JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, July 11, 2006)
JAMA NEWS RELEASES
HIGHER LEVELS OF COMMON DAILY ACTIVITY ASSOCIATED WITH LOWER RISK OF DEATH
WOMEN SMOKERS HAVE HIGHER RISK OF LUNG CANCER THAN MEN SMOKERS, THOUGH LOWER LUNG CANCER DEATH RATE
REMOVAL OF OVARIES DECREASES RISK OF CERTAIN CANCERS FOR WOMEN AT HIGH-RISK
WEIGHT GAIN MAY INCREASE RISK OF BREAST CANCER IN POSTMENOPAUSAL WOMEN
JAMA REPORT (VIDEO NEWS RELEASE SCRIPT)
VIDEO: Windows Media | Quicktime
HIGH LEVELS OF NORMAL DAILY ACTIVITY LINKED TO INCREASE IN OLDER ADULTS’ LIFE EXPECTANCY
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TV Note: This week's JAMA video news release is on the link between daily activity energy expenditure and the risk of death in older adults. The release will be fed Tuesday, July 11, from 9:00 - 9:30 a.m. ET on Intelsat America 6 (formerly Telstar 6), Transponder 11 (C-Band) and from 2:00 - 2:30 p.m. ET on Intelsat America 6, Transponder 11 (C-Band). For more information, call 312/464-JAMA (5262).
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 11, 2006
Media Advisory: To contact Todd M. Manini, Ph.D., call Susan Farrer at 301-496-1752. To contact editorial co-author Steven N. Blair, P.E.D., call Sarah Grohmann at 972-560-3236.
HIGHER LEVELS OF COMMON DAILY ACTIVITY ASSOCIATED WITH LOWER RISK OF DEATH
CHICAGO—Older adults who expend more energy through any daily activity, including non-exercise activity, have a lower rate of death than adults who are less active, according to a study in the July 12 issue of JAMA.
Observational studies have shown that older adults who report low physical activity levels are at a higher risk of death compared with those who report moderate or high levels of activity. These findings have been based on questionnaires asking about physical activity levels, which may not be recalled accurately and are unable to account for many types of daily activity, according to background information in the article. Self-reported physical activity does not provide accurate estimates of absolute amounts of activity (kilocalories per day) and thus is less precise in determining whether higher levels of total activity-induced energy expenditure offer survival advantages.
Todd M. Manini, Ph.D., of the National Institute on Aging, Bethesda, Md., and colleagues conducted a study to determine the association of free-living activity energy expenditure with death from all causes in a group of 302 high-functioning, community-dwelling older adults (aged 70-82 years). The researchers measured energy expenditure over a two week period using a technique that includes determining the rate at which certain isotopes of hydrogen and oxygen, given as “doubly labeled” water, are eliminated from the body as carbon dioxide, a direct measure of total energy expenditure. The resting metabolic rate was also measured. Participants were followed up over an average of 6.15 years (1998-2006). Fifty-five participants (18.2 percent) died during follow-up.
The researchers found that, after adjusting for various factors, higher levels of activity energy expenditure and physical activity were associated with a lower risk of death. Compared with the third of individuals with the lowest activity energy expenditure, those in the highest third had a 69 percent lower risk of death. The absolute risk of death was 12.1 percent in the highest tertile of activity energy expenditure, 17.6 percent in the middle, and 24.7 percent in the lowest tertile. According to self-reports, individuals expending higher levels of free-living activity energy were more likely to work for pay and climb stairs but self-reported high-intensity exercise, walking for exercise, walking other than exercise, volunteering, and caregiving did not differ significantly across the activity energy expenditure tertiles. The authors suggest that this lack of relationship is likely due to the inaccuracies of self-reported activity levels.
“Our study suggests that any activity energy expenditure in older adults can help lower mortality risks...,” the authors write. “Efforts to increase or maintain free-living activity energy expenditure will likely improve the health of older adults.”
(JAMA. 2006;296:171-179. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute on Aging, with additional support from the National Institute of Diabetes and Digestive and Kidney Diseases.
EDITORIAL: OBJECTIVELY MEASURED PHYSICAL ACTIVITY AND MORTALITY IN OLDER ADULTS
In an accompanying editorial, Steven N. Blair, P.E.D., of the Cooper Institute, Dallas, and William L. Haskell, Ph.D., of the Stanford University School of Medicine, Stanford, Calif., comment on the findings of Manini and colleagues.
“Higher levels of activity energy expenditure appear to be protective, and it is relevant to discuss how much and what type of physical activity is required to achieve these benefits. Ultimately, public health experts should consider how these results can be translated into recommendations for individuals.”
“...Manini et al’s conclusion that ‘simply expending energy through any activity may influence survival in older adults’ is provocative and if documented by future research would have major implications for physical activity recommendations. However, such a conclusion needs to be verified in studies that would combine activity energy expenditure assessed by doubly labeled water and the intensity profile determined using recently developed accelerometer [an instrument for measuring the rate of change of velocity per unit of time] technologies.”
(JAMA. 2006;296:216-218. Available pre-embargo to the media at www.jamamedia.org)
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 11, 2006
Media Advisory: To contact Claudia I. Henschke, Ph.D., M.D., call Jonathan Weil at 212-821-0566. To contact editorial co-author Alfred I. Neugut, M.D., Ph.D., call Elizabeth Streich at 212-305-6535.
WOMEN SMOKERS HAVE HIGHER RISK OF LUNG CANCER THAN MEN SMOKERS, THOUGH LOWER LUNG CANCER DEATH RATE
CHICAGO—Women who smoke appear to be more susceptible to lung cancer than men who smoke, though women smokers have a lower rate of lung cancer-related death, according to a study in the July 12 issue of JAMA.
In 2006 in the United States, it is estimated that lung cancer will cause 73,020 deaths in women, proportionately only slightly fewer than the estimated 90,470 deaths in men. Lung cancer now accounts for more deaths in women than any other cancer, more even than the second and third cancer killers (breast and colon cancer) combined, according to background information in the article. It has been hypothesized that women are more susceptible to tobacco carcinogens than men, but after diagnosis of lung cancer, they have better survival rates than men.
Claudia I. Henschke, Ph.D., M.D., of Cornell University, New York, and investigators with the International Early Lung Cancer Action Program examined the lung cancer risk of women compared with men, accounting for age and history of smoking, and also compared the rate of fatal outcomes between sexes. The study included 7,498 women and 9,427 men, at least 40 years of age, who had a history of cigarette smoking and were screened for lung cancer in North America between 1993-2005.
Lung cancer was diagnosed in 156 women and 113 men (rates of 2.1 percent and 1.2 percent, respectively). The researchers also found that women had a lower rate of lung cancer-related death, when controlling for pack-years of smoking, disease stage, tumor cell type and resection.
“If lung cancer risk for women who smoke is indeed higher than the risk for men of the same age who smoke, as indicated by the evidence presented here, this suggests that antismoking efforts directed toward girls and women need to be even more serious than those directed toward boys and men,” the authors write.
(JAMA. 2006;296:180-184. Available pre-embargo to the media at www.jamamedia.org)
EDITORIAL: WOMEN AND LUNG CANCER — GENDER EQUALITY AT A CROSSROAD?
In an accompanying editorial, Alfred I. Neugut, M.D., Ph.D., and Judith S. Jacobson, Dr.P.H., M.B.A., of Columbia University, New York, comment on the study by Henschke et al.
“The reasons women live with lung cancer longer than men are unclear,” they write. “Do women fare better because of their body size, better health behaviors, hormonal and reproductive factors, different cigarette smoking histories or patterns, or other factors? Women’s stage-for-stage advantage in survival appears to be a host effect and applies to all the major histological types of lung cancer.”
“The once prevalent adage, ‘You’ve come a long way, Baby!’ geared to female smokers, unfortunately now applies to increased smoking prevalence and lung cancer risk among women. To prevent gender equality in lung cancer from becoming a reality, it’s now time to turn back.”
(JAMA. 2006;296:218-219. Available pre-embargo to the media at www.jamamedia.org)
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 11, 2006
Media Advisory: To contact Steven A. Narod, M.D., call 416-351-3765.
REMOVAL OF OVARIES DECREASES RISK OF CERTAIN CANCERS FOR WOMEN AT HIGH-RISK
CHICAGO—Women with mutations in the BRCA1 or BRCA2 genes can significantly reduce their risk of certain types of cancer by having their ovaries removed, according to a study in the July 12 issue of JAMA.
Women with a harmful mutation in the BRCA1 or BRCA2 gene have a high lifetime risk of ovarian cancer (range, 15 percent-54 percent), and mutations in either of these genes increase susceptibility to cancers of the ovary, fallopian tube, and peritoneum (abdominal lining), according to background information in the article. Women with this mutation are often advised to undergo preventive oophorectomy (surgical removal of the ovaries). The effectiveness of this intervention has not been prospectively evaluated in a large group of patients.
Steven A. Narod, M.D., of the Centre for Research in Women's Health, Toronto, Ontario, and colleagues conducted a study to determine the absolute risks for developing ovarian, fallopian tube, and peritoneal cancers in a group of BRCA1 and BRCA2 mutation carriers and estimated the risk reduction associated with salpingo-oophorectomy (surgical removal of the ovaries and fallopian tubes). Women known to carry a BRCA1 or BRCA2 mutation were identified from an international registry between 1992 and 2003. A total of 1,828 carriers at 1 of 32 centers in Canada, the United States, Europe, and Israel completed questionnaires at baseline and follow-up. Participants were observed from the date of study entry until: diagnosis of ovarian, fallopian tube, or peritoneal cancer; death; or the date of the most recent follow-up.
After an average follow-up of 3.5 years, 50 new ovarian, fallopian tube, and peritoneal cancer cases were reported in the group. Of the 1,828 women, 555 (30 percent) underwent preventive removal of the ovaries and tubes prior to study entry, 490 (27 percent) underwent the procedure after entering the study, and 783 (43 percent) did not undergo the procedure. There were 32 new cancers diagnosed in women with intact ovaries.
The estimated cumulative incidence of peritoneal cancer is 4.3 percent at 20 years after oophorectomy. The overall (adjusted) reduction in cancer risk associated with bilateral oophorectomy is 80 percent. The researchers estimated the risk of ovarian cancer to be 62 percent for BRCA1 carriers and 18 percent for BRCA2 carriers in women up to age 75 with both ovaries intact.
“Women who carry a mutation in the BRCA1 gene are asked to consider prophylactic bilateral salpingo-oophorectomy at age 35 or thereabouts, in order to reduce the risk of ovarian, fallopian tube, and breast cancer. Our observations support this recommendation. It may be reasonable to wait until a time closer to menopause to prevent ovarian and fallopian tube cancer in BRCA2 carriers but this delay will diminish the level of protection offered against breast cancer in this subgroup,” the authors write.
“We estimate the magnitude of the risk reduction [from preventive removal of the ovaries and tubes] to be approximately 80 percent and the residual risk of 4 percent of peritoneal cancer is not sufficiently high to recommend against the procedure.
It is important that both the fallopian tubes and ovaries be removed because either site may be the origin of cancer and both organs should be examined in fine detail to rule out the presence of microscopic disease,” the researchers conclude.
(JAMA. 2006;296:185-192. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This work was supported by a grant from the Canadian Breast Cancer Research Alliance and from the National Institutes of Health.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, July 11, 2006
Media Advisory: To contact A. Heather Eliassen, Sc.D., call Lori Shanks at 617-534-1604.
WEIGHT GAIN MAY INCREASE RISK OF BREAST CANCER IN POSTMENOPAUSAL WOMEN
CHICAGO—Weight gain, particularly after menopause, is associated with an increased risk of breast cancer in women, according to an article in the July 12 issue of JAMA.
Background information in the article indicates that weight loss after menopause lowers circulating estrogen hormones in women, and because estrogen is directly related to breast cancer, weight loss is thought to decrease risk of the disease. Studies show that weight gain since early adulthood is associated with increased breast cancer risk in postmenopausal women, particularly those not taking postmenopausal hormones. However, weight changes in middle-aged to older women (50 years and older) has been studied less extensively.
A. Heather Eliassen, Sc.D., of Brigham and Women’s Hospital and Harvard Medical School, Boston, and colleagues analyzed data within the Nurses’ Health Study to determine the association between weight change and the risk of breast cancer among postmenopausal women. The researchers assessed weight change for two different periods—since 18 years of age and since menopause. A total of 87,143 postmenopausal women (ages 30 to 55 years) were followed up for up to 26 years to analyze weight change since age 18. Weight change since menopause was assessed among 49,514 women (followed up for up to 24 years).
Women who gained about 55 pounds or more since age 18 were at a 45 percent increased risk of breast cancer, compared with those who maintained their weight, with a stronger association among women who have never taken postmenopausal hormones. Women who gained about 22 pounds or more since menopause were at an 18 percent increased risk of breast cancer. Those who lost about 22 pounds or more since menopause (and kept the weight off) and had never used postmenopausal hormones were at a 57 percent lower risk of breast cancer than those who simply maintained their weight. The researchers concluded that 15 percent of the study’s breast cancer cases may be attributable to weight gain of 4.4 pounds or more since age 18 and 4.4 percent of the cases may be attributable to weight gain of 4.4 pounds or more since menopause.
“These data suggest that weight gain during adult life, specifically since menopause, increases the risk of breast cancer among postmenopausal women, whereas weight loss after menopause is associated with a decreased risk of breast cancer,” the authors write. “Women should be advised to avoid weight gain both before and after menopause to decrease their postmenopausal breast cancer risk.
(JAMA. 2006;296:193–201. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by a research grant from the National Cancer Institute. Dr. Eliassen was supported by a training grant from the Department of Defense and Cancer Education and a Career Development grant from the National Cancer Institute. Co-author Dr. Colditz was supported in part by a Cissy Hornug Clinical Research Professorship from the American Cancer Society.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
HIGH LEVELS OF NORMAL DAILY ACTIVITY LINKED TO INCREASE IN OLDER ADULTS’ LIFE EXPECTANCY
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SEVENTY-FIVE YEAR OLD NAOMI GLASS IS RETIRED, BUT THAT DOESN’T MEAN SHE’S NOT ACTIVE.
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“I never have a day where I have to think about how I’m going to fill it. It’s always filled with something or other.”
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BETWEEN HER HOUSEWORK, WHICH SHE SOMETIMES SHARES WITH HER BOYFRIEND, BOB, AND HER BUSY SCHEDULE VOLUNTEERING WITH VARIOUS ORGANIZATIONS, NAOMI IS OFTEN IN MOTION. AND THE MORE MOTION, THE LONGER THE LIFE, ACCORDING TO A NEW STUDY IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
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“The thing about this study is, we measured usual daily activity and not traditional exercise.”
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DR. TODD MANINI (mah-NIN-ee) AND COLLEAGUES AT THE NATIONAL INSTITUTE ON AGING IN BETHESDA, MARYLAND, AND RESEARCHERS AT A NUMBER OF OTHER INSTITUTIONS, COLLABORATED FOR THE STUDY. THEY STUDIED ABOUT THREE-HUNDRED OLDER ADULTS, AGES SEVENTY TO EIGHTY-TWO, WHO LIVED INDEPENDENTLY, TO SEE IF THEIR TYPICAL DAILY ENERGY USE WAS RELATED TO LONGER LIFE.
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“The first thing you need to know is that anytime we use energy, it’s released from the body as carbon dioxide.”
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THE RESEARCHERS GAVE THE STUDY PARTICIPANTS SPECIAL WATER TO DRINK, WHICH MADE IT POSSIBLE TO MEASURE CARBON DIOXIDE IN THEIR URINE. THAT TOLD THE RESEARCHERS HOW MUCH ENERGY THE STUDY PARTICIPANTS EXPENDED.
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National Institute on Aging
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“We found that over an eight-year period, that older adults in the low-activity group had three-times greater risk of death when compared to older adults in the high-activity group.”
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PEOPLE IN THE HIGH-ACTIVITY GROUP TENDED TO CLIMB TWO MORE FLIGHTS OF STAIRS A DAY, COMPARED TO THOSE IN THE LOW-ACTIVITY GROUP, AND THEY WERE MORE LIKELY TO WORK FOR PAY, VERSUS VOLUNTEERING OR NOT WORKING AT ALL. DR. MANINI SUMS IN UP THIS WAY:
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“The message here is that for older adults, any movement is better than no movement and that this can come from usual daily activities.”
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THAT’S GOOD NEWS TO NAOMI.
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“I think it’s encouraging to people to know that they can maintain their health or maybe improve it by just doing ordinary activities.”
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THIS IS MAVIS PRALL WITH THE JAMA REPORT.
