Looking back over relevant research papers that caught my attention last month, some stand out for me more than the others.  Here are three on depression that stood out and got me thinking.  The Fergusson et al paper looks at links between alcohol abuse and major depression.  There has been debate for years on whether alcohol dependence leads to depression or depression leads to alcohol dependence.  In this kind of debate, it's usually a good bet that both pathways contain some truth.  What this study adds is that often it is the alcohol dependence that is primary.  As the authors state " ... the associations between AAD (alcohol abuse or dependence) and MD (major depression) were best explained by a causal model in which problems with alcohol led to increased risk of MD as opposed to a self-medication model in which MD led to increased risk of AAD." 

In 2001 the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) WCRF/AICR set themselves the task of systematically assessing all good research on diet, physical activity and cancer and publishing a report that would be the largest study of its kind with conclusions that would be best the evidence could demonstrate.  Over 100 scientists from 30 countries were involved.  An expert panel of 21 of these scientists worked for 5 years to produce the report "Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective."  The follow-up companion Policy Report "Policy and Action for Cancer Prevention"  was published a little over a month ago and has recommendations for a series of different groups and organizations including government, industry, the media, schools, and work places. 

Here are five papers mostly looking at aspects of overweight.  The first, published recently in the Lancet, is a huge study on the effects of body-mass index (BMI) on subsequent mortality in nearly 900,000 adults.  It shows progressive excess mortality above the BMI range 22.5-25 kg/m2.  (To calculate your BMI click here).  At 40-45 kg/m2, the reduction in life expectancy of 8-10 years is comparable to the effects of being a smoker.  The second paper, by Neovius et al, also involved large numbers - over 45,000 older adolescents.  Again it showed excess mortality at long term follow-up, and commented "Obesity and overweight were as hazardous as heavy and light smoking, respectively".  The third study by Katseva et al looked at modifiable risk factors in European patients with cardiac disease.  The findings were depressing with obesity, for example, increasing stepwise from 25% at first survey, to 32.6% at second, to 38% at third survey.  Overall the authors concluded "These time trends show a compelling need for more effective lifestyle management of patients with coronary heart disease ... To salvage the acutely ischaemic myocardium without addressing the underlying causes of the disease is futile; we need to invest in prevention." 

Here's a gutsy, nutritional, low sunlight kind of blog post to suit our post-holiday season.  First the gutsy bit.  Irritable bowel syndrome (IBS) - with its characteristic symptoms of abdominal pain, altered bowel habit, and possibly bloating - is very common, affecting about 15% of the population.  Ford et al systematically reviewed all research on treating IBS with fibre, antispasmodics, or peppermint oil.  Fibre was some use, but only in the form of ispaghula (UK Fybogel, Isogel).  The antispasmodics otilonium and hysocine (UK Buscopan) seemed also to be of help.  But what attracted me to the study was the finding that most helpful of the three treatments seemed to be the old-fashioned remedy of taking peppermint oil. 

Here are six studies on eating and weight.  The first, by Maruyama and colleagues, demonstrates a strong association between both "eating until full" and "eating quickly" and the chances of being overweight.  The linked BMJ editorial by Denney-Wilson & Campbell discusses these findings further, including suggesting that "Clinicians should encourage parents to adopt a child led feeding strategy that acknowledges a child's desire to stop eating that begins from birth. Reassure parents that well children don't starve."  Unfortunately Llewellyn et al show that eating rate seems to be partly genetically determined - an even stronger reason to work hard to go against any tendency to gobble food.  The Denney-Wilson editorial gives other ways to encourage weight loss, and Leahy and colleagues underlines the value of one such approach - reducing the energy density (ED) of diets " ...  by decreasing fat and sugar and by increasing fruit and vegetables."  Children whose diet was changed in this way " ...

“ The vision must be followed by the venture.  It is not enough to stare up the steps - we must step up the stairs. ” - Vance Havner

Here are a series of information and assessment handouts on alcohol and food.  "We are what we eat" is bit over-simplified, but only a bit.  It's amazing how important what we eat and drink is for our psychological and physical health.  This site's blog posts  "New research shows diet's importance for preventing depression" and "Preventing cancer through life style choices" make this point well and also provide links with many other sources of information.  Searching the tag cloud brings up much recent relevant research and advice.  Try clicking, for example, on

Recent research: exercise, diet, and smoking

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