health

Study Links Vitamin B Supplements to Increased Lung Cancer Risk

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | October 26th, 2018

Dear Doctor: I'm 67 years old and because I was told that it's harder for folks my age to get enough vitamin B12, I started taking a B complex supplement. My husband, who is 72, did, too. But now it turns out that these are linked to lung cancer? What should we do?

Dear Reader: Over the years there have been occasional findings in a range of studies that certain B vitamins were associated with an increase in lung cancer risk. Known as one-carbon metabolism-related B vitamins for the way they behave in the body at a molecular level, they include B6 and B12, which are commonly found in B vitamin supplements. Because the data into the link between these particular B vitamins and lung cancer risk were inconsistent, and because the use of vitamin supplements is hitting an all-time high, researchers homed in on the topic. Their findings were published last year in the Journal of Clinical Oncology.

The scientists analyzed data collected from approximately 77,000 women and men who are taking part in a long-term study conducted by a cancer research center at the University of Washington. Known as the VITamins and Lifestyle (VITAL) Study, participants self-report health data through the use of questionnaires. DNA for analysis has been collected from about 70 percent of the study's participants. They range in age from 50 to 76 and live in a 13-county area of western Washington State. The authors of the B vitamin study were primarily interested in those who had been taking B vitamin supplements for at least a decade.

According to the findings of the B vitamin study, male smokers who took B6 or B12 supplements at very high dosages had three to four times the risk of developing lung cancer than men who smoked but did not take the supplements. Non-smoking men who took the supplements doubled their lung cancer risk.

Surprisingly, these findings did not extend to the women in the study. The B vitamins that the study participants were taking came from individual supplement sources. They did not come from multivitamins. This is an important distinction because the link to cancer occurred in study participants who were taking B vitamins at high dosages. The supplements delivered more than 11 times the recommended daily amount of B6, and a whopping 23 times the RDA of B12. As the author of the study has pointed out and as you have probably noticed yourself, B vitamins are now in vogue. They're so popular that, in addition to the scores of oral supplements, you see B12 shots regularly offered on demand in health food stores and some pharmacies.

B vitamins are vital to our well-being. However, the best way to get them is through a well-balanced and healthy diet. Eggs, dairy, fish and meat are good sources of B12. Many products, like breakfast cereals and soy or rice milk, are fortified with the vitamin. If you do need a supplement, read the label carefully and choose a product that doesn't provide more than the recommended daily allowance.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Try Not to Yawn While Reading This

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | October 24th, 2018

Dear Doctor: The 7-year-old in our family has discovered yawns are "catching," and he just loves it when he can get his daddy to start yawning, too. Of course, now he wants to know why, but even after looking online, we're not sure of the answer. Does anyone really understand yawning?

Dear Reader: True confession -- reading your question triggered a yawn. (OK, two.) That's not unusual, as it's estimated that for well over half of us, yawns are contagious. In a study at Duke University, a video of people yawning had close to 70 percent of the 328 participants doing the same during the three-minute showing, some as many as 15 times. Lest we think this is a humans-only phenomenon, contagious yawning is also a hallmark of chimpanzees and a group of primates known as Old World monkeys. And as dog owners can attest (yes, there are studies into this as well), it's a trait also shared by many of our canine companions.

So why do we yawn and why are they catching? Though these questions have tantalized scientists, philosophers and all of us yawners for millennia, we're still short on definitive answers. As far back as 400 B.C., Hippocrates pondered the origins of the spontaneous yawn. That is, a yawn that occurs without the prompt of someone else's yawn. He associated it with a general reflex to cool the body, which turns out to be a decent guess. Other theories put forth to explain the spontaneous yawn have included drowsiness, boredom, weariness and empathy. More recently, researchers have come to see potential for the yawn to be used as a diagnostic marker of neurological disease. To that end, there's now a specially designed yawning susceptibility scale to measure exactly how prone someone is to "catching" a yawn.

In recent years, researchers have identified a link between temperature and yawning, thus giving Hippocrates' theory from 2,000-plus years ago a nice boost. In one study, 120 pedestrians selected at random during both hot and cold weather were found to "catch" a yawn more frequently within a certain window of warmer temperatures. In another experiment, researchers were able to affect the rate of both spontaneous and contagious yawning with the use of cold and hot packs. Variables like the person's sex or age, how much they had slept the night before, time they spent outdoors, humidity and the season of the year didn't influence their yawning behavior.

Last year, researchers in England found a connection between spontaneous yawning and the primary motor cortex, a region of the brain that takes a lead role in generating the messages that initiate our physical movement. They also discovered that trying not to yawn actually increases the sense of needing to yawn. According to the researchers, these findings may help shine a light on conditions associated with impulse control, such as obsessive-compulsive disorder or Tourette's syndrome.

Thus far, research into yawning has added tantalizing bits and pieces of information about a simple action with complex origins. That's why, despite your best efforts at research, a definitive answer eluded you. Chances are, though, you yawned while reading this column. And if he was in the room with you, so did your 7-year-old.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

health

Latest Study Adds to Increasing Data on Benefits of Coffee

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | October 22nd, 2018

Dear Doctor: I'm only 22 and already I've gotten whiplash from all the studies about coffee. First it's bad for you, then it's good. Then, oops, no -- it's actually bad. My girlfriend's a serious coffee drinker, and she's thrilled about another new study that says coffee's going to help her live longer. Is that right? How do we know what to believe?

Dear Reader: We agree that the back-and-forth about coffee over the decades has been confusing and for coffee drinkers who want a final answer, frustrating. Part of this is because of the nature of ongoing research, which, as it asks new questions, incorporates the newest data. Add enough variables to any line of inquiry, and chances are quite good that the conclusions will shift, if not change.

Another factor that plays a role is the study itself. Many of the coffee studies, including this latest one, have been observational studies. That means that researchers gather data from large populations, identify and account for lifestyle or environmental factors that could sway results, then analyze the resulting data to draw conclusions. When they're finished they have a correlation, but not a definitive cause. That doesn't mean such studies should be discounted. Far from it. It was through observational studies that researchers first linked smoking to lung cancer. This in turn led to the more rigorous and targeted research that revolutionized how we view tobacco and tobacco products.

We suspect that coffee is the subject of so many studies for a couple of reasons. First, it's so widely consumed. Here in the United States, it's our favorite beverage. We drink more coffee than soda, tea and juice combined. Plus, thanks to its caffeine content, coffee is a stimulant. In fact, caffeine is the most widely consumed physiological stimulant in the world. That's why, with regular use, it can result in a mild form of physical dependence. In addition, caffeine has been associated with adverse side effects in some individuals, such as temporary spikes in blood pressure. All of this -- widespread use, potential physiological effects, as well as the numerous bioactive compounds that it contains -- have made coffee a prime target for research. Which brings us to the new study now making headlines.

Researchers in Britain looked at a decade's worth of health data for about 500,000 adults who regularly drank from one to eight cups of coffee per day. This included brewed and instant coffee, as well as decaf. According to their analysis, those who drank coffee regularly had a slightly (emphasis is ours) lower risk of death than did non-coffee drinkers. Although the study didn't address questions of how or why, the researchers have cited coffee's complexity.

In addition to the caffeine that reels us in, coffee contains over 1,000 different chemical compounds, including B vitamins, potassium, magnesium, as well as hundreds of phytochemicals with antioxidant and anti-inflammatory properties. However -- and this is important -- if you're not already a regular or heavy coffee drinker, don't dive into the deep end with a multi-cup habit. And when it comes to pregnant women, the consensus is clear -- severely limit (or quit) coffee. That's because the enzyme needed to metabolize caffeine is not present in the fetus.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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