Health Report:

Obesity, Lifestyle & Heart Disease

Effects of Lifestyle & Nutrition on Prostate Cancer

Ginkgo Biloba, Ulcerative Colitis & Coloretal Cancer

"A critical weekly review of important new research findings for health-conscious readers..."

By, Robert A. Wascher, MD, FACS

Photo of Dr. Wascher

Last Updated:  6/22/2008

The information in this column is intended for informational purposes only, and does not constitute medical advice or recommendations by the author.  Please consult with your physician before making any lifestyle or medication changes, or if you have any other concerns regarding your health.


There has been much written about the link between obesity and heart disease, and the consensus has generally been that increasing levels of excess weight are associated with increasing levels of coronary artery disease and heart attacks (myocardial infarction).  More recent research studies have attempted to quantify the extent of added risk associated with specific degrees of obesity, and some have also evaluated the benefits, if any, of varying levels of physical fitness among obese patients (please see my Archives for a review of some of these recent research studies).  In general, most of these recent studies continue to show that increasing levels of obesity are associated with increasingly greater risks of coronary artery disease (as well as an increasing incidence of high blood pressure, diabetes, stroke, arthritis, some forms of cancer, and premature death).  While obese people can somewhat reduce health risks with regular and vigorous exercise (the so-called “fit fat” person), most clinical research studies have observed that overall health risks still remain greater than those observed in lean people.  A new study, published in the journal Circulation, evaluates multiple lifestyle factors and their effects on health in obese people.

This study was conducted by researchers from Aarhus University and the Danish Cancer Society, in Denmark, and by researchers from Harvard University in Boston.  Nearly 55,000 men and women participated in the Danish Diet, Cancer and Health Study, and were free of heart disease and cancer upon enrolling in this study.  Participants were 50 to 64 years of age upon entry into this study, and were followed for an average of almost 8 years.  During the course of this study, 1,127 cases of coronary-artery-related complications occurred, including chest pain (angina) and myocardial infarction.  Using body mass index (BMI), a standardized measure of obesity that is based upon weight and height measurements, this study revealed that each additional unit of increase in BMI above the normal range was associated with a 5% increase in coronary artery complications in women, and a 7% increase in men.  As previous studies have shown, obese individuals who regularly engaged in 1 to 3.5 hours of exercise per week had a lower risk of coronary artery disease than obese patients who did not exercise.  Additionally (and not surprisingly), obese smokers had a considerably greater risk of experiencing cardiac events than obese nonsmokers.  Adhering to a heart-healthy diet also appeared to offer some protection against coronary artery disease among obese patients, although the difference in the incidence of coronary artery disease between the “healthiest diet” and intermediate degrees of less healthy diets was essentially nil. 

Taken together, the results from this very large Danish public health study confirm other recent studies that have shown that, even among obese people, lifestyle factors can have a significant influence on cardiac health.  However, none of these positive lifestyle changes, such as exercise, a heart-healthy diet, or abstinence from tobacco, can completely erase the harmful effects of obesity.  There is no substitute for shedding excess weight if you want to maintain your coronary arteries in the best possible shape.  However, if you are already actively working on eliminating excess weight, you can still incrementally decrease your risk of heart disease by adopting a healthy lifestyle while you work towards achieving a healthier BMI.



There have been numerous studies on the effects of various nutritional supplements on prostate cancer cells growing in a Petri dish in the laboratory, and in human prostate cancer cells implanted into mice.  However, there is precious little data on the effects of nutritional and other lifestyle interventions, if any, on actual prostate cancer tumors growing in living human beings.  As I have often mentioned before, there have been hundreds of previous research studies that have observed positive responses to experimental treatments in laboratory cell cultures and in mice and rats, but have subsequently failed to show any beneficial impact when applied to human subjects.  However, a new and exciting study, just published in the Proceedings of the National Academy of Sciences, provides a rare glimpse into the effects, at the genetic level, of nutritional and lifestyle interventions on prostate cancer tumor cells taken from the prostate glands of men with this disease.

This very intriguing study was performed by physicians and scientists at the University of California at San Francisco and the Preventive Medicine Research Institute in Sausalito, California, with assistance from the famed J. Craig Venter Institute in Rockville, Maryland.  Initial biopsies were taken from prostate cancer tumors in 30 men who had previously declined surgery or other conventional treatments for their prostate cancers, and all of these men subsequently participated in an intensive nutrition and lifestyle modification program.  In all cases, significant improvements in obesity, elevated blood pressure, and cholesterol levels were observed in these 30 men after 3 months of vigorous exercise, dieting and other healthy lifestyle modifications.  After this 3 month period of intensive lifestyle and nutrition modification, repeat needle biopsies were performed on their prostate cancer tumors.  Both the initial and subsequent prostate cancer biopsy samples were then subjected to specialized genetic testing that compared changes in the activity of individual genes within the tumor cells following 3 months of lifestyle and nutrition modification.

Gene expression profiling revealed that the activity of 48 individual genes had significantly increased following completion of the 3-month lifestyle modification program, while 453 genes had become less active.  The researchers then looked at all of the 501 genes that had undergone changes in their levels of expression, and assessed their functions as they related to cancer cell growth and progression.  After analyzing the functions of these 501 genes, the researchers determined that many of them were directly involved in critical pathways used by cancer cells to grow and divide.

Although this was only a small pilot study, it is one of only a handful of “in vivo” clinical research studies that have objectively studied the impact, at the level of gene activity, of healthy lifestyle modifications on active cancers growing within living human beings.  As such, the implications of this study’s findings are potentially enormous.  Although it is not possible to tell if these 30 men will experience a reduction in the growth or spread of their cancers as a result of these lifestyle modifications, the objective improvement in the “genetic profile” of their prostate cancers, following 3 months of intensive diet and exercise modification, is an exciting finding in and of itself.  The implications of this study’s results offer hope that rigorous lifestyle modifications may help to both prevent some cancers and to reduce the biological aggressiveness of cancers that have already developed.  However, this is only a small “proof of concept” research trial.  A larger randomized clinical research trial will now have to be performed using a similar approach, but with a “control group” of patients who do not undergo any lifestyle or nutrition modifications.  Additionally, this future randomized study will have to follow all of the participating patients for a sufficiently long period of time to allow any clinically significant differences between patient groups to become evident.  Meanwhile, this fascinating little study offers a tantalizing look (at the genetic level) at the potential impact of diet and lifestyle changes on the biology of cancer cells growing within the human body.



For the most part, the anti-inflammatory and anti-cancer effects of herbal supplements and vitamins with known antioxidant activity have turned out to be quite disappointing in human research trials, despite favorable results from previous laboratory research using cell cultures and laboratory mice and rats. 

The ginkgo biloba tree is an ancient plant with no known living relatives, and is often described as a “living fossil.”  Some living ginkgo trees in China are estimated to be nearly 3,000 years old, and fossilized specimens of this unique tree are numerous.  For thousands of years, the unique bi-lobed leaves of the ginkgo tree have been used for medicinal purposes, initially in traditional Chinese medicine, and more recently, throughout the remaining world.  Ginkgo leaves are known to possess antioxidant activity, converting cell-damaging “free radical” oxygen molecules, which are potentially toxic byproducts of normal metabolism, into less toxic substances.  A new study published in the journal Carcinogenesis has evaluated the effects of ginkgo biloba extract in preventing and treating inflammatory colitis in mice.  This study, from laboratories at the University of South Carolina and McGill University, in Canada, sought to demonstrate whether or not ginkgo biloba might be useful in preventing or treating ulcerative colitis, a chronic inflammatory disease of the rectum and colon associated with an increased risk of cancer development in humans.

In this study, inflammatory colitis was induced in laboratory mice.  The group of mice that was fed a standardized extract of ginkgo biloba had much lower levels of inflammatory substances in their circulation than the mice that were not given the ginkgo supplement.  Moreover, much lower numbers of immune cells associated with immune-mediated inflammation, known as CD4+ T-lymphocytes, were present in the mice that had received ginkgo supplements.  The activation of macrophages, which also participate in the inflammatory response, was also significantly reduced in the mice that received ginkgo biloba.  In this study, the use of ginkgo biloba extract was found to significantly decrease the degree of inflammatory colitis in this mouse model of ulcerative colitis. 

At this time, there are no active clinical trials assessing the effects of ginkgo biloba in human patients with ulcerative colitis, or other inflammatory bowel diseases, such as Crohn’s disease.  Based upon the intriguing results of this laboratory study, a human clinical trial to assess ginkgo biloba in patients with inflammatory bowel disorders should be initiated now.

Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity.

Dr. Wascher is an oncologic surgeon, professor of surgery, a widely published author, and the Director of the Division of Surgical Oncology at Newark Beth Israel Medical Center


Send your feedback to Dr. Wascher at rwascher@doctorwascher.net

Links to Other Health & Wellness Sites

Copyright 2008.  Robert A. Wascher, MD, FACS.  All rights reserved.

Dr. Wascher's Archives:

6-15-2008:  Preventable Deaths after Coronary Artery Bypass Graft (CABG) Surgery; Green Tea & Colorectal Cancer; Attention-Deficit/Hyperactivity Disorder (ADHD) & St. John’s Wort

6-8-2008:  Vitamin D & Prostate Cancer Risk; Radiofrequency Ablation (RFA) of Kidney (Renal) Cancer; Antisense Telomerase & Cancer

6-2-2008:  Acute Coronary Syndrome- Do You Know the Symptoms?; Green Tea & Lung Cancer; Episiotomy & Subsequent Deliveries- An Unkind Cut

5-25-2008:  Early Childhood Screening Predicts Later Behavioral Problems; Psychiatric Disorders Among Parents of Autistic Children; Social & Psychiatric Profiles of Young Adults Born Prematurely

5-18-2008:  Can Statins Reverse Coronary Artery Disease?; Does Breast Ultrasound Improve Breast Cancer Detection?; Preventive Care Services at Veterans Administration (VA) Medical Centers

5-11-2008:  Smoking Cessation & Risk of Death; Childhood Traumas & Adult Suicide Risk; “White Coat Hypertension” & Risk of Cardiovascular Disease

5-4-2008:  Super-Size Me: Fast Food’s Effects on Your Liver; Exercise, Weight & Coronary Artery Disease; Contamination of Surgical Instruments in the Operating Room

4-27-2008:  Stents vs. Bypass Surgery for Coronary Artery Disease; The “DASH” Hypertension Diet & Cardiovascular Disease Prevention; Testosterone Therapy for Women with Decreased Sexual Desire & Function

4-20-2008:  BRCA Breast Cancer Mutations & MRI Scans; Bladder Cancer Prevention with Broccoli?; Diabetes: Risk of Death Due to Heart Attack & Stroke

4-13-2008:  Breast Cancer Recurrence & Hormone Replacement Therapy (HRT); Carotid Artery Disease: Surgery vs. Stents?; Statin Drugs & Cancer Prevention

4-6-2008:  Human Papilloma Virus (HPV), Pap Smear Results & Cervical Cancer; Human Papilloma Virus (HPV) Infection & Oral Cancer; Hormone Replacement Therapy (HRT) & the Risk of Gastroesophageal Reflux Disorder (GERD)

3-30-2008:  Abdominal Obesity & the Risk of Death in Women; Folic Acid Pretreatment & Heart Attacks; Pancreatic Cancer Regression after Injections of Bacteria

3-23-2008:  Age of Transfused Blood & Risk of Complications after Surgery; Obesity, Blood Pressure & Heart Size in Children

3-16-2008:  Benefits of a Full Drug Coverage Plan for Medicare Patients?; Parent-Teen Conversations about Sex; Soy (Genistein) & Prostate Cancer

3-9-2008:  Flat Colorectal Adenomas & Cancer; Health Risks after Stopping Hormone Replacement Therapy (HRT); Television, Children & Obesity 

3-2-2008:  Medication & Risk of Death After Heart Attack; Hormone Replacement Therapy (HRT) & Mammogram Results; Selenium: Cancer, Heart Disease & Death

2-23-2008:  Universal Healthcare Insurance Study; Glucosamine & Arthritis

2-17-2008:  Exceptional Longevity in Men; Testosterone & Risk of Prostate Cancer; Smoking & Pre-malignant Colorectal Polyps

2-10-2008:  Thrombus Aspiration from Coronary Arteries; Intensive Management of Diabetes & Death; Possible Cure for  Down's Syndrome?

2-3-2008:  Vitamin D & Cardiovascular Health; Vitamin D & Breast Cancer; Green Tea & Colorectal Cancer

1-27-2008:  Colorectal Cancer, Esophageal Cancer & Pancreatic Cancer: Update from the 2008 American Society of Clinical Oncology's Gastrointestinal Cancers Symposium

1-20-2008:  Testosterone Levels & Risk of Fractures in Elderly Men; Air Pollution & DNA Damage in Sperm; Statins & Trauma Survival in the Elderly

1-12-2008:  Statins, Diabetes & Stroke and Obesity; GERD & Esophageal Cancer

1-7-2008:  Testosterone Supplements in Elderly Men; Colorectal Cancer-- Reasons for Poor Compliance with Screening Recommendations

12-31-2007:  Minority Women, Hormone Replacement Therapy & Breast Cancer; Does Health Insurance Improve Health?

12-23-2007:  Is Coffee Safe After a Heart Attack?; Impact of Divorce on the Environment; Hypertension & the Risk of Dementia; Emotional Vitality & the Risk of Heart Disease

12-16-2007:   Honey vs. Dextromethorphan vs. No Treatment for Kids with Night-Time Cough, Acupuncture & Hot Flashes in Women with Breast Cancer, Physical Activity & the Risk of Death, Mediterranean Diet & Mortality 

12-11-2007:  Bias in Medical Research; Carbon Nanotubes & Radiofrequency: A New Weapon Against Cancer?; Childhood Obesity & Risk of Adult Heart Disease

12-2-2007:  Obesity & Risk of Cancer; Testosterone Level & Risk of Death; Drug Company Funding of Research & Results; Smoking & the Risk of Colon & Rectal Cancer 


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