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The company behind motivational speaker Tony Robbins’ events in Australia still owes…

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• A blood test known as a cfDNA test has proven to be accurate in detecting colorectal cancer in the majority of cases.
• Colorectal cancer is often deadly, but screening for it can be inconvenient, so getting more adults to adhere to screening guidelines is a top priority.
• Experts believe the novel test could help bridge the gap and get more people to regularly screen for colorectal cancer.

A novel blood test for colorectal cancer screening appears effective in clinical trial data, but questions remain about how it can be utilized.

Colorectal cancer screening has a reputation for being difficult, but a new type of screening could make the process as easy as giving some blood. It could even be done during a regular check-up with your doctor. 

It’s effective too, but with some caveats. In a study published this week in The New England Journal of Medicine, researchers found that a type of blood test known as a cell-free DNA blood-based test or cfDNA test was able to detect colorectal cancer in 83% of patients who had the disease. The study was funded by Guardant Health, the maker of the test.

The detection rate is similar to an already widely used at-home screening test known as a fecal immunochemical (FIT) test, which is accurate in about eight out of 10 cases. 

Colonoscopies remain the “gold standard” for colorectal cancer detection and prevention but require significantly more time, scheduling, and preparation. A colonoscopy is able to accurately identify colorectal cancer in about 95% of cases.

Experts told Healthline that the combination of accuracy and accessibility could be a game changer for screening.

“It’s very, very exciting. I think this has real potential to reshape the entire landscape of colon cancer early detection,” Dr. Christopher Chen, an Assistant Professor of Oncology and Director of Early Drug Development at the Stanford Cancer Institute, Stanford Medicine, told Healthline.

Dr. Ben Park, MD, PhD, Director of the Vanderbilt-Ingram Cancer Center at Vanderbilt University, told Healthline, “It’s studies like these that we really need to move the needle forward and demonstrate that there is validity, or what we call clinical validation, of a test like this. It’s not perfect, as probably everyone can read from the numbers, but it’s a big start.”

Park was not affiliated with the research but disclosed that he is currently engaged in separate clinical trials involving Guardant Health.

Accurate in 83% of cases

The results of the study come from a large, multi-center trial known as the ECLIPSE trial. Some 8,000 patients between the ages of 45 and 84. Participants were at average risk for colorectal cancer and were already undergoing routine screening for colorectal cancer. 

The trial tested the effectiveness of Guardant Health’s Shield blood test compared to colonoscopy. Sixty-five participants in the trial had confirmed colorectal cancer from a colonoscopy. The cfDNA test positively identified cancer in 54 of 65 (83.1%) of those participants.

What the test does not do is test for precancerous lesions or polyps, which can develop into cancer. For precancerous lesions, the test only detected about 13% of cases.

“This test is not cancer prevention,” said Chen, “That’s an important distinction.”

Cell-free DNA blood-based tests work by detecting small DNA fragments in the blood that may be emitted by tumors or other cancerous tissue.

“I think it’s really one of the first tests that are using, for blood at least, not just mutations, but a combination of mutations and what we call, epigenetic marks or methylation of DNA as another marker for detecting cancer,” said Park.

Finding those small shreds of DNA is no easy task either, which is part of why cfDNA tests haven’t made a major breakthrough yet in screening colorectal cancer. 

“It’s been actually known for decades that all of the cells in our body shed or secrete this naked free floating DNA… so the challenge, even though we’ve known about this for decades, is that the technology didn’t exist for us to really be able to sift through and pick the needle out of the haystack,” said Park.

Only two-thirds of Americans get cancer screening

Colorectal cancer is the second-leading cause of all cancer-related deaths. Despite how deadly the disease is, many adults do not adhere to recommended screenings. Less than 60% of adults ages 45 to 75 receive those screenings, even though these screenings could prevent an estimated 35,000 deaths (nearly 70%) annually due to colorectal cancer.

“With a screening test, you’re testing otherwise healthy people. It’s a hard concept for people to grasp,” Dr. Robert Smith, PhD, Senior Vice President of Early Cancer Detection Science at the American Cancer Society, told Healthline.

While colonoscopies are incredibly accurate at detecting precancerous lesions and colorectal cancer, many simply will ignore them because of the hassle.

The appeal of the cfDNA blood test is that, even with less accuracy, getting more patients to regularly screen for colorectal cancer could be a net positive.

“A test that a patient never receives is never going to be effective. The potential for this to be adopted much more widely is still a very positive step forward, even with certain limitations to its utility,” said Chen.

“Would we prefer to stand on principle and say there’s less expensive, more accurate tests? And by the way, people commonly don’t do them, so we have a lot of people dying from colorectal cancer because they won’t get tested. Or do we capture the patient in the office and essentially make getting screened pretty simple and pretty appealing?” said Smith.

“We’re fairly loyal to the most accurate test. But it may be that the most accurate test is the test that a sizable fraction of the population will use,” he said.

The bottom line

A new blood test is able to detect colorectal cancer in about 83% of cases, similar to some at-home screening tests.

Colorectal cancer is one of the most deadly forms of cancer, but not enough adults regularly screen for it.

Experts believe the new test could help bridge the gap of accessibility and get more adults screened regularly.

This recipe is excerpted from the cookbook The Food That Loves You…

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• People who drank a small amount of apple cider vinegar each day lost weight and saw decreases in BMI and waist circumference.
• They also saw improvements in metabolic markers such as levels of blood glucose, triglycerides, and total cholesterol.
• Experts say apple cider vinegar, if used for weight loss, should be used alongside a healthy diet, physical activity, and other lifestyle changes.

Apple cider vinegar, made from fermented apple juice, is a tasty base for salad dressings. But it could also help people lose weight and improve their metabolic health, a recent study suggests.

Researchers found that people who drank up to 1 tablespoon of apple cider vinegar a day, mixed in water, had decreases in body weight, body mass index (BMI), and waist circumference.

They also saw improvements in metabolic markers such as blood levels of glucose, triglycerides, and total cholesterol.

The study was published Mar. 12 in BMJ Nutrition, Prevention & Health.

Researchers investigate if apple cider vinegar can boost weight loss

The study included 120 adolescents and young adults (aged 12 to 25 years) from Lebanon who had obesity or were overweight. Almost two-thirds of the participants were female. Most reported not having an exercise routine.

None of the participants were taking medications. Large doses of apple cider vinegar may interact with medications such as digoxin, insulin, medications for diabetes, and diuretic drugs (water pills).

Apple cider vinegar might also damage tooth enamel, in a similar way as fruit juice and soda.

Researchers randomly assigned participants to drink either apple cider vinegar (5, 10 or 15 milliliters) or lactic acid — both mixed in 1 cup of water — three times a day for 12 weeks. People didn’t know which drink they received.

Apple cider vinegar contains acetic acid, which gives it its strong flavor and sour smell. It also contains other compounds, such as polyphenols, which may have health benefits in addition to those of acetic acid. 

In the study, researchers used lactic acid as a comparison, or placebo, because it has a similar taste and appearance as apple cider vinegar.

Participants drank their assigned beverage in the morning on an empty stomach. This was to reduce the possible effects of people eating food at the same time.

Participants also recorded what they ate throughout the day in a diet diary, and recorded their physical activity.

During the first study visit and after 4, 8, and 12 weeks, researchers measured participants’ height, weight, waist circumference, and body fat. They also collected a blood sample from each participant to measure the levels of glucose, triglycerides, and total cholesterol.

People drinking apple cider vinegar lost on average 15 lbs in 12 weeks

People who drank daily doses of apple cider vinegar saw decreases in body weight and BMI at weeks 4, 8, and 12, compared to the first study visit, researchers found.

The largest weight changes occurred among people who drank 10 or 15 milliliters of apple cider vinegar a day. They lost on average 15 pounds over 12 weeks.

Waist circumference and body fat also decreased among people who drank apple cider vinegar, with similar changes seen among the three groups. This was only true at weeks 8 and 12, not week 4.

In addition, metabolic measures improved in people who drank apple cider vinegar. The level of their blood glucose decreased at weeks 4, 8, and 12, and triglycerides and total cholesterol decreased at weeks 8 and 12, compared to the first study visit. 

The 15-milliliter dose of apple cider vinegar for 12 weeks appeared most effective in reducing these blood markers.

In contrast, the placebo group lost an average of less than 1 pound over the 12 weeks and did not see significant changes in the other body measures or metabolic markers.

None of the study participants reported any negative side effects of drinking apple cider vinegar.

Researchers also found that participants’ diet and physical activity did not differ among the apple cider vinegar groups and placebo groups. This suggests that the changes in body measures and blood measures were due to the consumption of apple cider vinegar, they write.

Although people continued to follow their “normal” diet throughout the study, it is possible that they unconsciously cut back on their calories, said Dr. Amy Lee, head of nutrition for Nucific.

She also cautions that the study only included 120 people, so the results may not apply to the real world.

“Nutrition-based trials are difficult at times because we have to take into account one’s individual metabolism, and the impact of stress and their environment, which can play a role in one’s behavior and even the way one burns calories,” Lee told Healthline.

How apple cider vinegar may affect appetite

The results of the new study fit with earlier research, the authors write, which found similar benefits of consuming 15 or 30 milliliters of apple cider vinegar a day.

However, the reason apple cider vinegar has these kinds of effects on body measures and metabolic health is not fully understood.

Some research suggests that apple cider vinegar, or its individual compounds, may lower cholesterol and triglyceride levels. It might also slow the oxidation of low-density lipoproteins (LDLs). Both of these actions can improve heart health.

Taking apple cider vinegar before meals could also reduce appetite and increase a sense of fullness, as well as have a positive effect on insulin sensitivity, the authors wrote.

However, some studies suggest that the feeling of fullness after consuming vinegar may be due to discomfort and nausea rather than any direct appetite-suppressing properties.

“The mechanism of action of apple cider vinegar can make a difference in the way someone handles the foods that they eat, and ultimately, this translates to weight loss if done consistently,” Lee told Healthline.

Given the results of this kind of research, “there is nothing bad about taking something like apple cider vinegar,” she said, “but one should be mindful that success in losing weight and maintaining weight loss requires an overall change in intake of food and lifestyle change.”

Michelle Routhenstein, a registered dietitian nutritionist who specializes in heart disease at EntirelyNourished.com, agrees, saying apple cider vinegar is not a “magic pill.”

“[Apple cider vinegar] needs to be looked at in conjunction with overall diet and physical activity, as well as stress and sleep management, to have a significant long-lasting impact.”

Takeaway

Researchers randomly assigned 120 adolescents and young adults to drink apple cider vinegar or lactic acid — the placebo — in the morning on an empty stomach, both mixed in 1 cup of water.

People who drank apple cider vinegar lost weight and saw decreases in BMI and waist circumference over 12 weeks. They also had improvements in metabolic measures — levels of blood glucose, triglycerides and total cholesterol.

Apple cider vinegar may work by increasing fullness, decreasing appetite and having positive effects on insulin sensitivity and cholesterol and triglycerides. 

Dame Esther Rantzen has welcomed plans by Labour for a vote on…

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Housed near Bristol, UKHSA’s National Collection of Pathogenic Fungi (NCPF) is home to more than 4,500 isolates of potentially deadly fungi isolates, gathered over the last century.

In this blog post, we’ll cover the history of the NCPF: why it was set up, what it houses and how it continues to play an important role in protecting our health.

• Women with depression have an increased risk of developing cardiovascular disease than men.
• Women may be more vulnerable to the physiological effects of depression. Also, women experience hormonal changes later in life, and the cardioprotective effects of estrogen begin to diminish, putting them at a heightened risk for cardiovascular disease.
• There are several limitations of this study. Further research is needed.

A new study shows people with depression have a greater risk of developing cardiovascular disease, but more women experience heart disease due to depression compared to men. 

The findings were published March 12 in JACC: Asia.

Researchers examined the relationship between depression and cardiovascular outcomes by analyzing data from the JMDC Claims Database between 2005 and 2022. They found 4,125,720 eligible participants. The median age was 44 years, and 2,370,986 participants were men.

The study found that men with depression were at a 39% increased risk for heart disease whereas women with depression had a 64% increased risk of heart disease.

“This is an interesting study of sex-specific associations between depression and risk for cardiovascular disease in a large sample of Japanese adults,” said Dr. Allison Gaffey, assistant professor of cardiovascular medicine at Yale School of Medicine. “Managing depression seems essential for heart disease prevention. Results add to the evidence in favor of addressing depression—through screening, referral, and treatment—to reduce the risk for heart disease in men and women.”

Gaffey was not involved in the study.

The connection between depression and heart health

There are three main ways that depression and heart disease are connected, according to Dr. Roy C. Ziegelstein, MACP, Professor of Medicine and Vice Dean for Education at Johns Hopkins University School of Medicine.

Ziegelstein was not involved in the study.

First, depression is a risk factor for the development of heart disease, and this study highlights that relationship. Some consider depression a “non-traditional” cardiovascular risk factor, with other, perhaps better known, risk factors being considered “traditional” (e.g., high blood pressure, diabetes, high cholesterol, and cigarette smoking). 

Second, heart disease is associated with an increased likelihood of developing or being diagnosed with depression. These two aspects together lead to the description of the relationship between depression and heart disease as “bidirectional”. 

Third, individuals with depression after a cardiovascular event (e.g., a heart attack) are at greater risk of poor outcomes, including death, than individuals who have a cardiovascular event and who are not depressed.

“There are several reasons for the existence of this relationship, however one thing to note in particular is that individuals with depression find it more challenging to attend to many activities in life – including many of the activities that are important to prevent and/or treat heart disease – since many things seem to require extra effort and energy that individuals with depression feel they don’t have,” said Ziegelstein. 

Ziegelstein also pointed out that people with depression may have more difficulty exercising, eating healthy or taking medications as prescribed.

Also, “there is some evidence that individuals with mental illness – including depression – receive needed treatments for heart disease less frequently than individuals without mental illness, even for heart conditions of similar severity,” Ziegelstein added.

Depression and heart health disparities between men and women

As this study highlights, there are sex-based differences between cardiovascular disease risk and depression. Experts explain potential reasons for this association.

“As women progress to later stages of life (post-menopausal), their cardioprotective effects of estrogen begin to wane and coupled with higher rates of inflammation and stress hormones from depression, leads to the disparity between men and women,” said Dr. Hosam Hmoud, a cardiology fellow at Northwell Lenox Hill Hospital. 

Hmoud was not involved in the study.

Gaffey explained, “In general, women are more likely to be depressed than men, and this pattern is seen throughout the lifespan. Women may be more vulnerable to the physiological effects of depression.”

Heart disease is the leading cause of death for both men and women in the U.S., but many people are not aware of this fact.

“Much of the traditional teaching has emphasized that women may be ‘protected’ from heart disease, and for this reason, the actual risk of heart disease may be underestimated by women and health care providers,” Ziegelstein stated. 

For example, studies show that many people are unaware that heart disease is the #1 cause of death in women in the United States. 

“As a result of this ‘double whammy’ (women and health care providers both underestimating risk), risk factors for heart disease may not receive enough attention in women compared to men, and women may seek medical attention for symptoms later than men,” said Ziegelstein. “This is important because the severity of a heart attack, for example, is directly related to the time from the onset of symptoms to the time the individual seeks medical attention, so if women seek medical attention later, they will be at increased risk.”

Limitations of this study

While this study sheds light on an important health concern, further research is needed. Other factors need to be taken into consideration.

“This sample was based on medical claims information only, so subclinical symptoms of depression were not accounted for, and may be associated with a unique risk for depression. There was no data presented on which individuals received treatment for depression or other psychological conditions. Women-specific factors such as history of pregnancy, [were] not accounted for,” said Gaffey.

Ziegelstein explained several of the study limitations:

Perhaps most importantly, the group of individuals in this study are very different from the typical U.S. adult population. Although racial, ethnic and socioeconomic diversity are not described in this observational study, the claims database “mainly includes employees working for relatively large companies in Japan” and this is likely a much less diverse group of individuals than the typical U.S. adult population. Moreover, there are important differences in the prevalence of traditional risk factors in the population studied here compared to the U.S. adult population.

In addition, the definition of obesity in this study includes many individuals who would be considered overweight but not obese in the United States; despite this, the prevalence of obesity in this study is far less than in the U.S. adult population. Along with the lower prevalence of traditional cardiovascular risk factors compared to the U.S., these traditional risk factors were nearly twice as common in men in this study than in women, raising the possibility that the relative contribution of a non-traditional risk factor like depression might have been more important among the women. 

Finally, because this study is observational, it must be remembered that “depression” here is based on a diagnostic code in the database, with no indication of whether the condition is currently affecting the individual, how severe it is, or how long the individual has had that diagnosis. This is important because women are more likely than men to be diagnosed with depression in the United States, however, the prevalence of diagnosed depression was about the same in men and women in this study. That may suggest that the women in this study may have had more severe depression than the men, and that possibility affects the interpretation of these results as well.

Takeaway

A new study shows women with depression have a greater risk of developing cardiovascular disease than men.

According to experts, there are a few potential reasons for the sex-based differences between cardiovascular disease risk and depression. Women may be more vulnerable to the physiological effects of depression. Also, during post-menopausal years, women experience hormonal changes, and the cardioprotective effects of estrogen begin to decrease.

There are numerous limitations of this study. Further research is required.

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• A study has found a link between worsening metabolic syndrome and cancer risk.
• The risk for breast, endometrial, kidney, colorectal, or liver cancer was significantly higher.
• Experts say the metabolic effects of this condition could work together to increase risk.
• The best way to lower your risk is by reducing abdominal fat.
• Eating a nutritious whole-food diet and exercising can help.

A study published online ahead of the April 1, 2024 print version of Cancer has found that worsening metabolic syndrome appears to increase the risk of developing cancer.

According to the National Heart, Lung, and Blood Institute, metabolic syndrome is a clustering of symptoms that increases a person’s risk for coronary heart disease, diabetes, and stroke.

It may be recognized by the presence of three or more of the following symptoms:

• Abdominal obesity
• High blood pressure
• High blood sugar
• High blood triglycerides
• Low HDL (often referred to as “good” cholesterol)

Breast, endometrial, kidney, colorectal, and liver cancers were especially associated with this metabolic condition.

Per the study authors, management of metabolic syndrome could be an effective way to modulate cancer risk.

Worsening metabolic syndrome linked to cancer risk

To examine how metabolic syndrome affects cancer risk, the researchers studied 44,115 Chinese adults with an average age of 49 years.

Researchers calculated metabolic syndrome scores for participants based on the presence of each of the five metabolic syndrome symptoms, with a score of 0 being the lowest and a score of 5 being the highest.

The study participants were then placed into one of four different metabolic syndrome trajectories based on trends observed in their metabolic syndrome scores between 2006 and 2010. These trajectories were:

• low-stable (10.56% of participants)
• moderate-low (40.84% of participants)
• moderate-high (41.46% of participants)
• elevated-increasing (7.14$ of participants)“

While the first three groups maintained steady metabolic syndrome scores over time, the elevated-increasing group started out with elevated scores that rose over the course of the study period.

The four groups were then followed between 2010 and 2021.

During this time frame, 2,271 people were diagnosed with cancer.

When the team compared the elevated-increasing group with the low-stable group, they found that the risk of developing any type of cancer was 1.3 times greater.

However, the risks for developing certain types of cancers were also notably higher:

• breast cancer risk was 2.1 times higher
• endometrial cancer risk was 3.3 times higher
• kidney cancer risk was 4.5 times higher
• colorectal cancer risk was 2.5 times higher
• liver cancer risk was 1.6 times higher

Additionally, individuals with the elevated-increasing pattern had a greater increase in risk for all cancer types than the other groups combined.

The researchers further found that the elevated-increasing pattern and concurrent chronic inflammation was associated with a greater risk for breast, endometrial, colorectal, and liver cancer. Kidney cancer, however, was mainly seen in those in the elevated-increasing group who did not have without chronic inflammation.

Why metabolic syndrome might increase cancer risk

Dr. Michael Sturek, a member of the American Physiological Society, said the authors were correct in stating that metabolic syndrome is a constellation of factors, including obesity, high blood cholesterol and triglycerides, high blood pressure, mild increases in blood sugar, and chronic inflammation.

“These factors are interconnected and act synergistically to promote the adverse growth of tumors,” he explained.

Sturek, who was not involved in the study, went on to note that this has previously been shown in other studies as well.

However, the authors of this study have made the point that the rate of increase in severity of metabolic syndrome was a major reason that cancer risk was greater.

“The findings are solid,” he added, “but the molecular pathways causing the increase in cancer cannot be known from this study.”

Dr. Jared Braunstein, a board certified internist with Medical Offices of Manhattan and contributor to LabFinder who was not involved in the study, speculated, however, that leptin could play a role.

“Patients with metabolic syndrome tend to be obese and make high amounts of leptin which has been associated with prostate, colon, breast and endometrial cancers,” he said.

What you can do about metabolic syndrome

Braunstein advises that reducing obesity — especially abdominal obesity — is an important part of dealing with metabolic syndrome.

Visceral fat, the fat associated with abdominal obesity, is biologically active, secreting certain hormones and chemicals that can contribute to the development of diabetes and cardiovascular disease.

This fat tends to accumulate deep in the abdomen surrounding the internal organs, including the stomach, liver, and intestines. It is different from the subcutaneous fat that lies just under the skin.

“Probably the most proactive plan is to adopt a healthy lifestyle that includes proper nutrition and exercise, which can prevent MetS [metabolic syndrome] and inflammation,” added Sturek.

While there is no specific diet that is recommended for the treatment of metabolic syndrome, it is usually advised that people eat nutritious whole foods and avoid processed foods high in sugar and saturated fat.

Three anti-inflammatory diets that fit the bill include the Mediterranean diet, the DASH diet, and the whole-food, plant-based diet.

As far as exercise, Sturek pointed to a September 2022 study published in JAMA Internal Medicine in which it was found that taking 10,000 steps per day was associated with a lower risk of cancer.

He acknowledged, however, that compliance with a diet and exercise regimen is often difficult for people. “[I]t remains to be seen whether new weight control and diabetes drugs, like semaglutide (Ozempic) or tirzepatide (Mounjaro), will be effective treatments, also.”   

Takeaway

A new study has found a link between worsening metabolic syndrome and increasing risk of developing cancer.

Greater risk was especially seen with breast, endometrial, kidney, colorectal, and liver cancers.

It can’t be determined from the study exactly what the mechanism is that is responsible for the increase in risk.

However, there could be some sort of interplay between the metabolic effects associated with this condition.

Working to reduce abdominal obesity through a healthy diet and exercise is the best way to reverse metabolic syndrome and reduce your cancer risk.