An Aspirin a Day?

A low-dose daily aspirin doesn’t lower the risk of dying or having a heart attack or stroke in healthy older people. In fact, it may raise the risk of bleeding or dying, especially of cancer.

Researchers randomly assigned 19,114 healthy Australian and U.S. residents aged 70 or older (65 or older for U.S. blacks and Hispanics, who have a higher risk of heart disease) to take either a daily enteric-coated aspirin (100 milligrams) or a placebo.

After nearly five years, the aspirin takers were 14 percent more likely to have died than the placebo takers and 31 percent more likely to have died of cancer, though the risk was still low: 3.1 percent of the aspirin takers died of cancer, versus 2.3 percent of the placebo takers. Surprisingly, the aspirin takers were more likely than the placebo takers to die of colorectal cancer, though those results were less certain. (Aspirin takers had a lower risk in earlier studies.)

The aspirin takers were also 38 percent more likely to suffer a “major hemorrhage” such as stomach or brain bleeding serious enough to require transfusion, hospitalization, or surgery. And the aspirin takers were no less likely to be diagnosed with heart attack, stroke, dementia, or disability.

What to do: Don’t take a daily low-dose aspirin if you’re 70 or older and healthy, unless your doctor says otherwise. A low-dose daily aspirin may lower the risk of a heart attack or stroke in 50-to-69-year-olds at high risk, according to the U.S. Preventive Services Task Force. Ask your doctor.

N. Engl. J. Med. 2018. doi:10.1056/NEJMoa1803955, 10.1056/NEJMoa1805819, 10.1056/NEJMoa1800722.

Alcohol: Unsafe at Any Dose?

How much alcohol is best for your health?

A team of scientists examined studies on 28 million people to estimate the global burden of 23 diseases and injuries due to alcohol.

The risk of heart disease was 14 percent lower for men—and 18 percent lower for women—who drank one small serving of alcohol a day compared to those who drank none.

However, drinking even that amount each day was linked to a higher risk of many other health problems, including cancers of the breast, colon and rectum, and throat. Other outcomes—like cancer of the larynx or mouth, traffic injuries, and violence—increased at two or more small servings a day.

The estimated risks: In one year, one of the 23 outcomes would occur in 918 of 100,000 people aged 15 to 95 who had one drink a day, versus 914 of 100,000 people who drank no alcohol—not a huge difference. But the risk climbed to 977 of 100,000 people in those who had two drinks a day.

Those results are based on global data, so they include some outcomes—tuberculosis, for example—that don’t affect most Americans. And the studies didn’t assign people to drink or not, so they can’t prove that alcohol caused the risks or benefits.

Nevertheless, the results contradict the widespread belief—promoted by the alcohol industry—that alcohol is good for you.

“Alcohol is a colossal global health issue and small reductions in health-related harms at low levels of alcohol intake are outweighed by the increased risk of other health-related harms, including cancer,” concluded an editorial published with the study.

What to do: Don’t start drinking on a daily basis in order to protect your health.

Lancet 2018. doi:10.1016/S0140-6736(18)31310-2, 10.1016/S0140-6736(18)31571-X.

Vitamin D & Mood

Can extra vitamin D improve your mood, as some studies suggest?

New Zealand researchers randomly assigned 152 healthy women aged 18 to 40 to take either vitamin D (50,000 IU) or a placebo once a month. Each group reported their moods online.

After six months, the vitamin takers had no different depression, anxiety, or mood scores than the placebo takers.

What to do: Don’t expect vitamin D to improve your mood.

J. Nutr. Sci. 2018. doi:10.1017/jns.2018.14.

Photos (top to bottom): ismotionprem, Khorzhevska, highwaystarz.