Breast Cancer Patients Fare Worse When Adjuvant Chemotherapy Is Delayed

Breast cancer patients whose chemotherapy is initiated >60 days following surgery experience worse survival outcomes, according to a large, retrospective review of patient medical records conducted by Mariana Chavez-MacGregor, MD, and her colleagues at The University of Texas MD Anderson Cancer Center. The impact of treatment delay is greatest among patients with stage III or triple-negative breast cancer (TNBC) and those whose HER2-positive tumors have been treated with trastuzumab.

Breast Cancer

Most adjuvant breast cancer chemotherapy begins within a few weeks of surgery; however, previous research results differ on the impact that longer time to chemotherapy (TTC) might have on survival. Treatment delays also have been reported to occur more frequently among low-income groups, racial minorities, and Medicare patients.

To further investigate the impact of TTC, Chavez-Mac- Gregor, an assistant professor in the department of Breast Medical Oncology, Division of Cancer Medicine, at MD Anderson, and colleagues analyzed the records of 6827 patients diagnosed with stage I to III invasive primary breast cancer who received treatment at the cancer center between 1997 and 2011. Most patients had stage I/II disease (84.3%) and 15.5% had stage III.

Patient medical records were divided into three groups based on the number of days between completion of surgery and start of chemotherapy: ≤30 days (n = 2716), 31 to 60 days (n = 2994), and ≥61 days (n = 1117). Overall survival (OS), relapse-free survival (RFS), and distant relapse-free survival (DRFS) were assessed for the study population as a whole and also according to breast cancer subtype, with a median follow- up of 59.3 months.

Investigators applied multivariable models and adjusted for confounders to estimate 5-year OS, RFS, and DRFS for all patients based on TTC and other patient characteristics. They determined that when compared with patients who had adjuvant chemotherapy ≤30 days after surgery, patients whose TTC was ≥61 days post-surgery had a 19% increased risk of death (HR = 1.19; 95% CI, 1.02-1.38).

Although TTC was not significantly linked to outcome in patients with stage I disease, the risk of distant relapse was estimated to increase by 18% in stage II patients whose chemotherapy started 31 to 60 days after surgery, and by 20% in the ≥61 days cohort. For patients with stage III disease who started chemotherapy ≥61 days after surgery, the risk of death was increased by 76%, the risk of relapse by 34%, and the risk of distant relapse by 36%, when compared with patients whose TTC was ≤30 days.

The impact of TTC on survival and relapse also varied according to breast cancer subtype. Patients with hormone receptor (HR)-positive tumors receiving chemotherapy ≥61 days after surgery had a 29% increased risk of death (HR = 1.29; 95% CI, 1.02-1.64).

HR-positive patients who received chemotherapy 31 to 60 days after surgery were estimated to have a 15% increased risk of relapse and an 18% increased risk of distant relapse, compared with patients whose TTC was ≤30 days, the researchers reported.

The magnitude of risk was more pronounced when the researchers looked at the records of patients with TNBC and those who were HER2-positive and treated with trastuzumab.

Patients with TNBC who received chemotherapy either 31 to 60 days or ≥61 days after surgery had a 74% and 54% increased risk of death, respectively, compared with the ≤30 days group, but RFS and DRFS were not impacted by TTC in these patients.

For patients who were HER2-positive but not treated with trastuzumab (n = 551), outcomes were not adversely affected by longer TTC, but a statistically significant increase in death risk was observed in the trastuzumab- treated group (n = 591) when chemotherapy was initiated ≥61 days after surgery versus ≤30 days (HR = 3.09; 95% CI, 1.49-6.39). A trend toward worse RFS and DRFS was also reported for this group.

The researchers concluded that for patients with stage II and III breast cancer, those with TNBC, and those with HER2-positive tumors, “Every effort should be made to avoid postponing the initiation of adjuvant chemotherapy. This may lead to an improvement in outcomes for these subsets of patients.”

Can a transplant drug help eliminate lingering HIV infections?

Researchers studying the effects of immune suppressant drugs on  transplant patients with HIV have made a surprising discovery: A drug intended to hobble the body’s defense system may actually help destroy dormant reservoirs of the virus that causes AIDS.

In a paper published this week in the American Journal of Transplantation, authors found that when a small group of transplant patients received the drug sirolimus, they experienced a two- to threefold drop in HIV levels, whereas patients who received other immunosuppressants did not.

“We were pleasantly surprised,” said study coauthor Dr. Steven Deeks, an HIV expert and professor of medicine at University of California San Francisco. “It’s difficult with any drug to affect the [HIV] reservoir.”

Modern antiretroviral therapy, or ART, is able to stop the human immunodeficiency virus from replicating and destroying a patient’s immune system, yet the cocktail of drugs is unable to wipe out the virus entirely.

As a result, low levels of HIV persist in the body indefinitely, and patients must continue taking costly drugs, or risk a renewed assault on their immune system.

Scientists have been pursuing a number of means of destroying these so-called reservoirs, including “kick and kill” strategies that involve activating the dormant virus and then attacking it.

Deeks and his colleagues however have proposed a different approach, one that includes reducing inflammation.

Recent research has suggested that tissue inflammation helps HIV spread, because it summons the body’s immune cells, which are the preferred targets of HIV.

Sirolimus, which is also known as rapamycin, is believed to help reduce inflammation, but also has other benefits, study authors said.

Among those benefits was sirolimus’ ablity to prevent the immune system’s T-cells from producing a protein called CCR5, which normally coats the cell’s exterior.

HIV uses CCR5 as a doorway to enter the cell and once inside the host, the virus hijacks the cell’s machinery and starts making copies of itself.

Nathalia Holt, a molecular biologist who was not involved in the study, said sirolimus’ ability to attack HIV in several ways made it a promising treatment.

“You can see how this could work really nicely in a clinical trial,” she said.

Holt, who authored the book “Cured” — the story of two men who appear to have been cured of HIV after treatment in Berlin — said the combination of immune suppression and HIV resistance may have played a role in at least one case.

“Multipronged approaches like this one are our best bet at finding a therapy that’s curative,” she said.

The recent study examined 91 kidney transplant patients with HIV — 9% of whom received sirolimus. The data was taken from a larger, previously published trial that looked at 275 transplant patients to determine the safety and efficacy of using immunosuppressant drugs on HIV patients.

Because the study was not desgined to specifically examine the effects of sirolimus, the authors said further research was needed to confirm its effects on HIV. In fact, the National Institutes of Health has agreed to sponsor a targeted study of 30 patients, according to Deeks.

“We saw a very important, statistically significant signal, but I wouldn’t jump on this bandwagon that sirolimus is going to cure HIV,” said coauthor Dr. Peter Stock, a transplant surgeon and professor at UCSF.  “It does require a bigger study.”

In most transplants, the recipient’s immune system responds to the new organ as it would any foreign body — it attacks it. Because of this, most transplant patients must undergo a lifetime drug regimen that stifles their body’s defense system.

For many years, transplant surgeons believed that HIV patients should not receive replacement organs because their immune systems were already compromised. To suppress it further with drugs would hasten the onset of AIDS, they reasoned.

That view began to change though with the advent of new antiretroviral drugs.

Stock said that as a transplant surgeon, he was interested to see that while sirolimus appeared to reduce HIV levels for some patients, none of the variety of immunosuppresants studied was associated with an increase in the virus.

“We didn’t lose control, and that’s important,” Stock said.

Protect Your Heart, Protect Your Brain

What helps your heart can help your brain, too. Following a heart-healthy lifestyle can lower your chances of having a stroke, and it can also make a big difference in your mental abilities as you age. 

In fact, getting plenty of physical activity, eating a healthy diet and other behaviors that strengthen your heart can have a profound effect on the way you think, how you act and what you remember. 

“Most people don’t understand the connection between heart health and brain health, and as doctors we’re learning more every day,” said Ralph Sacco, M.D., chief of neurology at the Miller School of Medicine at the University of Miami and past president of the American Heart Association. “New studies have shown that the risk factors that can lead to heart disease and stroke, such as physical inactivity and obesity, also contribute to dementia, Alzheimer’s disease, memory loss and cognitive dysfunction.” 

Here’s what happens: Those unhealthy behaviors can lead to narrowing of the blood vessels. That reduces blood flow to the brain, and leads to hardening of the arteries of the heart and the brain. 

When your brain doesn’t get the blood flow it needs, it can begin to malfunction. As a result, Sacco said, you could experience problems thinking, trouble with memory, difficulty finding your way from place to place and deterioration in cognitive function. If blood flow to the brain is abruptly blocked, you could even have a stroke.

“People often associate memory loss with Alzheimer’s disease, and they think it can’t be prevented or treated,” said Sacco, the first neurologist to serve as president of the American Heart Association. “But controlling your risk factors for heart disease can make a difference in slowing its progression.”

Heart disease is the leading cause of death in America. Stroke ranks fourth, and it is also a leading cause of severe, long-term disability.  

“Most of the time, like heart disease, it takes years of uncontrolled, unhealthy habits to wreak havoc on your brain, so it’s important to think about healthy habits as early as childhood and maintain them through adulthood and middle age,” Sacco said. “Many of these unhealthy behaviors translate to high blood pressure, diabetes and elevated cholesterol by the time you’re in your 50s.”

The High Blood Pressure Connection
“The one factor that is the strongest predictor of brain health is high blood pressure,” Sacco said. “It’s the most significant risk factor for stroke. It also has the most evidence suggesting that it leads to blockages of small arteries and impaired brain health.” 

Many people don’t know they have high blood pressure because it has no visible symptoms, which is why it’s dubbed “the silent killer.” It can be controlled with lifestyle changes and high blood pressure medication, so visiting your healthcare professional to check your blood pressure is very important. Learn about high blood pressure and what you can do to control it.

Getting on the Right Path
It’s also important to discuss any cognitive problems you’re having with your healthcare provider. 

 “If you’re having trouble with memory or thinking, tell your doctor — and then tell your doctor again,” Sacco said. “We all have a little trouble when we age, like forgetting where we put our keys, but if your thinking problems seem more than usual your doctor may be able to find out if there’s really something wrong. You may need to be evaluated by a neurologist, or someone who specializes in cognitive issues.” 
You might undergo testing to test how well your memory is working. You might also need to see a neuropsychologist, who can use brain teasers, puzzles and other tests to assess your cognitive function and compare it to other people your age.

The next step: Strive for a healthy lifestyle. This includes getting plenty of physical activity and following a healthy diet that includes lots of fruits, vegetables, whole grains, low-fat dairy, lean protein and fish. Maintaining a healthy body weight, not smoking, and managing your blood pressure, blood sugar and cholesterol are all critical.

Small Organic Farms Can End World Hunger

Organic farms, although not necessarily always quite as health-friendly as advertised, harbor approximately 34% more diversity of species than conventional farming, according to a recent study by Oxford University. They are actually even more important than that: according to the U.N (report here, summary here) small organic farms are actually the key to solving hunger problems worldwide.

The reasons that small organic  farms are so important is many fold. The main reason is that by allowing more species, by not killing symbiotic bacteria in the soil and insects (like ants), you increase per plant yield while also helping maintain ecological stability (helping prevent collapse). These are the same reasons polyculture system are beneficial: extreme factors (like temperature or storms) do not suddenly “tip” the entire ecosystem, the plants are not all competing for the same resources, and more mutualist species can be supported. Inversely, all this is reversed in conventional monocultures.

Organic permaculture is more than just meaningful, more than just able to increase yield: it is able to solve hunger problems effectively, locally, without chemicals, and in a way that promotes ecological stability instead of exploitation until collapse. The answer is not to throw billions into GMOs, especially not in the form it is currently in.

Cancer treatment found in a tree.

The Lapacho tree has been studied for many years by cultures around the globe. It is an evergreen tree from South America that produces a type of bark that has been claimed to cure or prevent cancer, along with other illnesses. The scientific name is Tabebuia avellanedae, and the tea that is made from this bark is often referred to as “Pau d’arco,” though many alternative names have been used.

The University of Maryland found that this specific tea, or bark extract, has anticancer properties, as well as anti-inflammatory, antiparasitic, antifungal and antimicrobial properties. There has not been any well-known testing on humans, but studies have already proven that this particular bark provides a stimulation of immune system cells known as macrophages. Additionally, this bark has been reported to kill lung cancer cells and liver cancer cells that were grown and analyzed in a test-tube study.

The tea, often called Taheebo tea, is hard to mix with water, requiring up to 20 minutes of varying heat and boiling measures, but many people have reported this particular tea to have cured them of their health ailments. One website reports a testimonial that claims this tea to have cured a man diagnosed with lymphoma, and who had only a matter of months to live. In 2009, Anna Hodgekiss with the Daily Mail reported a woman who had been diagnosed with Crohn’s disease and who took it upon herself to test many different barks for a cure. She did not specify the particular bark she found successful, but she has already sold it to a pharmaceutical company, going to show that bark is a form of treatment in which people can place their trust.

The typical uses of Pau d’arco, listed by the University of Maryland, include treatment of cancer, candidiasis, influenza, parasitic disease, herpes and bacterial infection. Louise Tenney writes in the Cancer News Journal, that this tree bark, sometimes called Ipe Roxo, has curative powers that have proved countless times to have healed thousands of people. It very well might be that the cure for cancer is found in this tree bark.

Distributors of this bark reported that a client cured his dog of a skin condition with the tea. The owner himself claims this tea cured colon cancer in his own father. Although this tree is now endangered, the main producers of the tea instructs people to use their signature method when stripping the bark from the tree so that it does not kill the species but leaves it able to produce more bark for future harvests.

Downside of things

One of the drawbacks of this tea is reported by the American Cancer Society (ACS). High levels of the bark extract have the potential to be poisonous. One study, however, conducted in the 70s by the National Cancer Institute, found no toxic effects on liver or kidney tissue. The ACS also claims that many people are selling derivatives and false variations of the bark. There was a study in Canada that tested 12 products claiming to be Pau d’arco and found only one of these products to have contained lapachol, which is the pure ingredient of Pau d’arco.

The University of Maryland cautions consumers that this bark in heavy doses can cause unmanageable bleeding, while some proponents actually claim this is a blood builder. It is hard to tell how beneficial this herb exactly is, but it might prove more helpful than harsher Western medical treatments.

Sources of this article include:


Blind can ‘see’ with Israeli-developed camera system

OrCam uses advanced algorithms, video and audio technology to open up a new world for the visually impaired.

Erez Naaman demonstrates the OrCam in action. (photo credit: Courtesy)

Recent developments in technology have brought good news for the blind and the visually impaired. An Israeli device to assist such people is the first on the market — and far more inexpensive than alternative technologies being developed.

The OrCam Artificial Vision Device doesn’t actually restore vision, explained Erez Naaman, vice president of engineering at the Jerusalem-based maker of the device. “We do the next best thing — to help the visually impaired navigate the world with a low-cost device and without invasive procedures.”

The miniaturization of processors — which paved the way for smartphones loaded with GPS chips, Wi-Fi connections, accelerometers, and other sensors — has also led to the development of new health-related devices, from watches that record exercise sessions to monitors that use sensors to determine blood pressure, blood sugar levels, and more.

For years, researchers have been trying to figure out ways to harness sensor technology to assist people suffering from blindness and acute vision impairment, perhaps the most debilitating and difficult physical disability in a society that relies chiefly on visual cues.

One solution — developed in Israel — is Project Ray, a smartphone specially designed for blind and sight-impaired users, which uses sensors to help them navigate the world.

The device allows users control the phone by voice and touch. For example, when a user calls up a location program and swipes it, the device will use a GPS chip to tell them where they are.

The technology was promising enough for Qualcomm to use it in a smartphone that came out last year — the RAY Huawei Vision phone, a device that lets blind users not only make phone calls, but to send text messages, to browse the Internet, to identify the denomination of cash, to recognize colors, and to access over 100,000 audio books and magazines.

The OrCam solution uses sophisticated technology as well, in the form of a high-resolution video camera and smart algorithms that analyze what the camera is seeing, and reading back the information to a user in real time.

“It’s not even a 3-D camera,” Naaman told The Times of Israel at a meeting in Tel Aviv to promote the upcoming WearableTech 2014 event, which will feature OrCam’s solution, along with many others in the medical and health fields.

“The database recognizes words, remembers faces, locations and landmarks, describes shapes, and other features that are read back to users, letting them navigate situations successfully,” explained Naaman. To boot, the company is currently working on adding color to that list of features, he said.

With an OrCam attached to the frame of a pair of glasses, a user can even “read” newspapers, restaurant menus, or books, with the device recognizing whole words and reading them back to a user.

OrCam isn’t the only tech solution for the blind and the vision-impaired. The Argus II, made by US-based company Second Sight Medical Products, also uses a camera: It beams signals to an artificial retina implanted in the eye, and sends the signals to the brain’s visual cortex — allowing the user to form an image in his mind of what the camera is seeing.

The FDA has approved the Argus II as a humanitarian device — clinical studies and proof of effectiveness are not required for such devices — for the treatment of sufferers of Retinitis Pigmentosa, a degenerative eye disease that affects 1 in 4,000 Americans. Currently, the device is available only for testing, with a scaling-up of manufacturing expected this year.

The Argus II has been able to help some subjects more than others, and its developers are working on the much more powerful Argus III, due out next year.

But there are two differences between OrCam and the Argus II, as well as between the Israeli device and strictly medical procedures to help restore vision. “The OrCam is totally noninvasive, and isn’t even really a medical device in the strict sense of the term, so it doesn’t need regulatory approval,” explained Naaman. “And it’s a lot cheaper than other systems.” The Argus II costs $115,000, whereas the OrCam currently costs $2,500.

Among the inventors of OrCam is Prof. Amnon Shashua of Hebrew University, who also created the Mobileye driver early-warning system. Using vision technology, Mobileye senses when a car is likely to crash into another car or object, and issues a warning when a driver gets too close. Along with crash warnings, Mobileye, using advanced video detection and analysis, also warns drivers when they are veering out of their lane, when they are getting too close to a pedestrian or biker, or when they are speeding — and the system can even control a vehicle’s headlights, turning its high beams on and off when appropriate.

Although both OrCam and Mobileye use vision technology and were invented in part by the same person, the products have almost nothing in common technologically.

“The needs of drivers on the road and the needs of visually impaired people walking down the street are different. And its those needs that drive the technology,” said Naaman. “Mobileye has to do one thing — watch the road — very well. OrCam, however, has to do a lot of things. But it can afford to be less accurate than Mobileye, where an error could mean death.”

The OrCam technology, obviously, has great value beyond just a system for the visually impaired, and the company is looking at other ways it can be used.

“We have some ideas about other devices, which I can’t share,” Naaman continued. Not only could he not share the specifics, but he couldn’t name possible uses for the technology. “The truth is that this is so unique and different that it is creating a whole new category,” he said. “The devices that come out of this are likely to be very different than anything available right now.”



5 Reasons You Don’t Need To Fix Yourself

From the desk of Zedie.

5 Reasons You Don’t Need To Fix Yourself

From the desk of Zedie.

Mother and Child Activity Levels Linked.

People tend to become less physically active as they get older, and research shows that this sedentary trend is particularly strong after having a child.1


Active Children

According to one study, after having a first or subsequent child, 20 percent of young women changed from being active to inactive.2 And while parents (with dependent children) across the board are less active than non-parents, mothers tend to be even less active than fathers.3

If you’re a parent, this has implications for your health, of course, since regular physical activity (both exercise and non-exercise activity) is key for lowering your risk of chronic disease and maintaining your mobility, strength, and cognitive abilities as you get older.

What may be less obvious is that this tendency to become inactive affects your kids’ health, too, with recent research showing a close tie between activity levels in mothers and their children.

More Active Moms Have More Active Kids

Research published in the journal Pediatrics involved data from more than 500 4-year-olds and their mothers; both groups wore movement-tracking devices during their waking hours for about a week.

As you might suspect, mothers who were more active typically had more active children, although the strength of the association depended on the child’s weight, time at school, time of day and week, and the mother’s education level. Overall, the activity levels among the children over a 14-15 hour period were broken down as follows:

5 hours spent sitting or standing still
8 hours spent on light physical activity (walking, etc.)
1 hour spent on moderate-to-vigorous physical activity (running, etc.)
Mothers generally spent about one hour standing or sitting still, seven hours on light activity, and seven hours on more vigorous activity. The differing activity intensities, and sedentary time, were influenced by quite a few factors, including number and age of children at home, working hours, maternal BMI, and mother’s age leaving school.

The researchers suggested that providing targeted interventions for mothers of young children may help to increase activity levels in both groups, with the take-home message of the study being that a mother and child’s activity levels tend to be closely linked. If you’re an active parent, your child is likely to be active, too. If you’re not, your child is probably going to follow in your footsteps.

Why Physical Activity Is Important for Kids

It’s not only adults who benefit from physical activity. Children have just as much to gain from regular exercise, but only one in three children are physically active every day.4 Kids spend a lot of time sitting in classrooms at school and in front of screens (television, video games, and computers) at home. Children now spend more than 7.5 hours a day in front of a screen!5

What does your child stand to gain from swapping some of that screen time for an active game of tag, a ride around the neighborhood on their bicycle, or a hike in the woods with mom and dad?

For starters, it lowers their risk of becoming overweight or obese. About one-third of US children aged 2-19 years are overweight or obese, and childhood diabetes has increased 10-fold in the last 20 years. If this epidemic is not reversed we will, for the first time in history, see children living shorter lives than their parents. The risks of obesity for children are really that steep. As reported by the New York Times:6

“A study that tracked thousands of children through adulthood found the heaviest youngsters were more than twice as likely to die prematurely, before age 55, of illness or a self-inflicted injury.

Youngsters with a condition called pre-diabetes were at almost double the risk of dying before 55, and those with high blood pressure were at some increased risk. But obesity was the factor most closely associated with an early death. Adults who had the highest body mass index scores as children were 2.3 times as likely to have died early as those with the lowest scores.”

Beyond weight control, one of the primary benefits of exercise is that it normalizes your insulin and leptin levels, with the secondary benefits of weight loss and normalization of blood sugars. These basic factors in turn cascade outward, creating a ripple effect of positive health benefits, which are just as important for kids as they are for adults:

Improving your brainpower and boosting your IQ

Lowering your risk of heart disease and cancer

Building strong bones

Lowering your blood pressure Curing insomnia Losing weight
Relieving pain Balancing your mood and fighting depression Increasing your energy levels
Acquiring fewer colds Lowering your risk of diabetes and reversing pre-diabetes Slowing down your aging process
Exercise Is Important for Your Child’s Brain

The beneficial effect of exercise on brainpower deserves a special mention, as it has the potential to help your child excel in school and, ultimately, succeed in reaching their life’s goals. Exercise encourages your brain to work at optimum capacity by causing nerve cells to multiply, strengthening their interconnections and protecting them from damage. Animal tests have illustrated that during exercise, their nerve cells release proteins known as neurotrophic factors.

One in particular, called brain-derived neurotrophic factor (BDNF), triggers numerous other chemicals that promote neural health, and has a direct benefit on brain functions, including learning. According to one review of 14 studies, which ranged in size from as few as 50 participants to as many as 12,000, the more physically active schoolchildren are, the better they do academically.7 A test program conducted in 2010 at Naperville Central High School in Illinois also illustrated the power of exercise to boost school performance.

Students participated in a dynamic morning exercise program at the beginning of the day and had access to exercise bikes and balls throughout the day in their classrooms. The results were astounding. Those who participated nearly doubled their reading scores!8 Research has also shown that after 30 minutes on the treadmill, students solve problems up to 10 percent more effectively. The evidence speaks loud and clear that regular exercise can improve test scores, IQ levels, and task efficiency among students of all ages. Additional research highlights include:9

Among elementary school students, 40 minutes of daily exercise increased IQ by an average of nearly 4 points
Among 6th graders, the fittest students scored 30 percent higher than average students, and the less fit students scored 20 percent lower
Among older students, those who play vigorous sports have a 20 percent improvement in Math, Science, English, and Social Studies
Fit 18-year-olds are more likely to go on to higher education and get full-time jobs
Students who exercise before class improved test scores 17 percent, and those who worked out for 40 minutes improved an entire letter grade
Do You Need Help Staying Active with Kids?

If you have kids, it’s especially important to make your workouts time-effective. Fortunately, it’s a myth that you have to exercise for an hour, or even half an hour, daily to stay fit. If you exercise intensely, and correctly, you can achieve high levels of fitness with 20-minute workouts, or less. High-intensity interval training (HIIT) is one such example. You can also break up your longer workouts into smaller 15-minute sessions twice a day. Try to schedule your workouts at a time you know you won’t be interrupted, such as early in the morning or while your children nap.

For those days when you can’t fit in a structured exercise session, stay active anyway. Stand instead of sit while you fold laundry, put your kids in a stroller and take a walk around your neighborhood, walk from the far end of the parking lot when running errands, and generally move around as much as you can. This type of non-exercise activity is actually emerging as a key player in optimal health, and may be just as important, if not more important than structured exercise. A simple goal is to stand up once every 10 minutes while you’re sitting.

When you have preschool aged or older kids, make fitness a family affair by riding bikes, going for hikes, swimming, ice skating, and engaging in other vigorous activities as a family. Remember, your kids are watching your every move, and what better example could you set than to teach your kids the importance of staying physically fit? Every time you fit in a workout, go for a hike or walk the dog with your kids, you’re teaching them a lesson about fitness that will hopefully stay with them for a lifetime. To get started, here are 10 ideas to stay active as a family.

Physical Activity Should Be Fun for Kids

Unless your child is seriously overweight or obese (in which case he may benefit from seeing a personal trainer who specializes in children), you shouldn’t expect your child to log in 30 minutes on the treadmill or elliptical machine. The trick to getting kids interested in exercise at a young age is to keep it fun, not feeling like a chore.

Encourage your children to engage in activities that are naturally interesting to them, such as playing on the monkey bars, rollerblading, skateboarding, dancing, playing basketball with friends, or even helping you in the garden. Organized sports are great, but so are spontaneous romps through mud puddles, climbing trees, and making snow angels. Resist the urge to overly structure your child’s “exercise time,” instead encouraging natural active play.

Toward this end, allow your kids to exercise in bursts throughout the day — a game of tag here, a bike ride there — so they don’t feel pressured or like they’re being “punished.” And, again, it’s imperative that you act as a role model by staying active yourself. If your kids see you embracing exercise in a positive way, they will naturally follow suit.

What Are Jujubes Good For?

Botanical name: Ziziphus jujuba

Jujubes are a very interesting fruit with an even more interesting history. From the Rhamnaceae or Buckthorn botanical family, they’ve been cultivated in China for more than 4,000 years. There are at least 400 jujube varieties, successfully developed for their distinctive characteristics – principally varieties best for eating fresh and others for drying to attain a chewy, date-like consistency. While jujube trees are extremely hardy and can flourish in even extreme temperatures with as little as eight inches of rainfall a year, they prefer sunny over shady areas.

Jujube Nutrition Facts

Sometimes called red dates, Chinese dates, Korean dates, or Indian dates, jujubes come from deciduous and relatively small trees. Jujube trees grow at around 40 feet with shiny green leaves, modest-looking blossoms, and grape-to-strawberry-sized fruits containing a single large seed in the center. This makes them drupes.

Jujubes are red inside and out, with a crispy texture, edible skin, and a sweet-tart, apple-like flavor. When ripe, they can be stored at room temperature for about a week.

Jujubes weren’t much of a hit when introduced in the States in the late 1800s because they tried propagating a variety meant for drying. Not until the 1990s was the first truly tasty jujube variety imported into the U.S. by a private individual, and two more in 2007.

The best fresh jujube varieties to look for include Sugar Cane, Li, Sherwood, Chico, and Honey Jar (the latter reportedly the smallest and juiciest). The best drying varieties are Lang and Shanxi Li.
Dried jujube varieties can be used to substitute dates or apples in recipes. Just peel the fruit and remove the single seed inside. Jujubes can also be pickled whole or used to make tea.

Health Benefits of Jujubes

While they may not have a large amount of any one nutrient, jujubes contain a wide array of different ones, including magnesium, potassium, copper, niacin, calcium, manganese, phosphorus, and iron. They contain 20 times more vitamin C than any citrus fruit, strengthening the immune system and fighting infections, which may be why they’ve been used medicinally for millennia in many cultures, as a tea for sore throat, for example.

Medical studies have found that jujube fruits and extracts have the capacity help lower blood pressure, reverse liver disease, treat anemia, and inhibit the growth of tumor cells that can lead to leukemia. Jujube extracts are also used in skin care products used to diminish wrinkles, relieve dry skin, and treat sunburn pain.

How one fruit can have all these benefits has to do with not just the combination, but also the complexity of its phytonutrients. Scientists have identified eight flavonoids in jujube fruit, including spinosin and swertish, which have sedative properties – undoubtedly the reason jujube seeds are used to treat anxiety and insomnia in traditional Chinese medicine.

The free radical-scavenging phenol puerarin in jujubes helps keep your cholesterol levels in the normal range and decrease your risk of cardiovascular disease. The flavonoid apigenin (also found in chamomile, thyme, and red wine) contains antioxidants as well as anti-inflammatory and anti-tumor properties, helping to reduce the risk of cancer and positively impact the liver, digestion, and allergies.

Jujubes are also loaded with 18 of the most important amino acids, which aids in the formation of more than 50,000 proteins in the body, one of which triggers the wound-healing process.

Dried jujubes contain more carbohydrates, but have less fiber than fresh ones. They are much higher in calories, although they are more nutritious and an excellent source of energy.

However, consume jujubes in moderation because they contain fructose, which may be harmful to your health in excessive amounts.

Jujubes Nutrition Facts
Amt. Per Serving
100 grams (slightly less than ½ cup) of fresh jujube:

20 g
1 g

100 grams of dried jujube fruit:
74 g
4 g
Studies on Jujubes

Studies in 2012 on deproteinized polysaccharide extracted from jujube fruit was determined to be a potential anti-skin cancer agent, which scientists suggested be used for further in vivo and clinical trial experimentation for this purpose.1 The essential oil of ziziphus jujuba also was found to possess hair growth promoting activity2, and the extract was found to be an effective, safe treatment for chronic constipation and related maladies.3

Jujubes Healthy Recipes: Jujubes (Red Dates) and Egg Tea

Jujube Healthy Recipes

30 pitted jujubes (red dates)
4 rice bowls of water
One egg

Rinse jujubes thoroughly. Drain well. Set aside.
Put water and jujubes in a saucepan. Cook over medium-high heat and bring it to a boil. Reduce heat and simmer for about 45 minutes, until about 1 rice bowl of water left.
Carefully place an egg in a small saucepan. Cover with cold water. Bring to a boil over medium heat. Reduce heat and simmer gently for 3 minutes for a runny yolk, or cook for a longer time according to your preference. Drain egg with a slotted spoon.
Immediately transfer to a bowl of very cold water. Leave it to cool and peel off shell.
Transfer egg into saucepan with the jujube tea. Warm egg up a bit. Serve immediately.
(Source: Christine’s Recipes)

Jujube Fun Fact

Legends in some Asian countries say that jujube trees were closely watched because their sweet smell had the reputation of making people fall in love.


Up until the past decade, the jujube fruit has been quite misunderstood – a case of mistaken identity in its first introduction, if you will. Slowly, the true nature of this exotic fruit, its benefits and uses are coming to light outside of the jujube fruit’s Chinese origins.

Packed with vitamins and minerals, amino acids and flavonols, jujubes – a.k.a. Chinese dates – help maintain a steady flow of blood through the body, and encourage the healthy development of bones, muscles, skin, hair, enzymes, hormones, and neurotransmitters. Ongoing studies continue to recommend jujubes as a fruit with the potential to treat and even prevent allergies and several types of cancers.

Jujubes have calming properties, are a good source of natural antioxidants, and can help promote relaxation, maintain liver function, limit free radical damage, maintain cholesterol levels already within the normal range, and even treat hair loss.

Luckily, the West now has a better opportunity to discover what much of the world already knew – the delicious versatility of this exotic fruit.

Other sources:


1, Antiproliferation of melanoma cells by polysaccharide isolated from Zizyphus jujube, Nov. 2012
2, Hair growth promoting effect of Zizyphus jujuba essential oil, Nov. 2012
3, Ziziphus jujuba extract for the treatment of chronic idiopathic constipation: a controlled clinical trial, Nov. 2012

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