Daily Archives: 22 May 2024

NUS researchers reveal a connection between unhealthy diets and increased cancer risk

A team of researchers from the National University of Singapore (NUS) has made a significant breakthrough in understanding how poor diets contribute to an increased risk of cancer and other common diseases, such as diabetes. The findings of this study promise to enhance strategies for cancer prevention and promote healthier ageing.

Professor Ashok Venkitaraman spearheaded the research at the Cancer Science Institute of Singapore (CSI Singapore) and the NUS Centre for Cancer Research (N2CR) at the Yong Loo Lin School of Medicine. The team collaborated closely with colleagues from the Agency for Science, Technology and Research (A*STAR).

Professor Venkitaraman, the Director of CSI Singapore, highlighted the complexity of cancer’s causation, which involves genetic factors and environmental influences like diet, physical activity, and pollution. He stressed the importance of clarifying these interactions to devise effective preventative measures contributing to sustained health.

Central to their research was the study of methylglyoxal, a byproduct of glucose breakdown in cells, implicated in diabetes, obesity, and poor dietary habits. This chemical was found to be particularly damaging to the DNA of patients with an inherited risk of breast or ovarian cancers linked to a defective BRCA2 gene. Such damage serves as an early indicator of potential cancer development.

Further investigations revealed that individuals without the genetic defect but with elevated methylglyoxal levels—such as those suffering from diabetes or pre-diabetes associated with poor diet—also showed signs of increased cancer risk. Professor Venkataraman explained that detecting high methylglyoxal levels through a simple blood test, like the HbA1C, could be a marker for cancer risk, paving the way for preventative treatments through medication and dietary adjustments.

Dr Li Ren Kong, a Lee Kuan Yew Fellow at N2CR and the study’s first author mentioned that their initial goal was to explore risk factors in genetically predisposed families. Still, they uncovered a crucial link between energy metabolism and cancer development. This underscores the importance of diet and weight management in cancer risk reduction.

The research also challenged a long-standing theory in cancer genetics, known as Knudson’s ‘two-hit’ hypothesis, which posits that cancer-preventing genes need to be permanently disabled for cancer to emerge. The team’s findings suggest that temporary inactivation of these genes by compounds like methylglyoxal, mainly through repeated poor dietary choices or unmanaged diabetes, could cumulatively heighten cancer risk over time. These insights could significantly redirect future cancer research.

Their groundbreaking work, published in the prestigious journal Cell on 11 April 2024, has set the stage for subsequent studies. The team plans to explore further how metabolic disorders affect cancer risks in different populations, particularly in Singapore and other Asian contexts.

Looking ahead, the researchers are eager to delve deeper into the mechanisms they’ve uncovered between metabolism, diet, and cancer. Their goal is to develop more effective strategies to prevent or delay the onset of cancer, potentially transforming the landscape of cancer research and prevention.

More information: Li Ren Kong et al, A glycolytic metabolite bypasses “two-hit” tumor suppression by BRCA2, Cell. DOI: 10.1016/j.cell.2024.03.006

Journal information: Cell Provided by National University of Singapore

The Canadian Cardiovascular Society has recently released updated guidelines for evaluating the fitness of private and commercial drivers to operate vehicles

The latest update from the Canadian Cardiovascular Society (CCS) brings forth refreshed guidelines to evaluate the suitability of private and commercial drivers to operate vehicles safely. These guidelines, encapsulated in the CCS Fitness to Drive Guidelines, reflect the most recent insights into driving restrictions, particularly concerning the risk of sudden cardiac incapacitation. Employing the CCS Risk of Harm formula alongside available empirical evidence, these guidelines delineate the probability of such incapacitation and acceptable risk thresholds, thereby furnishing essential direction on when it is prudent to allow individuals to resume driving activities.

The recommendations outlined in the Fitness to Drive Guidelines are strategically crafted to assist physicians and healthcare practitioners in advising individuals grappling with heart-related ailments about the associated risks and appropriate durations for driving abstinence. Spearheaded by a panel of national experts, these updated, evidence-based guidelines have found their place in the esteemed Canadian Journal of Cardiology under the auspices of Elsevier.

Dr. Peter G. Guerra, the lead co-chair of the revamped guidelines from the Montréal Heart Institute, University of Montréal, underscores the pivotal role cardiovascular conditions play in compromising driving capability. Such conditions, owing to their potential to impede blood circulation to the brain, can precipitate alterations in mental acuity through various mechanisms like myocardial infarction, cardiac arrhythmias, and heart failure. Consequently, healthcare providers frequently find themselves tasked with evaluating the fitness of individuals with cardiac ailments to operate vehicles.

The Fitness to Drive Guidelines not only build upon but also enhance the efficacy of their predecessors, which have served as stalwart pillars of guidance for over two decades. These guidelines assimilate fresh insights from therapies, interventions, and disease entities in their evolution. Among the factors considered are percutaneous therapies for valvular disease, genetic disorders, and recent research elucidating the risk of shock or incapacitation in patients with implantable defibrillators.

Dr. Christopher S. Simpson, co-chair alongside Dr. Guerra, elaborates on the methodological approach to formulating these guidelines. Given the absence of randomised trials on Fitness to Drive, observational studies were leveraged to gauge the risk of driving impairment across various scenarios. Recommendations were then moulded on the foundation of the CCS Risk of Harm formula, a validated assessment tool of paramount significance. Notably, more stringent recommendations were tailored for commercial drivers, considering their prolonged periods behind the wheel, operation of larger vehicles, and potential transportation of a more significant number of passengers.

The Fitness to Drive Guidelines offer comprehensive recommendations for individuals with a spectrum of cardiovascular conditions. These conditions, numbering seven in total, encompass active coronary artery disease, valvular heart disease, heart failure, heart transplant, left ventricular assist devices, arrhythmia syndromes, implantable devices such as pacemakers and defibrillators, syncope episodes, and congenital heart disease.

Through meticulous analysis, expert consensus, and integration of contemporary evidence, the Canadian Cardiovascular Society continues to fortify its commitment to enhancing road safety while addressing individuals with cardiovascular disorders’ unique needs and challenges. These updated guidelines stand as a testament to the society’s unwavering dedication to safeguarding public health and fostering informed decision-making within cardiology and beyond.

More information: Peter G. Guerra et al, Canadian Cardiovascular Society 2023 Guidelines on the Fitness to Drive, Canadian Journal of Cardiology. DOI: 10.1016/j.cjca.2023.09.033

Journal information: Canadian Journal of Cardiology Provided by Elsevier