleep duration and stroke risk in metabolic syndrome have been uncovered.

Metabolic syndrome refers to a collection of conditions that, when taken together, increase the risk of stroke, diabetes, and heart disease.

These conditions include high blood pressure, or hypertension, elevated blood sugar levels, abnormal cholesterol or triglyceride levels, and excess body fat around the waist.

An estimated 34 percent of adults in the United States are considered to have metabolic syndrome.

Because of the increase in obesity levels across the U.S., the number of individuals that meet the criteria for metabolic syndrome is on the rise. For this reason, understanding the consequences and implications is becoming increasingly important.

The importance of sleep

Earlier research has drawn links between sleep duration and a range of negative health consequences, some of which include weight gain, increased risk of diabetes, and various cardiovascular outcomes.

Studies investigating how sleep duration might affect individuals with metabolic syndrome have, to date, been inconclusive. A recent study set out to take a fresh look at this interaction. Previous studies have relied on patients self-reporting sleep duration but, for the first time, the current study monitored sleep in a specific laboratory to improve accuracy.

The study was headed up by Julio Fernandez-Mendoza, who is an assistant professor at Penn State College of Medicine and a sleep psychologist at the Sleep Research & Treatment Center of the Penn State Health Milton S. Hershey Medical Center, both in Hershey.

In all, data from 1,344 adults were used. The average age of participants was 49, and a little under half of them were male (42 percent). Each spent one night in a sleep laboratory as part of the Penn State Adult Cohort.

Of this group, 39.2 percent had at least three metabolic syndrome risk factors. Over an average follow-up period of 16.6 years, 22 percent of the participants died.

Sleep and metabolic syndrome

As expected, analysis showed that participants with metabolic syndrome, when compared with people without this cluster of risk factors, were more likely to die of stroke during the follow-up period. When the researchers split the data by how much sleep each individual got, the results were intriguing.

People with metabolic syndrome who slept for more than 6 hours per night were 1.49 times more likely to die of stroke in the 16-year period. Those who slept for under 6 hours were 2.1 times as likely.

Similarly, those with metabolic syndrome who slept for under 6 hours were almost twice as likely to die from any cause, compared with those without the cluster of risk factors.

These results were generated even after researchers adjusted for sleep apnea - in which an individual's breathing pauses during the night - which is a known risk factor for heart disease.

"If you have several heart disease risk factors, taking care of your sleep and consulting with a clinician if you have insufficient sleep is important if you want to lower your risk of death from heart disease or stroke."

Julio Fernandez-Mendoza

Sleep laboratories often test for sleep apnea, but Fernandez-Mendoza thinks that doctors should also pay attention to the length of time that a patient sleeps.

Although interesting, the research will need to be replicated. The authors are also quick to acknowledge the study's flaws.

Firstly, the study is observational, so cause and effect can not be firmly concluded. Secondly, there were a low number of ethnic minorities within the group, leaving the possibility that racial differences are significant. Thirdly, and perhaps most importantly, the study is based on the results of just one night in a sleep laboratory. A study that measured sleep duration over a longer period of time would be preferable.

The findings pose more questions than they answer, as Fernandez-Mendoza says, "Future clinical trials are needed to determine whether lengthening sleep, in combination with lowering blood pressure and glucose, improves the prognosis of people with the metabolic syndrome."

If simply sleeping for a longer period of time can improve the health outlook of people with metabolic syndrome, it could save millions of lives and countless dollars spent on healthcare.

Learn how avocados might be useful in the treatment of metabolic syndrome.

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Scientists uncover dietary strategy to address obesity using component in red chili

Scientists have discovered a dietary strategy that may address obesity by reducing endotoxemia, a major contributor to chronic, low-grade inflammation (CLGI). The researchers uncovered an interaction between dietary capsaicin (CAP), the major pungent component in red chili, and gut microbiota. This novel mechanism for the anti-obesity effect of CAP acts through prevention of microbial dysbiosis and the subsequent gut barrier dysfunction that can lead to CLGI. The research is published in mBio, an open access journal of the American Society for Microbiology.

Little is known about the role of gut microbiota in the anti-obesity effect of CAP. High throughput 16S rRNA gene sequencing revealed that CAP significantly increased gut health-beneficial butyragenic bacteria and decreased LPS-producing bacteria and LPS biosynthesis. By using antibiotics and microbiota transplantation, the investigators showed that gut microbiota plays a causal role in dietary CAP-induced protective phenotype against high-fat-diet-induced CLGI and obesity. Moreover, cannaboid receptor type 1 (CB1) inhibition was partially involved in the beneficial effect of CAP. Together, these data suggest that the gut microbiome is a critical factor for the anti-obesity effects of CAP.

Article: Gut Microbiota Mediates the Protective Effects of Dietary Capsaicin against Chronic Low-Grade Inflammation and Associated Obesity Induced by High-Fat Diet, Chao Kang, Bin Wang, Kanakaraju Kaliannan, Xiaolan Wang, Hedong Lang, Suocheng Hui, Li Huang, Yong Zhang, Ming Zhou, Mengting Chen, Mantian Mi, mBio, doi: 10.1128/mBio.00470-17, published 23 May 2017.

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Where body fat is carried can predict cancer risk

Scientists have found that carrying fat around your middle could be as good an indicator of cancer risk as body mass index (BMI), according to research published in the British Journal of Cancer.

It shows that adding about 11cm to the waistline increased the risk of obesity related cancers¹ by 13 per cent.

For bowel cancer, adding around 8 cm to the hips is linked to an increased risk of 15 per cent.²

Carrying excess body fat can change the levels of sex hormones, such as oestrogen and testosterone, can cause levels of insulin to rise, and lead to inflammation, all of which are factors that have been associated with increased cancer risk.

This is the first study comparing adult body measurements in such a standardised way for obesity-related cancers.

Using a novel approach, scientists at the International Agency for Research on Cancer (IARC-WHO) showed that three different measurements of body size, BMI³, waist circumference, and waist to hip ratio all predicted similar obesity-related cancer risk in older adults.

The study combined data from around 43,000 participants who had been followed for an average of 12 years and more than 1,600 people were diagnosed with an obesity-related cancer.

Dr Heinz Freisling, lead study author and scientist at the International Agency for Research on Cancer (IARC-WHO), said: "Our findings show that both BMI and where body fat is carried on the body can be good indicators of obesity-related cancer risk. Specifically, fat carried around the waist may be important for certain cancers, but requires further investigation."

"To better reflect the underlying biology at play, we think it's important to study more than just BMI when looking at cancer risk. And our research adds further understanding to how people's body shape could increase their risk."

Being overweight or obese is the single biggest preventable cause of cancer after smoking and is linked to 13 types of cancer including bowel, breast, and pancreatic.

Dr Julie Sharp, Cancer Research UK's head of health information, said: "This study further highlights that however you measure it, being overweight or obese can increase the risk of developing certain cancers, including breast and bowel.

"It's important that people are informed about ways to reduce their risk of cancer. And while there are no guarantees against the disease, keeping a healthy weight can help you stack the odds in your favour and has lots of other benefits too. Making small changes in eating, drinking and keeping physically active that you can stick with in the long term can help you get to a healthy weight - and stay there."

Article: Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe, Heinz Freisling et al., British Journal of Cancer, doi: 10.1038/bjc.2017.106, published online 25 April 2017.

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