Smog And Appendicitis

Already recognized as a risk factor for heart attack, stroke and cancer, air pollution is now also being linked to attacks of appendicitis.

“Appendicitis is one of the most common reasons for North Americans to have surgery,” says gastroenterologist Dr. Gilaad Kaplan of the University of Calgary’s Departments of Medicine and Community Health Sciences.

Appendicitis, an inflammation of the appendix which is found between the small and the large intestine, is a disease that accompanies industrialization, and until now it was blamed on lack of fibre in modern diets. “But that doesn’t explain the drop in rates in the mid- and later 20th century. If anything, our fibre consumption was even worse,” he said. Cases dropped by 36 per cent in the United Kingdom between 1975 and 1994 on the heels of legislation to improve air quality and control industrial sources of air pollution. Similar rate drops were noted in the United States after the Clean Air Act came into effect in 1970. Kaplan and Paul Villeneuve of the Dalla Lana School of Public Health at the University of Toronto put together a team of researchers to find out if there is a connection in Canada, too.

The team identified 5,191 adult appendicitis patients aged 18 to 35 admitted to hospital in Calgary between April 1999 and the end of 2006, and correlated their exposure to air pollutants, including ozone, nitrogen dioxide, sulphur dioxide, carbon monoxide and dust and such. They found a modest increased risk, enough to say that some cases of appendicitis may be triggered by short-term exposure to air pollution.

The effect was greatest in summer, when people are outside more or more likely to leave windows open. Men may be more susceptible, perhaps, researchers note, because they are more likely to have outdoor occupations.

Now the team is planning a larger study involving many cities across Canada. That will show whether they’re onto something or if “it was just a fluke in Calgary,” said Kaplan.

It’s not yet known how smog might raise appendicitis risk, but based on results of other studies, researchers think exposure to air pollution might cause appendicitis either through an inflammatory response or by destroying the protective mucous lining of the colon, thereby increasing susceptibility to bacterial and viral infections.

If it is proven air quality is a contributing factor to appendicitis, cleaning up the air could save tens of millions of dollars a year, Kaplan said. Between 1991 and 1998, there were 65,675 cases of acute appendicitis in Ontario alone. Canadian adults have a one-in-12 risk of developing appendicitis sometime in their lifetime, he says. Reducing those odds even a little would decrease the burden of this disease on the country’s health care systems. And susceptible individuals could plan personal action to lower their risk, like timing strenuous outdoor activities like jogging or heavy lifting for days when there’s less smog.

Eat Slower, Lose Weight

Okay, so you’ve made another resolution to lose weight in the New Year. This year, try a different approach—in addition to watching what you eat, try to take longer to eat it. Researchers around the world are finding that those who want to lose weight do better grazing than gobbling.

Researchers at the Athens University Medical School in Greece and Imperial College in London, England, have found fast eating contributes to eating more. They had people eat 300 millilitres of ice cream at different rates, then compared blood measurements of levels of glucose, insulin, fats and gut hormones taken before eating and every half hour for the next 21⁄2 hours. People who took a full 30 minutes to finish the ice cream had higher concentrations of appetite-regulating hormones, and reported feeling fuller.

After we eat, hormones are released to tell us when we’re full and it’s time to stop eating. By eating quickly, we eat more before those hormones kick in.

“Our findings give some insight into an aspect of modern-day food overconsumption, namely the fact that many people, pressed by demanding working and living conditions, eat faster and in greater amounts than in the past,” said lead researcher Alexander Kokkinos of Laiko General Hospital in Athens. The research was reported in the Journal of Clinical Endocrinology and Metabolism.

In a comparison of 30 healthy women, some who eat quickly and some who eat slowly, researchers at the University of Rhode Island in the United States found those who ate more slowly ate significantly less yet felt fuller than the gulpers and gobblers—even though it took them 21 minutes longer to eat. Ironically, it takes at least 15 minutes for a message saying “I’m full” to get through to the brain—long after many fast food diners have already finished their meals and the calories are already increasing the circumference of tummies and thighs.

Make that North American tummies and thighs, not those of the French.

Researchers from France and the United States set out to discover the secret of the “French paradox”—the lower rate of heart disease and obesity in France, despite diets much higher in saturated fats from meats and dairy foods than those in the U.S. Also, fat is at least twice as calorie-rich as carbohydrates and protein, so how can the French be eating fewer calories than those in the U.S.?

This research was carried out at a U.S. fast-food icon—McDonald’s—where it was noted the average U.S. customer spends 14.4 minutes at the table which is 35 per cent less time than do the French, who took 22.2 minutes to eat. Oh yes, it was also found the portions served in the French restaurants were smaller than those served in the U.S. Even so, the French left feeling full after their comparatively more leisurely dining experience.

Japanese researchers discovered fast eating nearly doubles the risk of obesity. Researchers at the National Institute of Health and Nutrition in Tokyo studied 1,695 students, all 18 years old. At Nagoya University, middle-aged civil servants were studied and at Osaka University 3,000 adult men and women were studied. All three studies discovered the fatter folks are the fastest eaters. In Osaka, it was found men were 84 per cent more likely to be overweight, and women twice as likely, if they eat quickly.

So, here’s the news you can use. Around the world researchers notice slow eaters take small bites, put their utensils down between bites and chew, chew, chew.

Email the writer at: writer@legionmagazine.com

Email a letter to the editor at: letters@legionmagazine.com