Healthoughts
strong to the finish
Not only does spinach-chomping cartoon character Popeye have well-toned muscles, but he also may be in good cardiovascular shape.
Spinach, broccoli and other dark green, leafy vegetables contain substantial amounts of a substance called lutein. And recently, Keck School of Medicine researchers, in collaboration with colleagues at UCLA, showed that reduced levels of lutein in the blood are associated with a speedier buildup of cholesterol-filled lesions on the inner walls of arteries, a cardiovascular condition known as atherosclerosis.
"We may have identified one of the many components that account for the protective effects of vegetables," says James Dwyer, M.D., professor of medicine at the Keck School. "Findings suggest that increased intake of these dark green leafy vegetables may prevent-or at least slow-the progression of the underlying disease that leads to most heart attacks and strokes."
Dwyer and fellow researchers studied nearly 500 men and women in the Los Angeles area and monitored the amount of lutein absorbed from food into their blood streams. Over 18 months, they also used ultrasound to watch how rapidly the walls of their neck arteries thickened.
They found that those with the lowest levels of lutein in the blood had lesions in the artery wall that accumulated and thickened significantly faster than those who had the highest levels of lutein in the blood.
Lutein is in a class of antioxidant compounds known as carotenoids, which are found in many foods. Other studies have suggested lutein may be important in eye health and immune function. Besides spinach and broccoli, good sources of the antioxidant include collard greens, egg yolks, kale, leeks, peas and romaine lettuce.
Much more study is needed to confirm findings before doctors can recommend taking lutein as a supplement, though. As Dwyer notes, "Evidence is mounting that increased intake of vegetables and fruits is protective against cardiovascular disease. Unlike the use of supplements, such as beta carotene, increased intake of vegetables and fruit is also very unlikely to yield surprise adverse effects."
Seeing Red
Most people are used to seeing blood after getting a minor cut or scrape. Seeing blood in your urine, though, can be alarming.
"If you see blood, you definitely need to see a doctor," says Jeffry Huffman, M.D., a urologist at the Keck School of Medicine of USC. "Most of the time it's related to an infection, but it may indicate a more serious problem, even cancer."
Urinary tract infections are extremely common, especially among women. They usually cause uncomfortable symptoms that make them easily identifiable-burning during urination or frequent urination, for example-but they occasionally continue without symptoms for some time. Then blood may appear.
When a patient has blood in the urine, or hematuria, a physician conducts a urinalysis to look for chemical and cellular clues. White blood cells and bacteria in the urine mean an infection, which can be treated with antibiotics.
When amounts of blood in the urine are minute, the doctor usually retests the patient. "Some urine test results may show false positives for blood, especially if a microscopic exam is not done," Huffman says.
Kidney stones could also be the cause. Most stones pass out of the body on their own, but bigger stones may demand medical attention.
Depending on a person's age, risk factors and other symptoms, the doctor may order a variety of other tests such as an X-ray of the kidneys and bladder or a cystoscopy, a visual examination of the urinary tract using a lighted scope
another reasonto butt out
Cigarette for cigarette, smoking appears to pack a bigger punch for women than men when it comes to bladder cancer risk.
A study led by preventive medicine researcher J. Esteban Castelao, M.D., Ph.D., and colleagues at the Keck School of Medicine of USC and the Massachusetts Institute of Technology found that as a whole, cigarette smokers were found to run 2.5 times the risk of contracting bladder cancer than nonsmokers. But within this increased risk due to smoking, women appear to face an even greater risk than men.
For both genders, the risk of bladder cancer appeared to rise both with the number of cigarettes smoked each day and with the number of years that participants had smoked regularly. In nearly every category of smoking, however, the risks to women were greater than those to men.
Women who smoked 40 or more cigarettes a day (two packs) for 40 years or more, for example, faced more than twice the risk of contracting bladder cancer as men with the same smoking habit. These women incurred more than 11 times the risk of bladder cancer than non-smokers did, while the male smokers ran approximately five times the risk of non-smokers.
The researchers also analyzed blood samples from study participants, looking for evidence of arylamines, chemicals in cigarette smoke known to cause bladder cancer. They found that among men and women who smoked at the same level, markers of arylamine exposure were higher in women than in men.
When comparing types of cigarettes, researchers found no difference in bladder cancer risk associated with filtered versus unfiltered cigarettes or low-tar versus high-tar cigarettes-nor any difference in risk tied to whether smokers reported deep or shallow inhalations.
The American Cancer Society estimates that 53,200 Americans were diagnosed with the cancer and 12,200 Americans died from it in 2000. About half of all cases are believed to be caused by smoking
don't mess with stress
If your workday involves sweat and stress, your arteries may be the ones doing the heavy lifting.
Although regular exercise can protect against cardiovascular disease, physical activity under stressful circumstances at work appears to have no effect on-or may even hurt-cardiovascular health, according to Cheryl K. Nordstrom, a doctoral student at the USC Institute for Prevention Research.
Nordstrom examined links between workplace physical activity, stress and atherosclerosis in a group of 573 male and female Southern California utility company workers between ages 40 and 60. All were free of symptomatic cardiovascular disease.
She asked workers, via questionnaires, about their regular exercise away from work and their level of physical activity while on the job. She measured atherosclerosis in participants by determining the thickness of an artery's inner wall and looking for atherosclerotic lesions in the carotid arteries-the main arteries supplying blood to the brain. Atherosclerosis is a fatty buildup on artery walls that can impede blood flow to organs and potentially result in heart attack or stroke.
Workers who exercised most often during their leisure time had significantly less progression of atherosclerosis than other workers in the study.
However, the more workers reported being physically active at work, the greater their progression of atherosclerosis over time. Workplace activity was strongly correlated to workplace psychological stress, Nordstrom says. In addition, the number of hours spent at work appeared to be a risk factor for the progression of atherosclerosis.
Adjusting for age, 36 percent of the men in the most stressed-out fifth of the study participants had carotid lesions. But among the least stressed fifth of men, only 21 percent had carotid lesions.
Researchers did not observe the same patterns in women in the study. "Women in this age group may be protected from such effects, or current workplace questionnaires may not accurately assess stress in women," says Nordstrom
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