Tuesday, September 19, 2017

Taking a break from dieting may improve weight loss


Avoiding continuous dieting may be the key to losing weight and keeping the kilos off, the latest University of Tasmania research shows.

In findings published today in the International Journal for Obesity, School of Health Sciences researchers showed in a randomised controlled trial, that taking a two-week break during dieting may improve weight loss.

The study, funded by the National Health and Medical Research Council (NHMRC) of Australia, investigated the body's 'famine reaction' to continued dieting and its impact on weight loss in men with obesity.

During the study, two groups of participants took part in a 16-week diet which cut calorie intake by one third.

One group maintained the diet continuously for 16 weeks while the other maintained the diet for two weeks, then broke from the diet for two weeks eating simply to keep their weight stable, and repeated this cycle for 30 weeks in total to ensure 16 weeks of dieting.

Those in the intermittent diet group not only lost more weight, but also gained less weight after the trial finished.

The intermittent diet group maintained an average weight loss of 8 kg more than the continuous diet group, six months after the end of the diet.

Head of the University of Tasmania's School of Health Sciences Professor Nuala Byrne, who led the study with a team of collaborators from Queensland University of Technology and the University of Sydney, said dieting altered a series of biological processes in the body, which led to slower weight loss, and possibly weight gain.

"When we reduce our energy (food) intake during dieting, resting metabolism decreases to a greater extent than expected; a phenomenon termed 'adaptive thermogenesis' - making weight loss harder to achieve," Professor Byrne said.

"This 'famine reaction', a survival mechanism which helped humans to survive as a species when food supply was inconsistent in millennia past, is now contributing to our growing waistlines when the food supply is readily available."

Professor Byrne said while researchers in the past had shown that as dieting continued weight loss became more difficult, this latest MATADOR (Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound) study looked more closely at ways to lessen the famine response and improve weight loss success.

However Professor Byrne said while this two-week intermittent diet proved to be a more successful means of weight loss compared with continuous dieting, other popular diets which included cycles of several days of fasting and feasting were not any more effective that continuous dieting.

"There is a growing body of research which has shown that diets which use one to seven day periods of complete or partial fasting alternated with ad libitum food intake, are not more effective for weight loss than conventional continuous dieting," she said.

"It seems that the 'breaks' from dieting we have used in this study may be critical to the success of this approach.

Older adults are aware of medication risks


Geriatrics experts know that certain medications may have risks for older adults that outweigh their benefits, especially when safer alternatives are available. Medications that could be "potentially inappropriate" for older adults are included on recommendation lists that your healthcare provider can consult, such as the American Geriatrics Society (AGS) Beers Criteria or the STOPP-START list.

However, despite these recommendations, 25 percent of older adults take at least one potentially inappropriate medication every year. Taking these medications can increase the risk of being hospitalized due to a medication-related problem. Although 70 percent of older adults are willing to stop taking certain medications, healthcare providers continue to prescribe some potentially inappropriate medicines to older adults.

Researchers from the Institut Universitaire de Gériatrie in Montréal, Canada, designed a survey to learn about older adults' awareness of drug-related health risks. They conducted the survey over the telephone with 2,665 participants, aged 65 or older.
The researchers learned that:
    - 88 percent of the participants had used at least one prescription medication within the last 12 months.- 42 percent of the participants used medicines considered potentially inappropriate for older adults, including:
      Sedative and hypnotic medications, such as tranquilizers and sleeping pillsGlyburide (a type of medicine prescribed for people with diabetes)
      Proton pump inhibitors (medicines prescribed for acid reflux and several other conditions)
    -65 percent of participants knew that some prescriptions could be potentially harmful.
    - 42 percent of participants had discussed stopping one or more prescribed medications with their healthcare provider.
    - Both adults younger than 80 and older adults who were more aware of medication risks were more likely to have conversations with healthcare providers about stopping prescriptions.
    Just 7 percent of participants knew what the term "de-prescribing" meant. De-prescribing is the medical term for your healthcare provider taking you off a prescribed medication to improve your health or reduce the risk for adverse side effects.
    - About half of the survey participants researched information about medications on their own.
The researchers suggested that the more information people have about potential risks associated with their medications, the more likely they may be to discuss reducing potentially inappropriate medications.
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This summary is from "Older Adults' Awareness of Deprescribing: A Population-based Survey." It appears online ahead of print in the Journal of the American Geriatrics Society.

Link between youth football & later-life emotional, behavioral impairment


A new study has found an association between participation in youth tackle football before age 12 and impaired mood and behavior later in life. The study appears in Nature's Translational Psychiatry.

Researchers from Boston University's Chronic Traumatic Encephalopathy (CTE) Center studied 214 former American football players, including 43 who played only through high school and 103 who played only through college. The average age of the former players at the time of the study was 51. Participants received telephone-administered cognitive tests and completed online measures of depression, behavioral regulation, apathy and executive functioning (initiating activity, problem-solving, planning and organization).

Results from former players who started playing tackle football before the age of 12 were compared against those of participants who started playing at age 12 or later.

The study showed that participation in youth football before age 12 increased the risk of problems with behavioral regulation, apathy and executive functioning by two-fold and increased the risk of clinically elevated depression scores by three-fold. The increased risk was independent of the total number of years the participants played football, the number of concussions they reported, or whether they played through high school, college or professionally.

The researchers chose the cutoff of age 12 because the brain undergoes a key period of development and maturation between the years 10-12 in males. They examined other age cutoffs as well, though the age 12 cutoff led to the most robust findings. In addition, even when a specific age cutoff was not used, younger age of first exposure to football was associated with worse clinical function.

The new study follows previous research from the BU CTE Center that examined former professional players. In those studies, the former NFL players who started tackle football prior to age 12 had worse memory and mental flexibility, as well as structural brain changes on MRI scans, compared to former players who began at age 12 or older.

Comprehensive meta-analysis affirms cranberries' role in promoting a healthy urinary tract


A thorough review of dozens of studies led scientists to conclude that healthcare professionals should be telling their patients to have cranberry products as a first step in reducing recurrent UTIs. The comprehensive meta-analysis and assessment of human clinical trials, published in the official journal of the American Urological Association, The Journal of Urology®, assures practitioners and their patients that cranberry products are a low cost, low risk and effective way to help prevent recurrent UTIs.

To answer the question, "Can Cranberries Contribute to Reduce the Incidence of Urinary Tract Infections?" a total of 28 studies showing results from nearly 5,000 patients were considered. Authors found a statistically significant risk reduction in repeat UTIs overall, but not significant for any particular subgroup. However, patients with recurrent UTIs who ingested cranberry products and had undergone gynecological surgery, experienced a significant reduction in UTIs.

"Our investigation supports that cranberry products can be a powerful tool to fight off frequent UTIs," explains lead author, Dr. Ângelo Luís. "While recommendations for dosage and duration of treatment require further study, the efficacy of the medicinal properties of cranberry products has been well-established."

The review explains that the medicinal properties of cranberries may be attributed to their unique polyphenol, proanthocyanidins - or PACs, for short. Their ability to keep infection-causing bacteria from sticking to the urinary tract walls may be the major reason for their effectiveness in limiting infection growth and recurrence.

According to the authors, scientists and practitioners continue to explore the use of alternative therapies in the prevention of common infections as part of the global movement to reduce antibiotic use and resistance. It is estimated that one third of women in the United States will get a UTI by the age of 24.]

Sleep deprivation is an effective anti-depressant for nearly half of depressed patients

Sleep deprivation -- typically administered in controlled, inpatient settings -- rapidly reduces symptoms of depression in roughly half of depression patients, according the first meta-analysis on the subject in nearly 30 years, from researchers at the Perelman School of Medicine at the University of Pennsylvania. Partial sleep deprivation (sleep for three to four hours followed by forced wakefulness for 20-21 hours) was equally as effective as total sleep deprivation (being deprived of sleep for 36 hours), and medication did not appear to significantly influence these results.
The results are published today in the Journal of Clinical Psychiatry.

Although total sleep deprivation or partial sleep deprivation can produce clinical improvement in depression symptoms within 24 hours, antidepressants are the most common treatment for depression. Such drugs typically take weeks or longer to experience results, yet 16.7 percent of 242 million U.S. adults filled one or more prescriptions for psychiatric drugs in 2013. The findings of this meta-analysis hope to provide relief for the estimated 16.1 million adults who experienced a major depressive episode in 2014.

Previous studies have shown rapid antidepressant effects from sleep deprivation for roughly 40-60 percent of individuals, yet this response rate has not been analyzed to obtain a more precise percentage since 1990 despite more than 75 studies since then on the subject.

"More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results," said study senior author Philip Gehrman, PhD, an associate professor of Psychiatry and member of the Penn Sleep Center, who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. "Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered."

Reviewing more than 2,000 studies, the team pulled data from a final group of 66 studies executed over a 36 year period to determine how response may be affected by the type and timing of sleep deprivation performed (total vs early or late partial sleep deprivation), the clinical sample (having depressive or manic episodes, or a combination of both), medication status, and age and gender of the sample. They also explored how response to sleep deprivation may differ across studies according to how "response" is defined in each study.

"These studies in our analysis show that sleep deprivation is effective for many populations," said lead author Elaine Boland, PhD, a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Center. "Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate."

The authors note that further research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Also, future studies are needed to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation.

Increased physical activity boosts cognition


It is estimated that up to 75 percent of breast cancer survivors experience problems with cognitive difficulties following treatments, perhaps lasting years. Currently, few science-based options are available to help. In the journal Cancer, University of California San Diego School of Medicine researchers report in a pilot study of 87 female breast cancer survivors, an increase in physical activity more than doubled the women's post-treatment mental processing speed.

In a 12-week, randomized trial, half the women were enrolled in a physical activity intervention program tailored to each person's interests and abilities and incorporating wearable activity devices, while the other half were assigned to a control group that received emails addressing women's health topics, healthy eating, stress reduction and general brain health.

"Whether or not they receive chemotherapy, many breast cancer survivors experience a decline in brain function that impacts memory, thinking and concentration," said Sheri Hartman, PhD, assistant professor in the Department of Family and Preventive Medicine and co-director of the diet and physical activity shared resource at UC San Diego Moores Cancer Center. "The women who participated in the physical activity intervention experienced a significant improvement in cognitive processing speed and some improvements in their perceived mental abilities. This study supports the idea that exercise could be a way to help improve cognition among breast cancer survivors."

The study tested changes in cognition using both National Institutes of Health (NIH) Toolbox Cognition Domain, a computer-based test of cognitive abilities, and the Patient Reported Outcomes Measurement Information System for self-reporting brain function abilities and problems in all patients at the start and end of the 12-week period. This is the first completed randomized controlled trial using both a test of cognition and a self-reported method to assess the impact of physical activity on cancer survivors.

In the tests, women in the exercise arm showed more than double the improvements in processing speed, which measures how fast information can be taken in and used, compared to the control group. Looking closer, women in the intervention arm who were two years or less from diagnosis were four times more likely to show improvement in this area.

"This is a preliminary study, but it appears that intervening closer to diagnosis may be important to having an impact, and this is the population we may need to target," said Hartman.

Women in the intervention arm also had three times the improvements in self-report cognition abilities compared to the control group.

While the tests evaluated several aspects of cognition, only speed processing showed a significant improvement. Researchers recommend larger and longer trials evaluating the necessary duration of exercise and intensity of activities to determine if increased physical activity might impact other aspects of cognition.

Before the start of the study, all participants wore a research-grade accelerometer on their hips for seven days to measure physical activity at baseline and again for the last seven days of the trial to compare changes in minutes of moderately intense activity.

During the study period, women in the exercise arm wore a Fitbit One activity tracker. Data collected was sent to researchers to extract activity levels and to provide feedback and encouragement to engage in at least 150 minutes of moderate-to-vigorous physical activity per week, as recommended by the NIH. Researchers provided support through phone calls and emails.

"Survivors often report that their thinking is slower or feels more foggy. The brain just doesn't work at the same level as before cancer treatment," said Hartman. "By providing a program with support, women are more likely to make difficult behavioral changes that lead to an increase in physical activity."

The intervention program led to an approximately 100-minute increase in weekly physical activity in the participants in the exercise arm.

Participants were enrolled in the study between February 2015 and July 2016. To be eligible, women needed to be between 21 and 85 years of age and have been diagnosed and treated for breast cancer no more than five years before enrollment in the study. Participants were predominantly well-educated, non-Hispanic white women. Future research in cancer populations with greater diversity is needed, the authors said.

Monday, September 18, 2017

Diet is one of the strongest predictors of type 2 diabetes risk in older wome



A pioneering method, developed at Chalmers University of Technology, has demonstrated its potential in a large study, showing that metabolic fingerprints from blood samples could render important new knowledge on the connection between food and health. The study finds that diet is one of the strongest predictors of type 2 diabetes risk in older women.

Researchers from Chalmers University of Technology and Sahlgrenska Academy, University of Gothenburg, have found that several diet and nutrient biomarkers -- molecules that can be measured in blood that are related to diet -- are linked with both risk to have type 2 diabetes and future risk of developing diabetes.

The study, published in the leading nutrition research journal American Journal of Clinical Nutrition, was carried out on 600 women from Gothenburg where diagnosis of diabetes was made at the start of the study, at their age 64, and again after 5 ½ years.

The results underline that diet is an important factor when it comes to risk for developing type 2 diabetes, with fish, whole grains, vegetable oils and good vitamin E status found to be protective against type 2 diabetes, while red meat and saturated fat increased the risk for developing the disease.

"What is really important is that we were able to reach these conclusions without having any additional information on diet from the subjects," said lead author Doctor Otto Savolainen, who works at the Division of Food and Nutrition Science and the Chalmers Mass Spectrometry Infrastructure at Chalmers University of Technology.

The blood samples were analysed at Chalmers, where a unique metabolic fingerprint, including many different diet biomarkers, could be linked to each woman at the specific time the sample was taken. Using this method it was possible for the first time to objectively determine the impact of key dietary components on future type 2 diabetes risk, as well as to find differences in dietary patterns between women with and without type 2 diabetes.

"Collecting information about diet can be complicated and time consuming, and is always biased by what people remember and think they should report. Dietary biomarkers don't have this problem, and highlight that dietary recommendations to avoid red meat and saturated fat and increase intake of plant-based oils and whole grains do seem to hold true, at least in this group of women," says Associate Professor Alastair Ross, responsible senior researcher at Chalmers, at the Division of Food and Nutrition Science.

"The new method has allowed us to measure several markers of diet and nutrient status at the same time in a large number of people, which we believe is the first time this has been done," he says.

Although the role of diet is often discussed as a preventive measure for developing type 2 diabetes, this new research provides strong support for dietary guidelines, and underlines the importance of changing diet to improve health.

"New methods such as ours will help to improve how we measure diet and understand in more detail how dietary patterns relate to disease," says Alastair Ross.