Wednesday: Health Points

A study published Monday hints that fitness buffs appear to have "younger" DNA than the chronically sedentary. The finding could help scientists understand the effects of exercise and aging at a molecular level.

Previous research has shown that being physically active reduces the risk of heart disease, cancer and other diseases, potentially extending longevity.

Previous research has shown that older people have shorter ends than younger folks. Indeed, biologists say they shrink every time a cell divides.
Some 84 million people risk dying from cancer over the next decade, the World Health Organisation (WHO) and the International Atomic Energy Agency (IAEA) said.


The IAEA, the UN atomic watchdog, is involved in the fight agaist the disease through its Programme of Action for Cancer Therapy (PACT) division, which shares the organisation's knowledge of radiotherapy techniques with other partners in the field.

PACT head Massud Samiei told journalists that "the cancer epidemic will gather pace in developing countries."
About two-thirds of the cases were children who took the medicines unsupervised. However, about one-quarter involved cases in which parents gave the proper dosage and an allergic reaction or some other problem developed, the study by the U.S. Centers for Disease Control and Prevention reported.


The study included both over-the-counter and prescription medicines. It comes less than two weeks after the U.S. Food and Drug Administration warned parents that over-the-counter cough and cold medicines are too dangerous for children younger than 2.
The key is for both spouses to be comfortable expressing anger, rather than one or both suppressing anger, University of Michigan researchers report.


"The key matter is, when the conflict happens, how do you resolve it?" asks Ernest Harburg, PhD, professor emeritus with the University of Michigan's School of Public Health and psychology department. "If you bury your anger, and you brood on it ... and you don't try to resolve the problem, then you're in trouble."

Harburg's team found a higher death rate among married couples in which both spouses suppress anger, compared with other married couples. Their findings appear in the Journal of Family Communication.
Studies in the past have demonstrated that cannabis can cause cancer, but few have established a strong link between cannabis use and the actual incidence of lung cancer.


In an article published in the European Respiratory Journal, the scientists said cannabis could be expected to harm the airways more than tobacco as its smoke contained twice the level of carcinogens, such as polyaromatic hydrocarbons, compared with tobacco cigarettes.

The method of smoking also increases the risk, since joints are typically smoked without a proper filter and almost to the very tip, which increases the amount of smoke inhaled. The cannabis smoker inhales more deeply and for longer, facilitating the deposition of carcinogens in the airways.
BREAKFAST CEREALS
Seventh-Day Adventists are credited with creating breakfast cereals. They founded the Battle Creek Sanitarium, where they manufactured and promoted wholesome cereals. Will Keith Kellogg was an Adventist who discovered corn flakes in 1894 when a pot of cooked wheat was overcooked and then dried. Each grain became a separate flake. He introduced Rice Krispies in 1929. The Battle Creek Toasted Corn Flake Company was founded in 1906.


THE DOUGHNUT
Originally introduced by the Dutch as sweet dough fried in pork fat (known as "oily cakes"), the doughnut has been around a very long time, although its popularity surged with the doughnuts served to solders in World War I. The term "doughnut" either comes from the small balls of dough that looked like nuts, or a recipe from a mid-19th century cook who added nuts to the center of her fried dough and therefore referred to them as dough "nuts." The legend goes on to say that her son, a sea captain, didn't like the nuts so he had them cut out, creating the famous doughnut shape that we know today. Doughnuts remained as snacks, not breakfast -- often served in theaters -- until the doughnut machine was invented in the 1930s. By the 1940s and 1950s, Krispy Kreme and Dunkin' Doughnuts had been introduced, and the pairing of coffee and doughnuts secured their place in the breakfast repertoire. By the 1950s, "drop" doughnuts became very popular and Orange Drop Doughnuts showed up in the Betty Crocker Cookbook. Since no rolling or cutting was required -- just drop spoonfuls of batter into hot oil -- this category of doughnuts caught on quickly.
The number of Americans being diagnosed with and also living with type 2 diabetes is soaring, presenting a major health and economic crisis for the United States, a new study reports.


"What's alarming is we have 47 million uninsured people, but these people [in the study, enrolled under Medicare] are all insured. So in this kind of insured program, we have so many people who are not adhering to the recommended care," said Frank Sloan, lead author of the study published in the Jan. 28 issue of the Archives of Internal Medicine.

Sloan is professor of health policy and management at Duke University Medical Center in Durham, N.C.
The ayurvedic menu at Ananda Spa has been designed to balance the three doshas: Vata, Pitta, and Kapha. The doshas are roughly similar to our ectomorph, mesomorph, and endomorph body types, but they’re even more detailed, taking into consideration the shape of the face, skin type, hair, eyes, and temperament. Everyone is a mix of the three, but one dosha is predominant. If the doshas are balanced, you’ll enjoy good health, if not, you’re basically screwed…


…Once you know which dosha you align with, your ayurvedic practitioner will help you get in harmony through your food choices. To balance a Vata dosha, for example, you’re apparently supposed to eat mostly warm foods, such as soups, stews, warm milk, warm cereals, and baked bread (cream and butter are on the list too). And Vatas are advised to avoid cold foods, such as salads, iced drinks, and raw vegetables and greens. Hmm … doesn’t sound ideal for someone who is lactose-intolerant and loves her veggies.

Vitamin D and Calcium, Joint at the Hip

Sometimes I wonder about things. Like, why is the sky blue? Why do men have nipples? Why do we park in a driveway and drive on a parkway? Or, why is proper vitamin D intake important to calcium absorption? Dr. Fuhrman explains:
Vitamin D is a fat-soluble vitamin that your body makes after exposure to ultraviolet (UV) rays from the sun. Vitamin D functions as a hormone because it sends a message to the intestines to increase the absorption of calcium and phosphorus.
Sadly, Dr. Fuhrman had nothing on the whole driveway-parkway thing. Now, check out this parroting of good information. Reuters reports, vitamin D ups calcium's bone-building effect. Here’s an excerpt:
The women were between 70 and 80 years old. After 1 year, bone mineral density at the hip was preserved in the calcium group and the calcium+vitamin D group, but not in the double-placebo "control" group.


However, at 3 and 5 years, only the group that got calcium plus vitamin D group maintained hip bone density, the investigators report in the Journal of Clinical Endocrinology and Metabolism.

They conclude that adequate levels of vitamin D are necessary for calcium to do its job in keeping bones healthy.
Oh dear, now I’m wondering again. Where do get all this “vitamin D?” Well, George Harrison once sung, “Little darling, it's been a long cold lonely winter. Little darling, it feels like years since it's been here. Here comes the sun, here comes the sun.”

Cancer, the Pill, and a Load of Bull

This report sounds like a smarmy guy’s attempt to get his girlfriend on birth-control, but apparently research has determined that “the pill” protects against ovarian cancer. Maria Cheng of the Associated Press reports:
"Not only does the pill prevent pregnancy, but in the long term, you actually get less cancer as well," said Valerie Beral, the study's lead author and director of the Cancer Research UK Epidemiology Unit at Oxford University. "It's a nice bonus." The study was paid for by Cancer Research UK and Britain's Medical Research Council.


Beral and colleagues analyzed data from 45 studies worldwide, covering 23,257 women with ovarian cancer, of whom 31 percent were on the pill. They also looked at 87,303 women without ovarian cancer, of whom 37 percent were on the pill.

In both groups, the women on the pill took it for about five years. The researchers found that in rich countries, women taking oral contraceptives for a decade were less likely to develop ovarian cancer. Without the pill, about 12 women per 1,000 are expected to get ovarian cancer before age 75. But that figure dropped to 8 women per 1,000 in those on the pill.
Now, reports like this spread like wildfire. Actually, they’re more like a nugget that won’t flush. So in keeping up with the media frenzy, I asked Dr. Fuhrman about this research. Here’s what he had to say:
It increases the risk of the most common cancer in women; breast cancer and decreases the risk of ovarian cancer, which is comparatively rare and they are promoting more widespread use of the pill giving the false conclusion that it decreases cancer deaths overall. Pure bull! If people want to really decrease their risk of cancer they are simply going to have to eat lots of vegetables and exercise. How boring!
Honestly, can you make a bigger case for this country’s magical pill obsession? I mean come on! The medication in question is called, “THE PILL.” Perhaps next they’ll tell us it can part the sea and turn water into wine.

Girls and Puberty, Sooner and Sooner

It’s hard to fathom that an eight-year-old girl might be developing sexually, shouldn’t they be playing with toy ponies and think boys are icky—which we are—but apparently more and more young girls are starting puberty early. Dr. Fuhrman talks about it:
Physicians are seeing more and more girls with precocious sexual development, even before today’s average age of twelve, and medical studies confirm that the trend is real and getting worse. How early are our children developing today? At age eight, almost half black girls and 15 percent of white girls start developing breasts or pubic hair. At age nine, those numbers change to 77 percent of black girls and a third of white girls.1
This is an uncomfortable topic—even for a bull the china cabinet like me—but this is a serious matter and one that the medical community might be taking too lightly. Susan Brink of The Los Angeles Times investigates in Girl, You'll be a Woman Sooner Than Expected. Here’s an excerpt:
What's clear is that physical appearance is getting ahead of other aspects of girls' maturity. They might be perceived as far older than they are, even when they're still rummaging through their mothers' closets to clomp around in oversized high heels.


"My daughter started developing breasts maybe around age 8," says Rhonda Sykes of Inglewood. "She was still into her doll phase and dressing up to play." So Sykes began having frank mother-daughter conversations about curves and changing bodies a bit earlier than she expected.

"Whatever they look like, they know nothing," says Diana Zuckerman, president of the National Research Center for Women and Families. "Eight- and 9-year olds are learning to make change for a dollar. These are children who are learning the most fundamental facts in school. Imagine trying to teach that child the fundamentals of sex. They're not even playing Monopoly yet. They're still playing Candyland."

The medical community calls earlier puberty normal, the trend goes hand in hand with the obesity epidemic, and science has not yet pinpointed the reasons. And yet, when girls who are still children in the minds of their parents start developing breasts, many of their mothers remember that it happened later in their own lives -- and wonder why.
Brinks' report sites diet as a potential contributor to the problem of early puberty. She’s smart to do so. According to Dr. Fuhrman the standard American diet—which is responsible for all the obesity—is a major culprit. He explains:
Diet powerfully modulates estrogen levels. One recent study illustrated that eight-to-ten-year-olds, closely followed with dietary intervention for seven years, dramatically lowered their estrogen levels compared to a control group with dietary modification.2 Clearly, changing the diet of our children after the age of eight is not futile.
This graph might make things a little clearer for you. I scanned it—horribly—out of Dr. Fuhrman’s book Disease-Proof Your Child. It compares sex hormone levels in individuals eating a Western diet and those consuming a more vegetable-based Asian diet. Take a look:


The concern with all these sex hormones centers on lifetime cancer risk. Dr. Fuhrman explains why, check it out:
Early puberty is strongly associated with breast cancer, and the occurrence of breast cancer is three times higher in women who started puberty before age twelve.3
Also, studies have revealed the effects of different varieties of foods on puberty and cancer risk. More from Dr. Fuhrman:
Cohort studies, which follow two groups of children over time, have shown that the higher consumption of produce and protein-rich plant foods such as beans and nuts is associated with a later menarche, and the higher consumption of protein-rich animal foods—meat and diary—is associated with an earlier menarche and increased occurrence of adult breast cancer.4
As far as DiseaseProof goes, this is a common conclusion. The advantages of a vegetable-based nutritarian diet are profound. Dr. Fuhrman is stresses this in his new Food Scoring Guide. Here’s a quote:
Increasing your consumption of high-nutrient fruits and vegetables is the key to disease resistance, disease reversal, and a long, healthy life. The potential reduction in disease rates shows no threshold effect in the scientific studies. That means that as high-nutrient vegetables and high-nutrient fruits increase as a major portion of caloric intake, disease rates fall in a dose-dependent manner—the more the diet is comprised of these foods, the better your health will be.5
Granted, the problem is serious and apparently growing, but the good news is there is a solution, maybe the real problem is getting everyone on board.
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A Sunny Cancer-Fighter

“Laboratory, animal, and epidemiologic evidence suggests that vitamin D may be protective against cancer,” explains Dr. Fuhrman. According to him a lot of research has shown vitamin D to be a potent cancer-fighter. Take a look:
Epidemiologic studies suggest that a higher dietary intake of calcium and vitamin D, and/or sunlight-induced vitamin D synthesis, correlates with lower incidence of cancer, including lymphoma, breast, prostate, and colon cancer.1 In fact, for over 60 years, researchers have observed an inverse association between sun exposure and cancer mortality,2 and those with more sun exposure had fewer cancers.
Speaking of sun exposure—it’s important! Trust the facts. Being a mole-person is not a good idea. Get some sun, and, check out this study in the NewScientist. Sun-drenched populations are more protected against cancer. Andy Coghlan reports:
Sunshine is regularly blamed for causing fatal skin cancers, but it may help save your life if you develop a different cancer. It seems that sunlight has an overall protective effect as it stimulates the body's production of vitamin D, which helps to combat internal cancers, including those of the colon and prostate.


"A little sun exposure is a little better for you than avoiding sunlight," says Richard Setlow of Brookhaven National Laboratory in Upton, New York, who co-led the new work. "Vitamin D doesn't lower the incidence of internal cancers, but it prevents more people dying from them."
Now, in case you’re curious or you forgot. Here Dr. Fuhrman explains just what makes sunlight so special. More reason to go into the light:
Vitamin D is a fat-soluble vitamin that your body makes after exposure to ultraviolet (UV) rays from the sun. Vitamin D functions as a hormone because it sends a message to the intestines to increase the absorption of calcium and phosphorus.
For a long time I used to be a cave-dweller. I’d stay indoors all the time and hardly ever go outside. Not anymore. Now I drag my butt outside fairly often. How about you?
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Hormone Therapy and Breast Cancer Risk

According to new research, hormone replacement therapy can raise the risk of an uncommon type of breast cancer. Maggie Fox of Reuters reports:
They found women who took combined estrogen/progestin hormone-replacement therapy for three years or more had four times the usual risk of lobular breast cancer.


Their study, published in the January issue of Cancer Epidemiology, Biomarkers and Prevention, is one of dozens trying to paint a clearer picture of what dangers might come from taking HRT to treat menopause symptoms.

"Previous research indicated that five or more years of combined hormone-therapy use was necessary to increase overall breast-cancer risk," Dr. Christopher Li of the Fred Hutchinson Cancer Research Center, who led the study, said in a statement.

Meat, a Bad Idea for Breast Cancer

No one wants cancer. In Eat to Live, Dr. Fuhrman explains that the best way to prevent cancer is adopting a diet rich in fruits and vegetables. Take a look at this:
Humans are genetically adapted to expect a high intake of natural and unprocessed plant-derived substances. Cancer is a disease of maladaptation. It results primarily from a body’s lacking critical substances found in different types of vegetation, many of which are still undiscovered, that are metabolically necessary for normal protective function. Natural foods unadulterated by man are highly complex—so complex that the exact structure and the majority of compounds they contain are not precisely known. A tomato, for example, contains more than ten thousand different phytochemicals.
Conversely, eating lots of animal products and meat has the opposite effect. Need proof? Check out this study in the International Journal of Cancer. Here’s the abstract:
Meat intake has been positively associated with risk of digestive tract cancers in several epidemiological studies, while data on the relation of meat intake with cancer risk at most other sites are inconsistent. The overall data set, derived from an integrated series of case-control studies conducted in northern Italy between 1983 and 1996, included the following incident, histologically confirmed neoplasms: oral cavity, pharynx and esophagus (n = 497), stomach (n = 745), colon (n = 828), rectum (n = 498), liver (n = 428), gallbladder (n = 60), pancreas (n = 362), larynx (n = 242), breast (n = 3,412), endometrium (n = 750), ovary (n = 971), prostate (n = 127), bladder (n = 431), kidney (n = 190), thyroid (n = 208), Hodgkin's disease (n = 80), non-Hodgkin's lymphomas (n = 200) and multiple myelomas (n = 120). Controls were 7,990 patients admitted to hospital for acute, non-neoplastic conditions unrelated to long-term modifications in diet. The multivariate odds ratios (ORs) for the highest tertile of red meat intake (7 times/week) compared with the lowest (3 times/week) were 1.6 for stomach, 1.9 for colon, 1.7 for rectal, 1.6 for pancreatic, 1.6 for bladder, 1.2 for breast, 1.5 for endometrial and 1.3 for ovarian cancer. ORs showed no significant heterogeneity across strata of age at diagnosis and sex. No convincing relation with red meat intake emerged for cancers of the oral cavity, pharynx and esophagus, liver, gallbladder, larynx, kidney, thyroid, prostate, Hodgkin's disease, non-Hodgkin's lymphomas and multiple myeloma. For none of the neoplasms considered was there a significant inverse relationship with red meat intake. Thus, reducing red meat intake might lower the risk for several common neoplasms.
You just can’t be solid concrete research. Want more? Get load of this study in the European Journal of Cancer Prevention. The PCRM sent it over:
A substudy of the Diet, Cancer and Health study, a prospective cohort study established to evaluate the role of diet and cancer among 24,697 postmenopausal Danish women, was set up to evaluate the relationship between meat consumption and risk of breast cancer. This nested study looked at 378 women who developed breast cancer and matched them to controls who did not develop breast cancer. A higher intake of meat (red meat, poultry, fish, and processed meat) was associated with a significantly higher breast cancer incidence rate. Every 25 gram increase in consumption of total meat, red meat, and processed meat led to a 9, 15, and 23 percent increase in risk of breast cancer, respectively. However, the degree of risk may depend on genetics. Certain genes activate the carcinogens (heterocyclic amines) found in cooked meat. The study showed women with genes that rapidly activate these carcinogens are at particular risk of breast cancer if they eat meat.
Now, for more ways to prevent breast cancer, Dr. Fuhrman whipped up this list of ways women can protect themselves. Have a look:
1. Do not drink alcohol.
2. Do not smoke.
3. Do not take estrogen.
4. Have babies and nurse them for two years each.
5. Avoid dietary carcinogens, which are predominantly found in fatty fish and dairy fat.
6. Eat a high-nutrient, vegetable-based diet as described in my book, Eat To Live. Green vegetables are the most powerful anti-breast cancer food. Take note that a vegetarian diet does not show protection against breast cancer as much as a diet rich in green vegetables, berries, and seeds. It is the phytochemical nutrient density and diversity of the diet that offers the most dramatic protection against cancer, not merely the avoidance of meat or fat.
7. Take a multivitamin to assure nutritional completeness and take at least 100mg of DHA daily.
8. Use one tablespoon of ground flax seeds daily.
9. Don’t grill or fry foods. Steaming vegetables or making vegetable soups should be the major extent of cooking.
10. Exercise at least three hours a week, and maintain a lean body with little body fat.
I’m no doctor, but, I bet these tips would help against all cancers. What do you think?

Bad Foods that are Actually Great for Your Waist?

What the hell does that mean! The obviously coo-coo, Camille Noe Pagán of Health thinks red meat, ice cream, eggs, pizza, and Canadian bacon are getting a bad rap. Here’s some of this harebrained article:
Even burgers and meatballs can be light fare if you make them with ground sirloin, says Bonnie Gluck, M.S., R.D., a clinical dietitian at New York Methodist Hospital in New York City. "Lean red meat -- lean being the operative word -- is a great choice for women who are trying to shed pounds," she says. "It's an excellent source of protein. And protein takes longer to digest, helping you feel full and cutting the likelihood that you'll snack later on…"


…Not all studies support the dairy-aids-weight-loss claim. But Gluck feels there's more evidence for than against, even if full-fat dairy's secret is simply that it's more satisfying. "Many women find that low-fat versions of dairy products like ice cream and cheese just aren't satisfying," she says, "so they may eat a lot of them -- downing hundreds of calories in the process, trying to fulfill their craving -- when just a little bit of the full-fat stuff would have done the trick…"

…After years of being barred from the average American diet, things are looking sunny-side up for eggs. According to a study from Pennington Biomedical Research Center in Baton Rouge, Louisiana, overweight women who eat egg breakfasts lose twice as much weight as women who start their days with bagels. Researchers say the protein in eggs increases satiety and decreases hunger, helping women eat fewer calories throughout the day. "Eggs are a perfect protein source because they have all eight essential amino acids," Dave Grotto, R.D., author of "101 Foods That Could Save Your Life" says. "And recent research debunks the idea that they have adverse effects on the heart…."

…You already know you can enjoy some mozzarella on your favorite pie and still drop pounds. But there are other ways you can make that slice even healthier. To hike the diet-friendly fiber, choose a whole-wheat crust and top your pizza with veggies like peppers, artichokes, and broccoli. "Like protein, fiber is digested slowly and helps keep you feeling full, longer," Gluck says…

…Unlike a regular strip of crispy pork fat, Canadian bacon -- which comes from the loin, one of the leanest parts of the pig -- is a dieter's best friend, with a third less fat than regular bacon. If that isn't reason enough to put Canadian bacon on your plate, a recent study from Purdue University shows that women who eat a diet rich in lean pork and other protein keep more lean body mass during weight loss than women who eat a low- calorie diet with little pork and other protein sources. An added bonus: Women who eat meals rich in protein from pork report that they feel satisfied, in spite of the fact that they are on reduced-calorie diets, and say they're happier overall.
Okay, there’s no need to beat a dead horse here. Readers of this blog know that foods like this aren’t health promoting, so, I’ll make this a quick and decisive execution. First, here’s Dr. Fuhrman commenting on red meat. Take a look:
A recent study showed that after following almost 200,000 Americans for seven years, those who regularly consumed red meat had a double the occurrence of pancreatic cancer.1
Next up, dairy, yuck, just the thought of it makes me have to run to the bathroom. While I make a pit stop, you guys check out Dr. Fuhrman’s thoughts on dairy. Here:
Dairy is best kept to a minimum. There are many good reasons not to consume dairy. For example, there is a strong association between diary lactose and ischemic heart disease.2 There is also a clear association between high-growth-promoting foods such as dairy products and cancer. There is a clear association between milk consumption and testicular cancer.3
Okay, all better. Now, onto eggs and this might surprise you, but, Dr. Fuhrman isn’t that down on eggs. Here’s what he has to say:
If you choose a limited amount of animal products to be included in your family’s diet, I favor eggs over fish or dairy, because of the potential for transmission of chemicals, mercury, and PCBs in the fish and dairy. Eggs, because they are virtually pollution-free, would be favored choice over other animal products to add to an otherwise vegan diet.
I admit, sometime I forget about this because I don’t eat eggs. Here’s another thing I don’t eat, cheese. So, just what does the good doctor have to say about cheese? See for yourself. More from Dr. Fuhrman:
Dairy fat is also loaded various toxins and is the primary source of our nation’s high exposure to dioxin.4 Dioxin is a highly toxic chemical compound that even the U.S. Environmental Protection Agency admits is a prominent cause of many types of cancer in those consuming dairy fat, such as butter and cheese.5 Cheese is also a power inducer of acid load, which increases calcium loss further.6
Finally, the dreaded bacon, this one is easy, but, I’ll give Dr. Fuhrman a breather with this one. Check out this report linking the consumption of cured meats to chronic obstructive pulmonary disease (COPD). HealthDay News reported:
Using data compiled as part of the Third National Health and Nutrition Examination Survey, the study authors found a statistical association between people who ate 14 or more servings monthly of cured meats and the incidence of chronic obstructive pulmonary disease (COPD). This held true even after the researchers factored in such variables as age, smoking, and the amount of fruits and vegetables in the subjects' diets.


"People who eat 14 or more servings of cured meat per month have about an 80 percent increased odds of COPD versus people who don't eat cured meat at all," Dr. Rui Jiang, an associate research scientist at Columbia University Medical Center in New York City said.

And, the more cured meats a person eats a month, on average, the higher the risk of COPD, the study said.
So, with ALL this being said, I hardly think there is anything great about gobbling up large amounts of meat and dairy. Camille Noe Pagán would do well to check her sources—don’t you think?
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Milk Linked to Prostate Cancer

Reuters reports, low-fat or nonfat milk may be linked to an increased risk of prostate cancer. Take a look:
A total of 82,483 men from the study completed a quantitative food frequency questionnaire and various factors, such as weight, smoking status, and education levels were also noted, Park's group said.


During an average follow-up period of 8 years, 4,404 men developed prostate cancer. There was no evidence that calcium or vitamin D from any source increased the risk of prostate cancer. This held true across all racial and ethnic groups.

In an overall analysis of food groups, the consumption of dairy products and milk were not associated with prostate cancer risk, the authors found. Further analysis, however, suggested that low-fat or nonfat milk did increase the risk of localized tumors or non-aggressive tumors, while whole milk decreased this risk.

In a similar analysis, Dr. Yikyung Park, from the National Cancer Institute at National Institutes (NIH) of Health in Bethesda, Maryland, and colleagues investigated the relationship of calcium and vitamin D and prostate cancer in 293,888 men enrolled in the NIH-American Association of Retired Persons Diet and Health Study, conducted between 1995 and 2001. The average follow-up period was 6 years.