Should You Be Concerned About Barrett's Esophagus?

Barrett’s Esophagus is a condition where the lining of the esophagus is damaged by stomach acid and is replaced by tissue similar to that which is found in the stomach. The exact cause of Barrett’s Esophagus is unknown, but it is commonly seen in people with gastroesophageal reflux disease, or GERD. Reflux occurs when the contents of the stomach rises into the esophagus, which may cause heartburn or indigestion. Occasional reflux is common, but for those who experience this sensation more than twice a week, a diagnosis of GERD is made. Within this population, Barrett’s Esophagus affects about 1% of Americans, or about 700,000 adults (1), and it may progress into esophageal adenocarcinoma, a deadly form of cancer of the esophagus. Barrett’s Esophagus does not cause any signs or symptoms, so it is important for individuals suffering from chronic reflux (GERD) to visit their doctor for an endoscopy and biopsy of the esophageal tissue regularly. Although cancer diagnosis is rare, most diagnoses are made late stage when treatment is ineffective. Early detection of precancerous cells (dysplasia) may prevent the development of esophageal cancer (2).

Risk Factors

Individuals with the following characteristics are at higher risk for developing Barrett’s Esophagus:

• Diagnosed with GERD, or experiencing constant reflux

• Heavy alcohol and tobacco use

• Older age

• Being male

• Being Caucasian

• Obesity

• Consuming a poor diet (3, 4).

Research

A study published in the American Journal of Gastroenterology found that diets high in antioxidants such as Vitamin C, E, and beta-carotene are related with a reduced risk for Barrett’s Esophagus. Consuming a diet high in fruits and vegetables, versus the typical Western Diet of processed foods, showed the greatest reduction in risk. It is important to note that similar results were not found in individuals who took supplements. It is theorized that there are other compounds in whole fruits and vegetables with beneficial, anti-cancer properties. Parallel findings were also discovered in a study completed by the National Institute of Health; Individuals consuming low amounts of raw fruits and vegetables were associated with a greater risk of developing cancer associated with Barrett’s Esophagus (5, 6).

Prevention and Recommendations

An effort to minimize acid reflux may reduce the risk of progression to Barrett’s Esophagus. The following is a list of various lifestyle changes that can be made to decrease this likelihood:


Smoking Cessation

• Smoking is strongly associated with cancer of the esophagus and can contribute to the esophageal cancer related to Barrett’s Esophagus.


Drink in Moderation

• Alcohol relaxes the mechanism that prevents stomach contents from entering the esophagus.


Sleeping Habits

• Avoid lying down three hours following meals.

• Sleep with your head elevated to prevent acid from rising into the esophagus.


Weight Loss

• Loosing weight improves GERD symptoms, as well as reduces the risk for both Barrett’s Esophagus and the development of cancer.


Dietary Changes

• Eat a low-fat diet, as high fat meals take longer to digest thereby increasing the risk for acid to rise.

• Consume small, frequent meals.

• Increase daily intake of raw fruits and vegetables, especially those high in antioxidants.

• Reduce caffeine intake to 2 – 3 cups per day. Caffeine, similar to alcohol, relaxes the mechanism in the esophagus that prevents acid to rise.

• Foods such as chocolate, spicy foods, and peppermint have also been show to aggravate reflux and should be avoided as necessary (1, 7, 8).



Resources:
1. Dunbar, K. (2009, April 21). Barrett's Esophagus. Retrieved March 30, 2012, from John Hopkin's Pathology: http://apps.pathology.jhu.edu/blogs/barretts/?p=48

2. Locke, G., & Rich, J. (2008, July 1). Barrett's Esophagus. Retrieved March 30, 2012, from National Institute of Digestive Diseases Information Clearlinghouse: http://digestive.niddk.nih.gov/ddiseases/pubs/barretts/

3. National Cancer Institute. (2011, December 23). Esophageal Cancer Treatment. Retrieved March 30, 2013, from National Cancer Institute at the National Institute of Health: http://www.cancer.gov/cancertopics/pdq/treatment/esophageal/Patient

4. The Cleveland Clinic Foundation. (2009). Barrett's Esophagus. Retrieved March 30, 2012, from Cleveland Clinic: http://my.clevelandclinic.org/disorders/barretts_esophagus/hic_barrett%27s_esophagus.aspx

5. Tufts University. (2008). Antioxidants from Produce May Protect Esophagus. Tufts University. Boston, MA: Tufts University Health and Nutrition Newsletter.

6. Brown, L., Swanson, C., Gridley, G., Swanson, G., Shoenberg, J., Greenberg, R., et al. (1994). Adenocarcinoma of the Esophagus: Role of Obesity and Diet. Journal of the National Cancer Institute , 87 (2), 104-109.

7. Clark, G., Smyrk, T., Mirvish, S., Anselmino, M., Yamashita, Y., Hinder, R., et al. (1993). Effect of Gastroduodenal Juice and Dietary Fat on the Development of Barrett's Esophagus and Esophageal Neoplasia. 1 (3), 252-261.

8. Academy of Nutrition and Dietetics. (2012). Nutrition Therapy for Gastroesophageal Reflux Disease. Nutrition Care Manual . Chicago, IL.

About the Author

Stephanie Wilson is a senior nutrition major at Rochester Institute of Technology.  This May she will graduate from RIT and begin her Dietetic Internship at California Polytechnic in San Luis Obsipo.  Stephanie proudly describes herself as a marathoner, foodie, musician, and blogger at OntheRoadtoRD.com.  She hopes to one day follow in Carol’s footsteps and become a private practice dietitian and share her love of both nutrition and exercise with the public!
  

Women Need More Muscles

Women must weight train their whole life to support their muscles and bones

Bad news for us ladies, a recent study showed that body mass index (BMI) underestimates obesity in 48% of women. The study which was released this week determined that when body fat was measured by duel-energy x-ray absorptiometry (DXA), almost half of the women who were not considered obese using BMI measurements actually were (25% of men were mis-classified as non-obese). This study highlights the problems that women face as they age in losing a greater amount of muscle and bone mass then men.

Being considered the weaker sex for thousands of years, women were discouraged from engaging in physical activity, exercise and sports as recently as the mid-twentieth century. Consequently, even women considered engaging in physical activity unfeminine. Many of us were sedentary throughout most of our lives and dieted to stay thin when we were younger. We know that muscle loss accompanies dieting. As we approached forty, fifty, sixty and beyond, we accumulated more fat at the expense of muscle and bone (you have to use it or you lose it).

Both men and women need to engage in weight training, but women need it more. More attention should be placed on getting women of all ages to pump some iron to prevent the loss of muscle and bone that occurs with age. Today young women seem to embrace this idea, but older women should too (even 90 year olds). Weight training at any age promotes an increase in muscle and bone mass. In turn, stronger muscles and bones promotes improved health. Exercising your muscles is one way to decrease insulin resistance and increase coordination to prevent falls.

So ladies, don't lament the bum hand that we've been dealt in having more body fat then men. Get to the gym now and start cutting up (lose body fat and gain muscle). You will need to watch your diet too to get rid of that extra body fat, but no more dieting at the expense of your muscles. If you want to do it right, consult a personal trainer and a dietitian to get you on track. A personal trainer will teach you the correct form for lifting weights and a dietitian will tailor your diet to maximize fat loss and minimize muscle loss.

To your health!

Childhood Obesity: A Call to Action

Show your children the value of eating healthy foods 

Our children are at risk. Most parents identify drugs, alcohol, sex and violence as threats to the well-being of their children. In truth, childhood obesity will have a greater negative impact on more children than any of the concerns listed above. The most recent data from the National Health and Examination Survey (NHANES) collected in 2007-2008 shows a marked increase in the prevalence of obesity from 1976-1980 in all age groups.

Prevalence of Obesity in US Children and Adolescents

   Age                    1976-1980                  2007-2008

2-5 years               5.0%                            10.4%

6-11 years             6.5%                            19.6%

12-19 years           5.0%                            18.1%

Nearly one third of children in the US are either overweight or obese and they are at risk for future health problems.

Overweight and obese children are the targets of many health and social problems. They are often exposed to early social discrimination, which can lead to low self-esteem. This in turn can hamper their academic and social functioning into adulthood. They are also at increased risk for cardiovascular disease due to high cholesterol levels, high blood pressure and abnormal blood sugar levels. Additional health risks include asthma, fatty degeneration of the liver caused by a high concentration of liver enzymes, sleep apnea, and type 2 diabetes.

The causes of childhood overweight and obesity are many. Childhood obesity was aptly described by Dr. Hilde Bruch, a pioneer in the field over seventy years ago. She said, "To understand the obese child, one needs to remember that he (she) accumulated his (her) extra weight while living in a family that, wittingly or unwittingly, encouraged overeating and inactivity." The current culture of America encourages overeating and inactivity, and one must swim against the current to avoid these habits.

The solution is straightforward, but difficult to adopt for many families who are stressed for time. Calories must be balanced with eating healthy foods and engaging in daily activities. When looking for solutions to keep your kids healthy, look not further than your pantry and your own backyard.

Encourage Healthy Eating Habits

• Provide plenty of vegetables, fruits and whole grain foods.
• Offer protein from beans, lentils, nuts, fish, poultry and lean meats.
• Include some low-fat or non-fat dairy products.
• Offer smaller portion sizes.
• Limit sugar-sweetened beverages. One 12 ounce can of soda contains ten teaspoons of sugar.
• Encourage your family to drink lots of water.
• Limit consumption of sugar and saturated fat.
• Cook healthier meals at home and eat out less.
• Avoid calorie-rich temptations. An occasional treat is acceptable, but it should not be a daily occurrence.

Help Kids Stay Active

• Children should participate in at least 60 minutes of moderate intensity physical activity every day. Examples are taking a brisk walk, playing tag, jumping rope, playing soccer, swimming and dancing.
• Have children join you in your physical activity routine.
• Limit television, video games, and surfing on the web to no more than two hours a day. Children younger than 2 years should not view television at all.
• Do not allow your child to have a television or computer in their bedroom.

With attention, support, and hard work, our children can lose and maintain healthier weights.