Tuesday, June 18, 2019

Adequate protein intake associates with lower risk of frailty



Adequate intake of protein is associated with a reduced risk of frailty and prefrailty in older women, according to a new study from the University of Eastern Finland and Kuopio University Hospital. Adequate protein intake was defined as at least 1.1 g per kg of body weight. The findings were published in European Journal of Nutrition.
Frailty is a multidimensional condition common in older adults, and those affected are at an elevated risk of dependence and mobility loss, fall, fracture, multimorbidity and mortality. Evidence shows a strong link between frailty and malnutrition, and protein may be the most important nutrient at play, mostly through its effect on muscle health. The Nordic Nutrition Recommendations (2012) suggest protein intake of 1.1-1.3 g per kg of body weight as adequate for preserving physical capacity in older adults. However, there is a paucity of data regarding the association of protein intake with frailty. The newly published study examined associations between protein intake and protein sources with frailty status in older women.
Participants were 440 women aged 65--72 years enrolled in the Osteoporosis Risk Factor and Prevention-Fracture Prevention Study. Their protein intake in g per kg of body weight was calculated using a three-day food record at baseline in 2003--2004. At the three-year follow-up in 2006--2007, frailty phenotype was defined as the presence of three or more, and prefrailty as the presence of one or two of the Fried criteria: low grip strength, low walking speed, low physical activity, exhaustion (defined using a low life satisfaction score), and weight loss of more than five per cent.
The study shows that getting the recommended amount of dietary protein was associated with a lower risk of frailty and prefrailty in older women. Moreover, the consumption of animal protein was associated with a lower likelihood of frailty. The recommended protein intake (1.1-1.3 g per kg of body weight) for an older person weighing 70 kg corresponds to a minimum intake of 77 g of protein. To illustrate, the protein content of a chicken breast per portion is 25 g, one boiled egg 6 g, and two slices of whole grain bread 6 g.
"The public health recommendation is to eat an optimal diet with an adequate intake of protein. Adequate protein intake is important for muscle health and, according to the new results, may also prevent frailty. However, further research is still required in this area," Senior Lecturer Arja Erkkilä from the University of Eastern Finland concludes.

Food neophobia may increase the risk of lifestyle diseases


Food neophobia, or fear of new foods, may lead to poorer dietary quality, increase the risk factors associated with chronic diseases, and thus increase the risk of developing lifestyle diseases, including cardiovascular diseases and type 2 diabetes.
These are some of the findings of a study conducted by the Finnish National Institute for Health and Welfare, the University of Helsinki, and the University of Tartu in Estonia.
Food neophobia is an eating behaviour trait in which a person refuses to taste and eat food items or foods they are not familiar with. The study examined the independent impact of eating behaviour, and especially food neophobia, on dietary quality as well as lifestyle diseases and their risk factors. So far, little research has been carried out on this area.
The study monitored individuals aged between 25 and 74 years in the Finnish FINRISK and DILGOM cohorts and an Estonian biobank cohort during a seven-year follow-up.
Food neophobia is hereditary
Food neophobia has been observed to be a strongly hereditary trait: twin studies have found that up to 78% of it may be hereditary. The trait can be easily measured using the FNS questionnaire (Food Neophobia Scale), which contains ten questions charting the respondent's eating behaviour. The FNS questionnaire was also used to measure and quantify the fear of new foods in this study.
Food neophobia is common in children and older persons, in particular. Few studies have so far been carried out on food neophobia in the adult population.
Traits similar to food neophobia, including picky and fussy eating, also occur in different age groups in the population. These eating behaviours may also have a significant impact on dietary quality and subsequently health. As different traits associated with eating behaviours have overlapping characteristics making a clear-cut distinction between them is challenging.
Food neophobia has independent health impacts
The study found that food neophobia is linked to poorer dietary quality: for example, the intake of fibre, protein and monounsaturated fatty acids may be lower and the intake of saturated fat and salt greater in food neophobic individuals.
Additionally, a significant association was found between food neophobia and adverse fatty acid profile and increased level of inflammatory markers in blood. Subsequently, food neophobia also increases the risk of developing cardiovascular diseases or type 2 diabetes.
It is often thought that the impacts of eating behaviour and diet on health are mainly mediated through weight changes alone. In this study, however, the impacts of food neophobia emerged independently regardless of weight, age, socioeconomic status, gender or living area.
Your parents were right: you should always try all foods!
"The findings reinforce the idea that a versatile and healthy diet plays a key role, and even has an independent role in health. If we can intervene in deviant eating behaviours, such as food neophobia, already in childhood or youth. This will help to prevent potential future health problems early on", says Research Professor Markus Perola from the National Institute for Health and Welfare.
"Hereditary factors and our genotype only determine our predisposition to food neophobia. Early childhood education and care and lifestyle guidance in adulthood can provide support in the development of a diverse diet."

Monday, June 17, 2019

Poor oral health linked to a 75% increase in liver cancer risk


A new study, by researchers at Queen's University Belfast, analysed a large cohort of over 469,000 people in the UK, investigated the association between oral health conditions and the risk of a number of gastrointestinal cancers, including liver, colon, rectum and pancreatic cancer. Models were applied to estimate the relationship between cancer risk and self-reported oral health conditions, such as painful or bleeding gums, mouth ulcers and loose teeth. Whilst no significant associations were observed on the risk of the majority gastrointestinal cancers and poor oral health, a substantial link was found for hepatobiliary cancer.
"Poor oral health has been associated with the risk of several chronic diseases, such as heart disease, stroke and diabetes", explained Dr Haydée WT Jordão, from the Centre of Public Health at Queen's University Belfast and lead author of the study. "However, there is inconsistent evidence on the association between poor oral health and specific types of gastrointestinal cancers, which is what our research aimed to examine."
Of the 469,628 participants, 4,069 developed gastrointestinal cancer during the (average) six-year follow up. In 13% of these cases, patients reported poor oral health. Participants with poor oral health were more likely to be younger, female, living in deprived socioeconomic areas and consumed less than two portions of fruit and vegetables per day.
The biological mechanisms by which poor oral health may be more strongly associated with liver cancer, rather than other digestive cancers, is currently uncertain. One explanation is the potential role of the oral and gut microbiome in disease development. "The liver contributes to the elimination of bacteria from the human body", stated Dr Haydée WT Jordão. "When the liver is affected by diseases, such as hepatitis, cirrhosis or cancer, its function will decline and bacteria will survive for longer and therefore have the potential to cause more harm. One bacteria, Fusobacterium nucleatum, originates in the oral cavity but its role in liver cancer is unclear. Further studies investigating the microbiome and liver cancer are therefore warranted."
Another theory in explaining the higher cancer risk due to poor oral health suggests that participants with a high number of missing teeth may alter their diet, consuming softer and potentially less nutritious foods, which in turn influence the risk of liver cancer2.
Liver cancer is the sixth bigger cancer killer in the EU, claiming the lives of almost 60,000 people per year3. The five-year survival rate for the disease across Europe is just 11%4 and approximately 9 in 10 cases are in individuals over the age of 55 ref media pack3. It is believed that up to half of cases of liver cancer are preventable, with risk factors often relating to lifestyle, such as overweight or obesity, smoking and alcohol consumption.

Friday, June 14, 2019

Lower risk of Type 1 diabetes seen in children vaccinated against 'stomach flu' virus x



Vaccinating babies against a virus that causes childhood "stomach flu" greatly reduces their chance of getting so sick that they need hospital care, a new study shows.
But the study also reveals a surprise: Getting fully vaccinated against rotavirus in the first months of life is associated with a lower risk of developing Type 1 diabetes later on.
As a group, children who received all recommended doses of rotavirus vaccine had a 33 percent lower risk than unvaccinated children of getting diagnosed with type 1 diabetes -- a lifelong disease with no known prevention strategies or cure.
A team from the University of Michigan made the finding using nationwide health insurance data, and published their results in the journal Scientific Reports.
The study provides strong post-market evidence that the vaccine works. Children vaccinated against rotavirus had a 94 percent lower rate of hospitalization for rotavirus infection, and a 31 percent lower rate of hospitalization for any reason, in the first two months after vaccination. Rotavirus hits infants and toddlers hardest; it can cause diarrhea and vomiting that can lead to dehydration or loss of fluids.
Yet the study finds more than a quarter of American children don't get fully vaccinated against rotavirus, and that the rate varies widely across the country. Less than half of children in New England and Pacific states were fully vaccinated. Two-thirds of children in the central part of the country were fully vaccinated.
The Centers for Disease Control and Prevention recommends that infants receive the multi-dose vaccine starting no later than 15 weeks, and finish receiving it before they are eight months old. Infants receive the vaccine in oral drops.
Type 1 diabetes relationship
The paper's authors, led by epidemiologist Mary A.M. Rogers, Ph.D., caution that they cannot show a cause-and-effect relationship between rotavirus vaccination and Type 1 diabetes risk.
"This is an uncommon condition, so it takes large amounts of data to see any trends across a population," says Rogers, an associate professor in the U-M Department of Internal Medicine. "It will take more time and analyses to confirm these findings. But we do see a decline in Type 1 diabetes in young children after the rotavirus vaccine was introduced."
The new result echoes the findings of a study of Australian children published earlier this year, which found a 14 percent reduced risk of Type 1 diabetes after the rotavirus vaccine was introduced in that country. That study, and the new one, suggest that a childhood vaccine may lead to a lower risk of a later chronic condition.
It also fits with laboratory studies showing that rotavirus attacks the same kind of pancreas cells that are affected in people with Type 1 diabetes.
The death of insulin-producing cells, called beta cells, means people with Type 1 diabetes depend on injections of insulin, and multiple daily checks of their blood sugar, for life. If the condition is not managed well, people with Type 1 diabetes may develop problems with their kidneys, heart, eyes, blood vessels and nerves over time.
Data-driven discovery
The U-M team used anonymous insurance data from 1.5 million American children born before and after the modern rotavirus vaccine was introduced in 2006. In nearly all cases, the vaccine was free, with no copayment, to the family of the infant. The total lifetime cost of caring for an individual with Type 1 diabetes has been estimated in the millions of dollars.
The risk was especially lower among children who received all three doses of the pentavalent form of the vaccine than those who received two doses of the monovalent form. The pentavalent rotavirus vaccine protects against 5 types of the rotavirus while the monovalent vaccine protects against 1 type.
Children partially vaccinated -- that is, started the vaccine series but never finished it -- did not have a lower risk of Type 1 diabetes.
More than 540,000 of the children in the study and born after 2006 received the complete series of rotavirus shots; nearly 141,000 received at least one dose, and more than 246,000 did not.
Another comparison group, born in the five years before the vaccine was available, included nearly 547,000 children.
In absolute terms, Rogers and her colleagues report that eight fewer cases of Type 1 diabetes would be expected to occur for every 100,000 children each year with full vaccination.
Type 1 diabetes, once called "juvenile diabetes," only affects a few children out of every 100,000, so having such a large pool of data can help spot trends, says Rogers, an epidemiologist who worked with internist Catherine Kim, M.D., M.P.H. and statistician Tanima Basu, M.S. Rogers and Kim are members, and Basu is a staff member, of the U-M Institute for Healthcare Policy and Innovation, which provided the data used in the study.
"Five years from now, we will know much more," says Rogers. "The first groups of children to receive the rotavirus vaccine in the United States are now in grade school, when Type 1 diabetes is most often detected. Hopefully, in years to come, we'll have fewer new cases -- but based on our study findings, that depends upon parents bringing in their children to get vaccinated."

Thursday, June 13, 2019

Two hours a week is key dose of nature for health and wellbeing



Spending at least two hours a week in nature may be a crucial threshold for promoting health and wellbeing, according to a new large-scale study.
Research led by the University of Exeter, published in Scientific Reports and funded by NIHR, found that people who spend at least 120 minutes in nature a week are significantly more likely to report good health and higher psychological wellbeing than those who don't visit nature at all during an average week. However, no such benefits were found for people who visited natural settings such as town parks, woodlands, country parks and beaches for less than 120 minutes a week.
The study used data from nearly 20,000 people in England and found that it didn't matter whether the 120 minutes was achieved in a single visit or over several shorter visits. It also found the 120 minute threshold applied to both men and women, to older and younger adults, across different occupational and ethnic groups, among those living in both rich and poor areas, and even among people with long term illnesses or disabilities.
Dr Mat White, of the University of Exeter Medical School, who led the study, said: "It's well known that getting outdoors in nature can be good for people's health and wellbeing but until now we've not been able to say how much is enough. The majority of nature visits in this research took place within just two miles of home so even visiting local urban greenspaces seems to be a good thing. Two hours a week is hopefully a realistic target for many people, especially given that it can be spread over an entire week to get the benefit."
There is growing evidence that merely living in a greener neighbourhood can be good for health, for instance by reducing air pollution. The data for the current research came from Natural England's Monitor of Engagement with the Natural Environment Survey, the world's largest study collecting data on people's weekly contact with the natural world.
Co-author of the research, Professor Terry Hartig of Uppsala University in Sweden said: "There are many reasons why spending time in nature may be good for health and wellbeing, including getting perspective on life circumstances, reducing stress, and enjoying quality time with friends and family. The current findings offer valuable support to health practitioners in making recommendations about spending time in nature to promote basic health and wellbeing, similar to guidelines for weekly physical".

Low vitamin K levels linked to mobility limitation and disability in older adults



Low levels of circulating vitamin K are linked to increased risk of mobility limitation and disability in older adults, identifying a new factor to consider for maintaining mobility and independence in older age, according to a study led by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.
The study, published online in May in advance of print in the Journal of Gerontology: Medical Sciences, is the first to evaluate the association between biomarkers of vitamin K status and the onset of mobility limitation and disability in older adults.
"Because of our growing population of older people, it's important for us to understand the variety of risk factors for mobility disability," said Kyla Shea, first and corresponding author and a nutrition scientist in the Vitamin K Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University.
"Low vitamin K status has been associated with the onset of chronic diseases that lead to disability, but the work to understand this connection is in its infancy. Here, we're building on previous studies that found that low levels of circulating vitamin K are associated with slower gait speed and a higher risk of osteoarthritis," she continued.
The new study examined two biomarkers: circulating levels of vitamin K (phylloquinone) and a functional measure of vitamin K (plasma ucMGP). Using participant data from the Health, Aging, and Body Composition Study (Health ABC), the study found that older adults with low levels of circulating vitamin K were more likely to develop mobility limitation and disability. The other biomarker, plasma ucMGP, did not show clear associations with mobility limitation and disability.
Specifically, older adults with low circulating vitamin K levels were nearly 1.5 times more likely to develop mobility limitation and nearly twice as likely to develop mobility disability compared to those with sufficient levels. This was true for both men and women.
"The connection we saw with low levels of circulating vitamin K further supports vitamin K's association with mobility disability," said senior author Sarah Booth, a vitamin K and nutrition researcher, and director of the HNRCA. "Although the two biomarkers we looked at are known to reflect vitamin K status, biomarker levels can also be affected by additional known or unknown factors. Further experiments to understand the mechanisms of biomarkers and vitamin K and their role in mobility are needed."
The study used data from 635 men and 688 women ages 70-79 years old, approximately 40 percent of whom were black, who participated in Health ABC. In Health ABC, mobility was assessed every six months for six to ten years through annual clinic visits and phone interviews in the intervening time. For the present analysis, the researchers defined mobility limitation as two consecutive semi-annual reports of having any amount of difficulty either with walking a quarter of a mile or climbing 10 steps without resting, and mobility disability as two consecutive semi-annual reports of having a lot of difficulty or inability to walk or climb the same amount.
Circulating vitamin K levels reflect the amount of vitamin K in the diet. The best food sources of vitamin K include leafy greens such as spinach, kale and broccoli and some dairy products. For an average adult, one cup of raw spinach provides 145 micrograms (mcg) of vitamin K1, or 181 percent of the Daily Value; one cup of raw kale provides 113 mcg, or 141 percent; and half of a cup of chopped boiled broccoli provides 110 mcg, or 138 percent.

Low-carb Mediterranean diet had a greater effect on reducing fat around the liver, heart and the pancreas, compared to low-fat diets


A research team led by Ben-Gurion University of the Negev (BGU) Prof. Iris Shai has published a significant long-term study on the impact of Mediterranean and low-carb diets and exercise, measuring their impact with magnetic resonance imaging (MRI) technology to map body fat.
In the study, "The Beneficial Effects of Mediterranean Diet Over Low-fat Diet May Be Mediated by Decreasing Hepatic Fat Content," published in the Journal of Hepatology, researchers conducted full-body MRI scans of 278 obese subjects, mapping their fat deposits before, during and after the 18-month trial period to analyze the effects of various diet regimes on body fat distribution.
The CENTRAL trial is a randomized, controlled trial conducted at BGU in collaboration with the Dimona Nuclear Research Center and Soroka University Medical Center in Israel, as well as Harvard University and Leipzig University in Germany.
The study showed that a low-carb Mediterranean diet had a greater effect on reducing fat around the liver, heart and the pancreas, compared to low-fat diets with similar calorie counts, although the weight loss was similar. The team also found that moderate physical exercise reduced the amount of visceral fat stored around the stomach.
The researchers reported that the dramatic 30% reduction in liver fat combined with moderate weight loss is a key element in reducing health risks associated with obesity over the long term. High hepatic fat content is associated with metabolic syndrome, type 2 diabetes mellitus and coronary heart disease. Together with moderate weight loss, fat around the heart decreased by 11% (about 70 cc reduction in volume) and visceral fat was reduced by 25%. Pancreatic and muscle fat was reduced by only 1 to 2%.
"Reduction in liver fat is a better predictor of long-term health than reduction of visceral fat, which was previously believed to be the main predictor," according to Prof. Shai, a member of BGU's S. Daniel Abraham International Center for Health and Nutrition and School of Public Health. "The findings are a significant contributor to the emerging understanding that for many obese individuals, excess liver fat is not merely a sign of health risks associated with obesity, including cardiovascular disease and diabetes, but is likely also a cause."
The research team tested the significance of reducing liver fat (in contrast to visceral fat) by comparing the results of some 278 overweight people who followed two reduced-calorie diet regimes: a Mediterranean diet and a low-fat diet. Following the subjects for 18 months demonstrated that changing their respective nutrition habits was consistent with the trial groups to which they were randomly assigned.
"Healthy nutrition, while also maintaining consistent, moderate weight loss, has a much more dramatic impact on levels of body fat related to diabetes, heart disease and cardiovascular disease than we previously thought," Prof. Shai says.
The CENTRAL study has achieved significant breakthroughs toward developing personalized nutritional protocols to address a variety of specific fat deposits using MRI technology, the most precise method currently available for mapping and quantifying fat deposits throughout the human body and for understanding their significance and the role they play.
The CENTRAL study, unprecedented in both its length and breadth, contributes a vast database, consisting of thousands of body images, for finding and mapping fat deposits in the human body. During a person's lifetime, fat cells move between body parts and that fat plays a variety of health roles, from defense to neutral to poisonous. By following the extent and breadth of these changes over time, the researchers, who have developed technologies to quantify specific types of fats, have now paved the way for deeper, more precise understanding of the dynamics of weight loss during a diet period.