Healty Tips: 2014

New Year Health Tips

New Year Health Tips

Today, I am going to share few of the very interesting articles on New year health tips for everyone.

While i was surfing online for the best new year health tips for the coming year 2015, I could see few articles that makes me to publish on my health tips blog so that people would be benefitted from reading and following those tips.

Health Tips for a New Year 2015

20 Tips to Help You Keep Your New Year's Resolutions

Once we have put some thought into our vision for the future, and set goals that are based on health rather than perfectionism, then the following simple steps can help you develop and maintain the resolve to achieve your goals.

1. Be realistic.
2. Aim for self-improvement and learning.
3. Line your goals up with your priorities.
4. Set a realistic time frame for change.
5. Focus on self-care and nurturance through the change.
6. Develop your patience.
7. Be honest with yourself - change requires commitment.
8. Look for ways to reduce stress, as it will undermine your discipline and your health.
9. Be prepared to try something new.
10. Be prepared to learn from your mistakes.
11. Celebrate the small steps.
12. Be curious and open to the learning.
13. Look for balance in life.
14. Stay focused.
15. Use self-care and self-reflection to help you accomplish your goals.
16. Look for others who share your goals, and support each other.
17. Have 'safe' people who will encourage you during your highs and lows.
18. Take actions to commit to good decision making.
19. Be non-defensive and open to examining poor decision making.
20. Have some fun along the way - joy can fuel positive change.

Top 10 Healthiest New Year's Resolutions

New Year’s resolutions are a bit like babies: They’re fun to make but extremely difficult to maintain.

Read more Top 10 Healthiest New Year's Resolutions

15 health tips for the new year

Year after year we make resolutions to exercise regularly, eat well, and give up smoking and other bad habits. Following such basic rules can cut heart disease risk by 80 percent, diabetes risk by 90 percent and cancer risk by 50 percent, according to the Harvard Nurses' Health Study.

Read more 15 health tips for the new year

9 Healthy New Year’s Resolutions

Want to downsize your figure? Start downsizing your dishes. Studies show using smaller plates and bowls promote weight loss because they help to curb overeating.

Read more 9 Healthy New Year’s Resolutions

8 Tips for Making and Keeping Healthy New Year's Resolutions

If you are the type of person who makes but never keeps New Year's resolutions, these suggestions can help you make healthy -- and attainable -- goals this year.

1. Don't abandon the idea of setting resolutions because you have broken them in the past. You may need to simply readjust the type and number of goals you're setting for yourself.

2. Do be realistic. A resolution to run a marathon by year's end is likely unrealistic for an inexperienced exerciser. Likewise, resolving to stop all your unhealthy habits at once is likely to fail. Pick a safe, attainable goal with a realistic time frame. For example, if your resolution is to eat healthier, begin by eliminating one unhealthy food from your diet at a time, not all unhealthy foods.

Read more 8 Tips for Making and Keeping Healthy New Year's Resolutions

5 Diet Resolutions for New Year

Are you making bold resolutions on January 1 to "eat right" -- whatever that means? Stop trying to overhaul your entire diet in a day! Resolve to think small and you can reach any diet goal -- one focused step at a time. Why not start with these simple tips?

Read more 5 Diet Resolutions for New Year

10 Tips to Help You Keep Your New Year’s Resolution

Chances are at some time in your life you’ve made a New Year’s resolution — and then broken it. This year, stop the cycle of resolving to make change and then not following through. If your resolution is to take better care of yourself and get healthy, you will have a much better year if your resolution sticks. Here are 10 tips to help you get started.

1. Be Realistic

The surest way to fall short of your goal is to make your goal unattainable. For instance, resolving to NEVER eat your favorite food again is setting you up to fail. Instead, strive for a goal that is attainable, such as avoiding it more often than you do now.

2. Plan Ahead

Don’t make your resolution on New Year’s Eve. If you wait until the last minute, it will be based on your mindset that particular day. Instead, it should be planned well before December 31 arrives.

3. Outline Your Plan

Decide how you will deal with the temptation to skip that exercise class or have that piece of cake. This could include calling on a friend for help, practicing positive thinking and self-talk, or reminding yourself how your “bad” will affect your goal.

4. Make a “Pros” and “Cons” List

It may help to see a list of items on paper to keep your motivation strong. Develop this list over time, and ask others to contribute to it. Keep your list with you and refer to it when you need help keeping your resolve.

5. Talk About It

Don’t keep your resolution a secret. Tell friends and family members who will be there to support your resolve to change yourself for the better or improve your health. The best-case scenario is to find a buddy who shares your New Year’s resolution and motivate each other.

6. Reward Yourself

This doesn’t mean that you can eat an entire box of chocolates if your resolution is to eat a better diet. Instead, celebrate your success by treating yourself to something you enjoy that doesn’t contradict your resolution. If you have been sticking to your promise to eat better, for example, reward yourself with new fitness clothing or by going to a movie with a friend.

7. Track Your Progress

Keep track of each small success. Short-term goals are easier to keep, and each small accomplishment will help keep you motivated. Instead of focusing on losing 30 pounds, focus on losing the first five. Keep a food journal to help you stay on track, and reward yourself for each five pounds lost.

8. Don’t Beat Yourself Up

Obsessing over the occasional slip won’t help you achieve your goal. Do the best you can each day, and take one day at a time.

9. Stick to It

Experts say it takes about 21 days for a new activity to become a habit and six months for it to become part of your personality. It won’t happen overnight, so be persistent and patient!

10. Keep Trying

If you have totally run out of steam when it comes to keeping your resolution by mid-February, don’t despair. Start over again! Recommit yourself for 24 hours. You can do anything for 24 hours. The 24-hour increments will soon build on each other and, before you know it, you will be back on track.

Read more 10 Tips to Help You Keep Your New Year’s Resolution

10 Better-for-You New Year’s Resolutions

Making a New Year’s resolution this year? If it’s to lose those pesky 10 pounds—for the sixth year in a row—why not consider making a new, more doable resolution with equally big health payoffs? Take your pick of these 10 attainable resolutions that you can actually tackle this year.

Read more 10 Better-for-You New Year’s Resolutions

100 Ways to Start Your Year Off Light

Healthy Tips for the New Year

With the new year comes new expectations and goals, often accompanied by the fear of falling off the resolutions wagon by month’s end. Make this year different. Put aside over-blown resolutions and commit to making small changes all year to make this year your lightest ever. The benefits: Lose weight, put a bounce in your step, get some calm in the kitchen, and become a healthier you without feeling deprived.

Read more 100 Ways to Start Your Year Off Light

How to Prevent Heart Attack

Health Tips on How to Prevent Heart Attack

Today i am going to share you the most and the important topic for every human being in their life to live a healthy and a happier lifestyle. The article covers the health tips for preventing the heart attack and heart diseases. Hope everyone will be familiar about the topic and might not known how to prevent heart attack. By reading this article you will be knowing how to be safe yourself in preventing heart disease and heart attacks.

Health Tips on How to Prevent Heart Attack

Taking Responsibilities for your Health

Cardiovascular disease (also called heart disease) is a class of diseases that involve the heart, the blood vessels. Cardiovascular disease is one of the major causes for death in USA, lasting for 34 percent of deaths, many suddenly and most of them were premature. If you were prone to diabetes, your risk increases naturally. One of the best prevention against this heart attack or disease is to understand the risk and to follow the treatment options. This first step for preventing the heart attack is to take responsibility for your health.

Know your Risks

For Cardiovascular disease, the major risk factor is the age. The person is older is getting affected by the heart attack first.

Stop Smoking

Continuous smoking will leads to heart diseases. It has been published in one of the article that cigarette smoking and second-hand exposure to smoke increase the risk of heart attack and other Cardiovascular disease like lung disease, stroke and etc. Article on Health Benefits of Quitting Smoking

Maintain a Balanced Blood Pressure

High blood pressure causes heart attacks and it goes without symptoms in most of the individuals. Heredity and the increasing age is the risk of this disease.

Monitor your Blood lipids or Cholesterol

High blood lipids may cause the Cardiovascular disease. Every human body has the Lousy Cholesterol, Healthy Cholesterol and Triglycerides. The lower the Lousy Cholesterol will lead to a heart disease in a human.

Maintain your body weight

It is good to maintain a healthy weight by doing regular exercise. Every day exercise will help you in reducing the heart problems, hypertension and makes you relax and comfort throughout the day.

Drinking Water in Empty Stomach in Early Morning

Drinking water in the early morning is very important for one's health. That too drinking a liter of water in an empty stomach in the early morning is highly beneficial for the human body.

It is really a tough thing to drink water in an empty stomach in early morning as this would lead to vomiting sensation for everyone. But it is our duty to drink at least a liter of water in an empty stomach to maintain a healthy lifestyle. Initially we can drink a glass of water and after that one can increase the amount of water day by day. Article on Benefits of Drinking Water in Empty Stomach in Early Morning

Christmas Health Tips for a Healthy Lifestyle

Christmas Health Tips for a Healthy Lifestyle

Christmas or Christmas Day is nothing but an annual festival especially for the christian peoples on commemorating the birth of Jesus Christ. It is most commonly celebrated on 25th December every year. Celebrated among peoples all over the world.

Today I am going to share you few health tips on this Christmas day that must be followed by everyone to live a peaceful and a healthier lifestyle.

Health tips for Christmas December 25

Drink Plenty of Water

It is good to drink more water that helps in easy digestion for everyone. Only drinking water will helps us in preventing from diseases. So drinking a minimum of 5 liters every day will keep us safe from disease causing germs.

You can read out this article
Health Benefits of Drinking Hot Water in an Empty Stomach in Early Morning

Eat Fresh Fruits and Vegetables.

Always eat fresh fruits that really brings you some energy. Before you eat just wash the fruits and as well as your hands. This will not affect you. Just have the right kind of vegetables at this winter season. Try to avoid vegetables that cause cold on this winter months.

Following Diet

Maintain a proper diet by having your food at the right time. Never skip breakfast as this would lead to ulcer and other problems. Try to eat fresh juices in between break fast and lunch as this would help you in keeping your very energetic through the day.

Morning Exercise

It is good to start a day with a little warm up or exercise which makes your mind and body fresh the whole day. Morning exercise also helps you to concentrate on the jobs and makes you relax from tension. If you feel yourself not comfortable in doing exercise, just have a little walk, which really helps you. Before walking you can drink some hot water which helps in burning of calories in terms of sweat.

Sleep 8 Hours a Day

In this hurry bury world, we need to keep our mind and body relax. This can be done only if you could sleep 8 hours completed in a day without any disturbances. Doctor advice everyone to have a continuous 8 hours sleep at the night. While sleep just keep away your cell phones which would helps you in having a deep sleep.

Drinking Green Tea

Drink green tea instead of having a caffeine at the morning. There are many health benefits of drinking a green tea in the morning.

Related Article
Health Benefits of Drinking Green Tea

Plan a trip outing

Just make yourself in planning a trip or tour along with your family members to a nice and chill place where you can be much happier.

Hope everyone would be following these simple tips on this Christmas festival to have a happier lifestyle. I wish you every one a very happy and a merry Christmas.

Health Tips on How to Prevent Cold and Cough in the Winter Season

Health Tips on How to Prevent Cold and Cough in the Winter Season

Winter season started and everyone must be worried about suffering from cold, sore throat, cough, running nose, fever and etc.

Here today, I am going to explain you few of the health tips and as well as how to prevent yourself from cold and cough in this winter seasons.

Health Tips on How to Prevent Cold and Cough

Always keep your hands clean

It is better to wash your hands frequently with good soap which will protect you from microbes and germs. In few situations, without our knowledge we might touch someone's hands or sneeze. In those cases make yourself clean by washing your hands with the soap.

Also after you using your bathrooms clean your hands with hand-wash. This may help us to lead a healthier lifestyle.

Clean your surroundings

Everyone must keep their places and surroundings clean. We need to clean our houses, bathrooms, bedrooms and other living rooms. Doctor advised to keep your mobile phones clean every-time. Since without our knowledge a few may use our cell phones. Through this way also the germs may come and enter into your body.

In-Take of Healthy Foods

As winter season started, everyone must be careful in what you eat. Few fruits and vegetables are needs to be avoided in these winter months. So get the advice of your family doctors and schedule yourself. Eat a healthy and nutritious diets with fresh fruits and vegetables. This helps in protecting our body from causing diseases like cold and cough.

Hope everyone would understand these health tips on How to prevent cold and cough in these winter season in order to have a healthy lifestyle.

Healthy Foods To Eat to Lose Weight Fast

Healthy Foods To Eat to Lose Weight Fast

With changing time, irrespective of the age, we have become very prone towards junk food intake, which in the long run comes up with problems such as overweight and obesity. While some people understand that they need to lose weight but lacks motivation, whereas the other group knows the health risks that junk foods brings but continues with their eating habits. However, there is good news for those people who could not control their eating habits. With the healthy ways to lose weight fast, you can keep eating without thinking much about the calorie count.

There are many healthy foods to eat to lose weight. Let’s take a look at them.

Eggs are very rich in protein content and can replace most of the high calorie foods. You could start your day with an egg sandwich, which would supply a good amount of energy to start a fresh day. You can have a glass of milk, or juice and an egg in your breakfast.

If you are thinking about healthy eating plan to lose weight, soups are the right alternative to heavy meals and keep you energetic as well. You can have soups in lunch or dinner. Soups made from colorful and leafy vegetables such as carrots, tomatoes, beans are very healthy and extremely low in calories. You can also add shredded chicken or mushrooms in the soup to make it even more tasty and healthy.

Oats are considered as the rich source of fiber that helps in reducing weight effectively. It is amazing breakfast option. A bowl of oats with a glass of milk could make your morning even healthier. If you want, you can add fruits and dry fruits to enhance the taste of your breakfast. Foods that are rich in fiber should always be included in the healthy diets to lose weight.

Coming to hunger breaks in between meals, it is better to resist your temptation of having junk foods, instead have some healthy snacks. Almonds, Walnuts are high on fiber content and boost fat burning process. Also nuts are known for boosting memory and enhance hair growth. You can also take a sip from a cup of green tea. Green tea is known for slimming down and reduction of weight. It has a lot of anti-oxidants which encourages metabolism and burns more calories than your think. Furthermore, a cup of green tea with a spoonful of honey, can keep your skin ten years younger and blemish-free. You can also much on fresh fruits, if you are too hungry in between meals.

Articles which may be useful

How to Lose Weight Naturally At Home Fast

Diet Plans to Lose Weight Fast

How To Lose Weight Fast

Salads are again the best source of proteins, vitamins, carbohydrates, calcium and fulfill your body needs in just a full bowl. You can add some broccoli, cabbages, lettuce leaves, radishes and tomatoes in your healthy salad diet to get some instant energy minus calorie.

Now when you know how to lose weight fast and healthy, what are you waiting for? Get a lifestyle that is systematic, eat healthy, go for a brisk walk daily and stay in shape forever.

25 Interesting Facts about Girls

1. The vagina is only as deep as your middle finger.

2. The vagina keeps itself clean and healthy by constantly producing mucus which turns white when it’s exposed to the air.Discharge also prevents the vagina from drying out. Discharge will begin to appear some time before your first period begins.

3. Females can ovulate before they have their period.

4. Cramps and painful periods may be caused by low calcium and magnesium levels.

5. The usual amount of blood lost during a period is between one and six tablespoons(120 ml blood and tissue).

6. Menstrual fluid is mostly made up of water.

7. A lot of girls’ hymen are broken through using a tampon or during active sports such as horse back riding or cycling. Masturbation, too, can break the hymen. There is an opening in the hymen that lets menstrual fluid flow out.

8. The fallopian tubes are about 10 cm long. The egg travels from the ovary to the uterus along these tubes.

9. Girls are born with about 300,000 eggs.

10. Ovary is about the size of a walnut/olive. The uterus is about the size of a pear/clenched fist.

11. The average woman has about 500 periods in her lifetime.

12. If a tampon has absorbed as much as it can and has to be changed within 4 hours, try a tampon with a higher absorbency. If a tampon still has lots of white patches showing when you take it out after about four hours, try a tampon with lower absorbency. Change your tampon every 4-8 hours.

13. PMS symptoms: breast tenderness, feeling swollen or bloated, change in appetite, headaches, acne or skin rash, constipation or diarrhea, abdominal cramps, feeling sad/tired/irritable or clumsy.

14. You get cramps when your uterus contracts (squeezes) slightly to help get rid of most of its lining.

15. If you are taking the birth control pill these five drugs may interfere with its effectiveness: antihistamines, alcohol, analgesics, antacids, antibiotics.

16. A pregnancy test only works 2 weeks after a suspected conception.

17.Girls’ primary school completion rates are below 50 per cent in most poor countries.

18.One in seven girls in developing countries is married before age 15, and 38 per cent are married before age 18.

19. In sub-Saharan Africa, more women than men are living with HIV, and young women
aged 15–24 years are as much as eight times more likely than men to be HIV positive.

20. Both Barbie and Bratz dolls are so thin, they lack the internal proportions to have bodily organs like kidneys or large intestines; both would lack the 17-22% of body fat necessary for females to menstruate.

21. If Barbie were a real woman, she would be 7'2", weigh 101 pounds, and have a 19” waist and 39FF chest. A real woman with these proportions would be unable to support her upper body and stand up straight.

22. Female characters in children’s cartoon shows are five times more likely to be shown in revealing, skimpy clothing (even when they are animals) and three times more likely to be shown with physically-impossible tiny waists.

23. Eating disorders like anorexia and bulimia used to start in the “tweens” – doctors are now treating them in girls as young as five or six.

24. Three-quarters of female characters in TV situation comedies are underweight; only 1 in 20 is average size. Moreover, female characters that are heavier tend to get made fun of more often, and 80% of the time these negative comments are rewarded with audience laughter.

25. By the time they graduate high school, children will have spent more time watching TV than in the classroom or talking with their parents.

Health Benefits of Different Types of Milk

1. Coconut milk:
Coconut milk is a common ingredient in South Indian cooking that makes the curry rich and delicious.

What are the health benefits of coconut milk?
Coconuts provide vitamins, minerals and fibers that prevent diseases like gallbladder stones and liver diseases, inflammation and skin diseases, to name a few. If you want proteins, coconut milk is a good source. It also provides iron, selenium, sodium, calcium, magnesium, phosphorus and potassium, vitamins: C, E, B1, B3, B5 and B6. Surprisingly coconut milk is far richer in calcium than regular milk. Rest assured that coconut milk also supports the immune system, helps in weight loss and is great for digestion.

2. Almond milk:
Almonds are a great snack if you are fasting or if you simply want a potent healthy snack to keep you full for longer. Some dishes also use almonds as garnish and it is an excellent medium in desserts.

What are the health benefits of almond milk?
Almond milk, just like coconut milk, is a great alternative for vegans. Almond milk is a good source for proteins; it is also low in calories unlike cow's milk. This milk contains vitamin E, magnesium, monounsaturated fats, manganese, copper and riboflavin. Boost your energy and lower heart diseases with almond milk.

3. Cow's milk:
This is the most commonly used milk in India. Cow's milk is also used to make enticing Indian sweets.

What are the health benefits of cow's milk?
This milk contains fats, minerals and vitamins like vitamin D, proteins, vitamin B, potassium, iodine and it is a good substitute to Omega 3. Cow's milk is not fattening but it should be complimented with a healthy diet. Besides strengthening the bones with calcium, cow's milk is known to control blood pressure as it contains potassium, iodine promote thyroid function and prevents gout.

4. Goat's milk:
Most Indians may not use goat's milk, but high up in the hilly regions of northern Indian, goat's milk is widely used. But the buck does not stop there, globalization and India's love for Italian food has seen an increase in the import of goat cheese.

What are the health benefits of goat's milk?
According to researchers, goat's milk helps prevent softening of bone and anemia. It also aids digestion and 'metabolic utilization of minerals such as iron, calcium, phosphorus and magnesium'. The secret lies in the high presence of iron, calcium, phosphorus and magnesium. Apparently goat's milk has less fat, builds your immune system, and reduces anti-inflammation of the bowel.

5. Raw milk:
Consuming raw milk is a trend that promotes the importance of organic food. But is it a wise choice?

What are the health benefits of raw milk?
The debate still continues on the health benefits of raw milk over pasteurised milk. Raw milk contains proteins, carbohydrates, fats, vitamins and minerals, but scientists do not believe the claims of health benefits of raw milk. There are healthy bacteria in raw milk; some say that pasteurised milk kills these microbes, but scientists believe it's all for a good cause.

You need to know:
- Pasteurization DOES NOT reduce milk's nutritional value.
- Pasteurization DOES kill harmful bacteria.
- Pasteurization DOES save lives.

6. Soy milk:
This is a common substitute for those who are lactose intolerant or vegetarian. Soy milk also comes under probiotic food choice.

What are the health benefits of soy milk?
Soy milk contains fatty acids, proteins, fiber, vitamins and minerals that are beneficial for the smooth functioning of our body. You can count on soy milk to improve good cholesterol and help in weight loss; the omega 3 and 6 in soy milk strengthens the blood vessels, claims to prevent prostrate cancer, osteoporosis and postmenopausal syndrome.

7. Cardamom or eliachi milk:
May not be a common ingredient in milk, but flavoured milk is always refreshing on a hot day. Cardamom milk is healthier than having flavoured milk like chocolate and strawberry.

What are the health benefits of cardamom milk?
Cardamom contains potassium, calcium, riboflavin, niacin, vitamin-C and magnesium. It is also used as an antiseptic, antispasmodic, carminative, digestive, diuretic, expectorant, stimulant, stomachic and tonic. These are the traditional uses of cardamom.

Health Tips for Today - Healthy Food Recipes

SITAGLAPTIN USE AND HEART FAILURE RISK

Signals of a possible heart-failure (HF) hazard from second-line treatment with dipeptidyl peptidase-4 (DPP-4) inhibitors in patients with type 2 diabetes seen in recent randomized and observational studies have risen a few decibels^[1]. An analysis of patient-level data from nationwide US insurance records saw initiation of sitagliptin (Januvia, Merck), one the most commonly used DPP-4 inhibitors, pose an 84% increased risk (p=0.01) of new HF hospitalization among diabetic patients initially with HF who had been treated withmetformin or a sulfonylurea. The more than 7600 patients in the cohort had been followed a median of 1.4 years.

Sitagliptin therapy showed no sign of increasing risk for all-cause hospitalization or death, which was the primary end point of the study, published July 2, 2014 in Circulation: Heart Failureby first author Daniala L Weir (University of Alberta, Edmonton) and colleagues.

As in prior analyses hinting at similar risks from DPP-4 inhibitors, in which only some diabetic patients already had HF when the drugs were started, HF hospitalization was a secondary end point while primary-end=point outcomes for DPP-4 inhibition were, in contrast, often favorable or neutral.

The increased HF risk in the current analysis "is likely clinically relevant," according to the authors, with an observed number needed to harm of 29, "and may have implications for choice of add-on therapy for patients with HF and diabetes poorly controlled with other agents."

They continue, "Although our results are intriguing, it is clear that additional studies are required, specifically in patients with HF, to solidify the risk/benefit picture," especially given "inconsistent" evidence from clinical trials regarding any HF risk from DPP-4 inhibitors.

Recent Causes for Concern

The randomized SAVOR-TIMI 53 trial of saxagliptin (Onglyza, Bristol-Myers Squibb/AstraZeneca) showed a significant 27% increased risk of HF hospitalization in 16 492 diabetic patients with a CV history or otherwise at elevated CV risk. That was despite saxagliptin noninferiority for the primary end point of CV death, nonfatal MI, or nonfatal ischemic stroke vs placebo.

And the 5380-patient Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care in Patients with Type 2 Diabetes Mellitus and Acute Coronary Syndrome (EXAMINE) trial ofalogliptin (Nesina, Takeda Pharmaceuticals) showed a nonsignificant trend suggesting more HF in diabetic patients taking the DPP-4 inhibitor. Both studies had been reported by heartwire .

On the other hand, a recent unpublished post hoc analysis of the much smaller Vildagliptin in Ventricular Dysfunction Diabetes Trial (VIVIDD), which focused on echocardiographic rather than clinical end points, found no elevated risk of HF hospitalizations or other HF events in diabetic patients with HF who received vildagliptin (Galvus, Novartis).

Two observational studies presented recently at the International Society of Endocrinology and the Endocrine Society joint scientific sessions, and covered by Medscape Medical News, gave somewhat conflicting results regarding DPP-4-inhibitor use and HF outcomes. One retrospective study of 13 185 outpatients with diabetes on metformin showed a significantly elevated HF risk over four years among those also taking a DPP-4 inhibitor compared with a different second-tier antidiabetic agent. And in the other study, a cohort of 32 419 matched pairs of patients with diabetes taking or not taking a DPP-4 inhibitor, DPP-4 inhibitors were not associated with an increased risk of CV events and may have even improved HF overall.Data from Diabetic Patients Initially With HF

The analysis of 7620 diabetic patients and HF (58% male) treated with metformin or a sulfonylurea but not a thiazolidinedione included 887 patients who started on sitagliptin sometime after their HF diagnosis.

In an adjusted analysis, there were no differences between sitagliptin users and nonusers for the primary end point of all-cause hospitalization or death, the secondary end point of HF hospitalization or death from any cause, or all-cause death or all-cause hospitalization by themselves. However, HF admissions went up significantly with sitagliptin.

In addition, treatment with metformin was associated with a 22% reduced adjusted risk of the primary end point (p<0 .001="" 10="" 16="" and="" end="" for="" insulin="" of="" p="0.004).</p" point="" raised="" sulfonylureas="" that="" users="" was="" whereas="">

"Before recent studies, there was little evidence, either clinical or basic science, to suggest DPP-4 inhibition would increase the risk of heart failure," write Drs Deepak L Bhatt and Matthew A Cavender (Brigham and Women's Hospital, Boston, MA) in an accompanying editorial^[2].

"In contrast, basic science data largely suggested that DPP-4 inhibition should improve cardiovascular events, including ventricular function," they continue, noting the confusing state of the evidence so far.

"The findings of this analysis, as well as other recent studies, highlight the need for well-designed trials that rigorously assess for HF in patients with diabetes. The ongoing . . . Trial Evaluating Cardiovascular Outcomes with Sitagliptin [TECOS] has randomized approximately 14 000 patients with type 2 diabetes [and preexisting CVD] to sitagliptin or placebo, and it may help establish whether the class of DPP-4 inhibitors does indeed cause HF."

Adjusted* Odds Ratio (95% CI), Exposure vs No Exposure to Sitagliptin and Metformin in Diabetic Patients With HF

End points	Sitagliptin OR (95% CI), p	Metformin OR (95% CI), p
All-cause death or hospitalization	0.84 (0.69–1.03), 0.10	0.78 (0.71–0.85), <0 .001="" td="">
All-cause death	1.16 (0.68–1.97), 0.59	0.52 (0.37–0.71), <0 .001="" td="">
All-cause hospitalization	0.93 (0.76–1.14), 0.46	0.79 (0.71–0.87), <0 .001="" td="">
HF-related hospitalization or death	1.34 (0.93–1.92), 0.12	0.70 (0.57–0.86), 0.001
HF-related hospitalization	1.84 (1.16–2.92), 0.01	0.87 (0.66–1.12), 0.28

*Adjusted for age and sex; type of medical insurance; household income; recent glycosylated hemoglobin, low- and high-density lipoprotein cholesterol, triglycerides, and estimated glomerular filtration rate; history of CVD; antidiabetic drug therapies; CV drug therapies

CI=confidence interval

OR=odds ratio

The trial's primary end point is "time to first confirmed CV event (a composite defined as CV-related death, nonfatal MI, nonfatal stroke, or unstable angina requiring hospitalization)." Time to congestive HF is a TECOS secondary end point.

According to Weir et al, although the ongoing DPP-4 inhibitor trial as well as the earlier ones "enrolled patients with established cardiovascular disease or risk factors, none specifically identified individuals with established heart failure. Therefore, it is unlikely the upcoming results of the TECOS trial will provide evidence for the safety of sitagliptin therapy in those with preexisting HF, unless evaluated as a subgroup."

GENOMICS OF LUNG CANCER

Researchers from Dana-Farber Cancer Institute, the Broad Institute of MIT and Harvard, and other centers have identified novel mutations in a well-known cancer-causing pathway in lung adenocarcinoma, the most common subtype of lung cancer. Knowledge of these mutations could potentially identify a greater number of patients with treatable mutations because many potent cancer drugs that target these mutations already exist. In addition, these findings, published online in Nature, may expand the number of possible new therapeutic targets for this disease.

Study Details

In this new study researchers from the Cancer Genome Atlas (TCGA) Research Network, led by Dana-Farber scientist Matthew Meyerson, MD, PhD, examined the genomes, RNA, and protein from 230 lung adenocarcinoma samples. In three-quarters of the samples, the scientists ultimately identified mutations that put a cell-signaling pathway known as the RTK/RAS/RAF pathway into overdrive.

“Lung adenocarcinoma is the leading cause of human cancer death. This is because there are so many ways to develop the disease, and many different pathways are altered in this cancer,” said Dr. Meyerson. “In recent years, we have made enormous progress in lung adenocarcinoma treatment by targeting EGFR, ALK, and other mutated proteins. Through this study, we are able to add to the range of such alterations and therefore gain potential new therapeutic targets.”

Mutations affecting the RTK/RAS/RAF pathway can cause it to become stuck in the “on” state. As a result, signals that promote cancer cell proliferation and survival are produced continuously. However, drugs are currently available that curb aberrant activity of this pathway and prompt therapeutic responses in patients.

“About 10% of patients have tumors with EGFR mutations, and these patients uniquely benefit from anti-EGFR therapy,” said Alice Berger, PhD, a postdoctoral fellow in the Meyerson lab and coauthor of the study. “We were motivated to find genetic aberrations in patients that lack EGFR mutations and that might be similarly suitable for therapeutic targeting. Ultimately, we want to be able to provide every patient with an effective drug for their specific cancer.”

Oncogene Mutations Identified

In the group’s initial scan of the tumor samples, researchers identified oncogene mutations that would increase RTK/RAS/RAF pathway activity in 62% of the samples; these tumor samples were classified as oncogene-positive. To identify additional alterations, the investigators looked at DNA copy number changes, or changes in gene number resulting from the deletion or amplification of sections of DNA in the genome. In doing so, they detected amplification of two oncogenes, ERBB2 and MET, which are part of the RTK/RAS/RAF pathway in the oncogene-negative cancers. Gene amplification usually leads to increased expression of the encoded protein in cells.

Now that these amplifications have been identified in cancers without other activity of the RTK/RAS/RAF pathway, clinicians may be able to treat patients whose tumors have specific gene changes with drugs that are either currently available or under development.

“It is quite striking that we have now identified an actionable mutation in over 75% of patients with lung adenocarcinoma, a significant improvement from a decade ago,” said Dr. Meyerson.

Additional analysis identified other genes that may play important roles in lung cancer development. Mutations in one of these genes, NF1—a known tumor suppressor gene that regulates the RTK/RAS/RAF pathway—had previously been reported in lung cancer. Mutations of NF1 also put that pathway into overdrive. Another mutated gene, RIT1, is also part of the RTK/RAS/RAF pathway, and this is the first study to associate mutation of this gene with lung cancer.

“This is one of the most comprehensive studies of lung adenocarcinoma to date,” said coauthorJoshua Campbell, PhD, a postdoctoral fellow in the Meyerson lab. “The TCGA data enabled us to profile and analyze DNA, RNA, and methylation from over 200 tumors, and it made the discovery of these rare alterations possible.”

ANTIOXIDANTS PROBABLY HARMFUL IN CANCER

While alternative health gurus often encourage increasing antioxidants in the diet and the taking of antioxidant nutritional supplements such as beta-carotene, vitamins A, C, and E, and selenium, new research findings suggest that antioxidants could do more harm than good, especially in cancer patients.

The idea is discussed in a perspective article on the promise and perils of antioxidants for cancer patients in the July 10 issue of the New England Journal of Medicine.

Coauthor David Tuveson, MD, PhD, professor and deputy director of the Cold Spring Harbor Laboratory Cancer Center in New York, explained in an interview with Medscape Medical News that the idea that antioxidants could be useful in cancer goes back to Linus Pauling, and is based on observations that oxidation within cells is needed for cell growth. "As cancer cells growth rapidly, a cancer cell would have more oxidation within it than a normal cell," he added, and the hope was that antioxidants would interfere with these cellular oxidative processes and would suppress the growth.

"Although some early preclinical studies supported this concept," the authors write, there have now been several clinical trials that have shown no effect of antioxidants on reducing the incidence of cancer, and there have even been suggestions of harm in persons who are at risk for cancer.

Dr. Tuveson noted a clinical trial from Scandinavia in the early 1990s, which found that high doses of antioxidants, particularly beta-carotene, were associated with more lung cancer rather than less as had been hoped for.

There was a similar finding from the Selenium and Vitamin E Cancer Prevention Trial (SELECT), which found that the antioxidants did not reduce the risk for prostate cancer, as had been hoped, and in fact increased the risk in some men.

Dose-dependent Harmful Effect

The perspectives article was prompted by new findings reported earlier this year, he said. An animal study carried out by Swedish researchers showed that the harm from antioxidants was dose-dependent (Sci Transl Med. 2014;6:221ra15). The study was conducted in a genetically engineered mouse model that mimics early human non-small-cell lung cancer. The researchers studied N-acetylcysteine (which is used in patients with chronic obstructive pulmonary disease) and also derivatives of vitamin E, and they found that these antioxidants "actually increased cancer burden and mortality in a dose-dependent manner."

"The mice got lung cancer faster and they died more quickly of the disease," Dr. Tuveson said.

In their perspective article, Dr. Tuveson and coauthor Navdeep Chandel, PhD, from Northwestern University in Chicago, address the question of why.

It turns out that all cells have not only oxidative mechanisms producing reactive oxygen species, they also have a mechanism by which they produce antioxidants, and so there is a balance between the 2 in each cell. "And cancer cells, because they make more oxidants, also make more antioxidants," Dr. Tuveson explained.

"So when adding an antioxidant as a supplement, all you are doing is increasing a pool of what is already there," he said. "But you are not actually stopping the oxidative mechanisms, and you are not stopping the production of oxidants in the first place, and the pathways that are fuelling cell growth," he added."All you are doing is helping the cancer cell deal with the toxic effects of the oxidants, and by doing so you may be actually making the cancer cell even stronger," Dr. Tuveson said."The antioxidants that we take as a supplement or in our diet don't go after the root cause of how oxidants promote cancer cell biology,...and our suggestion is that we need to look much more carefully at these mechanisms if we are to truly develop strategies to prevent cancer," he said.

In their article, the authors propose 2 strategies for further research — the development of antioxidants that target specific intracellular sites of oxidant production, and also a synthetic lethal strategy directed at antioxidants produced within the cell. Both of these strategies are currently at the research stage, with work focused on developing compounds that could be tested in humans.

As for the clinical implications of the research so far, Dr. Tuveson said: "We don't firmly say that taking antioxidants is dangerous for cancer patients...but I do believe that our article will cause those discussions to begin."

However, others have already warned cancer patients not to take antioxidants; for instance, prostate cancer patients have been warned against taking selenium, as previously reported by Medscape Medical News.

In addition, there is a question of whether antioxidants may interfere with common cancer treatments, such as chemotherapy and radiotherapy, as these work by increasing oxidation within cancer cells, Dr. Tuveson commented. This is an area that needs to be studied more, he said.

This issue of antioxidants being harmful to cancer patients was raised last year by Nobel laureate James Watson, PhD, who is chancellor emeritus at the Cold Spring Harbor Laboratory. He described a new hypothesis on reactive oxygen species that he considers is "among my most important work since the double helix."

Dr. Watson proposed that antioxidant levels within cancer cells are a problem and are responsible for resistance to treatment, and that the untreatability of late-stage cancer might be the result of "its possession of too many antioxidants."

"The time has come to seriously ask whether antioxidant use more likely causes than prevents cancer," Dr. Watson said. Nutritional intervention trials have shown no obvious effectiveness in preventing cancer or in lengthening mortality, and, "in fact, they seem to slightly shorten the lives of those who take them."

HIGH CHOLESTEROL MAY INCREASE BREAST CANCER RISK

A link has been found between high blood cholesterol and breast cancer risk in a large retrospective cross-sectional study,according to research presented at Frontiers in CardioVascular Biology 2014 in Barcelona, Spain.

However, the lead investigator cautioned that this is a preliminary finding, and experts have noted that the study did not control for obesity, which is known to be associated with breast cancer.

The study "only suggests an association between high cholesterol and breast cancer," said presenter Rahul Potluri, MD, from the Aston University School of Medical Sciences in Birmingham, United Kingdom.

He warned against overstating the findings. "Further research is required before anything can be confirmed. However, 10 to 15 years down the line, if further prospective studies confirm these findings, there is the possibility for a clinical trial on the use of statins in the prevention of breast cancer," he told Medscape Medical News.

Retrospective Analysis

Dr. Potluri said the team was prompted to study the possible link after research in mice suggested that lowering circulating cholesterol or interfering with its metabolism could be used to prevent or treat breast cancer (Science. 2013;342:1094-1098).

"We wanted to see if there were any associations between high cholesterol and breast cancer in a large sample," he explained.

He and his team conducted a retrospective analysis of a large clinical database of patient records from 2000 to 2013 in the United Kingdom.

Of the 664,159 women identified, 22,938 (3.5%) had high cholesterol and 9312 had breast cancer.

More women with high cholesterol than with normal cholesterol developed breast cancer (2.3% vs 1.4%)

In fact, having hyperlipidemia increased the risk for breast cancer by 1.64 times (95% confidence interval, 1.50 - 1.79).

"Further research is required to confirm this link before it can have any significance for patients," Dr. Potluri noted. "However, this provides a starting point."

Link Between Hypercholesterolemia and Breast Cancer No Surprise

"We have known for some time that obesity is associated with increased risk of breast cancer, especially in postmenopausal women," said Gabriel N. Hortobagyi, MD, professor of medicine in the Department of Breast Medical Oncology at the University of Texas M.D. Anderson Cancer Center in Houston, who was not involved in the study.

"There is also a large body of work that suggests that overweight or obese women with breast cancer have a higher risk of recurrence and death, despite receiving state-of-the-art treatment," he toldMedscape Medical News.

"There is also work that suggests that obesity and inflammation are linked and, of course, there is ample evidence that inflammation, obesity, and cardiovascular disease are linked. Obesity and the metabolic syndrome are also linked, so finding that hyperlipidemia and risk of breast cancer are associated is no surprise," he explained.

Dr. Hortobagyi also noted that data "suggest that patients with diabetes and breast cancer have a higher risk of recurrence, and that treatment of diabetes with metformin might be associated with reduced risk of recurrence of breast cancer."

On the basis of such data, Dr. Hortobagyi and his group are participating in a large adjuvant trial, led by the National Cancer Institute of Canada, looking at the addition of metformin to standard adjuvant therapy in primary breast cancer.

"That study has accrued more than 3500 patients but is not mature enough for analysis. This is an evolving story, and it is increasingly complex," he said.