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• Re: Residence in mountainous compared with lowland areas in relation to total and coronary mortality
  J.G. Landers
  Published on: 27 April 2016
• Cancer and altitude differences
  Joseph G. Landers
  Published on: 27 April 2016

• Published on: 27 April 2016

  Re: Residence in mountainous compared with lowland areas in relation to total and coronary mortality

  • J.G. Landers

  Dear Editor,

  In this paper the longer survival of inhabitants of Arachova, Greece at 950 metres elevation, compared with 2 lowland villages was ascribed to the exercise enforced by the mountainous terrain.

  There may be an additional explanation to do with food. Hauswirth et al. High w-3 Fatty Acid Content in Alpine Cheese. (Circulation 2004;109:l03-7) report from Switzerland that cheeses from alpine past...

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  Dear Editor,

  In this paper the longer survival of inhabitants of Arachova, Greece at 950 metres elevation, compared with 2 lowland villages was ascribed to the exercise enforced by the mountainous terrain.

  There may be an additional explanation to do with food. Hauswirth et al. High w-3 Fatty Acid Content in Alpine Cheese. (Circulation 2004;109:l03-7) report from Switzerland that cheeses from alpine pastures contain very substantially more cardio-protective and cancer-protective fatty acids than English cheddar, with industrial-type Emmental,alpine cheeses with partial silage-feeding and cheeses from linseed-supplemented cows intermediate in such beneficial fatty acids.

  Of course the chemical composition of typical diets in the 3 Greek villages would need to be studied before the Swiss findings were accepted as applicable there. The implications could be far-reaching: Laments about the abandonment of the traditional Mediterranean diet do not so far take into account that, as thousands of Greeks have moved from the mountains to the lowlands in search of education or work, even when they have continued to eat foods with the accustomed names, the composition of those foods, if from lowland sources, may be less beneficial than in the mountains.

  Baibas et al. also reported the paradox of higher BP, triglyceride and total cholesterol in the mountain village, at odds with the survival advantage there.

  Morcos and Camilo, Int J Vitam Nutr Res 00l;71(5):306-12 gave rats a diet high in fish oils and garlic. Chronically, triglyceride and LDL remained suppressed but total cholesterol and HDL levels increased after initial suppression. Further work in the 3 villages should look at HDL and LDL levels.

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  Conflict of Interest:
  None declared.

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• Published on: 27 April 2016

  Cancer and altitude differences

  • Joseph G. Landers, Retired

  Dear Editor

  In their prospective study, Baibas et al (JECH 2005;59(4):274- 8)showed that, in a Greek mountain village at 950 metres, total mortality and not merely coronary mortality was lower than in two lowland villages. What follows assumes that the cancer figures included within "other causes" follow this pattern.

  In 'Geographic Cancer Risk and Intracellular Potassium/Sodium ratios'.Cancer Detection...

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  Dear Editor

  In their prospective study, Baibas et al (JECH 2005;59(4):274- 8)showed that, in a Greek mountain village at 950 metres, total mortality and not merely coronary mortality was lower than in two lowland villages. What follows assumes that the cancer figures included within "other causes" follow this pattern.

  In 'Geographic Cancer Risk and Intracellular Potassium/Sodium ratios'.Cancer Detection and Prevention 1986;9:171-94, B. Jansson reported a high intracellular K+/Na+ ratio correlating with low cancer mortality. Apart from diet, the favourable ratio of ions is promoted, inter alia at higher altitudes by an effect involving the sodium pump. Among ten studies supportive of altitude-low cancer effects cited by Jansson, several show an altitude effect mainly at sites exposed to air, viz. mouth, esophagus,larynx and lung. Even 250 metres can make a difference. Jansson had ideas about the mechanism possibly involved in this cancer prophylaxis.

  Recent animal studies, if applicable to humans, permit further speculations about a mechanism, viz. relative inhibition of Na+K+ATPase (causing low intracellular K+/Na+) at low altitudes, leading to cell detachment from one another and from substrate (Contreras et al.Journal of Cell Science 1999;112:4223-32).Such detached cells would normally die from the form of apoptosis named anoikis, but if the cells express the activated neurotrophic receptor trkB, via a pathway through PI(3)K and Akt, non-malignant cells can be converted into highly tumorigenic cells (Douma et al.Nature 2004;430:1034-9).One assumes other factors must be present.

  To isolate the contribution to longevity of physical exertion under hypoxia, as proposed by Baibas et al, I suggest studying mortality in towns built on a high plateau, compared with those at similar mean elevations, which are spread up and down a mountainside.

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  Conflict of Interest:
  None declared.

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