Skipping Breakfast Can Lead to Unhealthy Habits All Day Long

Compared to breakfast-eaters, breakfast-skippers tend to weigh more and have other unhealthy habits, such as consuming too many sugary drinks or high-calorie snacks, according to a panel discussion during a symposium at the Institute of Food Technologists (IFT) 2012 Annual Meeting & Food Expo.

Research shows about 18 percent of Americans older than age 2 regularly skip breakfast, said Nancy Auestad, PhD, vice president of regulatory affairs at the Dairy Research Institute. They are missing out on key nutrients, she said, pointing to statistics that show breakfast-eaters get about 17 percent of their daily calories from breakfast as well as a significant portion of their daily recommend intake of several key nutrients, such as Vitamin D (58 percent), Vitamin B12 (42 percent) and Vitamin A (41 percent).

In addition, studies of young people found that breakfast-skippers consume 40 percent more sweets, 55 percent more soft drinks, 45 percent fewer vegetables and 30 percent less fruit than people who eat breakfast.

“Most of these negative factors were abbreviated when breakfast was consumed, compared with breakfast-skippers,” said Heather Leidy, PhD, assistant professor in the department of nutrition and exercise physiology at the University of Missouri. “Targeting that behavior could lead to a reduction in obesity.”

Leidy conducted research focusing on the role of protein in breakfast, and she found that the effects of breakfast-skipping were felt throughout the day. She assembled a group of 10 breakfast-skipping teenagers and split them into groups that consumed no breakfast, a normal-protein breakfast and a high-protein breakfast. By measuring their hunger levels and several other indicators, she found that eating a healthy breakfast of any kind lead to more satiety and less overeating throughout the day, but these benefits were especially prominent among the teens who ate the high-protein breakfast. They consumed about 200 calories less in evening snacking, she said.

Her study also used magnetic resonance imaging to determine that a protein-rich breakfast reduces the brain signals controlling food desires, even many hours after breakfast.

Despite the benefits of consistently eating breakfast, all the participants in Leidy’s study went back to being breakfast-skippers within six months, citing the lack of available healthy, high-protein foods. This means the food industry has to work to create more of these options to fit into the lifestyle of busy kids and adults.

Menopausal women could 'work out' their hot flashes

Menopausal women who exercise may experience fewer hot flashes in the 24 hours following physical activity, according to health researchers.

In general, women who are relatively inactive or are overweight or obese tend to have a risk of increased symptoms of perceived hot flashes, noted Steriani Elavsky, assistant professor of kinesiology at Penn State.

Perceived hot flashes do not always correspond to actual hot flashes. Most previous research analyzed only self-reported hot flashes. This is the first study known to the researchers to look at objective versus subjective hot flashes.

Elavsky and colleagues studied 92 menopausal women for 15 days. The women recruited for this study were different from many earlier menopause studies, said Elavsky. In the past, women in menopause studies were experiencing severe symptoms and seeking help. They were probably not representative of the general population.

"Our sample included women with mild to moderate symptoms and they were recruited for a study of physical activity, not for a study of menopause," said Elavsky. "We recruited women residing in the community. We used recruitment sources that included a variety of outlets in the community frequented by women, like libraries, fairs, gyms, advertisements in local newspapers, etc."

The women were 40 to 59 years old, with an average of two children and were not on hormone therapy. During analysis the researchers separated the women into normal weight and overweight/obese categories and higher fit and lower fit categories. These categories were not necessarily mutually exclusive.

The participants wore accelerometers to monitor their physical activity and also wore monitors that measured skin conductance, which varies with the moisture level of the skin. Each participant recorded the individual hot flashes she had throughout the 15-day period on a personal digital assistant.

Through these two methods of recording hot flashes, the researchers found the frequency of objective and subjective hot flashes. Objective hot flashes occurred when the monitor recorded them; subjective hot flashes occurred when the woman reported them. When an objective and a subjective hot flash were recorded within five minutes of each other, it was considered a "true positive" hot flash, the researchers report in the current issue of Menopause.

"Some physiological explanations would suggest that performing physical activity could increase hot flashes because it acutely increases body core temperature," said Elavsky.

To the contrary, the researchers found that this premise was not true, as on average the women in the study experienced fewer hot flash symptoms after exercising. However, the women who were classified as overweight, having a lower level of fitness or were experiencing more frequent or more intense hot flashes, noticed the smallest reduction in symptoms.

It is not yet known if a woman could use diet and exercise to lose weight and become more fit and therefore experience fewer hot flashes, but it is a possibility worthy of future investigation, noted the researchers.

"For women with mild to moderate hot flashes, there is no reason to avoid physical activity for the fear of making symptoms worse," said Elavsky. "In fact, physical activity may be helpful, and is certainly the best way to maximize health as women age. Becoming and staying active on a regular basis as part of your lifestyle is the best way to ensure healthy aging and well being, regardless of whether you experience hot flashes or not."

Also working on this research were Joaquin U. Gonzales, assistant professor of exercise physiology, Texas Tech University; David N. Proctor and Nancy I. Williams, both professors of kinesiology and physiology, Penn State; and Victor W. Henderson, professor of health research and policy and neurology and neurological sciences, Stanford University.

Dietary fiber alters gut bacteria, supports gastrointestinal health

A University of Illinois study shows that dietary fiber promotes a shift in the gut toward different types of beneficial bacteria. And the microbes that live in the gut, scientists now believe, can support a healthy gastrointestinal tract as well as affect our susceptibility to conditions as varied as type 2 diabetes, obesity, inflammatory bowel disease, colon cancer, and autoimmune disorders such as rheumatoid arthritis.

As these microbes ferment fiber in the intestine, short-chain fatty acids and other metabolites are produced, resulting in many health benefits for the host, said Kelly Swanson, a U of I professor of animal sciences.

"When we understand what kinds of fiber best nurture these health-promoting bacteria, we should be able to modify imbalances to support and improve gastrointestinal health," he said.

This research suggests that fiber is good for more than laxation, which means helping food move through the intestines, he added.

"Unfortunately, people eat only about half of the 30 to 35 grams of daily fiber that is recommended. To achieve these health benefits, consumers should read nutrition labels and choose foods that have high fiber content," said Swanson.

In the placebo-controlled, double-blind intervention study, 20 healthy men with an average fiber intake of 14 grams a day were given snack bars to supplement their diet. The control group received bars that contained no fiber; a second group ate bars that contained 21 grams of polydextrose, which is a common fiber food additive; and a third group received bars with 21 grams of soluble corn fiber.

On days 16-21, fecal samples were collected from the participants, and researchers used the microbial DNA they obtained to identify which bacteria were present. DNA was then subjected to 454 pyrosequencing, a "fingerprinting" technique that provides a snapshot of all the bacterial types present.

Both types of fiber affected the abundance of bacteria at the phyla, genus, and species level. When soluble corn fiber was consumed, Lactobacillus, often used as a probiotic for its beneficial effects on the gut, increased. Faecalibacterium populations rose in the groups consuming both types of fiber.

According to Swanson, the shifts in bacteria seen in this study—which occurred when more and differing types of fiber were consumed—were the opposite of what you would find in a person who has poor gastrointestinal health. That leads him to believe that there are new possibilities for using pre- and probiotics to promote intestinal health.

"For example, one type of bacteria that thrived as a result of the types of fiber fed in this study is inherently anti-inflammatory, and their growth could be stimulated by using prebiotics, foods that promote the bacteria's growth, or probiotics, foods that contain the live microorganism," he said.

Caffeine boosts power for elderly muscles

A new study to be presented at the Society for Experimental Biology meeting on 30th June has shown that caffeine boosts power in older muscles, suggesting the stimulant could aid elderly people to maintain their strength, reducing the incidence of falls and injuries.

For adults in their prime, caffeine helps muscles to produce more force. But as we age, our muscles naturally change and become weaker.

Sports scientists at Coventry University looked for the first time at whether these age-related changes in muscle would alter the effect of caffeine. They found that caffeine continued to enhance muscle performance in two different muscles from mice, although it was less effective in older muscles.

Jason Tallis, the study's primary author, said: "Despite a reduced effect in the elderly, caffeine may still provide performance-enhancing benefits."

For adults in their prime, caffeine helps muscles to produce more force. But as we age, our muscles naturally change and become weaker. So, sports scientists at Coventry University looked for the first time at whether these age-related changes in muscle would alter the effect of caffeine.

Caffeine's effect was smallest for juvenile muscles, suggesting caffeine may not have an enhancing effect in developing muscles.

The decline in muscle strength that occurs as we age contributes to injuries and reduces quality of life. The process is not well understood, but it is clear that preserving muscle tone is key.

Tallis said: "With the importance of maintaining a physically active lifestyle to preserve health and functional capacity, the performance-enhancing benefit of caffeine could prove beneficial in the aging population."

The researchers isolated muscles from mice ranging in age from juvenile to elderly, then tested their performance before and after caffeine treatment. They looked at two different skeletal muscles, which are the muscles we can control voluntarily. The first was the diaphragm, a core muscle used for respiration; the second was a leg muscle called the extensor digitorum longus (EDL), used for locomotion.

Why a diet high in DHA improves memory

We've all heard that eating fish is good for our brains and memory. But what is it about DHA, an omega-3 fatty acid found in fish, that makes our memory sharper?





Medical researchers at the University of Alberta discovered a possible explanation and just published their findings in the peer-reviewed journal Applied Physiology, Nutrition, and Metabolism.





Principal investigator Yves Sauve and his team discovered lab models fed a high-DHA diet had 30 per cent higher levels of DHA in the memory section of the brain, known as the hippocampus, when compared to animal models on a regular, healthy diet.





"We wanted to find out how fish intake improves memory," says Sauve, a researcher in the Faculty of Medicine & Dentistry who works in the department of physiology, the department of ophthalmology and the Centre for Neuroscience.





"What we discovered is that memory cells in the hippocampus could communicate better with each other and better relay messages when DHA levels in that region of the brain were higher. This could explain why memory improves on a high-DHA diet."





Sauve noted it is a key finding that when a diet is supplemented with DHA, that additional stores of the omega-3 fatty acid are deposited in the brain. His team confirmed this finding, a discovery other labs have noted as well.





Supplementing your diet with DHA, such as increasing fish intake or taking supplements, could prevent declining DHA levels in the brain as we age, says Sauve.





This research was funded by Alberta Innovates – Health Solutions.





Earlier this year, Sauve and other colleagues discovered DHA prevents the accumulation of a toxic molecule at the back of the eye that causes age-related vision loss. He is continuing his research in this area.

Fighting Alzheimer's Disease With Exercise

In a recent Journal of Biological Chemistry "Paper of the Week," research led by Ayae Kinoshita at the Kyoto University Graduate School of Medicine in Japan reveals the benefits of exercise in combating Alzheimer's disease.

The most common cause of dementia, Alzheimer's disease results in the loss of cognitive faculty. In the majority of cases, Alzheimer's disease occurs after age 65, and factors such as diet and exercise appear to play a role in its development, with high-fat diets as a risk factor.

Kinoshita's research compared the effects of 1) diet control, 2) voluntary exercise and 3) diet control plus exercise in an Alzheimer's disease mouse model. The results showed that exercise was more beneficial than diet control in reducing _-amyloid formation (a defining characteristic of Alzheimer's disease) and restoring memory loss induced by a high-fat diet in these mice. Moreover, Kinoshita's team found that the effect of diet control plus exercise was not significantly different than exercise alone. They attribute the positive effects of exercise to increased degradation of _-amyloid deposits in the brain.

"Based on the results in this research," Kinoshita suggests, "exercise should be given priority to prevent Alzheimer's disease."

Significant Cardiovascular Risk With Low Carbohydrate-High Protein Diets

Women who regularly eat a low carbohydrate, high protein diet are at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not, a study just published on the British Medical Journal website suggests.

Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years.

Low carbohydrate-high protein diets are frequently used for body weight control. Although they may be nutritionally acceptable if the protein is mainly of plant origin (e.g. nuts) and the reduction of carbohydrates applies mainly to simple and refined ones (i.e. unhealthy sweeteners, drinks and snacks), the general public do not always recognise and act on this guidance.

Studies on the long term consequences of these diets on cardiovascular health have generated inconsistent results. So a team of international authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years).

Women completed an extensive dietary and lifestyle questionnaire and diet was measured on the low carbohydrate-high protein (LCHP) score where a score of two would equal very high carbohydrate and low protein consumption through to 20 which would equal very low carbohydrate and high protein consumption.

Factors likely to influence the results were taken into account including smoking, alcohol use, diagnosis of hypertension, overall level of activity and saturated / unsaturated fat intake.

After these variables were included, results showed that 1270 cardiovascular events took place in the 43,396 women (55% ischaemic heart disease, 23% ischaemic stroke, 6% haemorrhagic stroke, 10% subarachnoid haemorrhage and 6% peripheral arterial disease) over 15 years.

The incidence of cardiovascular outcomes increased with an increasing LCHP score.

Unadjusted figures show that, compared with an LCHP score of six or less, cardiovascular diseases increased by 13% for women with a score from 7 to 9, to 23% for those with a score from 10 to 12, to 54% for those with a score from 13 to 15, and to 60% for those with a score of 16 or higher.Significant Cardiovascular Risk With Low Carbohydrate-High Protein Diets, Experts Warn

Women who regularly eat a low carbohydrate, high protein diet are at greater risk of cardiovascular disease (such as heart disease and stroke) than those who do not, a study just published on the British Medical Journal website suggests.

Although the actual numbers are small (an extra 4-5 cases of cardiovascular disease per 10,000 women per year) the authors say that this is a 28% increase in the number of cases and that these results are worrying in a population of young women who may be exposed to these dietary patterns and face the excess risk for many years.

Low carbohydrate-high protein diets are frequently used for body weight control. Although they may be nutritionally acceptable if the protein is mainly of plant origin (e.g. nuts) and the reduction of carbohydrates applies mainly to simple and refined ones (i.e. unhealthy sweeteners, drinks and snacks), the general public do not always recognise and act on this guidance.

Studies on the long term consequences of these diets on cardiovascular health have generated inconsistent results. So a team of international authors carried out a study on just under 44,000 Swedish women aged between 30 and 49 years from 1991-92 (with an average follow-up of 15 years).

Women completed an extensive dietary and lifestyle questionnaire and diet was measured on the low carbohydrate-high protein (LCHP) score where a score of two would equal very high carbohydrate and low protein consumption through to 20 which would equal very low carbohydrate and high protein consumption.

Factors likely to influence the results were taken into account including smoking, alcohol use, diagnosis of hypertension, overall level of activity and saturated / unsaturated fat intake.

After these variables were included, results showed that 1270 cardiovascular events took place in the 43,396 women (55% ischaemic heart disease, 23% ischaemic stroke, 6% haemorrhagic stroke, 10% subarachnoid haemorrhage and 6% peripheral arterial disease) over 15 years.

The incidence of cardiovascular outcomes increased with an increasing LCHP score.

Unadjusted figures show that, compared with an LCHP score of six or less, cardiovascular diseases increased by 13% for women with a score from 7 to 9, to 23% for those with a score from 10 to 12, to 54% for those with a score from 13 to 15, and to 60% for those with a score of 16 or higher.

After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg).

In absolute terms, the adjusted figures represent an additional four to five cases of cardiovascular diseases per 10,000 women per year compared with those who did not regularly eat a low carbohydrate, high protein diet.

Increasing level of education and physical activity reduced the risk of cardiovascular disease whilst increasing levels of smoking increased the risk.

The authors conclude that LCHP diets "used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins" are associated with cardiovascular risk. This study doesn't, however, address the questions concerning the possible benefit of short-term effects of LCHP diets that can be used to control weight or insulin resistance, which the authors say needs further investigation.

An accompanying editorial argues that the short term benefits of weight loss seem outweighed by longer term cardiovascular harms. Anna Floegel from the German Institute of Human Nutrition and Tobias Pischon from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancy between conclusions from different types of studies in this field "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from these diets in the short-term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term."


After adjusting for other cardiovascular risk factors, there was still a significant 5% increase in the likelihood of a cardiovascular event or death with every two point increase in the LCHP score. The 5% increase resulted from a daily decrease of 20g of carbohydrates (equivalent to a small bread roll) and a daily increase of 5g of protein (equivalent to one boiled egg).

In absolute terms, the adjusted figures represent an additional four to five cases of cardiovascular diseases per 10,000 women per year compared with those who did not regularly eat a low carbohydrate, high protein diet.

Increasing level of education and physical activity reduced the risk of cardiovascular disease whilst increasing levels of smoking increased the risk.

The authors conclude that LCHP diets "used on a regular basis and without consideration of the nature of carbohydrates or the source of proteins" are associated with cardiovascular risk. This study doesn't, however, address the questions concerning the possible benefit of short-term effects of LCHP diets that can be used to control weight or insulin resistance, which the authors say needs further investigation.

An accompanying editorial argues that the short term benefits of weight loss seem outweighed by longer term cardiovascular harms. Anna Floegel from the German Institute of Human Nutrition and Tobias Pischon from the Max Delbrück Center for Molecular Medicine in Germany, say that the discrepancy between conclusions from different types of studies in this field "need to be resolved before low carbohydrate-high protein diets can be safely recommended to patients."

In the meantime, they suggest that any benefits gained from these diets in the short-term "seem irrelevant in the face of increasing evidence of higher morbidity and mortality from cardiovascular diseases in the long term."

Omega-3 fatty acid, curcumin protect an injured spinal cord

Researchers from the Department of Neurosurgery at the David Geffen School of Medicine and the Department of Integrative Biology and Physiology at UCLA have found that a diet enriched with docosahexaenoic acid (DHA), an omega-3 fatty acid, and curcumin, a component of the Indian spice turmeric, can protect the injured spinal cord and minimize the clinical and biochemical effects of spinal cord myelopathy in rats. This finding is fleshed out in the article "Dietary therapy to promote neuroprotection in chronic spinal cord injury. Laboratory investigation," by Langston Holly, M.D., and colleagues, published today online in the Journal of Neurosurgery: Spine. DHA reduces inflammation and provides structural material to plasma membranes. Curcumin produces strong anti-inflammatory and antioxidant effects. Both agents are safe to use and have been documented to have positive effects on the injured brain. Thus the researchers hypothesized that the combined effects of DHA and curcumin could protect the spinal cord from the cascade of cellular and related biological injuries that result from chronic cord injury.

Cervical spondylotic myelopathy is the most common disorder of the spine found in middle-aged patients. Neurological deficits associated with this disorder are related to a primary mechanical spinal injury that is followed by a secondary biological injury. Wear and tear on the spine, due to age or congenital narrowing of the spinal canal, leads to mechanical compression of the spinal cord. This cord compression in turn leads to biological cell injury or death and consequent neurological dysfunction. The primary mechanical injury can usually be corrected by surgery or other management strategies; to date, the secondary biological injury has been more difficult to treat.

The authors set out to develop a noninvasive way to promote neuroprotection from the biological injury that follows spinal cord compression in cervical spondylotic myelopathy. In the laboratory, the authors studied three groups of rats. To simulate cervical spondylotic myelopathy, the researchers placed an expandable polyvinyl alcohol sponge between two laminae of the spine in the animals. This produced delayed myelopathy. After the procedure, the first group of rats was fed a "Western diet" (a form of rat chow high in saturated fats and sugar), whereas the second group was fed a diet enriched with DHA and curcumin. A third group was given a standard rat diet and the animal's spines were left intact.

The animals' walking ability was examined before the procedure and repeatedly for several weeks following it. The researchers compared each group's walking behavior before and after the procedure and noted any differences between groups. Animals fed the Western diet demonstrated significant gait dysfunction as early as three weeks postoperatively, which continued throughout the six-week test period. Animals fed a diet enriched with DHA and curcumin displayed no significant difference in walking ability compared with preoperatively and demonstrated significantly better gait function six weeks after the procedure than animals fed the Western diet. Accompanying this paper, the authors provide two videos showing differences in gait function between these two groups.

The authors also examined the effects of diet after spinal injury on the molecular level. They measured levels of 4-hydroxynonenal (4-HNE), brain-derived neurotrophic factor (BDNF), and syntaxin-3 in the region of the rat spine that was compressed as well as in a region lower in the spine—the lumbar enlargement—where nerves controlling the lower limbs are attached to the spinal cord. The lumbar enlargement was included because cord injury can extend downward from the original site. Significantly higher levels of 4-HNE, an indication of severe cellular membrane damage, were found in both spinal sites in rats fed the Western diet. There was no significant difference between the levels of 4-HNE found in rats fed a diet enriched with DHA and curcumin and control rats with intact spines. Levels of BDNF and syntaxin-3 were significantly lower in both spinal sites in rats fed the Western diet. There were no significant differences in the levels of BDNF and syntaxin-3 between rats fed the diet enriched with DHA and curcumin and control rats. BDNF is a key factor involved in neural repair and promotes the transmission of information across synapses. Syntaxin-3 plays an important role in the release of neurotransmitters into the synapses.

This study shows that diet can play an important role in the response of the rat body to spinal injury. Rats fed a diet enriched with DHA and curcumin displayed significantly better walking ability than animals fed a "Western diet" high in saturated fats and sugar. In addition, there were significant differences in the levels of 4-HNE, BDNF, and syntaxin-3 between rats fed the Western diet and rats fed the DHA and curcumin–enriched diet. On the other hand, there were no significant differences in any of the parameters examined between rats fed the enriched diet and control rats with intact spines.

On the basis of their findings, the authors conclude: "DHA and curcumin can counteract the effects of chronic spinal cord compression through several molecular mechanisms, resulting in the preservation of neurological function."

Long-term calcium and vitamin D supplement use = increased risk of kidney stones

Calcium and vitamin D supplements are associated with high calcium levels in the blood and urine, which could increase the risk of kidney stones, a new study finds. The results will be presented Tuesday at The Endocrine Society's 94th Annual Meeting in Houston.

"The use of calcium and vitamin D supplementation may not be as benign as previously thought," said principal investigator J. Christopher Gallagher, M.D., professor and director of the Bone Metabolism Unit at Creighton University Medical Center in Omaha, NE. "Pending further information, people should not exceed the guidelines suggested by the Institute of Medicine, which are 800 international units of vitamin D, and 800-1,200 milligrams per day of calcium."

Taking vitamin supplements has become a widespread practice throughout many parts of the world. In the United States alone, it is estimated that nearly two-thirds of women take vitamin supplements, with calcium and vitamin D among the most commonly used. Despite their popularity, the precise health effects of long-term calcium and vitamin D supplementation remain unclear.

Previous research has indicated that high levels of calcium in the urine, or hypercalciuria, may increase the risk of kidney stones. Elevated calcium in the blood, or hypercalcemia, is associated with many complications, including bone and kidney problems.

Gallagher and study lead author Vinod Yalamanchili, M.D., research fellow in Creighton University's Bone Metabolism Unit, studied 163 healthy, postmenopausal women between the ages of 57 and 85 years. All participants were randomly assigned to receive a vitamin D supplement of 400, 800, 1600, 2400, 3200, 4000, or 4800 international units a day, or placebo. Then, their calcium intake was increased from an initial intake of 691 to 1,200-1,400 milligrams per day. Investigators measured blood and urinary calcium levels at the beginning of the study, and then every three months for one year.

They found that approximately 48 participants, or 33 percent, developed high urinary levels of calcium at some time in the study. These participants had 88 episodes of high urinary calcium. Hypercalciuria has been linked to an increased risk of kidney stones identified in previous studies. No incidents of kidney stones were reported during this one-year study, which was funded by The National Institute on Aging.

Additionally, about 10 percent of study subjects developed high blood levels of calcium. This translates into 25 episodes among 16 participants. In both cases, the increases were unrelated to the dosage of vitamin D.

"Because of the unpredictable response, it is not clear whether it is the extra calcium, the vitamin D or both together that cause these problems," Gallagher said. "However, it is possible that long-term use of supplements causes hypercalciuria and hypercalcemia, and this can contribute to kidney stones. For these reasons, it is important to monitor blood and urine calcium levels in people who take these supplements on a long-term basis. This is rarely done in clinical practice."

Moderate coffee consumption offers protection against heart failure

While current American Heart Association heart failure prevention guidelines warn against habitual coffee consumption, some studies propose a protective benefit, and still others find no association at all. Amidst this conflicting information, research from Beth Israel Deaconess Medical Center attempts to shift the conversation from a definitive yes or no, to a question of how much.

"Our results did show a possible benefit, but like with so many other things we consume, it really depends on how much coffee you drink," says lead author Elizabeth Mostofsky, MPH, ScD, a post-doctoral fellow in the cardiovascular epidemiological unit at BIDMC. "And compared with no consumption, the strongest protection we observed was at about four European, or two eight-ounce American, servings of coffee per day."

The study published June 26 online in the Journal Circulation: Heart Failure, found that these moderate coffee drinkers were at 11 percent lower risk of heart failure.

Data was analyzed from five previous studies – four conducted in Sweden, one in Finland – that examined the association between coffee consumption and heart failure. The self-reported data came from 140,220 participants and involved 6,522 heart failure events.

In a summary of the published literature, the authors found a "statistically significant J-shaped relationship" between habitual coffee consumption and heart failure, where protective benefits begin to increase with consumption maxing out at two eight-ounce American servings a day. Protection slowly decreases the more coffee is consumed until at five cups, there is no benefit and at more than five cups a day, there may be potential for harm.

It's unclear why moderate coffee consumption provides protection from heart failure, but the researchers say part of the answer may lie in the intersection between regular coffee drinking and two of the strongest risk factors for heart failure – diabetes and elevated blood pressure.

"There is a good deal of research showing that drinking coffee lowers the risk for type 2 diabetes, says senior author Murray Mittleman, MD, DrPH, a physician in the Cardiovascular Institute at Beth Israel Deaconess Medical Center, an Associate Professor of Medicine at Harvard Medical School and director of BIDMC's cardiovascular epidemiological research program. "It stands to reason that if you lower the risk of diabetes, you also lower the risk of heart failure."

There may also be a blood pressure benefit. Studies have consistently shown that light coffee and caffeine consumption are known to raise blood pressure. "But at that moderate range of consumption, people tend to develop a tolerance where drinking coffee does not pose a risk and may even be protective against elevated blood pressure," says Mittleman.

This study was not able to assess the strength of the coffee, nor did it look at caffeinated versus non-caffeinated coffee.

"There is clearly more research to be done," says Mostofsky. "But in the short run, this data may warrant a change to the guidelines to reflect that coffee consumption, in moderation, may provide some protection from heart failure."

Jon's Health Tips

I. Things I take/get/do that are good for me (Note #9 especially!)

1. Statins

A. Statins = Reduced Risk of Recurrent Cardiovascular Events in Men, Women

2. Vitamin D/ Sun

A. Low vitamin D levels linked to weight gain in some older women

B. Treating vitamin D deficiency may improve depression

C. Low vitamin D level is linked to greater chance of risk factors for Type 2 diabetes and heart disease

D. Sun Exposure = Decreased Risk for Pancreatic Cancer

E. Vitamin D with calcium shown to reduce mortality in elderly (I need to increase my calcium)

3. Exercise

A. Keeping Fit May Reduce Breast Cancer Risk

B. Tai Chi increases brain size, benefits cognition in elderly

Previous trials have shown increases in brain volume in people who participated in aerobic exercise, and in one of these trials, an improvement in memory was seen. However, this was the first trial to show that a less aerobic form of exercise, Tai Chi, as well as stimulating discussion led to similar increases in brain volume and improvements on psychological tests of memory and thinking.

4. Alcohol

A. Higher quality of life seen among regular moderate drinkers than among abstainers

5. Fish oil/Fish

A. OMEGA-3 LOWERS INFLAMMATION IN OVERWEIGHT OLDER ADULTS

New research shows that omega-3 fatty acid supplements can lower inflammation in healthy, but overweight, middle-aged and older adults, suggesting that regular use of these supplements could help protect against and treat certain illnesses.

B. Healthy Habits - Eating fresh fish regularly

Eating fresh fish regularly reduces the risk of colorectal cancer by 12%. The protective effect of fish consumption is more prominent in rectal cancer than in colon cancer. The risk reduction for rectal cancer was as much as 21%, whereas the reduction for colon cancer was 4%.

6. Reduced salt consumption

A. Too much salt may damage blood vessels /lead to high blood pressure


6. Resveratrol

A. Resveratrol: natural exercise performance enhancer

7. Olive Oil Dressing On Salads

A. Olive Oil Healthiest Dressing On Salads

8. Aspirin

A. Aspirin before heart surgery reduces the risk of post-operative acute kidney failure

Aspirin taken for five days before a heart operation can halve the numbers of patients developing post-operative acute kidney failure.

B. Healthy Habits - Low-dose aspirin

Low-dose aspirin, a common strategy for preventing cardiovascular disease, can also reduce nonvascular deaths, including cancer deaths. A meta-analysis of 23 randomized studies offers conclusive evidence that low-dose aspirin offers cancer preventive effects, and showed significant treatment effects after approximately four years of follow up.

9. Coffee/tea (I'm increasing my coffee consumption)

A. High blood caffeine levels linked to avoidance of Alzheimer's disease

Those cups of coffee that you drink every day to keep alert appear to have an extra perk – especially if you're an older adult. A recent study monitoring the memory and thinking processes of people older than 65 found that all those with higher blood caffeine levels avoided the onset of Alzheimer's disease in the two-to-four years of study follow-up. Moreover, coffee appeared to be the major or only source of caffeine for these individuals.

II. Things I don't do that I should:


1. 'Dessert with breakfast diet' helps avoid weight regain by reducing cravings

Dieters have less hunger and cravings throughout the day and are better able to keep off lost weight if they eat a carbohydrate-rich, protein-packed breakfast that includes dessert. These findings come from a new study.

2. Peaches, plums, nectarines fight obesity, diabetes, heart disease

3. Calorie-restricted diet keeps heart young

People who restrict their caloric intake in an effort to live longer have hearts that function more like those in people who are 20 years younger. Researchers have found that a key measure of the heart’s ability to adapt to physical activity, stress, sleep and other factors that influence the rate at which the heart pumps blood, doesn’t decline nearly as rapidly in people who have significantly restricted their caloric intake for an average of seven years.

Statins: Reduced Risk of Recurrent Cardiovascular Events in Men, Women

Cholesterol-lowering statin drugs appear to be associated with reduced risk of recurrent cardiovascular events in men and women, but do not appear to be associated with reduced all-cause mortality or stroke in women, according to a report of a meta-analysis published June 25 in the Archives of Internal Medicine, a JAMA Network publication.

Statins have been used to lower cholesterol levels for the last 20 years, but most of the clinical trials on the drugs have predominantly enrolled men. There have been conflicting results on the benefits of statins for women with cardiovascular disease compared with men in secondary cardiovascular disease prevention, according to the study background.

Jose Gutierrez, M.D., M.P.H., of Columbia University Medical Center, New York, and colleagues conducted a meta-analysis of 11 clinical trials (a total of 43,191 participants) to examine whether statin therapy was more effective than placebo in preventing recurrence of cardiovascular events and all-cause mortality in men and women. Researchers also sought to determine the sex-specific effect of statins on the risk of recurrent cardiac and cerebrovascular events.

"In our results, statin therapy reduced the recurrence rate of any type of cardiovascular event, all-cause mortality, coronary death, any MI [myocardial infarction or heart attack], cardiac intervention, and any stroke type. The stratification by sex showed no statistically significant risk reduction for women taking statins compared with women taking placebo for the reduction of all-cause mortality and any type of stroke," the authors comment.

However, the authors observe that the results of their meta-analysis "underscore" the low rate of women being enrolled in cardiovascular prevention clinical trials.

"Women represented only a fifth of the studied sample, limiting the strength of our conclusions. In our results, the benefit associated with statin administration in women did not reach statistical significance compared with placebo in at least two outcomes, all-causes mortality and any stroke type. The reason for this difference is uncertain. One possibility is that the small sample size of women limits the power of the study," the authors note.

The authors conclude "this meta-analysis supports the use of statins in women for the secondary prevention of cardiovascular events."

Low vitamin D levels linked to weight gain in some older women

Kaiser Permanente study finds most older women have insufficient levels of the 'sunshine vitamin'

Older women with insufficient levels of Vitamin D gained more weight than those with sufficient levels of the vitamin, according to a new study funded by the National Institutes of Health and published online today in the Journal of Women's Health. The study of more than 4,600 women ages 65 and older found that over nearly five years, those with insufficient levels of Vitamin D in their blood gained about two pounds more than those with adequate levels of the vitamin.

"This is one of the first studies to show that women with low levels of Vitamin D gain more weight, and although it was only two pounds, over time that can add up," said study author Erin LeBlanc, MD, an endocrinologist and researcher at the Kaiser Permanente Center for Health Research in Portland, Oregon. "Nearly 80 percent of women in our study had insufficient levels of Vitamin D. A primary source of this important vitamin is sunlight, and as modern societies move indoors, continuous Vitamin D insufficiency may be contributing to chronic weight gain."

Vitamin D was in the news recently when a panel of primary care experts-- the US Preventive Services Task Force-- said healthy postmenopausal women may need higher doses of the vitamin to prevent fractures, and that there isn't enough evidence to recommend the supplements for younger people. Other expert groups, including The Endocrine Society, have a different take, saying many adults do need Vitamin D supplements to keep their bones healthy. 1

"Our study only shows an association between insufficient levels of Vitamin D and weight gain, we would need to do more studies before recommending the supplements to keep people from gaining weight," LeBlanc said. "Since there are so many conflicting recommendations about taking Vitamin D for any reason, it's best if patients get advice from their own health care provider."

She points out that this study was conducted among older women who, for the most part, were not trying to lose weight—though some of them did so as a natural result of aging. About 60 percent of the 4,659 women in the study remained at a stable weight (within 5 percent of their starting weight) over the 4.5-year study period, 27 percent lost more than 5 percent of their body weight, and 12 percent gained more than 5 percent of their body weight.

Most women in the study (78 percent) had less than 30 nanograms per millimeter (ng/ml) of Vitamin D in their blood—the level defined as sufficient by The Endocrine Society panel of experts who set clinical guidelines on Vitamin D deficiency. These women had higher baseline weight to begin with: 148.6 pounds, compared with 141.6 pounds for women whose Vitamin D levels were 30 ng/ml or above. Insufficient levels had no association with weight changes in the entire group of women, or in the group that lost weight. But in the group of 571 women who gained weight, those with insufficient Vitamin D levels gained more—18.5 pounds over five years—than women who had sufficient Vitamin D. The latter group gained 16.4 pounds over the same period.

'Dessert with breakfast diet' helps avoid weight regain by reducing cravings

>Dieters have less hunger and cravings throughout the day and are better able to keep off lost weight if they eat a carbohydrate-rich, protein-packed breakfast that includes dessert. These findings come from a new study that will be presented Monday at The Endocrine Society's 94th Annual Meeting in Houston.

"The goal of a weight loss diet should be not only weight reduction but also reduction of hunger and cravings, thus helping prevent weight regain," said Daniela Jakubowicz, MD, the study's principal investigator.

Jakubowicz, a senior physician at Tel Aviv University's Wolfson Medical Center in Holon, Israel, and her co-authors studied nearly 200 nondiabetic obese adults who were randomly assigned to eat one of two low-calorie diets. Both diets had the same number of daily calories—about 1,600 for men and 1,400 for women—but differed mainly in the composition of breakfast.

One group received a low-carbohydrate diet, featuring a 304-calorie breakfast with only 10 grams of carbohydrates, or "carbs." The other group ate a 600-calorie breakfast with 60 grams of carbs, which included a small sweet, such as chocolate, a doughnut, a cookie or cake. Both diets contained protein (such as tuna, egg whites, cheese and low-fat milk) at breakfast, but the "dessert with breakfast diet" had 45 grams of protein, 15 grams more than in the low-carb diet.

Halfway through the eight-month study, participants in both groups lost an average of 33 pounds (15.1 kilograms, or kg) per person, which Jakubowicz said shows that "both diets work the same." However, in the last four months of the study, the low-carb group regained an average of 22 pounds (11.6 kg) per person, while participants who ate the dessert with breakfast diet lost another 15 pounds (6.9 kg) each, the authors reported.

In addition, the study subjects who ate the dessert with breakfast diet reported feeling less hunger and fewer cravings compared with the other group. Subjects' food diaries showed that the dessert with breakfast group had better compliance in sticking to their calorie requirements. Women who ate the dessert with breakfast diet were allowed 500 calories for lunch and about 300 calories for dinner. Men in that group could eat a 600-calorie lunch and up to 464 calories at dinner.

As further evidence supporting the dessert with breakfast diet, the levels of ghrelin, the so-called "hunger hormone," dropped much more after breakfast than in the low-carb group: 45.2 percent versus 29.5 percent, respectively, according to the abstract.

Jakubowicz attributed the better results from the dessert with breakfast diet to meal timing and composition. She said the diet's high protein content reduced hunger; the combination of protein and carbs increased satiety, or feeling full; and the dessert decreased cravings for sweet, starchy and fatty foods. Such cravings often occur when a diet restricts sweets and can result in eating many fattening foods that are not allowed on the diet, she said.

This study was published in the March issue of the journal Steroids.

Treating vitamin D deficiency may improve depression

Women with moderate to severe depression had substantial improvement in their symptoms of depression after they received treatment for their vitamin D deficiency, a new study finds. The case report series will be presented Saturday at The Endocrine Society's 94th Annual Meeting in Houston.

Because the women did not change their antidepressant medications or other environmental factors that relate to depression, the authors concluded that correction of the patients' underlying shortage of vitamin D might be responsible for the beneficial effect on depression.

"Vitamin D may have an as-yet-unproven effect on mood, and its deficiency may exacerbate depression," said Sonal Pathak, MD, an endocrinologist at Bayhealth Medical Center in Dover, Del. "If this association is confirmed, it may improve how we treat depression."

Pathak presented the research findings in three women, who ranged in age from 42 to 66. All had previously diagnosed major depressive disorder, also called clinical depression, and were receiving antidepressant therapy. The patients also were being treated for either Type 2 diabetes or an underactive thyroid (hypothyroidism).

Because the women had risk factors for vitamin D deficiency, such as low vitamin D intake and poor sun exposure, they each underwent a 25-hydroxyvitamin D blood test. For all three women, the test found low levels of vitamin D, ranging from 8.9 to 14.5 nanograms per milliliter (ng/mL), Pathak reported. Levels below 21 ng/mL are considered vitamin D deficiency, and normal vitamin D levels are above 30 ng/mL, according to The Endocrine Society.

Over eight to 12 weeks, oral vitamin D replacement therapy restored the women's vitamin D status to normal. Their levels after treatment ranged from 32 to 38 ng/mL according to the study abstract.

After treatment, all three women reported significant improvement in their depression, as found using the Beck Depression Inventory. This 21-item questionnaire scores the severity of sadness and other symptoms of depression. A score of 0 to 9 indicates minimal depression; 10 to 18, mild depression; 19 to 29, moderate depression; and 30 to 63, severe depression.

One woman's depression score improved from 32 before vitamin D therapy to 12, a change from severe to mild depression. Another woman's score fell from 26 to 8, indicating she now had minimal symptoms of depression. The third patient's score of 21 improved after vitamin D treatment to 16, also in the mild range.

Other studies have suggested that vitamin D has an effect on mood and depression, but there is a need for large, good-quality, randomized controlled clinical trials to prove whether there is a real causal relationship, Dr Pathak said.

"Screening at-risk depressed patients for vitamin D deficiency and treating it appropriately may be an easy and cost-effective adjunct to mainstream therapies for depression," she said.

Low vitamin D level is linked to greater chance of risk factors for Type 2 diabetes

A new study presents more evidence of a possible link between low vitamin D levels and a higher risk of Type 2 diabetes and heart disease. The results will be presented Saturday at The Endocrine Society's 94th Annual Meeting in Houston.

The study found an inverse relationship between the level of vitamin D in the blood and the presence of the metabolic syndrome, which is a group of risk factors that increases the risk of heart disease and Type 2 diabetes. People with the highest blood levels of vitamin D had a 48 percent lower risk of having the metabolic syndrome than did those with the lowest vitamin D levels, the authors reported.

"This association has been documented before, but our study expands the association to people of diverse racial and ethnic backgrounds," said the lead author, Joanna Mitri, MD, a research fellow at Tufts Medical Center in Boston. "These include minority groups that are already at higher risk of diabetes."

Furthermore, all study participants were at risk of developing diabetes because they had prediabetes, abnormally high blood sugar levels that are not yet high enough to be classified as diabetes. Prediabetes affects an estimated 79 million Americans ages 20 or older, according to 2010 statistics from the Centers for Disease Control and Prevention.

Mitri and her co-investigators conducted the study using data from participants of the Diabetes Prevention Program, a large, now-completed study funded by the National Institutes of Health. They divided study subjects into three groups based on plasma 25-hydroxyvitamin D level, which is the most common way used to measure vitamin D status in the body, according to Mitri. The Institute of Medicine recommends a 25-hydroxyvitamin D level of 20 to 30 ng/mL as adequate for healthy people.

In the new study, the group with the highest levels of vitamin D had a median vitamin D concentration of 30.6 nanograms per milliliter, or ng/mL, and those in the lowest group had a median vitamin D concentration of 12.1 ng/mL. The risk of having the metabolic syndrome with a high vitamin D level was about one half the risk with a low vitamin D level, Mitri said.

The researchers also found an association between vitamin D status and some of the individual components of the metabolic syndrome, which includes a large waist size, low HDL ("good") cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood glucose (sugar). Study participants with the best vitamin D status had a smaller waist circumference, higher HDL cholesterol and lower blood sugar.

Mitri cautioned that their research does not prove that vitamin D deficiency causes Type 2 diabetes, or even that there is a link between the two conditions.

"However, the metabolic syndrome is common, and progression to Type 2 diabetes is high," she said. "If a causal relationship can be established in ongoing and planned studies of vitamin D, this link will be of public health importance, because vitamin D supplementation is easy and inexpensive."

Keeping Fit May Reduce Breast Cancer Risk

Women who keep fit with regular exercise, even mild physical activity, may reduce their risk of developing breast cancer, even after the menopause, but not if they also put on a lot of weight, according to a new study from the US.

The researchers found that the greatest effect was in women who exercised recreationally 10 to 19 hours a week: this appeared to reduce their risk of developing breast cancer by around 30%.

However, they also found that substantial weight gain can negate this benefit.

They write about their work in a paper due to be published this week in the journal Cancer.

Study author Lauren McCullough, a doctoral candidate at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health, and colleagues, examined the effect of recreational physical activity, done at different points in life, including after the menopause, on women's risk of developing breast cancer.

While others have already shown that exercise can reduce breast cancer risk, McCullough and colleagues were interested in some of the questions that still remain unanswered. For example, how much exercise, and how often? Does it have to be intense, or does mild physical activity also have an impact? Does this work for all body types or just some? And does it work for all types of breast cancer?

For this study, they examined data on over 3,000 women aged between 20 and 98 years who took part in the Long Island Breast Cancer Study Project: a multistudy effort that began in 1993 to investigate whether environmental factors are responsible for breast cancer.

About half the women (1,504) had breast cancer, and of these the vast majority had invasive breast cancer (1,271).

The researchers found that:

* Women who exercised during their reproductive years or during the menopause had a reduced risk for breast cancer.

* Exercising 10 to 19 hours per week, outside of work activity, was linked to the largest, approximately 30%, reduction in risk.

* All levels of exercise, from mild to intense, were linked to reduction in risk of the most common breast cancers in American women, the hormone receptor positive (ER and PR positive) breast cancers.

* However, active women who gained a significant amount of weight, particularly after the menopause, had an increased risk for breast cancer, suggesting weight gain can wipe out the beneficial effect of exercise.

McCullough and colleagues did not examine the underlying reasons for the effect of exercise on breast cancer risk, but suggest it may have something to do with controlling energy balance and obesity, that leads to reduced insulin resistance and inflammation.

They conclude that:

"Collectively, these results suggest that women can still reduce their breast cancer risk later in life by maintaining their weight and engaging in moderate amounts of activity."

McCullough told the press:

"The observation of a reduced risk of breast cancer for women who engaged in exercise after menopause is particularly encouraging given the late age of onset for breast cancer."

Higher quality of life seen among regular moderate drinkers than among abstainers

Data from a nationally representative sample of 5,404 community-dwelling Canadians ages 50 and older at baseline (1994/1995) was used to estimate the effects of alcohol drinking patterns on quality of life when subjects were aged =50 years and after a follow-up period. Health-related quality of life was assessed with the Health Utilities Index Mark 3 (HUI3). The authors report that most participants showed stable alcohol-consumption patterns over 6 years.

Detailed information was available on the participants alcohol consumption. Moderate drinkers were defined as those having 1 drinks per week with no more than 3 on any day for women and no more than 4 on any day for men. The repeated assessments allowed for the investigators to classify subjects according to changes over time in their drinking patterns, so that "persistent moderate drinkers" could be identified. 31.4% of the subjects decreased their intake over the follow-up period. The investigators also did secondary analyses among subjects who did not report any adverse health conditions (heart disease, cancer, stroke, or diabetes) during the first four years of follow up; these subjects were referred to as "consistently healthy."

Regular moderate drinkers had the highest indices of quality of life at baseline, but subsequent changes in quality of life indicators were similar in all groups except for those reporting decreasing alcohol consumption. The investigators conclude that regular moderate drinkers had higher initial levels of health-related quality of life than abstainers and those in other groups. However, rates of decline over time were similar for all groups except those decreasing their consumption from moderate levels, who showed a greater decline in their level of health-related quality of life than regular moderate users.

While Forum reviewers admired the intent of this study, there were concerns about some of the statistical and epidemiologic aspects. The reasons that some people stopped drinking or decreased their intake were not known; although they were 'consistently healthy' at baseline. Forum reviewer Harvey Finkel comments: "As people age, even disregarding medical obstacles, social interactions generally decrease, which leads to both less stimulation to drink and less opportunity to drink." It is thus important that the reasons that someone stops drinking, or decreases his or her intake, are taken into account.

Further, the "baseline" quality of life measures in this study were obtained when subjects were aged 50 or older; this baseline value of quality of life was higher in moderate drinkers. However, there are statistical problems if adjustments are made for this when quality of life is assessed subsequently and related to drinking pattern. Peto has described this problem as a "horse-racing effect." He states that in prospective studies, the correlation between exposures (e.g., drinking pattern) and outcomes (e.g., quality of life) assessments during follow up are likely to be the same as the outcome at the end of follow up. As an analogy he uses a race between 'slow' and 'fast' horses; it is likely that the fast horses will be ahead at the mid-point of the race as well as at the end. Environmental effects on quality of life begin early in life, and if one adjusts for the mid-life value (as done and referred to as "baseline" in the present study), you may end up disregarding much of the effect of subsequent alcohol intake.

Overall, this study shows a positive relation between regular moderate alcohol intake and quality of life in middle-aged adults. The effects on the subsequent quality of life as one ages of continued alcohol consumption, or of decreasing intake, remain unclear.

OMEGA-3 LOWERS INFLAMMATION IN OVERWEIGHT OLDER ADULTS

New research shows that omega-3 fatty acid supplements can lower inflammation in healthy, but overweight, middle-aged and older adults, suggesting that regular use of these supplements could help protect against and treat certain illnesses.

Four months of omega-3 supplementation decreased one protein in the blood that signals the presence of inflammation by an average of more than 10 percent, and led to a modest decrease in one other inflammation marker. In comparison, participants taking placebos as a group saw average increases of 36 percent and 12 percent, respectively, of those same markers. Janice Kiecolt-Glaser Chronic inflammation is linked to numerous conditions, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer’s disease, as well as the frailty and functional decline that can accompany aging.

Study participants took either 2.5 grams or 1.25 grams of active omega-3 polyunsaturated fatty acids in their supplements. Polyunsaturated fatty acids are considered“good fats” that, when consumed in proper quantities, are associated with a variety of health benefits. Study participants taking a placebo consumed pills containing less than 2 teaspoons per day of a mix of oils representing a typical American’s daily dietary oil intake. Ronald Glaser “Omega-3 fatty acids may be both protective so that inflammation doesn’t go up, as well as therapeutic by helping inflammation go down,” said Jan Kiecolt-Glaser, professor of psychiatry and psychology at Ohio State University and lead author of the study.

“This is the first study to show that omega-3 supplementation leads to changes in inflammatory markers in the blood in overweight but otherwise healthy people. In terms of regulating inflammation when people are already healthy, this is an important study, in that it suggests one way to keep them healthy.” Martha Belury The study is published online and scheduled for later print publication in the journal Brain, Behavior and Immunity.

The scientists recruited 138 adults - 45 men and 93 women - who were in good health, but who were either overweight or obese and lived sedentary lives. Their average age was 51 years. Based on body mass index, a measure of weight relative to height, 91 percent of the participants were overweight and 47 percent were obese.

Inflammation tends to accompany excess body fat, so the researchers recruited participants who were most likely high in pro-inflammatory blood compounds at the beginning of the study.

“We wanted to have enough room to see a downward trend. Most other trials testing the effects of omega-3 supplements on inflammation used people who were seriously diseased or skinny and healthy,” said Kiecolt-Glaser, also an investigator in Ohio State’s Institute for Behavioral Medicine Research (IBMR). “You can see results in people with serious diseases, but there’s a lot of other noise in that system. We wanted to make sure we were studying results in people who were fairly fit but who weren’t exercising, because exercise can clearly lower inflammation.”

The researchers also excluded from participation people taking a variety of medications to control mood, cholesterol and blood pressure as well as vegetarians, patients with diabetes, smokers, those routinely taking fish oil, people who got more than two hours of vigorous exercise each week and those whose body mass index was either below 22.5 or above 40.

Participants received either a placebo or one of two different doses of omega-3 fatty acids - either 2.5 grams or 1.25 grams per day. The supplements were calibrated to contain a ratio of the two fish oil fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), of seven to one. Previous research has suggested that EPA has more anti-inflammatory properties than does DHA.

After four months, participants who had taken the omega-3 supplements had significantly lower levels in their blood of two proteins that are markers of inflammation, also called pro-inflammatory cytokines. The low-dose group showed an average 10 percent decrease in the cytokine interleukin-6 (IL-6), and the high-dose group’s overall IL-6 dropped by 12 percent. In comparison, those taking a placebo saw an overall 36 percent increase in IL-6 by the end of the study.

Levels of the cytokine tumor necrosis factor-alpha (TNF-a) also dropped, but in a more modest way, by 0.2 percent and 2.3 percent in the low- and high-dose groups, respectively. The placebo group’s TNF-a increased by an average of 12 percent.

IL-6 and TNF-a are two of a family of six cytokines that, when stimulated, produce an inflammatory response to a stressor such as an injury or infection, said study co-author Ron Glaser, professor of molecular virology, immunology and medical genetics and director of the IBMR.

“You need this good inflammation for an initial response, but if it stays up, and inflammation becomes chronic, then you’ve got a problem,” Glaser said. “Our research and studies done by others have shown that these two cytokines are clearly related to overall health - and when they’re elevated in the blood, that is not good for overall health. So the more ways we can find to lower them, the better.”

Statistically, there was no significant difference in lowered inflammation between the two doses, but each dose clearly produced cytokine reductions that differed significantly from the placebo group.

“These data support the idea that a higher dose of omega-3 is not necessarily better than a lower dose in terms of prevention of inflammation,” said Martha Belury, professor of human nutrition at Ohio State and a co-author of the study.

However, levels of omega-3 fatty acids in participants’ blood increased according to which dose they consumed, which improved their ratio of omega-6 fatty acids to omega-3 fatty acids. The current typical American diet contains between 15 and 17 times more omega-6 than omega-3, a ratio that researchers suggest should be lowered to 4-to-1, or even 2-to-1, to improve overall health.

“Scientists tend to agree that the best way to gauge a person’s omega-3 status is to see whether that ratio goes down,” Belury said. “That’s what we saw in this study, and it was achieved through supplementation. We wanted participants to maintain normal diets and simply add this modest amount of oil to their existing diet. We expected and we found that their blood plasma omega-3 fatty acids went up in a dose-responsive manner.”

The Food and Drug Administration considers daily omega-3 supplementation of up to 3 grams to be “generally regarded as safe.” The doses in this study were within those safety parameters, but the researchers did not extend their findings to make a general recommendation about omega-3 supplementation.

“Although omega-3 fatty acids cannot take the place of good health behaviors, people with established inflammatory diseases or conditions may benefit from their use,” Kiecolt-Glaser said.

The researchers also sought to determine whether omega-3 fatty acids could reduce depression symptoms, but participants had relatively few symptoms to begin with so no significant reductions were seen. Depression is also associated with chronic inflammation, but research hasn’t yet fully defined the mechanisms behind that relationship.

Antibacterials in Personal-Care Products Linked to Allergy Risk in Children

Exposure to common antibacterial chemicals and preservatives found in soap, toothpaste, mouthwash and other personal-care products may make children more prone to a wide range of food and environmental allergies, according to new research from Johns Hopkins Children’s Center.

Results of the NIH-funded study are published online ahead of print June 18 in the Journal of Allergy and Clinical Immunology.

Using existing data from a national health survey of 860 children ages 6 to 18, Johns Hopkins researchers examined the relationship between a child’s urinary levels of antibacterials and preservatives found in many personal-hygiene products and the presence of IgE antibodies in the child’s blood. IgE antibodies are immune chemicals that rise in response to an allergen and are markedly elevated in people with allergies.

“We saw a link between level of exposure, measured by the amount of antimicrobial agents in the urine, and allergy risk, indicated by circulating antibodies to specific allergens,” said lead investigator Jessica Savage, M.D., M.H.S., an allergy and immunology fellow at Hopkins.

The researchers caution that the findings do not demonstrate that antibacterials and preservatives themselves cause the allergies, but instead suggest that these agents play a role in immune system development.

The investigators say their findings are also consistent with the so-called hygiene hypothesis, which has recently gained traction as one possible explanation behind the growing rates of food and environmental allergies in the developed world. The hypothesis suggests that early childhood exposure to common pathogens is essential in building healthy immune responses. Lack of such exposure, according to the theory, can lead to an overactive immune system that misfires against harmless substances such as food proteins, pollen or pet dander.

“The link between allergy risk and antimicrobial exposure suggests that these agents may disrupt the delicate balance between beneficial and bad bacteria in the body and lead to immune system dysregulation, which in turn raises the risk of allergies,” Savage added.
In the study, those with the highest urine levels of triclosan — an antibacterial agent used in soaps, mouthwash and toothpaste — had the highest levels of food IgE antibodies, and therefore the highest allergy risk, compared with children with the lowest triclosan levels. Children with the highest urinary levels of parabens — preservatives with antimicrobial properties used in cosmetics, food and medications — were more likely to have detectable levels of IgE antibodies to environmental allergens like pollen and pet dander, compared with those with low paraben levels.

The team initially zeroed in on seven ingredients previously shown to disrupt endocrine function in lab and animal studies. These compounds were bisphenol A — found in plastics — and triclosan, benzophenone-3 and propyl, methyl, butyl and ethyl parabens, found in personal-hygiene products and some foods and medications. Interestingly, triclosan and propyl and butyl parabens, all of which have antimicrobial properties, were the only ones associated with increased allergy risk in the current study, the researchers noted.

“This finding highlights the antimicrobial properties of these agents as a probable driving force behind their effect on the immune system,” said senior investigator Corinne Keet, M.D., M.S., an allergist at Johns Hopkins Children’s Center.

Children with the highest urine levels of triclosan had nearly twice the risk of environmental allergies as children with the lowest urinary concentrations. Those with highest levels of propyl paraben in the urine had twice the risk of an environmental allergy. Food allergy risk was more than twice as pronounced in children with the highest levels of urinary triclosan as in children with the lowest triclosan levels. High paraben levels in the urine were not linked to food allergy risk.

Sun Exposure /Sun-sensitive Skin Type Decreased Risk for Pancreatic Cancer

High levels of ultraviolet radiation at an individual’s birth location, sun-sensitive skin type and a history of skin cancer each decreased risk for pancreatic cancer, according to study results presented at the American Association for Cancer Research’s Pancreatic Cancer: Progress and Challenges conference, held here June 18-21.

Rachel Neale, Ph.D., principal investigator at Queensland Institute of Medical Research in Queensland, Australia, presented the results of a population-based, case-control study that adds to the already conflicting data about sun exposure, vitamin D gained from sun exposure and cancer risk.

“Several ecological studies, including one conducted in Australia, have suggested that people living in areas with high sun exposure have lower risk for pancreatic cancer,” Neale said. “However, some studies of circulating vitamin D indicate that people with high vitamin D are at increased risk, and one study of vitamin D intake supports this increased risk.”

The results of this study support the existing ecological data which indicate that sun exposure has a protective effect against pancreatic cancer.

Neale and colleagues recruited 714 people in Queensland, Australia, between 2007 and 2011. They were matched by age and sex to 709 control participants. All participants were interviewed about socio-demographic information and medical history. In addition, they were asked about the location of their birth, skin cancer history and skin type, defined by skin color, tanning ability and propensity to sunburn.

Using NASA’s Total Ozone Mapping Spectrometer, the researchers assigned a level of ultraviolet radiation to each birth location and then split them into thirds based on how much radiation was present.

Participants born in areas with the highest levels of ultraviolet radiation had a 24 percent lower risk for pancreatic cancer compared with those born in areas of low ultraviolet radiation.

In addition, although all skin types had some significant association with pancreatic cancer risk, those classified as having the most sun-sensitive skin had a 49 percent decreased risk for pancreatic cancer compared with those classified as having the least sun-sensitive skin. Finally, participants with a history of skin cancer or other sun-related skin lesions had a 40 percent lower risk for pancreatic cancer than those who had not reported skin lesions.

“There is increasing interest in the role of sun exposure, which has been largely attributed to the effect of vitamin D, on cancer incidence and mortality,” Neale explained. “It is important that we understand the risks and benefits of sun exposure because it has implications for public health messages about sun exposure, and possibly about policy related to vitamin D supplementation or food fortification.”

Moving forward, Neale recommended that researchers conduct large cohort studies that measure sun exposure comprehensively, and serum vitamin D.

“There are several trials of vitamin D that are either under way or planned, and pooling data from these might give some clue about vitamin D and pancreatic cancer,” Neale said.

Too much salt may damage blood vessels /lead to high blood pressure

Eating a high-salt diet for several years may damage blood vessels — increasing your risk of developing high blood pressure, according to research reported in the American Heart Association journal Circulation. People with this type of blood vessel damage who eat a high-salt diet

are more likely to develop hypertension, or high blood pressure. This research hints at the presence of a "sodium amplification loop" in which eating too much salt for a long time damages blood vessels, leading to a greater chance of developing high blood pressure if the high-salt diet is continued.

Researchers didn't assess the cause-and-effect relationship between salt intake and high blood pressure. But the study's results "add to the considerable evidence that a diet heavy on salt is closely linked to high blood pressure," said John Forman, M.D., lead author of the study and a nephrologist at Brigham and Women's Hospital and Harvard Medical School in Boston, Mass.

"In addition, this study reinforces guidelines backed by the American Heart Association and other professional organizations that recommend reducing salt consumption to minimize the risk of developing high blood pressure," Forman said.

One gram of sodium is equal to 2.5 grams of table salt (sodium chloride).

Researchers conducted an observational study (PREVEND) in which they tracked the sodium intake of 5,556 men and women from the general population of Groningen, Netherlands. Sodium intake was assessed by collecting multiple 24-hour urine samples, which is considered the optimal method to measure sodium intake.

Researchers analyzed the association between sodium consumption and blood levels of uric acid and albumin in the urine — both markers of blood vessel damage — in participants not taking high blood pressure medicine.

During a median follow-up of 6.4 years, 878 new hypertension diagnoses were made.

Higher sodium intake was associated with increasing levels of uric acid and albumin over time. The higher the levels of these markers, the greater the risk of developing hypertension if dietary salt intake was high, researchers found. Compared with participants eating the least amount of sodium (about 2,200 milligrams a day), those eating the most (about 6,200 mg/d) were 21 percent more likely to develop high blood pressure. However, those who had high uric acid levels and ate the most salt were 32 percent more likely to develop high blood pressure while those with high urine albumin levels and highest salt intake were 86 percent more likely to develop high blood pressure

A high-salt diet is believed to be responsible for 20 percent to 40 percent of all cases of high blood pressure in the United States. Because the study involved only European Caucasians, the results should be replicated in Hispanics, African-Americans and others in the United States; however, other researchers have found a link between a high-salt diet and high blood pressure in these other populations, Forman said.

Peaches, plums, nectarines fight obesity, diabetes, heart disease

Peaches, plums and nectarines have bioactive compounds that can potentially fight-off obesity-related diabetes and cardiovascular disease, according to new studies by Texas AgriLife Research.

The study, which will be presented at the American Chemical Society in Philadelphia next August, showed that the compounds in stone fruits could be a weapon against "metabolic syndrome," in which obesity and inflammation lead to serious health issues, according to Dr. Luis Cisneros-Zevallos, AgriLife Research food scientist.

"In recent years obesity has become a major concern in society due to the health problems associated to it," said Cisneros-Zevallos, who also is an associate professor at Texas A&M University. "In the U.S., statistics show that around 30 percent of the population is overweight or obese, and these cases are increasing every year in alarming numbers."

While he acknowledged that lifestyle, genetic predisposition and diet play a major role in one's tendency toward obesity, "the major concern about obesity is the associated disease known as metabolic syndrome.

"Our studies have shown that stone fruits – peaches, plums and nectarines – have bioactive compounds that can potentially fight the syndrome," Cisneros-Zevallos said. "Our work indicates that phenolic compounds present in these fruits have anti-obesity, anti-inflammatory and anti-diabetic properties in different cell lines and may also reduce the oxidation of bad cholesterol LDL which is associated to cardiovascular disease."

What is unique to these fruits, he said, is that their mixture of the bioactive compounds work simultaneously within the different components of the disease.

"Our work shows that the four major phenolic groups – anthocyanins, clorogenic acids, quercetin derivatives and catechins – work on different cells – fat cells, macrophages and vascular endothelial cells," he explained. "They modulate different expressions of genes and proteins depending on the type of compound.

"However, at the same time, all of them are working simultaneously in different fronts against the components of the disease, including obesity, inflammation, diabetes and cardiovascular disease," he explained.

Cisneros-Zevallos said this is believed to be the first time that "bioactive compounds of a fruit have been shown to potentially work in different fronts against a disease."

"Each of these stone fruits contain similar phenolic groups but in differing proportions so all of them are a good source of health promoting compounds and may complement each other," he said, adding that his team plans to continue studying the role of each type of compound on the molecular mechanisms and confirm the work with mice studies.

Resveratrol: natural exercise performance enhancer

A natural compound found in some fruits, nuts and red wine may enhance exercise training and performance, demonstrates newly published medical research from the University of Alberta.

Principal investigator Jason Dyck and his team found out in experiments that high doses of the natural compound resveratrol improved physical performance, heart function and muscle strength in lab models.

"We were excited when we saw that resveratrol showed results similar to what you would see from extensive endurance exercise training," says Dyck, who works in the Faculty of Medicine & Dentistry as a researcher in the department of Pediatrics and the department of Pharmacology. "We immediately saw the potential for this and thought that we identified 'improved exercise performance in a pill.' "

His team's findings were published in the peer-reviewed Journal of Physiology in late May.

Dyck and his team will soon start starting testing resveratrol on diabetics with heart failure to see if the natural compound can improve heart function for this patient group. The 10-week study is expected to start within the next few months.

"I think resveratrol could help patient populations who want to exercise but are physically incapable. Resveratrol could mimic exercise for them or improve the benefits of the modest amount of exercise that they can do," says Dyck. "It is very satisfying to progress from basic research in a lab to testing in people, in a short period of time."

Tai Chi increases brain size, benefits cognition in elderly

Scientists from the University of South Florida and Fudan University in Shanghai found increases in brain volume and improvements on tests of memory and thinking in Chinese seniors who practiced Tai Chi three times a week, reports an article published today in the Journal of Alzheimer's Disease.

Findings were based on an 8-month randomized controlled trial comparing those who practiced Tai Chi to a group who received no intervention. The same trial showed increases in brain volume and more limited cognitive improvements in a group that participated in lively discussions three times per week over the same time period.

Previous trials have shown increases in brain volume in people who participated in aerobic exercise, and in one of these trials, an improvement in memory was seen. However, this was the first trial to show that a less aerobic form of exercise, Tai Chi, as well as stimulating discussion led to similar increases in brain volume and improvements on psychological tests of memory and thinking.

The group that did not participate in the interventions showed brain shrinkage over the same time period, consistent with what generally has been observed for persons in their 60s and 70s.

Numerous studies have shown that dementia and the syndrome of gradual cognitive deterioration that precedes it is associated with increasing shrinkage of the brain as nerve cells and their connections are gradually lost.

"The ability to reverse this trend with physical exercise and increased mental activity implies that it may be possible to delay the onset of dementia in older persons through interventions that have many physical and mental health benefits," said lead author Dr. James Mortimer, professor of epidemiology at the University of South Florida College of Public Health.

Research suggests that aerobic exercise is associated with increased production of brain growth factors. It remains to be determined whether forms of exercise like Tai Chi that include an important mental exercise component could lead to similar changes in the production of these factors. "If this is shown, then it would provide strong support to the concept of "use it or lose it" and encourage seniors to stay actively involved both intellectually and physically," Dr. Mortimer said.

One question raised by the research is whether sustained physical and mental exercise can contribute to the prevention of Alzheimer's disease, the most common dementing illness.

"Epidemiologic studies have shown repeatedly that individuals who engage in more physical exercise or are more socially active have a lower risk of Alzheimer's disease," Dr. Mortimer said. "The current findings suggest that this may be a result of growth and preservation of critical regions of the brain affected by this illness."

Olive Oil Healthiest Dressing On Salads

The vegetables in salads are chock-full of important vitamins and nutrients, but you won't get much benefit without the right type and amount of salad dressing, a Purdue University study shows.

In a human trial, researchers fed subjects salads topped off with saturated, monounsaturated and polyunsaturated fat-based dressings and tested their blood for absorption of fat-soluble carotenoids – compounds such as lutein, lycopene, beta-carotene and zeaxanthin. Those carotenoids are associated with reduced risk of several chronic and degenerative diseases such as cancer, cardiovascular disease and macular degeneration.

The study, published early online in the journal Molecular Nutrition & Food Research, found that monounsaturated fat-rich dressings required the least amount of fat to get the most carotenoid absorption, while saturated fat and polyunsaturated fat dressings required higher amounts of fat to get the same benefit.

"If you want to utilize more from your fruits and vegetables, you have to pair them correctly with fat-based dressings," said Mario Ferruzzi, the study's lead author and a Purdue associate professor of food science. "If you have a salad with a fat-free dressing, there is a reduction in calories, but you lose some of the benefits of the vegetables."

In the test, 29 people were fed salads dressed with butter as a saturated fat, canola oil as a monounsaturated fat and corn oil as a polyunsaturated fat. Each salad was served with 3 grams, 8 grams or 20 grams of fat from dressing.

The soybean oil rich in polyunsaturated fat was the most dependent on dose. The more fat on the salad, the more carotenoids the subjects absorbed. The saturated fat butter was also dose-dependent, but to a lesser extent.

Monounsaturated fat-rich dressings, such as canola and olive oil-based dressings, promoted the equivalent carotenoid absorption at 3 grams of fat as it did 20 grams, suggesting that this lipid source may be a good choice for those craving lower fat options but still wanting to optimize absorption of health-promoting carotenoids from fresh vegetables.

"Even at the lower fat level, you can absorb a significant amount of carotenoids with monounsaturated fat-rich canola oil," Ferruzzi said. "Overall, pairing with fat matters. You can absorb significant amounts of carotenoids with saturated or polyunsaturated fats at low levels, but you would see more carotenoid absorption as you increase the amounts of those fats on a salad."

The findings build on a 2004 Iowa State University study that determined carotenoids were more bioavailable – absorbed by the intestines – when paired with full-fat dressing as opposed to low-fat or fat-free versions. Ferruzzi; Wayne Campbell, a Purdue professor of nutrition science; Shellen Goltz, a Purdue graduate student in food science; and their collaborators, Chureeporn Chitchumroonchokchai and Mark L. Failla at Ohio State University, are the first to study different types of fats in differing amounts in human subjects.

Vitamin D with calcium shown to reduce mortality in elderly

Study shows vitamin D and calcium reduce mortality but not vitamin D alone

A study recently published in the Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM) suggests that vitamin D—when taken with calcium—can reduce the rate of mortality in seniors, therefore providing a possible means of increasing life expectancy.

During the last decade, there has been increasing recognition of the potential health effects of vitamin D. It is well known that calcium with vitamin D supplements reduces the risk of fractures. The present study assessed mortality among patients randomized to either vitamin D alone or vitamin D with calcium. The findings from the study found that the reduced mortality was not due to a lower number of fractures, but represents a beneficial effect beyond the reduced fracture risk.

"This is the largest study ever performed on effects of calcium and vitamin D on mortality," said Lars Rejnmark, PhD, of Aarhus University Hospital in Denmark and lead author of the study. "Our results showed reduced mortality in elderly patients using vitamin D supplements in combination with calcium, but these results were not found in patients on vitamin D alone."

In this study, researchers used pooled data from eight randomized controlled trials with more than 1,000 participants each. The patient data set was comprised of nearly 90 percent women, with a median age of 70 years. During the three-year study, death was reduced by 9 percent in those treated with vitamin D with calcium.

"Some studies have suggested calcium (with or without vitamin D) supplements can have adverse effects on cardiovascular health," said Rejnmark. "Although our study does not rule out such effects, we found that calcium with vitamin D supplementation to elderly participants is overall not harmful to survival, and may have beneficial effects on general health".

Statins Shown to Cause Fatigue

In a study of more than 1,000 adults, researchers at the University of California, San Diego, found that individuals taking cholesterol-lowering statin drugs are more likely than non-users to experience decreased energy, fatigue upon exertion, or both. The researchers suggest that these findings should be taken into account by doctors when weighing risk versus benefit in prescribing statins.

Statin drugs are among the best selling and most widely used prescription drugs on the market. Recently, increasing attention has focused on statins’ side effects, particularly their effect on exercise. While some patients have reported fatigue or exercise intolerance when placed on statins, randomized trials had not previously addressed occurrence of fatigue-with-exertion or impaired energy in patients on statins relative to placebo.

In the June 11 issue of Archives of Internal Medicine, Beatrice Golomb, MD, PhD, associate professor of medicine at UC San Diego School of Medicine, and colleagues present randomized trial data which show that these side effects were significantly greater in persons placed on statins than those on a placebo.

More than 1,000 adults from San Diego were randomly allocated to identical capsules with placebo, or one of two statins at relatively low potencies: pravastatin (Pravachol) at 40mg, or simvastatin (Zocor) at 20mg – chosen as the most water-soluble and most fat-soluble of the statins, at doses expected to produce similar LDL (“bad cholesterol”) reduction. According to the researchers, the cholesterol reduction would be similar to that expected with atorvastatin (Lipitor) at 10mg, or rosuvastatin (Crestor) at 2.5-5mg.

Persons with heart disease and diabetes were excluded. Neither subjects nor investigators knew which agent the subject had received. Subjects rated their energy and fatigue with exertion relative to baseline, on a five-point scale, from “much worse” to “much better.”

Those placed on statins were significantly more likely than those on placebo to report worsening in energy, fatigue-with-exertion, or both. Both statins contributed to the finding, though the effect appeared to be stronger in those on simvastatin. (Simvastatin led to significantly greater cholesterol reduction.)

“Side effects of statins generally rise with increasing dose, and these doses were modest by current standards,” said Golomb. “Yet occurrence of this problem was not rare – even at these doses, and particularly in women.”

The magnitude of the effect observed can be seen in the research findings if, for example, 4 of 10 treated women on simvastatin cited worsened energy or exertional fatigue; 2 in 10 cited worsening in both, or rated either one as “much worse”; or if 1 in 10 study participants rated energy and exertional fatigue as “much worse.”

“Energy is central to quality of life. It also predicts interest in activity,” said Golomb. “Exertional fatigue not only predicts actual participation in exercise, but both lower energy and greater exertional fatigue may signal triggering of mechanisms by which statins may adversely affect cell health.”

For these reasons, the researchers state that decreases in energy, and increases in exertional fatigue on statins represent important findings which should be taken into account in risk-benefit determinations for statins. According to Golomb, this is particularly true for groups for whom evidence does not support mortality benefit on statins – such as most patients without heart disease, and women and those over 70 or 75, even if heart disease is present.

Aspirin before heart surgery reduces the risk of post-operative acute kidney failure

Aspirin taken for five days before a heart operation can halve the numbers of patients developing post-operative acute kidney failure, according to research presented at the European Anaesthesiology Congress in Paris today (Sunday).

Professor Jianzhong Sun (MD, PhD), professor and attending anaesthesiologist at Jefferson Medical College, Thomas Jefferson University (Philadelphia, USA), told the meeting that in a study of 3,219 patients, pre-operative aspirin therapy was associated with a reduction in acute renal failure of about three in every 100 patients undergoing coronary artery bypass graft (CABG), valve surgery or both.

The patients were divided into two groups: those taking aspirin within five days before their operation (2,247 patients) and those not taking it (972 patients) [1]. Although the researchers had no record of the precise dose taken, doses of between 80-325mg per day is the normal dose for aspirin that is taken over a period of time.

After adjusting their results for various differing characteristics such as age, disease, and other medications, the researchers found that pre-operative aspirin was associated with a significant decrease in the incidence of post-operative kidney failure: acute renal failure occurred in 86 out of 2247 patients (3.8%) taking aspirin, and in 65 out of 972 patients (6.7%) not taking it [1]. This represented an approximate halving in the risk of acute renal failure.

Prof Sun said: "Thus, the results of this clinical study showed that pre-operative therapy with aspirin is associated with preventing about an extra three cases of acute renal failure per 100 patients undergoing CABG or/and valve surgery."

Acute renal failure or injury is a common post-operative complication and has a significant impact on the survival of patients undergoing heart surgery. "It significantly increases hospital stay, the incidence of other complications and mortality," said Prof Sun. "From previous reports, up to 30% of patients who undergo cardiac surgery develop acute renal failure. In our studies, about 16-40% of cardiac surgery patients developed it in various degrees, depending upon how their kidneys were functioning before the operation. Despite intensive studies we don't understand yet why kidney failure can develop after cardiac surgery, but possible mechanisms could involve inflammatory and neurohormonal factors, reduced blood supply, reperfusion injury, kidney toxicity and/or their combinations."

He continued: "For many years, aspirin as an anti-platelet and anti-inflammatory agent has been one of the major medicines in prevention and treatment of cardiovascular disease in non-surgical settings. Now its applications have spread to surgical fields, including cardiac surgery, and further, to non-cardiovascular diseases, such as the prevention of cancer. Looking back and ahead, I believe we can say that aspirin is really a wonder drug, and its wide applications and multiple benefits are truly beyond what we could expect and certainly worthy of further studies both in bench and bedside research."

Prof Sun said that more observational and randomised controlled clinical trials were required to investigate the role played by aspirin in preventing post-operative kidney failure, but he believed that the effect might also be seen in patients undergoing non-cardiac surgeries.

"For instance, the PeriOperative ISchemic Evaluation-2 trial (POISE-2) [2] is ongoing and aims to test whether small doses of aspirin, given individually for a short period before and after major non-cardiac surgeries, could prevent major cardiovascular complications such as heart attacks and death, around the time of surgery."

Other findings from Prof Sun's research showed that diabetes, high blood pressure, heart disease, heart failure, and diseases of the vascular system were all independent risk factors for post-operative acute kidney failure.