เตือนคนไข้มะเร็ง เนื้อสัตว์ทำให้อายุสั้น

thairath130704_002หมอของแพทยสมาคมโรคมะเร็งอเมริกัน กล่าวเตือนว่าผู้ที่เพิ่งถูกตรวจวินิจฉัยโรคว่าเป็นมะเร็งลำไส้ใหญ่ ที่เคยชอบกินเนื้อวัว หรือเนื้อลูกแกะที่มีสีค่อนข้างคล้ำ และอาหารเนื้อสำเร็จรูปมากๆ  ควรจะระวังเอาไว้ว่า อาจจะอยู่ต่อไปอีกได้ไม่เกิน 8 ปี

หมอแมจอรี แมคคัลเลาดห์ กำชับว่า “คนไข้ควรจะปฏิบัติตามคำแนะนำเรื่อง ให้จำกัดการกินเนื้อสัตว์เหล่านั้นอย่างเคร่งครัด อาหารพวกนั้น ได้แก่ เนื้อวัว ฮอตด็อก และไส้กรอก เป็นต้น” ก่อนหน้านี้ก็เคยมีการศึกษาพบมาก่อนแล้วว่า การกินเนื้อสัตว์เหล่านี้มากเกี่ยวข้องกับการเป็นมะเร็ง

อย่างไรก็ตาม ขณะนี้ยังหาหลักฐานที่แสดงว่า คนไข้ที่ยังขืนกินอาหารพวกนี้จะมีชีวิตอยู่ต่อไปได้อีกนานสักเท่าไหร่ได้น้อย

สถาบันสาธารณสุขแห่งชาติอเมริกันได้คาดประมาณว่า ในปีนี้จะมีผู้ป่วยด้วยโรคนี้มากประมาณ 143,000 ราย และอาจมีผู้เสียชีวิตลงสัก 51,000 ราย.

ที่มา : ไทยรัฐ  4 กรกฎาคม 2556

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Credit : indianapublicmedia.org

Credit : indianapublicmedia.org

Red meat tied to worse colon cancer outcomes: study

By Andrew M. Seaman

NEW YORK | Mon Jul 1, 2013 4:03pm EDT

(Reuters Health) – People who report eating the most red and processed meat before being diagnosed with colon cancer are more likely to die during the next eight years, according to a new study.

“It’s another important reason to follow the guidelines to limit the intake of red and processed meat,” said Marjorie McCullough, the study’s lead author from the American Cancer Society in Atlanta.

While the new study can’t prove eating red or processed meats – such as beef, hot dogs and sausages – causes colon cancer deaths, previous studies have found that eating the meats is tied to an increased risk of developing the cancer.

There’s less evidence, however, on how people’s diets after colon cancer diagnoses affect their chances of survival.

The U.S. National Institutes of Health estimates that about 143,000 Americans will be diagnosed with colon and rectal cancers in 2013, and about 51,000 people will die from them.

For the new research, McCullough and her colleagues used data from a different study on 184,000 Americans who didn’t have cancer between 1992 and 1993, and who were periodically asked about what they ate.

After excluding people, who had – among other things – multiple types of cancer, unverified diagnoses and missing information, the researchers had data on 2,315 men and women who were diagnosed with colon or rectal cancer between the start of the study and June 30, 2009.

Overall, 966 of them died between the start of the study and December 31, 2010.

The researchers found no link between how much red or processed meat a person ate after their diagnosis and their risk of death, but the amount of meat a person ate before their diagnosis was tied with their risk of dying during the study.

About 43 percent of the 580 people who ate about 10 servings of red or processed meat per week at the start of the study died during the follow up period. That compared to about 37 percent of the 576 people who ate about two servings per week.

The researchers also found that people who consistently ate more red or processed meat before and after their colon cancer diagnosis were more likely to die from that cancer during the study, compared to those who at the least before and after diagnosis.

‘THREE OR FOUR TIMES PER WEEK’

Dr. Jeffrey Meyerhardt, who wrote an editorial accompanying the new study in the Journal of Clinical Oncology, said it’s possible that the link between red and processed meats and colon cancer comes from cancer-causing compounds found in cooked meat or preservatives.

“The primary message is a confirmation that increased intake of red or processed meat can have detrimental effects on the development of colon cancer, the type of cancer and other health effects of patients in the long term,” Meyerhardt, a gastrointestinal oncologist at the Dana-Farber Cancer Institute in Boston, said.

McCullough said about three or four servings of red or processed meats per week is a good target for people.

“We’re not saying people need to be vegetarians. It’s really just limiting intake and making it more the exception than the rule,” she said.

Dr. Elisa Bandera, associate professor of epidemiology at Rutgers Cancer Institute of New Jersey in New Brunswick, said in an email to Reuters Health that maintaining a healthy weight, healthy diet and regular exercise likely has benefits for cancer prevention and survival.

But she cautioned that these are only findings from one study.

“We need more studies evaluating the impact of meat and other dietary factors on cancer survival before any recommendations can be made to cancer survivors,” wrote Bandera, who was not involved with the new study.

SOURCE: bit.ly/W1OrcD Journal of Clinical Oncology, online July 1, 2013.

SOURCE : www.reuters.com

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บุหรี่ทำร้ายสตรี หนักยิ่งกว่าบุรุษ

thairath130506_002วารสาร “มะเร็งโรคระบาดวิทยาตัววัดความเสี่ยงและการป้องกัน” เปิดเผยว่า บุหรี่เป็นอันตรายกับผู้หญิงเสียยิ่งกว่าผู้ชาย มันทำให้ผู้หญิงเสี่ยงกับโรคมากขึ้นอีกร้อยละ 19 ในขณะที่ผู้ชายเสี่ยงร้อยละ 9

มหาวิทยาลัยโตรอนโตของแคนาดา ได้ศึกษาจากสถิติทางการแพทย์ของคนไข้ 600,000 คน พบว่าผู้หญิงที่สูบบุหรี่เสี่ยงที่จะเป็นโรคมะเร็งลำไส้สูงกว่าผู้ชายถึง 2 เท่า “ผลการศึกษาส่อให้รู้ว่าบุหรี่เป็นพิษแก่ร่างกาย ผู้หญิงหนักกว่าของผู้ชาย”

ก่อนหน้านี้ ผู้เชี่ยวชาญเคยพบมาบ้างแล้วว่าสตรีจะต้องเสี่ยงกับโรคหัวใจวายมาตั้งแต่เริ่มสูบ มากกว่าผู้ชายที่ติดบุหรี่โดยไม่อาจทราบสาเหตุได้
ทางหน่วยวิจัยโรคมะเร็งของอังกฤษเคยบอกไว้ว่า “เป็นที่รู้กันดีอยู่แล้วว่าการสูบบุหรี่ทำให้เป็นมะเร็งได้อย่างต่ำถึง 14 ชนิด รวมทั้งมะเร็งลำไส้”.

ที่มา : ไทยรัฐ 6 พฤษภาคม 2556

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One in five UK women is a smoker

One in five UK women is a smoker

Smoking ‘poses bigger risk to women’

By Michelle Roberts
Health editor, BBC News online
1 May 2013

Smoking may pose a bigger health threat to women than men, say researchers.

Women who smoke have a higher risk of cancer than men, Norwegian investigators found.

They looked at the medical records of 600,000 patients and discovered the bowel cancer risk linked to smoking was twice as high in women than men.

Female smokers had a 19% increased risk of the disease while male smokers had a 9% increased risk, Cancer Epidemiology, Biomarkers & Prevention reports.

For men and women, the evidence is clear – being a non-smoker means you’re less likely to develop cancer, heart disease, lung disease and many other serious illnesses”

Sarah Williams of Cancer Research UK

In the study, nearly 4,000 of the participants developed bowel cancer. Women who started smoking when they were 16 or younger and those who had smoked for decades were at substantially increased risk of bowel cancer.

Biologically vulnerable?

The University of Tromso team who carried out the research say it is the first study to show women who smoke less than men still get more colon cancer.

But they were unable to take into account other factors that might affect the risk of this type of cancer, such as alcohol and diet.

The findings suggest that women may be biologically more vulnerable to the toxic effects of tobacco smoke.

Experts already know that women who start smoking increase their risk of a heart attack by more than men who take up the habit, although it is not clear why.

A new piece of research published in the Journal of Clinical Endocrinology & Metabolism suggests a possible explanation.

A team from the University of Western Australia found teenaged girls exposed to passive smoking had lower levels of the “good” form of cholesterol that reduces heart disease risk.

Second-hand smoke

Second-hand smoke did not appear to have the same impact on teenage boys, however.

The study looked at more than 1,000 adolescents living in Perth, Australia.

Lead researcher Chi Le-Ha said: “Considering cardiovascular disease is the leading cause of death in women in the Western world, this is a serious concern.”

Around one in every five men and women in the UK is a smoker.

Although smoking rates have been falling among both sexes, the decline has been less rapid in women.

In England in 2010, more than a quarter of secondary school pupils had tried smoking at least once and 5% were regular smokers. Girls were more likely to smoke than boys – 9% of girls had smoked in the last week compared with 6% of boys.

Quitting smoking cuts your risk of many diseases, including cancer.

According to research in more than one million women, those who give up smoking by the age of 30 will almost completely avoid the risks of dying early from tobacco-related diseases.

Sarah Williams of Cancer Research UK said: “It’s well established that smoking causes at least 14 different types of cancer, including bowel cancer.

“For men and women, the evidence is clear – being a non-smoker means you’re less likely to develop cancer, heart disease, lung disease and many other serious illnesses.”

June Davison, senior cardiac nurse at the British Heart Foundation, said more research was needed to understand the effects of second-hand smoke.

SOURCE : www.bbc.co.uk

 

 

นักวิจัยชี้ว่าผู้ที่ลิ้นไวต่อรสชาติต่างๆ เสี่ยงต่อการเป็นมะเร็งลำไส้ใหญ่แต่มีโอกาสเป็นไซนัสน้อยกว่า

voathai130320_001มีคนราว 25 % โดยเฉพาะชาวเอเซียและคนผิวดำที่ลิ้นไวต่อรส ในขณะที่คนลิ้นด้านรสมีอยู่ประมาณ 30 %

นักวิจัยของศูนย์เรื่องการได้กลิ่นและการรับรสของมหาวิทยาลัยแห่งรัฐฟลอริด้า ซึ่งบุกเบิกด้านการศึกษาเกี่ยวกับผู้ที่มีความไวต่อการรับรสหรือ supertasters กล่าวว่า มีผู้คนในโลกราว 25 % ที่ไวต่อการรับรสอาหารต่างๆ ซึ่งส่วนใหญ่แล้วมักเป็นผู้หญิงมากกว่าผู้ชาย และมักเป็นชาวเอเซียและคนผิวดำมากกว่าคนผิวขาว ในขณะที่คนที่ลิ้นค่อนข้างด้านรสนั้นมีอยู่ประมาณ 30 % การไวต่อการรับรสชาติต่างๆ นี้เป็นผลจากจำนวนและความหนาแน่นของปุ่มรับรสที่ลิ้น รวมทั้งจากปัจจัยด้านกรรมพันธุ์ด้วย และผู้ที่ลิ้นไวต่อการรับรสมักมีน้ำหนักตัวน้อยและมีรูปร่างผอมกว่าคนทั่วไป เนื่องจากความไวของประสาทสัมผัสเรื่องรสนี้ทำให้ไม่ชอบรสชาติของไขมัน แต่ขณะเดียวกันคนกลุ่มนี้ก็มักเสี่ยงต่อการเป็นมะเร็งลำไส้ใหญ่มากกว่าเนื่องจากไม่ค่อยชอบรสขมของผักใบเขียวสีเข้ม นักวิจัยชี้ว่านอกจากปุ่มรับรสที่ลิ้นแล้ว ร่างกายของคนเรายังมีปลายประสาทรับรสอยู่ที่ส่วนอื่นๆ เช่นในลำไส้ ในจมูก ในสมอง และเชื่อว่ามีอยู่ในปอดด้วย นักวิจัยเชื่อว่าการมีปลายประสาทที่ไวเป็นพิเศษต่อการรับรสขมในจมูกช่วยป้องกันการติดเชื้อแบคทีเรีย และทำให้บุคคลนั้นมีโอกาสติดเชื้อโรคโพรงจมูกอักเสบหรือไซนัสน้อยกว่าคนทั่วไป

ที่มา : www.voathai.com  20.03.2013

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yahoo130319_001

People Who Taste Too Much

Genetically Wired Supertasters Find Unusual Health Benefits

By Sumathi Reddy | The Wall Street Journal – Tue, Mar 19, 2013 12:22 PM EDT

There is a good reason why kale evokes such strong feelings in different people.

What is harshly bitter to some 25% of the world—often classified as “supertasters”—is barely bitter to about another third. The rest of us fall somewhere in between. Such stark differences in how we perceive taste are programmed into our DNA.

“Supertasters in general get everything more intense,” says Linda Bartoshuk, a professor with the University of Florida Center for Smell and Taste and a pioneer in the study of supertasting. “When you put it all together we say that supertasters live in a neon food world compared to the pastel food world” everyone else lives in, she says.

A relatively high proportion of professional chefs are supertasters, Dr. Bartoshuk says. Also, supertasting abilities are more common in women than men, and in Asians and African-Americans than Caucasians. In the U.S., roughly 15% of people are supertasters, she estimates.

Recent research has uncovered some surprising health consequences of being a supertaster. People who are supertasters have a heightened risk for developing colon cancer, possibly because they tend to avoid eating vegetables, one study found. Another found they have a tendency to like salty food, which may block bitter tastes.

On the positive side, supertasters tend to be leaner than the general population, possibly because they often find fatty foods distasteful. And a study last year showed that supertasters were better able to fend off some bacterial sinus infections than people who have normal tasting abilities, perhaps because of a protective ability afforded by the supertaster gene.

Supertasters typically have a higher density of fungiform papillae, mushroom-shaped projections on the tongue that contain taste buds. Some experts say one way to tell if a person is a supertaster is to count the number of papillae in a small area after dying the tongue with food coloring, a test that can be done at home. Another common test, which can be purchased online, is to give people a particularly bitter chemical such as PROP or PTC, which are similar to a compound found in many dark-green vegetables. Most people find PROP and PTC bitter, but not unbearable, while others don’t taste it at all. For supertasters, the experience is often nauseating.

“It was the most disgusting taste I’ve ever experienced,” says Rachel Antenucci, a 22-year-old food science graduate student at Pennsylvania State University who was diagnosed as a supertaster this summer. Foods that turn her off include Starbucks dark roast coffee, radishes and most hard liquors, she says. But she loves ice cream and dark chocolate, unlike many supertasters who usually avoid such foods.

Scientists have identified some of the genes associated with tasting ability. For example, some two dozen genes are linked with different types of bitterness. One theory is that sensitivity to bitter flavor could have evolved as a protective mechanism against poisonous plants.

Taste buds on the tongue have receptors that tell us if a food is sweet or sour or some other taste. Recent research is finding that taste receptors are found all over the body, including in the gut, nose, and brain, says Danielle Reed, a member at Monell Chemical Senses Center in Philadelphia. It isn’t clear what role these receptors play in the body, but scientists suggest they might have a protective function, as they do in the mouth.

For example, a recent study by researchers at the University of Pennsylvania and the Monell Center showed that supertasters were better able to fend off bacterial sinus infections because of a particular bitter-taste receptor in their nose. The study, published last year in the Journal of Clinical Investigation, involved laboratory work with sinus tissue samples from 56 people.

“Even in the preliminary data we’ve generated…it looks like the ability to taste or not taste this [bitter compound] is going to be fairly instrumental in upper respiratory disease,” says Noam Cohen, an associate professor at the University of Pennsylvania and a surgeon at Philadelphia VA Medical Center, who co-authored the study with Dr. Reed.

Dr. Cohen says he is currently investigating the role of taste receptors found in the lungs. “We think the bitter receptors over time were developed to protect us against bacteria,” he says. “We may find them anywhere the body is working to protect us from bacteria.”

Supertasters may face some increased health risks because they often eat fewer dark-green vegetables, which can be bitter. A 2005 study in the journal Digestive Diseases and Sciences found that the risk for developing colon cancer—measured by number of polyps—was directly proportional to the ability to taste bitter, particularly PROP, the chemical compound similar to that found in cabbage. The study tested the association between PROP and the number of colonic polyps, a measure of colon cancer risk, in 251 men.

Beverly Tepper, a professor of food science at Rutgers University, in New Brunswick, N.J., found in a study that women who don’t taste PROP tend to be heavier than those who are supertasters. The 2011 study, published in the journal Appetite, found that among 14 nontasters and 18 supertasters—all lean, young women—the nontaster women consumed more calories in a buffet setting. In a similar study presented at a conference last year, 75 lean women ate buffet meals for several days in a lab. Women classified as medium tasters or nontasters consumed more calories, less protein and marginally more fat than the supertasters.

“Some people may be considered fussy eaters and to a certain extent…it reflects their genetics,” says Dr. Tepper.

Supertasters sometimes get intense pleasure from foods. Karen Manning, 58, of Cincinnati, didn’t know she was a supertaster. But when she worked in marketing for Jimmy Dean, the sausage and breakfast-sandwich maker, the food scientists were constantly asking her to participate in tastings. “You can taste things in products that nobody else can,” she recalls being told.

Ms. Manning, who now owns an advertising-and-consulting firm, says she can distinguish between different types of pepper burn—black versus red—and different seasonings. She dislikes really sweet or bitter foods and the slimy texture of fat on meat. And she’s learned to work around some tastes: She will roast Brussels sprouts, for example, and sprinkle sugar on them to make them palatable.

Scientists say research to identify more taste receptors and their associated genes could help dietitians tailor advice to different palates. “I think we’re close to the point where, instead of a dietitian saying, ‘Eat less fat, eat more fruits and vegetables,’ they could figure out what foods you do or don’t like with a survey or genetic test,” says John Hayes, a professor of food science at Penn State and lead author of a 2010 study showing supertasters’ preference for salt. “They could say, ‘You know, I want you to eat more fruits and vegetables but you’re going to find it hard to eat kale or Brussels sprouts. Maybe you should try sweet potatoes and squash instead.'”

SOURCE : finance.yahoo.com

เดินช่วยยืดอายุผู้ป่วยมะเร็งลำไส้ให้ยืนนานมากกว่าคนเอาแต่นอนเกือบครึ่งเท่าตัว

thairath130206_001สมาคมต่อต้านโรคมะเร็งของสหรัฐฯแจ้งว่า  ผู้ป่วยโรคมะเร็งลำไส้ หากพยายามเดินให้บ่อยกว่าการนอนบนที่นอน จะไม่ค่อยเสียชีวิต แม้ว่าจะถูกวินิจฉัยโรคมานานตั้ง 7 ปีแล้ว

หัวหน้านักวิจัยปีเตอร์ แคมป์เบลล์ กล่าวอธิบายว่า เรื่องนี้ไม่ใช่จะอวดว่าการออกกำลังจะช่วยยืดอายุการอยู่รอดออกไปได้ แต่การออกกำลังจะให้คุณมากกว่าการไม่ได้ทำ ไม่ว่าจะเป็นการเดิน ยืดเส้นยืดสายและการทำสวน แค่ครั้งละ 5-10 นาที ก็พอ โดยไม่จำเป็นต้องเหนื่อยยาก ถึงกับไปวิ่งมาราธอนหรือไปไต่เขา

เขากับคณะได้วิเคราะห์กรณีของผู้ป่วยชาวอเมริกัน ได้พบว่า ผู้ป่วยที่ออกกำลังมากที่สุด โดยเดินได้นานอาทิตย์ละ 2-2.30 ชม. หรือมากกว่านั้น ต่างจะพากันยืดอายุการอยู่รอดออกไปได้มากกว่าผู้ที่ไม่ค่อยได้ปฏิบัติ ระหว่างร้อยละ 28-42

อย่างไรก็ดี นักวิจัยได้เตือนว่า การออกกำลังไม่ใช่ถึงขนาดจะใช้แทนการรักษาตามมาตรฐานอย่าง เช่น การผ่าตัด และในบางราย อาจเป็นเคมีบำบัดกันได้.

ที่มา : ไทยรัฐ 6 กุมภาพันธ์ 2556

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Exercise tied to better colon cancer survival odds

By Genevra Pittman | Reuters – Thu, Jan 24, 2013

NEW YORK (Reuters Health) – People with colon cancer who spend more time walking and fewer hours on the couch are less likely to die over the seven to eight years after being diagnosed, a new study suggests.

The findings don’t prove exercise itself boosts a person’s survival chances, researchers said. But the pattern held even after the study team took into account how advanced patients’ cancers were, their age and other aspects of their diet, lifestyle and health.

“Any activity is better than none,” including walking, stretching and gardening, said Peter Campbell, the lead researcher on the study from the American Cancer Society.

“Five to ten minutes at a time is fine, and the type of activity we’re talking about here, this isn’t marathon running or climbing the Alps.”

Campbell’s analysis included about 2,300 people who developed colon cancer out of an initial pool of 184,000 volunteers in a cancer prevention and nutrition study launched in 1992.

Over an average of eight years after their diagnosis, 846 people with colon cancer died – including 379 from cancer.

The researchers found that study participants who exercised the most – equal to two and half hours of walking per week or more – both before and after being diagnosed were 28 to 42 percent less likely to die during the follow-up period than those who barely exercised at all.

Spending six or more hours of leisure time on the couch daily before diagnosis, compared to less than three hours, was tied to a 36 percent higher chance of dying. Being sedentary after a cancer diagnosis was linked to a 27 percent increased risk of death – although that particular finding could have been due to chance, the researchers noted this week in the Journal of Clinical Oncology.

To account for the fact that very sick people can’t exercise, Campbell and his colleagues excluded anyone who died within two years of their last survey, and found similar results.

Researchers have known for a while that obesity and exercise affect a person’s risk of getting colon cancer in the first place, said Dr. Jeffrey Meyerhardt from the Dana-Farber Cancer Institute in Boston, who has also studied exercise and colon cancer survival.

“The question when you’re a patient with colorectal cancer is, ‘Do those things matter once I get the disease? Are there things I can do in addition to standard treatment to reduce my risk of recurrence?'” he told Reuters Health.
Researchers said there are a couple of possible explanations for why exercise, both pre- and post-diagnosis, might benefit people with cancer.

“What we think is at least part of what is happening is, people are going into surgery and adjuvant treatment in a more fit state,” Campbell told Reuters Health.

In addition, he said, “If you’re active both before and after diagnosis, there are a lot of changes that occur in your blood,” such as in levels of insulin and other hormones.

“There are a lot of systemic changes that occur that probably decrease your chance of recurrence and ultimately dying.”

People in the study who exercised regularly were less likely to die in general and of cardiovascular disease – such as heart attacks and lung disease – in particular. For those patients, exercise likely has the same benefit as for cancer-free people, Campbell said.

“Patients that have colon cancer, about two-thirds of them survive after five years and what they end up dying of is what all older people end up dying of, and that’s usually cardiovascular disease.”

He said people with colon cancer should discuss with their doctors when they can get back to physical activity. Some patients with anemia, for example, might want to hold off on exercise, and others who are immune compromised should probably avoid public gyms.

Meyerhardt recommended that people who exercised before their diagnosis return to that level of activity. Those who are new to exercise should take small steps toward increasing their activity, he added, such as walking and physical therapy.

However, Meyerhardt emphasized, exercise isn’t a substitute for standard colon cancer treatments like surgery, and in some cases, chemotherapy.

SOURCE: http://bit.ly/WhX6oU Journal of Clinical Oncology, online January 22, 2013.
SOURCE: news.yahoo.com

ไม่ออกกำลังกายร้ายเหมือนสูบบุหรี่

วารสารแลนเซทลงพิมพ์ผลการศึกษาที่พบว่า ผู้ใหญ่ทั่วโลก 1 ใน 3 ไม่ออกกำลังกาย และการมีชีวิตแบบนั่ง ๆ นอน ๆ ทำให้มีคนเสียชีวิตปีละ 5 ล้านคน และว่าการออกกำลังกายไม่เพียงพอเป็นสาเหตุการเสียชีวิตกว่า 5.3 ล้านคน จากผู้เสียชีวิตทั้งหมด 57 ล้านคนทั่วโลกเมื่อปี 2551 การไม่ออกกำลังกายเป็นปัจจัยเสี่ยงเสียชีวิตพอ ๆ กับการสูบบุหรี่หรือโรคอ้วน  หากลดพฤติกรรมนั่ง ๆ นอน ๆ ลงได้ร้อยละ 10 จะช่วยให้คนเสียชีวิตน้อยลงถึง 500,000 คนในแต่ละปี วารสารแลนเซทเรียกร้องให้ทั่วโลกช่วยกันส่งเสริมให้คนออกกำลังกาย เช่น ปรับปรุงทางเท้าและทางจักรยานในเขตเมือง เพิ่มชั่วโมงพละศึกษาในโรงเรียน เพิ่มสถานที่ออกกำลังกายสาธารณะแบบไม่เสียค่าใช้จ่าย

ที่มา: แนวหน้า 22 กรกฎาคม  2555

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Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy

The Lancet, Volume 380, Issue 9838, Pages 219 – 229, 21 July 2012

Summary

Background

Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world’s population is inactive, this link presents a major public health issue. We aimed to quantify the effect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level.

Methods
For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population.

Findings
Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9—9·6) of type 2 diabetes, 10% (5·6—14·1) of breast cancer, and 10% (5·7—13·8) of colon cancer. Inactivity causes 9% (range 5·1—12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world’s population by 0·68 (range 0·41—0·95) years.

Interpretation
Physical inactivity has a major health effect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially.

Funding
None.

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Lack of Exercise as Deadly as Smoking, Study Finds
By ALICE PARK | @aliceparkny | July 18, 2012

When it comes to being couch potatoes, Americans aren’t alone. Physical inactivity has become a global pandemic, say researchers in a series of related papers  published in the journal Lancet. According to one of the reports, lack of exercise causes as many as 1 in 10 premature deaths around the world each year — roughly as many as smoking.

About 5.3 million of the 57 million deaths worldwide in 2008 could be attributed to inactivity, the new report estimates, largely due to four major diseases: heart disease, Type 2 diabetes, breast cancer and colon cancer. The study finds that if physical inactivity could be reduced by just 10%, it could avert some 533,000 deaths a year; if reduced by 25%, 1.3 million deaths could be prevented. Say we got everyone off the couch and eliminated inactivity altogether: the life expectancy of the world’s population would rise by about 0.68 years (more, if you discount those who were already active), comparable to the effect of doing away with smoking or obesity.

For the study, led by I-Min Lee in the division of preventive medicine at Brigham and Women’s Hospital, scientists calculated something called a population attributable fraction (PAF), a measure of the contribution of risk factors like physical inactivity to diseases such as heart disease or diabetes, and even risk of death. The PAF told researchers how many cases of disease could theoretically be prevented if the risk factor were eliminated — that is, if all inactive people in a population were to start exercising sufficiently.

Lee and his colleagues collected data on physical inactivity and outcomes of the four major diseases — heart disease, Type 2 diabetes, breast cancer and colon cancer — as well as rates for death from all causes. They then calculated PAFs for 123 countries. Overall, the estimates suggest that lack of exercise causes about 6% of heart disease, 7% of Type 2 diabetes, and 10% of breast and colon cancers worldwide.

Exercise has long been known to can lower risk factors like high blood pressure, high blood sugar and high cholesterol, which in turn reduces the risk of heart disease and diabetes. Physical activity also keeps heart vessels healthy and inhibits the formation of atherosclerotic plaques that can cause blood clots.

As for breast cancer, exercise may protect women by reducing fat — particularly dangerous belly fat, whose metabolic activity may trigger tumor growth in breast tissue. Colon cancer may work differently: researchers believe that exercise helps keep digestion regular and prevents potentially cancer-causing waste from encouraging abnormal growths in the colon.

Current guidelines recommend that people get about 150 minutes of moderate exercise a week — a half-hour of brisk walking five times a week would do it. But in another Lancet paper published in the series, Pedro Hallal of the Federal University of Pelotas, in Brazil, and his colleagues found that 31% of adults worldwide (1.5 billion people) and 4 out of 5 teens aren’t exercising enough to meet that standard and therefore putting themselves at risk for chronic disease.

The researchers analyzed self-reports of exercise among adults in 122 countries, representing 89% of the world’s population, and among teens in 105 countries. Rates of physical inactivity were higher in high-income countries than in low-income nations. The Americas were overall the most sedentary region — with 43% of the population not exercising enough — while rates of inactivity were lowest in southeast Asia (17%).

One key reason is that we rely too much on modern conveniences like cars to get around. In the U.S., for example, fewer than 4% of people walk to work and fewer than 2% bike to commute; compare that to about 20% of people who walk to work in China, Germany and Sweden, and the more than 20% who bike their commutes in China, Denmark and the Netherlands, WebMD reports. Add to that the inordinate time most of us spend sitting — at the office, in front of the computer or watching TV.

Hallal estimates that sedentary people have a 20% to 30% greater risk of heart disease and diabetes than regular exercisers. But despite the deadly effects of lack of exercise, Hallal says physical activity doesn’t get the same attention or funding as other health risk factors. “It gets underfunded and undervalued,” Hallal told the Los Angeles Times. “But it’s huge everywhere in the world.”

There was some encouraging news in the results as well: thanks to greater awareness about the importance of physical activity in improving health, about 31% of adults do report engaging in vigorous exercise three or more days a week.

Another paper in the Lancet series also examined what kinds of interventions might help people get active. Researchers analyzed 100 reviews of clinical and community-based efforts to encourage exercise and found some simple strategies that seemed to work: using signs to motivate people to use the stairs instead of the elevator, for instance, or offering free exercise classes in public places such as parks, especially geared toward women, lower-income folks and the elderly, groups who are less likely to get the recommended amount of exercise. Studies from the U.S., Australia, Belgium, Canada, England and Germany indicate that maintaining streets and improving lighting can boost activity levels by as much as 50%.

The authors of the study pointed to a particularly effective program called Ciclovía, which started in Bogotá, Columbia, and has spread to 100 other cities in the Americas. On Sunday mornings and public holidays, the program closes city streets to motorized vehicles, leaving roadways open for walkers, runners, skaters and bikers. Ciclovía attracts about a million people each week, the study notes, mostly people on lower incomes, and accounts for 14% of people’s weekly recommended exercise.

Commenting on the Lancet series, many experts agreed that physical activity should be a global priority, though some took issue with the comparison with smoking. In an interview with WebMD, Timothy Armstrong, coordinator of the surveillance and population-based prevention program for the World Health Organization, noted that if the authors of the first paper had calculated the effects of smoking the same way they had for inactivity, the death statistics wouldn’t be quite so similar. Further, as Dr. Claire Knight of Cancer Research U.K. told the BBC, even if smoking and inactivity kill the same number of people, far fewer people smoke than are sedentary, making tobacco more risky to the individual.

Nevertheless, no one disagrees that the world population as a whole must start exercising more — and soon. “This is a super, super analysis,” Dr. James Levine, professor of medicine at the Mayo Clinic, told WebMD regarding Lee’s paper in the Lancet. “We know that as soon as somebody gets out of their chair, their blood sugar improves, their blood cholesterol and triglycerides improve, and that’s very consistent. Every time you get up it gets better. Every time you sit down it gets worse.”

The message, he says, is simple — get moving.

 

Data from: healthland.time.com