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It's official - the medical community has accepted that a key element in preventing allergies and asthma is early childhood exposure to allergens - whether peanuts, dust, or pets. Instead of avoiding the allergens (which was the medical advice for decades) - getting early exposure to them is key to preventing allergies. Apparently growing up on a farm is best (with exposure to farm dirt and dust), especially a dairy farm with animals and raw milk (a number of studies have found that unprocessed raw milk and its microbes also helps health). But if one doesn't live on a farm, then having furry pets in early childhood is also beneficial in reducing the incidence of allergies. The following study shows that microbes are involved - pet microbes were found in the guts of many of those children who did not develop early allergies! From Medscape:

Furry Pets 'Enrich' Gut Bacteria of Infants at Risk for Allergies

In a small, preliminary study, infants in households with furry pets were found to share some of the animals' gut bacteria - possibly explaining why early animal exposure may protect against some allergies, researchers say. The infants' mothers had a history of allergy, so the babies were at increased risk. It was once thought that pets might be a trigger for allergies in such children, the authors pointed out online September 3 in the Journal of Allergy and Clinical Immunology.

"Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease," coauthor Dr. Merja Nermes, of the University of Turku in Finland, told Reuters Health by email. "Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive."Adding pet microbes to the infant intestinal biome may strengthen the immune system, she said.  ...continue reading "Early Childhood Experiences Key to Preventing Allergies"

Another study finding negative health effects from air pollution. This year I've posted several studies that found negative effects on the brain (and even cognition) from air pollution for people of all ages. Now this latest study found that in areas with air pollution, long-term exposure to outdoor fine particulate matter (PM2.5),which are fine particles in the air, are linked to an overall increase in risk of death, especially due to cardiovascular disease. The fine particles in the air contribute to the development of potentially fatal heart and lung diseases because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles, like airborne soil and sand, are removed from the body's airways. From Science Daily:

Link between air pollution, increased deaths and increased deaths from heart disease affirmed

In what is believed to be the largest, most detailed study of its kind in the United States, scientists at NYU Langone Medical Center and elsewhere have confirmed that tiny chemical particles in the air we breathe are linked to an overall increase in risk of death. The researchers say this kind of air pollution involves particles so small they are invisible to the human eye (at less than one ten-thousandth of an inch in diameter, or no more than 2.5 micrometers across).

In a report on the findings, published in the journal Environmental Health Perspectives online Sept. 15, the scientists conclude that even minuscule increases in the amount of these particles (by 10 micrograms per cubic meter of air, for example) lead to an overall increased risk of death from all causes by 3 percent -- and roughly a 10 percent increase in risk of death due to heart disease. For nonsmokers, the risk increase rises to 27 percent in cases of death due to respiratory disease.

"Our data add to a growing body of evidence that particulate matter is really harmful to health, increasing overall mortality, mostly deaths from cardiovascular disease, as well as deaths from respiratory disease in nonsmokers," says lead study investigator and health epidemiologist George Thurston, ScD, a professor of population health and environmental medicine at NYU Langone. "Our study is particularly notable because all the data used in our analysis comes from government- and independently held sources."

According to Thurston, fine particles can contribute to the development of potentially fatal heart and lung diseases because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles, like airborne soil and sand, are removed from the body's airways. Moreover, Thurston says, fine particles are usually made of harmful chemicals such as arsenic, selenium, and mercury, and can also transport gaseous pollutants, including sulfur and nitrogen oxides, with them into the lungs.

For their research, Thurston and his colleagues evaluated data from a detailed health and diet survey conducted by the National Institutes of Health (NIH) and the American Association of Retired Persons (AARP). The NIH-AARP study involved 566,000 male and female volunteers, ages 50 to 71, from California, Florida, Louisiana, New Jersey, North Carolina, Pennsylvania, and the metropolitan areas of Atlanta and Detroit. Analyzing information gathered about the participants between 2000 and 2009,....

Indeed, the team did not find any significant difference in the effect of particulate matter exposure between different sexes or age groups or by level of education. The researchers also noted that limiting the analysis to only the state of California, which has the most rigorous controls on air pollution, did not produce a different overall level of risk; instead, they found the same association between particulate matter exposure and increase in risk of death from all nonaccidental causes and from cardiovascular disease.

Another study found that young children who more time spent outside in natural light for 3 years resulted in fewer cases of myopia (near-sightedness). Specifically, the good results were found from one additional 40-minute class of outdoor activities each school day, as well as parents encouraging their children to play outdoors after school hours, especially during weekends and holidays. So....those of you who are parents of children huddled inside - get them outside daily in the sunlight to soak up sunshine for vitamin D and to help their vision. From Science Daily:

Additional time spent outdoors by children results in decreased rate of nearsightedness

The addition of a daily outdoor activity class at school for three years for children in Guangzhou, China, resulted in a reduction in the rate of myopia (nearsightedness, the ability to see close objects more clearly than distant objects), according to a study in the September 15 issue of JAMA.

Myopia has reached epidemic levels in young adults in some urban areas of East and Southeast Asia. In these areas, 80 percent to 90 percent of high school graduates now have myopia. Myopia also appears to be increasing, more slowly, in populations of European and Middle Eastern origin. Currently, there is no effective intervention for preventing onset. Recent studies have suggested that time spent outdoors may prevent the development of myopia, according to background information in the article.

Mingguang He, M.D., Ph.D., of Sun Yat-sen University, Guangzhou, China, and colleagues conducted a study in which children in grade 1 from 12 primary schools in Guangzhou, China (six intervention schools [n = 952 students]; six control schools [n = 951 students], were assigned to 1 additional 40-minute class of outdoor activities, added to each school day, and parents were encouraged to engage their children in outdoor activities after school hours, especially during weekends and holidays (intervention schools); or children and parents continued their usual pattern of activity (control schools). The average age of the children was 6.6 years.

The 3-year cumulative incidence rate of myopia was 30.4 percent (259 cases among 853 eligible participants) in the intervention group and 39.5 percent (287 cases among 726 eligible participants) in the control group. Cumulative change in spherical equivalent refraction (myopic shift) after 3 years was significantly less in the intervention group than in the control group.

"Our study achieved an absolute difference of 9.1 percent in the incidence rate of myopia, representing a 23 percent relative reduction in incident myopia after 3 years, which was less than the anticipated reduction. However, this is clinically important because small children who develop myopia early are most likely to progress to high myopia, which increases the risk of pathological myopia. Thus a delay in the onset of myopia in young children, who tend to have a higher rate of progression, could provide disproportionate long-term eye health benefits," the authors write.

More research support for extra virgin olive oil and the Mediterranean diet being associated with anti-cancer effects, In a study conducted in Spain, women supplementing their diet with extra EVOO (extra virgin olive oil) had a lower incidence of breast cancer after about 5 years.

The Mediterranean diet stresses eating a lot of fruits, vegetables, seeds, nuts, legumes, whole grains, fish, and olive oil.

From Science Daily: Mediterranean diet plus olive oil associated with reduced breast cancer risk

Eating a Mediterranean diet supplemented with extra virgin olive oil was associated with a relatively lower risk of breast cancer in a study of women in Spain, according to an article published online by JAMA Internal Medicine.

The Mediterranean diet is known for its abundance of plant foods, fish and especially olive oil. Miguel A. Martínez-González, M.D., of the University of Navarra in Pamplona and CIBEROBN in Madrid, Spain, and coauthors analyzed the effects of two interventions with the Mediterranean diet (supplemented with extra virgin olive oil [EVOO] or nuts) compared with advice to women to follow a low-fat diet. Study participants in the two intervention groups were given EVOO (one liter per week for the participants and their families) or mixed nuts (30 grams per day: 15 grams of walnuts, 7.5 grams of hazelnuts and 7.5 grams of almonds).

From 2003 to 2009, 4,282 women (ages 60 to 80 and at high risk of cardiovascular disease) were recruited. Women were randomly assigned to the Mediterranean diet supplemented with EVOO (n=1,476), the Mediterranean diet supplemented with nuts (n=1,285) or the control diet with advice to reduce their dietary intake of fat (n=1,391). The women were an average age of 67.7 years old, had an average body mass index of 30.4, most of them had undergone menopause before the age of 55 and less than 3 percent used hormone therapy. During a median follow-up of nearly five years, the authors identified 35 confirmed incident (new) cases of malignant breast cancer.

The authors report that women eating a Mediterranean diet supplemented with EVOO showed a 68 percent relatively lower risk of malignant breast cancer than those allocated to the control diet. Women eating a Mediterranean diet supplemented with nuts showed a nonsignificant risk reduction compared with women in the control group.

The authors note a number of limitations in their study including that breast cancer was not the primary end point of the trial for which the women were recruited; the number of observed breast cancer cases was low; the authors do not have information on an individual basis on whether and when women in the trial underwent mammography; and the study cannot establish whether the observed beneficial effect was attributable mainly to the EVOO or to its consumption within the context of the Mediterranean diet. [The original study.]

Yes, even healthy newborns have a diversity of viruses in the gut - this is their virome (community of viruses), and it undergoes changes over time. In fact, the entire infant microbiome (community of microbes) is highly dynamic and the composition of bacteria, viruses and bacteriophages changes with age. One interesting finding is that initially newborn babies have a lot of bacteriophages (viruses that infect bacteria), but that these decline over the first two years of age. From Medical Xpress:

Viruses flourish in guts of healthy babies

Bacteria aren't the only nonhuman invaders to colonize the gut shortly after a baby's birth. Viruses also set up house there, according to new research at Washington University School of Medicine in St. Louis. All together, these invisible residents are thought to play important roles in human health.The study, published online Sept. 14 in Nature Medicine, reports data from eight healthy infants and is one of the first surveys of viruses that reside in the intestine. The investigators analyzed stool samples to track how the babies' bacterial gut microbiomes and viromes changed over the first two years of life.

"We are just beginning to understand the interplay between all the different types of life within our gut," said senior author Lori R. Holtz, MD, assistant professor of pediatrics. "They are not stand-alone communities. We also are seeing that the environment of the infant gut is extremely dynamic, which differs from the relative stability that has been shown in adults."The earliest stool samples were taken at 1-4 days of life, and even at this early time point, Holtz noted, viruses were present ...continue reading "Viruses Live in The Guts of Healthy Babies"

New research has found that low vitamin D levels among older adults is associated with accelerated cognitive decline and impaired performance (particularly in areas of memory and executive function). The next research in this area will have to look at whether vitamin D supplementation will change (slow down) the decline. Please note that it is widely accepted that an average daily intake of 1000 IU  of D3 daily is safe. The best source of  vitamin D is sunlight. From Science Daily:

Low vitamin D among elderly associated with decline in cognition, dementia

Vitamin D insufficiency among the elderly is highly correlated with accelerated cognitive decline and impaired performance, particularly in domains such as memory loss that are associated with Alzheimer's disease and dementia, researchers with the UC Davis Alzheimer's Disease Center and Rutgers University have found. The effect is "substantial," with individuals with low vitamin D declining at a rate three times faster than those with adequate vitamin D levels

The researchers said their findings amplify the importance of identifying vitamin D insufficiency among the elderly, particularly high-risk groups such as African-Americans and Hispanics, who are less able to absorb the nutrient from its most plentiful source: sunshine. Among those groups and other darker-skinned individuals, low vitamin D should be considered a risk factor for dementia, they said. "Independent of race or ethnicity, baseline cognitive abilities and a host of other risk factors, vitamin D insufficiency was associated with significantly faster declines in both episodic memory and executive function performance," said Joshua Miller...

The large, longitudinal study was conducted in nearly 400 racially and ethnically diverse men and women in Northern California participating in longitudinal research at the Alzheimer's Disease Center in Sacramento, Calif. Fifty percent of participants were Caucasian and 50 percent were African-American or Hispanic. The participants had a mean age of 76 and were either cognitively normal, had mild cognitive impairment, or dementia.The participants' serum vitamin D status was measured at the beginning of the study.... Overall, 26 percent were deficient and 35 percent were insufficient. Among Caucasians, 54 percent had low vitamin D, compared with 70 percent of African-Americans and Hispanics.

Over five years of follow-up, vitamin D deficient individuals experienced cognitive declines that were two-to-three times faster than those with adequate serum vitamin D levels. In other words it took only two years for the deficient individuals to decline as much as their counterparts with adequate Vitamin D declined during the five-year follow-up period.

Exposing the skin to sunlight is the major source of vitamin D. Racial and some ethnic minorities are at greater risk of low vitamin D because the higher concentration of melanin that makes their skin darker -- and protects against skin cancer in sunny climates -- also inhibits synthesis of vitamin D. Diet is the other major source of vitamin D. Dietary vitamin D is obtained particularly through dairy consumption. The intake of dairy products is especially low among minority groups, with only 6.5 percent of African-Americans and 11 percent of Mexican-Americans nationwide consuming the recommended three daily servings of dairy products, the study says.

Image result for dark chocolate So far all the studies I've seen in the past 2 years about cocoa and chocolate have found various beneficial health effects from regularly eating small amounts of cocoa and chocolate. Now 2 new studies found benefits from the flavanols found in cocoa beans and chocolate. The studies found that consuming cocoa flavanols lowers blood pressure, increases flow-mediated vasodilation,improves blood cholesterol profile, and that regular dietary intake may reduce the risk of cardiovascular disease (CVD). However, note that chocolate and cocoa contain other compounds besides flavanols and these may also be exerting positive effects.

So now the question becomes, which chocolates have high levels of flavanols? Modern processing removes some of the flavanols - in fact, the more it undergoes processing, the more flavanols are lost. But it appears that dark chocolate and cocoa that has not undergone Dutch processing is best. According to a Medscape article on cocoa flavanols: "Traditional processing methods that yield "modern chocolate," especially alkalinization (dutching or Dutch processing, to mellow flavor), strips flavanols from cocoa. The bitterness from cacao mostly comes from flavanols. With the emerging recognition of the beneficial effects of flavanols there has been a shift in commercial production towards chocolate forms with high flavanol content." A recent study by Consumer Lab, which compared flavanol levels across many cocoa and chocolate products, also found that some chocolate brands were contaminated with cadmium (a toxic heavy metal), but that cocoa nibs had significantly lower levels. At any rate, the medical evidence does not support gorging on chocolate, but instead consuming chocolate or cocoa in moderation. From Science Daily:

Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people

Two recently published studies in the journals Age and the British Journal of Nutrition (BJN) demonstrate that consuming cocoa flavanols improves cardiovascular function and lessens the burden on the heart that comes with the aging and stiffening of arteries. The studies also provide novel data to indicate that intake of cocoa flavanols reduces the risk of developing cardiovascular disease (CVD).

As we age, our blood vessels become less flexible and less able to expand to let blood flow and circulate normally, and the risk of hypertension also increases. Arterial stiffness and blood vessel dysfunction are linked with cardiovascular disease -- the number one cause of deaths worldwide....Cocoa flavanols are plant-derived bioactives from the cacao bean. Dietary intake of flavanols has been shown to have a beneficial effect on cardiovascular health but the compounds are often destroyed during normal food processing. Earlier studies have demonstrated that cocoa flavanol intake improves the elasticity of blood vessels and lowers blood pressure....These two studies in Age and BJN are the first to look at the different effects dietary cocoa flavanols can have on the blood vessels of healthy, low-risk individuals with no signs or symptoms of cardiovascular disease.

Cocoa flavanols increase blood vessel flexibility and lower blood pressure - In the study published in Age, two groups of 22 young (<35 years of age) and 20 older (50-80 years of age) healthy men consumed either a flavanol-containing drink, or a flavanol-free control drink, twice a day for two weeks. The researchers then measured the effect of flavanols on hallmarks of cardiovascular aging, such as arterial stiffness (as measured by pulse wave velocity), blood pressure and flow-mediated vasodilation (the extent to which blood vessels dilate in response to nitric oxide). They found that vasodilation was significantly improved in both age groups that consumed flavanols over the course of the study (by 33% in the younger age group and 32% in the older age group over the control intervention). In the older age group, a statistically and clinically significant decrease in systolic blood pressure of 4 mm Hg over control was also seen.

Improving cardiovascular health and lowering the risk of CVD - In the second study, published in BJN, the researchers extended their investigations to a larger group (100) of healthy middle-aged men and women (35-60 years) with low risk of CVD. The participants were randomly and blindly assigned into groups that consumed either a flavanol-containing drink or a flavanol-free control drink, twice a day for four weeks.

"We found that intake of flavanols significantly improves several of the hallmarks of cardiovascular health," says Professor Kelm. In particular, the researchers found that consuming flavanols for four weeks significantly increased flow-mediated vasodilation by 21%. Increased flow-mediated vasodilation is a sign of improved endothelial function and has been shown by some studies to be associated with decreased risk of developing CVD. In addition, taking flavanols decreased blood pressure (systolic by 4.4 mmHg, diastolic by 3.9 mmHg), and improved the blood cholesterol profile by decreasing total cholesterol (by 0.2 mmol/L), decreasing LDL cholesterol (by 0.17 mmol/L), and increasing HDL cholesterol (by 0.1 mmol/L).

The researchers also calculated the Framingham Risk Score -- a widely used model to estimate the 10-year cardiovascular risk of an individual -- and found that flavanol intake reduced the risk of CVD. "Our results indicate that dietary flavanol intake reduces the 10-year risk of being diagnosed with CVD by 22% and the 10-year risk of suffering a heart attack by 31%," says Professor Kelm.

The combined results of these studies demonstrate that flavanols are effective at mitigating age-related changes in blood vessels, and could thereby reduce the risk of CVD in healthy individuals. The application of 10-year Framingham Risk Scores should be interpreted with caution as the duration of the BJN study was weeks not years and the number of participants was around 100, not reaching the scale of the Framingham studies. That being said, Professor Kelm comments that "the reduction seen in risk scores suggests that flavanols may have primary preventive potential for CVD."

The following studies reinforce the advice that people should eat a variety of fruits and vegetables, as well as olive oil (part of the Mediterranean diet).

Studies find that consumption of fruits, vegetables, herbs, and extra virgin olive oil have various health benefits, and the following studies, even though not done with humans, suggest some reasons for their health benefits.

Luteolin appears to have anti-tumor effects, and so may reduce cancer risk. Dietary sources of luteolin include celery, broccoli, green pepper, parsley, thyme, dandelion, perilla, chamomile tea, carrots, olive oil, peppermint, rosemary, navel oranges, and oregano. Extra-virgin olive oil contains the ingredient oleocanthal, which appears to kill a variety of human cancer cells without harming healthy cells.

From Science Daily: Natural compound could reduce breast cancer risk in some women

The odds of women being diagnosed with breast cancer increase in postmenopausal women who have taken a combined estrogen and progestin hormone replacement therapy; these women also have an increased risk of developing progestin-accelerated breast tumors. Now, researchers have found that luteolin, a natural compound found in herbs such as thyme and parsley as well as vegetables such as celery and broccoli, could reduce the cancer risk for women who have taken hormone replacement therapy.

 "Nevertheless, research has proven that a higher incidence of breast cancer tumors can occur in women receiving therapies that involve a combination of the natural component estrogen and the synthetic progestin. Most older women normally have benign lesions in breast tissue," Hyder said. "These lesions typically don't form tumors until they receive the 'trigger'-- in this case, progestin--that attracts blood vessels to cells essentially feeding the lesions causing them to expand." His newest study shows that when the supplement luteolin is administered to human breast cancer cells in the lab, benefits can be observed including the reduction of those vessels "feeding" the cancer cells causing cancer cell death.

.... the natural compound exerts its anti-tumor effects in a variety of ways. Then, Hyder further tested laboratory mice with breast cancer and found that blood vessel formation and stem cell-like characteristics also were reduced in vivo, or inside the body.

From Medical Xpress: Ingredient in olive oil kills cancer cells with their own enzymes

A Rutgers nutritional scientist and two cancer biologists at New York City's Hunter College have found that an ingredient in extra-virgin olive oil kills a variety of human cancer cells without harming healthy cells. The ingredient is oleocanthal, a compound that ruptures a part of the cancerous cell, releasing enzymes that cause cell death.

Paul Breslin, professor of nutritional sciences in the School of Environmental and Biological Sciences, and David Foster and Onica LeGendre of Hunter College, report that oleocanthal kills cancerous cells in the laboratory by rupturing vesicles that store the cell's waste....Scientists knew that oleocanthal killed some cancer cells, but no one really understood how this occurred. Breslin believed that oleocanthal might be targeting a key protein in cancer cells that triggers a programmed cell death, known as apoptosis....  

After applying oleocanthal to the cancer cells, Foster and LeGendre discovered that the cancer cells were dying very quickly – within 30 minutes to an hour....LeGendre, a chemist, provided the answer: The cancer cells were being killed by their own enzymes. The oleocanthal was puncturing the vesicles inside the cancer cells that store the cell's waste – the cell's "dumpster," as Breslin called it, or "recycling center," as Foster refers to it. These vesicles, known as lysosomes are larger in cancer cells than in healthy cells, and they contain a lot of waste. But oleocanthal didn't harm healthy cells, the researchers found. It merely stopped their life cycles temporarily – "put them to sleep," Breslin said. After a day, the healthy cells resumed their cycles.  

The issue of overdiagnosis and overtreatment rears its head again - this time in a study looking at thyroid cancer detection and death rates. The death rate from thyroid cancer has stayed the same since 1935, as has the number of thyroid cancers presenting with symptoms of thyroid cancer. But...the number of new cases of silent thyroid cancer -- the kind where patients have no symptoms -- almost quadrupled in recent years, and these are the tiny cancers that probably won't cause a problem in the person's lifetime. The researchers then discuss how NOT to find these tiny silent thyroid cancers, so as to avoid overdiagnosis and the harms of overtreatment. From Science Daily:

Increased detection of low-risk tumors driving up thyroid cancer rates, study finds

Low-risk cancers that do not have any symptoms and presumably will not cause problems in the future are responsible for the rapid increase in the number of new cases of thyroid cancer diagnosed over the past decade, according to a Mayo Clinic study published in the journal Thyroid. According to the study authors, nearly one-third of these recent cases were diagnosed when clinicians used high-tech imaging even when no symptoms of thyroid disease were present.

"We are spotting more cancers, but they are cancers that are not likely to cause harm," says the study's lead author, Juan Brito Campana, M.B.B.S., an assistant professor of medicine at Mayo Clinic. "Their treatment, however, is likely to cause harm, as most thyroid cancers are treated by surgically removing all or part of the thyroid gland. This is a risky procedure that can damage a patient's vocal cords or leave them with lifelong calcium deficiencies." Dr. Brito says harm is not limited to physical suffering. "Treatment can cause financial hardship for patients and their families and for society as a whole, as millions of dollars are spent for unnecessary and problematic surgeries," he says....At the same time, the incidence of thyroid cancer is increasing more rapidly than that of any other cancer and is on track to become the third most common cancer in women.

In this study, Dr. Brito and his colleagues drew on data from the Rochester Epidemiology Project. They analyzed the records of 566 men and women who were diagnosed with thyroid cancer in Olmsted County, Minnesota, between 1935 and 2012. Specifically, they examined the number of new cases of thyroid cancer, the deaths due to the disease, and the method of diagnosis.

Researchers found that the number of new cases of thyroid cancer doubled in recent years -- from 7.1 per 100,000 people from 1990 to 1999 to 13.7 per 100,000 people from 2000 to 2012. Over the same period, the number of new patients with thyroid cancer presenting with symptoms of thyroid cancer remained the same. In contrast, the number of new cases of silent thyroid cancer -- the kind where patients have no symptoms -- almost quadrupled. The proportion of patients with thyroid cancer who die of the disease has not changed since 1935.

The study found that the most frequent reasons for identifying silent thyroid cancer were review of thyroid tissue removed for benign conditions (14 percent); incidental discovery during an imaging test (19 percent); and investigations of patients with symptoms or palpable nodules that were clearly not associated with thyroid cancer, but triggered the use of imaging tests of the neck (27 percent)."We are facing an epidemic of diagnosis in thyroid cancer," says Dr. Brito. 

Researchers say one approach to curtail the detection of these lesions would be to limit the use of certain imaging technologies. Another tactic would be to engage patients in deliberating their treatment options. In many cases, active surveillance may be preferred over surgery by patients with small, relatively benign cancers that could take decades to grow to any appreciable size or cause life-threatening problems. Dr. Brito thinks something as simple as not using the word "cancer" to refer to these small and silent thyroid lesions could reduce the number of unnecessary treatments for patients with a more favorable prognosis. Rather than calling these lesions thyroid cancer, he would recommend a less emotionally charged term, such as papillary lesions of indolent course.

Thyroid gland. Credit: Mayo Foundation for Medical Education and Research

The following article posted average life expectancies for both men and women in countries throughout the world. But what was interesting is that it also gave the average years that a person would be healthy and also unhealthy (which is typically the last years of life). And no matter which country one looks at and the average life expectancy of men and women, it turns out that on average people spend about one eighth of their life in a disabled or unhealthy state. Or between 10 to 20% of their life disabled or unhealthy.

So looking at the United States, it is expected that the average women will live 81 years, but about 13 of those years will be in poor health. Men in the USA will live on average 76 years, but of that about 11 years will be unhealthy. Which means, don't wait until retirement to travel and do all those things you want to do, because you may have health issues preventing you from doing those things - so get out there NOW and DO IT ALL. The "bucket list" should be started now. (Note: I only copied information for 5 countries, but the actual chart has 188 countries. Do go check it out.) From NPR News:

Check Out Life Spans Around The World — And Likely Years Of Ill Health

How Long Will You Live — And How Many Of Those Years Will Be Healthy?

Here are the life expectancies in 188 countries — and the number of unhealthy years a person faces. No matter where you live, the range for years of healthy life is 80 to 90 percent.

Life expectancy compared with global average:

COUNTRY       MALE    UNHEALTHY YEARS       FEMALE       UNHEALTHY YEARS

GLOBAL            68                  8                                     74                       10

CANADA           79                 10                                     83                       12

CHINA               73                   8                                     79                         9

MEXICO             72                  9                                      78                       11

RUSSIA               65                 7                                       76                       10

USA                    76                 11                                      81                       13


Credit: Christopher Groskopf and Alyson Hurt/NPR  
   Notes: — Life expectancies are estimated for individuals born in 2013.  

It's one of those good news/bad news stories. A study in the medical journal The Lancet found that people around the world — in countries rich, poor and in the middle — are living longer. But here's the rub. You can't count on living those extra years in good health.

In the first of what will be an annual look at health along with life span around the world called the Global Burden of Disease Study, researchers found that between 1990 and 2013, life expectancy rose by 6.2 years. The average life span at birth across the globe is now 71.5 years, though rates vary tremendously by region. People live the longest, according to the Lancet study, in Andorra, in southwestern Europe, or an average of 83.9 years. People die the youngest, an average of 48.3 years, in Lesotho, in Africa.

But regardless of socioeconomics, geography or total number of years lived, the study shows what appears to be a universal part of the human condition: people live an average of one-eighth of their lives in a disabled or unhealthy state.

"What's interesting is that wherever you go around the world, about seven-eighths of life expectancy is healthy," says Peter Byass, professor of global health at UmeaUniversity in Sweden. "I'm not sure we totally understand why.We probably can't do a lot about decreasing this part of life that's not healthy," he adds. "That pretty much appears to be a part of being human."

Healthy life — the measure researchers used, called HALE, or healthy life expectancy years — ranged from a high of 73.4 years in Japan to a low, again in Lesotho, of 42 years. Not much is known about when those years of ill health occur. "A lot of the unhealthy stuff is around end of life," says Byass.

Spending more money on health care doesn't seem to reduce the proportion of life spent in ill health. The study was based on regional data and showed that in high-income North America, men live an average of 76.64 years, but only 66.17 of those years are healthy; women live an average of 81.62 years, but experience good health in only 68.85 of those years. The United States, which spends more on health care than any other country, is part of that high-income region. "This is seen even in places where there's a high investment in health care," says Byass, who wrote a commentary accompanying the Lancet study.

Countries where people die the youngest have the highest rates of communicable diseases like AIDS, malaria and tuberculosis as well as high rates of maternal and childhood mortality and malnutrition. "If we want to have a healthier global population, more equal health, the world has got to invest in getting rid of those avoidable problems in poorer countries, mainly in Africa," says Byass.