Could Coffee Lower Men's Risk for Prostate Cancer?

Men who drink at least six or more cups of coffee a day may be cutting their risk for advanced prostate cancer by 60 percent, new research suggests. This is the first large study looking specifically at the relationship between coffee and metastatic prostate cancer, lead researcher Kathryn Wilson said. "This is an exciting finding, because there aren't many modifiable risk factors for prostate cancer." A definite cause-and-effect link is still far from proven, experts say, and just how coffee might help thwart prostate malignancy isn't clear.

"There are a lot of compounds in coffee that have various biological effects. It's a major source of antioxidants and that might have anti-cancer effects," said Wilson, a research fellow in epidemiology at the Harvard School of Public Health, Boston. "Also, coffee seems to have effects on insulin and has been associated with a lower risk of type 2 diabetes. In addition, insulin is thought to play a role in many cancers, including prostate cancer." Compounds in coffee also have an impact on sex hormone levels, according to the study.

But right now, the findings point only to an association between a love of "java" and a healthier prostate. More study will be needed to confirm the findings and to see if a biological explanation for the phenomenon exists, Wilson said. The bottom line, she said: "It's probably too early to tell someone that should go out and start drinking coffee just because of this study." The report was published in the May 17 online edition of the Journal of the National Cancer Institute. Prostate cancer is the most common cancer diagnosed and the second leading cause of cancer death in men in the United States. In the U.S. it affects one in six men during their lifetime. More than 2 million Americans and 16 million men around the world are prostate cancer survivors, the researchers say.

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New Clues to How Gastric Bypass Surgery Combats Diabetes

Gastric bypass surgery has been known to improve blood sugar control, often sending people with type 2 diabetes into remission, but experts have long wondered exactly how that happens. Now, a new study provides some clues. Circulating amino acids linked with insulin resistance decline dramatically in those who have the bypass surgery, the researchers discovered. They compared 10 obese people with diabetes who had the surgery with 11 who lost weight through dieting. "Something happens after gastric bypass that does not happen as much after the diet-induced weight loss," said Dr. Blandine Laferrere, an associate professor of medicine at St. Luke's Roosevelt Hospital Center and Columbia University, both in New York City.

The surgery, which reduces the stomach to the size of a small pouch, also modifies the junction between the stomach and small intestine. It leads to a dramatic reduction in the level of circulating amino acids that have been linked with diabetes. "The fact that gastric bypass results in the remission of diabetes in the majority of patients is not new," said Laferrere. According to background information in the study, 50 percent to 80 percent of diabetes cases go into remission after the surgery. What doctors have been trying to figure out, she said, is why the bypass surgery is so good at making the diabetes disappear. "The diabetes improves almost immediately, before a significant amount of weight loss occurs," she said. "That points out it is something other than the weight loss."

In the new study, the researchers evaluated biochemical compounds involved in metabolic reactions in the participants. Each group had lost about 20 pounds. The investigators found that the bypass patients had much lower levels of amino acids known as branched-chain amino acids, and the amino acids phenylalanine and tyrosine. "Those changes in the amino acids could be implicated in the mechanism of diabetes remission after gastric bypass," Laferrere said. Experts know the amino acids are linked with insulin resistance partly due to animal studies, she said. "If you supplement the diet of rats with branched-chain amino acids, you can induce more insulin resistance," she explained.

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Do Immune System Ills Help Drive Type 2 Diabetes?

New research suggests that the development of insulin resistance and type 2 diabetes may be linked to an immune system reaction gone awry. "The main point of this study is trying to shift the emphasis in thinking of type 2 diabetes as a purely metabolic disease, and instead emphasize the role of the immune system in type 2," said study co-author Dr. Daniel Winer, an endocrine pathologist at Toronto General Hospital in Canada. When the research began, Winer was a postdoctoral fellow at Stanford University in California. The researchers have identified immune system antibodies in people who are obese and insulin-resistant that aren't present in people who are obese without insulin resistance. They also tested a drug that modifies the immune system in mice fed a fatty diet, and found that the medication could help maintain normal blood sugar levels.

The findings were published online April 17 in the journal Nature Medicine. Funding for the study was provided by the U.S. National Institutes of Health. Nearly 26 million Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention. Between 90 percent and 95 percent of these cases are type 2 diabetes, where the body doesn't use insulin efficiently, so the pancreas must make increasing amounts of insulin. Eventually, the pancreas stops making enough insulin to meet the increased demand. The less common form of the disease, type 1 diabetes, occurs when the immune system mistakenly destroys the insulin-producing beta cells in the pancreas. This type of diabetes is considered an autoimmune disease, and isn't linked to how much a person weighs.

Although the causes of type 2 haven't been clear, it's known that the disease runs in families, suggesting a genetic component. Also, while type 2 is strongly linked to increased weight, not everyone who is overweight gets type 2 diabetes. And, that's what got the researchers searching for another factor. Winer explained that excess weight has been linked to inflammation, which can cause the immune system to react. As visceral fat (abdominal fat) expands, it eventually runs out of room, explained Winer. At that point, the fat cells may become stressed and inflamed, and eventually the cells die. When that happens, immune system cells known as macrophages come to sweep up the mess.

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