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The spice turmeric is a very popular supplement nowadays, believed to have all sorts of health benefits due to the curcumin in it (e.g. that it is anticancer, anti-Alzheimer's, anti inflammatory). And yes, studies in the lab (in vitro and in vivo) look very promising. However, a large 2017 review of existing studies also found evidence that "curcumin is unstable under physiological conditions and not readily absorbed by the body, properties that make it a poor therapeutic candidate". In other words, the hype for curcumin supplements is not matching the reality, especially or probably because it is so poorly absorbed by humans. But researchers keep trying. And keep in mind that turmeric has other compounds in it also - it is not just curcumin and nothing else.

A "double-blind, placebo-controlled clinical trial" is the best evidence for something being effective. That means a study where people are randomly assigned to groups, no one actually knows who is getting what, and there is a placebo group that is getting a "sham" treatment. A recent study did exactly that in testing a new formulation of curcumin (Theracurmin) that was easily absorbed (bioavailable) by the persons participating in the study.

And yes - they found health benefits, specifically improvements in memory and attention in those persons taking the curcumin supplements over a 18 month period (as compared to those taking a placebo and whose memory and attention deteriorated over that time). The subjects (who were between 50 and 90 years of age) did not have dementia at the start of the study, but were showing signs of "normal aging" or had mild neurocognitive disorder. Brain scans (before and after treatment) suggested that the behavioral and cognitive benefits from curcumin were associated with "decreases in plaque and tangle accumulation in brain regions moduating mood and memory" - so it had anti-inflammatory and/or anti-amyloid brain effects.

So...  Stay tuned. Meanwhile, perhaps frequent eating of foods containing turmeric may also have beneficial effects, as some studies suggest. From Science Daily:

Curcumin improves memory and mood

Lovers of Indian food, give yourselves a second helping: Daily consumption of a certain form of curcumin -- the substance that gives Indian curry its bright color -- improved memory and mood in people with mild, age-related memory loss, according to the results of a study conducted by UCLA researchers. .... Found in turmeric, curcumin has previously been shown to have anti-inflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India, where curcumin is a dietary staple, have a lower prevalence of Alzheimer's disease and better cognitive performance.

The double-blind, placebo-controlled study involved 40 adults between the ages of 50 and 90 years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or 90 milligrams of curcumin twice daily for 18 months. All 40 subjects received standardized cognitive assessments at the start of the study and at six-month intervals, and monitoring of curcumin levels in their blood at the start of the study and after 18 months. Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months.

The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not, Small said. In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos. The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions. [Original study.]

Many people look forward to retirement, thinking of all the wonderful things they will finally be able to do.  However, what no one expects is that retirement can have a negative effect on their cognitive functioning. This is what a long-term study carried out by the University of London in the United Kingdom found. The study tracked 3,433 civil servants for the 14 years before retirement, and then another 14 years afterward. The participants were given periodic examinations to assess their cognitive functioning (verbal memory, abstract reasoning, etc.).

The researchers found that when people did eventually retire, they experienced decline in their verbal memory 38 percent faster than before they stopped working. They concluded that the act of retirement significantly accelerates verbal memory decline. They also found that a higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline after retirement across the different employment grades.

The researchers pointed out that the adverse effect of retirement on verbal memory is consistent with the results of other studies. That's why they stress how important it is to continue undertaking mentally stimulating activities after retirement in order to prevent this decline. The researchers felt that the study results supported the ‘use it or lose it’ hypothesis regarding verbal memory function. But the good news was that retirement seemed to have little impact on other domains of cognitive functions, such as abstract reasoning and verbal fluency. They just showed normal age-related declines over time.

From European Journal of Epidemiology: Effect of retirement on cognitive function: the Whitehall II cohort study

According to the ‘use it or lose it’ hypothesis, a lack of mentally challenging activities might exacerbate the loss of cognitive function. On this basis, retirement has been suggested to increase the risk of cognitive decline, but evidence from studies with long follow-up is lacking. We tested this hypothesis in a cohort of 3433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement.

We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. In analyses stratified by employment grade, higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains. In conclusion, these findings are consistent with the hypothesis that retirement accelerates the decline in verbal memory function. This study points to the benefits of cognitively stimulating activities associated with employment that could benefit older people’s memory.

A recent study's results give hope to those who haven't really exercised or been physically active as they've gone through middle-age (it's viewed as "sedentary aging") and wonder if this dooms them in some way. Is it too late to get benefits from starting to exercise now? Studies show that being sedentary (that is, not being physically active or exercising weekly) and in "poor physical fitness" in middle-age is a risk factor for later heart failure. This is because a consequence of "sedentary aging" is stiffness of the heart, specifically the left ventricle (thus a loss of "cardiac plasticity").

But the study found that after 2 years of an exercise program in (formerly) sedentary middle-aged adults, they improved their maximal oxygen uptake, decreased the heart's stiffness, and improved overall fitness. All good, even though it was a small study (only 53 people completed the study). So the bottom line is: No, it's not too late to start exercising. The heart has elasticity and can remodel itself if the exercise is started before age 65 and is done 4 to 5 times a week. The adults studied were both male and female, between the ages of 45 and 64,  and exercised or were physically active for a total of 150 to 180 minutes a week, which meant at least 30 minutes 4 or 5 times a week.

Looking at the study's exercise regimen, it's clear that a variety of exercises or physical activities (low, moderate, and high intensity) is necessary. Some of the time one should be active or exercise to a point of breaking a sweat and feeling the heart pump. This meant that over time the participants increased their exercise frequency, duration, and intensity. Think about it - as you get more fit, it takes more to get your heart pumping and to break a sweat, and you can handle more exercise. 

Unfortunately the "control group", who did a combination of yoga, balance, and strength training 3 times a week for 2 years did not show improvements in heart plasticity, maximal oxygen uptake, or in overall fitness.Yikes. Sooo...the study clearly shows it is worth getting off your butt and making the effort to exercise. Perhaps view it as brushing your teeth - a daily nuisance, but necessary for health. The researchers themselves stated "Exercise is medicine." From Science Daily:

Proper exercise can reverse damage from heart aging

Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure -- if it's enough exercise, and if it's begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit, the exercise regimen should begin by late middle age (before age 65), when the heart apparently retains some plasticity and ability to remodel itself, according to the findings by researchers at the Institute for Exercise and Environmental Medicine (IEEM), which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas.

And the exercise needs to be performed four to five times a week. Two to three times a week was not enough, the researchers found in an earlier study..... The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down: One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 percent of peak rate for 4 minutes, with 3 minutes of recovery, repeated four times (a so-called "4 x 4"). Each interval session was followed by a recovery session performed at relatively low intensity. One day's session lasted an hour and was of moderate intensity. (As a "prescription for life," Levine said this longer session could be a fun activity such as tennis, aerobic dancing, walking, or biking.) One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation -- the "talk test.".... One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.

The more than 50 participants in the study were divided into two groups, one of which received two years of supervised exercise training and the other group, a control group, which participated in yoga and balance training.A t the end of the two-year study, those who had exercised showed an 18 percent improvement in their maximum oxygen intake during exercise and a more than 25 percent improvement in compliance, or elasticity, of the left ventricular muscle of the heart, Dr. Levine noted. He compared the change in the heart to a stretchy, new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the heart's left ventricle, the chamber that pumps oxygen-rich blood back out to the body, he explained.

"When the muscle stiffens, you get high pressure and the heart chamber doesn't fill as well with blood. In its most severe form, blood can back up into the lungs. That's when heart failure develops," said Dr. Levine, who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who don't exercise and aren't fit, leaving them with small, stiff chambers that can't pump blood as well[Original study.]

For those who need convincing that lifestyle can contribute to development of cancer or its prevention, new medical research has once again supported the importance of lifestyle choices. A report from Australian researchers (with similar findings as a study in the US) stated: an estimated 38% of cancer deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices.

And what were the lifestyle choices that are linked to cancer?  The researchers list 20 separate things (in 8 broad groups) that are known to cause or are linked to cancer. They are: tobacco smoke (smoking or second-hand smoke), dietary factors (low-intake of fruit, non-starchy vegetables, and dietary fiber; and high intake of red and processed meat), overweight/obesity, alcohol, physical inactivity, solar ultraviolet radiation, certain infections (they list 7 infections, such as human papillomavirus, hepatitis B, hepatitis C), and reproductive factors (lack of breastfeeding, menopausal hormone therapy use, combined oral contraceptive use). Note that they found that the #1 most important lifestyle factor is tobacco smoke - and it accounted for about 23% of all preventable cancer deaths in Australia. From Medscape:

One Third of Cancer Deaths Could Be Prevented by Lifestyle

As we head into the festive season, many are looking forward to the tradition of "Eat, drink, and be merry." But as another research paper shows that more than a third of cancer deaths could be prevented by lifestyle, maybe a qualifier should be added:"celebration in moderation." The latest statistics come from Australia, where researchers note that 44,004 cancer deaths occurred in 2013. But an estimated 38% of these deaths and 33% of cancer diagnoses could have been prevented with healthy lifestyle choices, says a research team led by Louise Wilson, MEpi, at the QIMR Berghofer Medical Research Institute and the University of Queensland, Brisbane.

These cancer diagnoses and deaths were seen in Australians of all ages and are directly attributable to 20 known modifiable risk factors within eight categories that are established causes of cancer, the study authors say. The report is published in the February 2018 issue of the International Journal of Cancer.

Smoking was the leading cause of preventable cancer death in Australia in 2013 and accounted for 23% of all cancer deaths. ...Three other categories of modifiable risk factors — poor diet, overweight/obesity, and infections — accounted for 5% of cancer deaths each. In a fifth category, alcohol-related cancer accounted for 2.4% of deaths. Physical inactivity factors were responsible for 0.8% of cancer deaths, overexposure to ultraviolet radiation for 3.2% of cancer deaths, and, in the eighth category, reproductive or hormonal factors were linked to 0.4% of cancer deaths.

In the diet category, risk factors include low intake of fruit, nonstarchy vegetables, and dietary fiber and high intake of red and processed meat. In the infection category, seven cancer-causing agents, including human papillomavirus (associated with cancer of the vulva, vagina, penis, anus, oral cavity, and oropharynx) and Helicobacter pylori (noncardia stomach cancer), are included. Lack of breastfeeding, use of menopausal hormone therapy, and use of combined oral contraceptive use (breast and cervical cancer) are listed as preventable risk factors in the reproductive category.

These findings are in keeping with other research on the role of modifiable lifestyle-related risk factors in cancer prevention. As previously reported by Medscape Medical News, results from a large cohort study in the United States led researchers to conclude that 20% to 40% of cancer cases and related mortality could be prevented by not smoking, maintaining a healthy weight, and exercising regularly. In another report, results from a national online survey undertaken by the American Society of Clinical Oncology showed that, like their Australian counterparts, most US adults don't know alcohol and obesity are major risk factors for cancer[Original study.]

A dividing lung cancer cell. Lung cancer is associated with smoking. Credit: National Institute of Health (NIH). 

 

The message is clear from a recent study: older adults should get out and move, move , move (brisk walking is fine) - to lower the risk of early death. The older women engaging in the most moderate to vigorous activity had a 65% lower risk of early death during an average follow-up period of 2.3 years (when compared to the women with the least exercise).

How much exercise did the groups get? The least active had 6.8 minutes per day of moderate to vigorous exercise, and the most active had about 68 minutes/day of moderate to vigorous physical activity. The women wore a Fitbit type of device (an accelerometer) that measured their movements. Moderate to vigorous exercise was any movement that got the heart rate up a bit, made them sweat a little - and which could be brisk walking.

The study was done with older women (in their 70s), but one would think it also applies to men. Note: all-cause mortality means death from any cause (death in general). From Medscape:

Intense Exercise Tied to 65% Lower Death Risk in Older Women

Older women who engaged in the greatest amount of moderate to vigorous physical activity, such as brisk walking, were found to have a 65% lower risk of all-cause mortality compared with women who performed the least amount of such exercise, a new study reports. The researchers examined women in their early 70s in the Women's Health Study (WHS) who wore a triaxial accelerometer for 7 days to measure physical activity. The findings, by Dr I-Min Lee (Brigham and Women's Hospital, Boston, MA) and colleagues, were published November 6, 2017 in Circulation.

It's been known for a long time that physical activity is associated with lower mortality rates, Dr Lee told theheart.org | Medscape Cardiology.... Now that physical activity can be better measured using a research-grade triaxial accelerometer, the magnitude of the reduced risk of short-term death with recommended amounts of moderate to vigorous physical activity can be seen to be as strong as not smoking, Lee said. ... This study "reinforces the message that adults should strive to meet physical activity guidelines of 150 minutes of moderate or 75 minutes of vigorous exercise per week," Dr Alpa Patel (American Cancer Society, Atlanta, Georgia) who recently published a related article that showed benefits from walking told theheart.org | Medscape Cardiology.

From 2011 to 2015, 18,289 of 29,494 living women (63%) in the Women's Health Study agreed to participate in the current study.... The remaining 17,708 women were mailed a research-grade triaxial accelerometer (ActiGraph GT3X+, ActiGraph Corp) and asked to wear it on their hips for 7 days (but to take it off when sleeping or swimming) and then mail it back. 

The women spent a median of 8.4, 5.8, and 0.5 hours/day being sedentary, doing light physical activity, and doing moderate to vigorous physical activity, respectively. "The least active quartile were doing 8 minutes a day of moderate to vigorous . . . physical activity," Lee said, which was typically "brisk walking, anything that gets your heart rate up a little bit, gets you to sweat a little bit." The most active quartile did about 68 minutes/day of moderate to vigorous physical activity. During an average follow-up of 2.3 years, 207 women died. The total amount of physical activity was inversely related to the risk of all-cause mortality during follow-up, after adjustment for age and time spent wearing the device. 

What does it take to live to 100 in relatively good health? Are there common psychological traits? A study looked at 29 rural Italians aged 90 to 101 and their 51 younger family members to try to answer that question. They found that the elderly  participants had worse physical health but better mental well-being than their younger family members.

The older adults had a positive attitude or positivity (resilience and optimism), they worked hard, and had strong bonds with family and religion. They also had a strong need for control (family members called them "domineering") and a love of the land. The researchers summarized: "Exceptional longevity was characterized by a balance between acceptance of and grit to overcome adversities along with a positive attitude and close ties to family, religion, and land, providing purpose in life." From Science Daily:

Common psychological traits in group of Italians aged 90 to 101

In remote Italian villages nestled between the Mediterranean Sea and mountains lives a group of several hundred citizens over the age of 90. Researchers at the University of Rome La Sapienza and University of California San Diego School of Medicine have identified common psychological traits in members of this group. The study, publishing in International Psychogeriatrics, found participants who were 90 to 101 years old had worse physical health, but better mental well-being than their younger family members ages 51 to 75.

"The main themes that emerged from our study, and appear to be the unique features associated with better mental health of this rural population, were positivity, work ethic, stubbornness and a strong bond with family, religion and land." There were 29 study participants from nine villages in the Cilento region of southern Italy. 

"The group's love of their land is a common theme and gives them a purpose in life. Most of them are still working in their homes and on the land. They think, 'This is my life and I'm not going to give it up,'" said Anna Scelzo, first author of the study with the Department of Mental Health and Substance Abuse in Chiavarese, Italy. Interview responses also suggested that the participants had considerable self-confidence and decision-making skills. "This paradox of aging supports the notion that well-being and wisdom increase with aging even though physical health is failing," said Jeste, also the Estelle and Edgar Levi Chair in Aging and director of the Sam and Rose Stein Institute for Research on Aging at UC San Diego.

"We also found that this group tended to be domineering, stubborn and needed a sense of control, which can be a desirable trait as they are true to their convictions and care less about what others think," said Scelzo. "This tendency to control the environment suggests notable grit that is balanced by a need to adapt to changing circumstances." [Original study.

Rural village in the region of Cilento,  Italy. Credit: Wikipedia.

This is interesting, that blood pressure naturally starts lowering in the 14 to 18 years prior to death in people 60 years or older - whether they are healthy, have hypertension, have heart disease, take hypertension medicines or not.

The researchers analyzed 20 years of medical data for patients in the United Kingdom, and while everyone's blood pressure dropped for more than a decade before death, the decreases were "steepest in patients with hypertension, dementia, heart failure, and late-life weight loss". From Science Daily:

Blood pressure declines 14 to 18 years before death

Blood pressure in the elderly gradually begins to decrease about 14 or so years before death, according to a new study published today in the Journal of the American Medical Association Internal Medicine. Researchers from UConn Health and the University of Exeter Medical School in the U.K. looked at the electronic medical records of 46,634 British citizens who had died at age 60 or older. The large sample size included people who were healthy as well as those who had conditions such as heart disease or dementia.

They found blood pressure declines were steepest in patients with dementia, heart failure, late-in-life weight loss, and those who had high blood pressure to begin with. But long-term declines also occurred without the presence of any of these diagnoses.

Doctors have long known that in the average person, blood pressure rises from childhood to middle age. .... Some studies have indicated that blood pressure might drop in older patients and treatment for hypertension has been hypothesized as explaining late-life lower blood pressures. But this study found blood pressure declines were also present in those without hypertension diagnoses or anti-hypertension medication prescriptions. Further, the evidence was clear that the declines were not due simply to the early deaths of people with high blood pressure. [Original study.]

Interesting study results - being overweight (a higher body mass index or BMI) is linked to dementia more than 20 years later, but in the few years before dementia onset body mass index (BMI) is lower in those who develop dementia than in those who don't develop dementia. The researchers hypothesize that 2 processes are going on:  A higher BMI (overweight or obese) in mid-life is harmful (a direct effect), and then there is weight loss during the preclinical dementia phase. Bottom line: best is a normal weight in mid-life to try to prevent dementia later on in life. From Science Daily:

Obesity increases dementia risk

People who have a high body mass index (BMI) are more likely to develop dementia than those with a normal weight, according to a new UCL-led study. The study, published in the Alzheimer's & Dementia journal, analysed data from 1.3 million adults living in the United States and Europe. The researchers also found that people near dementia onset, who then go on to develop dementia, tend to have lower body weight than their dementia-free counterparts.

"The BMI-dementia association observed in longitudinal population studies, such as ours, is actually attributable to two processes," said lead author of the study, Professor Mika Kivimäki (UCL Institute of Epidemiology & Health). "One is an adverse effect of excess body fat on dementia risk. The other is weight loss due to pre-clinical dementia. For this reason, people who develop dementia may have a higher-than-average body mass index some 20 years before dementia onset, but close to overt dementia have a lower BMI than those who remain healthy."

In this study, researchers from across Europe pooled individual-level data from 39 longitudinal population studies from the United States, the United Kingdom, France, Sweden, and Finland. A total of 1,349,857 dementia-free adults participated in these studies and their weight and height were assessed. Dementia was ascertained using linkage to electronic health records obtained from hospitalisation, prescribed medication and death registries.

A total of 6,894 participants developed dementia during up to 38 years of follow-up. Two decades before symptomatic dementia, higher BMI predicted dementia occurrence: each 5-unit increase in BMI was associated with a 16-33% higher risk of this condition (5 BMI units is 14.5 kg for a person 5'7" (170 cm) tall, approximately the difference in weight between the overweight and normal weight categories or between the obese and overweight categories). In contrast, the mean level of BMI during pre-clinical stage close to dementia onset was lower compared to that in participants who remained healthy. [Original study.]

There are health benefits to having a dog, based on results from studies and testimonials from dog owners. Now a study of millions of Swedes found  that dog ownership is associated with a lower risk of cardiovascular disease (CVD) in single-person households and a lower risk of death from cardiovascular or other causes ("all cause mortality") in general. Owning a hunting dog breed had the strongest association with cardiovascular health. Some of these health benefits are due to dogs providing companionship, affection, and increased physical activity (all those walks) of their owners. And of course there's sharing of microbes. From Science Daily:

Dog ownership linked to lower mortality rate

A team of Swedish scientists have used national registries of more than 3.4 million Swedes aged 40 to 80 to study the association between dog ownership and cardiovascular health. Their study shows that dog owners had a lower risk of death due to cardiovascular disease or to other causes during the 12-year follow-upA total of more than 3.4 million individuals without any prior cardiovascular disease in 2001 were included in the researchers' study linking together seven different national data sources, including two dog ownership registers. 

"A very interesting finding in our study was that dog ownership was especially prominent as a protective factor in persons living alone, which is a group reported previously to be at higher risk of cardiovascular disease and death than those living in a multi-person household. Perhaps a dog may stand in as an important family member in the single households. The results showed that single dog owners had a 33 percent reduction in risk of death and 11 percent reduction in risk of cardiovascular disease during follow-up compared to single non-owners. Another interesting finding was that owners to dogs from breed groups originally bred for hunting were most protected," says Mwenya Mubanga, lead junior author of the study and PhD student at the Department of Medical Sciences and the Science for Life Laboratory, Uppsala University.

"These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how dogs could protect from cardiovascular disease. We know that dog owners in general have a higher level of physical activity, which could be one explanation to the observed results. Other explanations include an increased well-being and social contacts or effects of the dog on the bacterial microbiome in the owner," says Tove Fall, senior author of the study and Associate Professor in Epidemiology at the Department of Medical Sciences and the Science for Life Laboratory, Uppsala University. "There might also be differences between owners and non-owners already before buying a dog, which could have influenced our results, such as those people choosing to get a dog tending to be more active and of better health." [Original study.]

A large study by researchers at the State University of NY, of 65,869 postmenopausal women found that those who have a history  of gum or periodontal disease also have an overall higher risk of cancer. The women with a history of periodontal disease also had an increased risk for several specific cancers: breast, esophageal, gallbladder, lung and melanoma cancers. This cancer and gum disease association occurred in both nonsmokers and smokers.

How is periodontal disease "promoting" cancer? How it occurs is still unclear, but one theory suggests the gum disease bacteria are in the saliva, which is swallowed, and so the bacteria get into the gut, esophagus, or lungs. Or bacteria from diseased gum tissues get into "systemic circulation" and so get to distant sites in the body.  One of the researchers pointed out that "Certain periodontal bacteria have been shown to promote inflammation even in tiny amounts, and these bacteria have been isolated from many organ systems and some cancers including esophageal cancers."

From Medscape: Gum Disease and Increased Link to Many Cancers

Brushing, flossing, and regular dental checkups appear to do much more than maintain a healthy smile. Now, a large prospective cohort study shows that postmenopausal women with a history of periodontal disease, including those who have never smoked, are at significantly increased overall risk for cancer as well as site-specific cancers, including lung, breast, esophageal, gallbladder, and melanoma skin cancers.

The study authors note that these results add to the growing body of evidence from smaller studies and studies in men that link periodontal disease to total cancer risk. The Centers for Disease Control and Prevention (CDC) estimate that 47% of adults 30 years of age and older in the United States have some form of periodontal disease, ranging from mild to severe. At age 65 years and older, however, 70% of adults have moderate to severe periodontal disease, according to the CDC.

The study involved almost 66,000 postmenopausal women in the United States, who were enrolled in the ongoing Women's Health Initiative Observational Study (WHI-OS). During a mean follow-up of 8.32 years, the team identified 7149 cancers and found that periodontal disease history was associated with a 14% increased total cancer risk. When analyses were limited to 34,097 never-smokers, there was also an increased risk for overall cancer.

An association between periodontal disease and site-specific cancers was observed in breast, lung, esophageal, gallbladder, and melanoma skin cancers. There was a borderline association with stomach cancer, the study authors report, and periodontal disease was not associated with cancers of the pancreas; liver; lower digestive tract organs; or lip, oral cavity, and pharynx combined. Similarly, there was no association with genitourinary and lymphoid and hematopoietic malignancies.

For the study, the investigators looked at periodontal disease information in 65,869 women aged 54 to 86 years at 40 US centers. Mean age was 68 years. Most women were non-Hispanic whites with some college education. All participants answered the question "Has a dentist or dental hygienist ever told you that you had periodontal or gum disease? (No/Yes)" between 1999 and 2003 on the annual Year-5 WHI-OS follow-up questionnaire. Cancer outcomes were documented through September 2013 with a maximum 15-year follow-up period.

 Women who reported a history of periodontal disease were also more likely to report a history of smoking, secondhand smoke exposure, alcohol use, hormone therapy (estrogen plus progestin), and a cancer diagnosis, the study authors report. At the same time, no significant differences were observed in body mass index, physical activity levels, or history of diabetes between women with periodontal disease and those without. [Original study.]