Latest Health Reseach + Previous Reports

Lots of controversy about the efficacy of vitamins lately, especially two I take, B-12 (I take Zantac – see below) and D-3:

Daily multivitamin won't help boost the average American's health

Three new studies find that a daily multivitamin won't help boost the average American's health.

The studies found that popping a daily multivitamin didn't ward off heart problems or memory loss, and wasn't tied to a longer life span.

The studies, published in the Dec. 17 issue of the journal Annals of Internal Medicine, found that multivitamin and mineral supplements did not work any better in these respects than placebo pills.

Most clinical studies on vitamins flawed by poor methodology

“More than 90 percent of U.S. adults don’t get the required amounts of vitamins D and E for basic health,” Frei said. “More than 40 percent don’t get enough vitamin C, and half aren’t getting enough vitamin A, calcium and magnesium… Even though such studies often significantly understate the value of vitamin supplements, the largest and longest clinical trial of multivitamin/mineral supplements found a total reduction of cancer and cataract incidence in male physicians over the age of 50. It suggested that if every adult in the U.S. took such supplements it could prevent up to 130,000 cases of cancer each year", Frei said.

Acid-Reflux Drugs Tied to Lower Levels of Vitamin B-12

People who take certain acid-reflux medications might have an increased risk of vitamin B-12 deficiency, according to new research published in the Journal of the American Medical Association. Taking proton pump inhibitors (PPIs) to ease the symptoms of excess stomach acid for more than two years was linked to a 65 percent increase in the risk of vitamin B-12 deficiency. Commonly used PPI brands include Prilosec, Nexium and Prevacid. Researchers also found that using acid-suppressing drugs called histamine-2 receptor antagonists -- also known as H2 blockers -- for two years was associated with a 25 percent increase in the risk of B-12 deficiency. Common brands include Tagamet, Pepcid and Zantac.

Low vitamin B12 levels increase the risk of fractures in older men


Vitamin D Supplements Won't Help Prevent Disease: Review

ow levels of vitamin D have been implicated as a potential cause of diseases ranging from cancer to diabetes. Now an extensive review suggests it's really the other way around: Low levels of the "sunshine vitamin" are more likely a consequence -- not a cause -- of illness.

In their review of almost 500 studies, the researchers found conflicting results. Observational studies, which looked back at what people ate or the kinds of supplements they took, showed a link between higher vitamin D levels in the body and better health.

But, in studies where vitamin D was given as an intervention (treatment) to help prevent a particular ailment, it had no effect. The one exception was a decreased death risk in older adults, particularly older women, who were given vitamin D supplements.

Vitamin D is known to play a key role in bone health. Low levels of vitamin D have been found in a number of conditions, including heart disease, autoimmune diseases, diabetes, cancer and Parkinson's disease. These findings may explain why so many Americans are currently taking vitamin D supplements.

The observational studies showed a potential benefit from vitamin D. For example, vitamin D was associated with a 58 percent reduced risk of cardiovascular events, a 38 percent decreased risk of diabetes and a 34 percent decreased risk of colon cancer in these studies.

But, when the researchers looked to the randomized clinical trials that used vitamin D as a treatment, they failed to find any effect on disease occurrence or severity from raising vitamin D levels.

However, vitamin D did reduce the risk of dying from any cause in older people taking 800 international units a day, according to the review.

Low vitamin D causes damage to the brain">

My high school sports : 4 years of tennis, one of soccer, but I'm very active now, and have been for quite some time:

Seventy year olds who don’t frequently visit the doctor have something unexpected in common – most played high school sports. They were active on a team over 50 years ago and are more likely to be active into their late 70s.

Regular physical activity in later life boosts likelihood of 'healthy aging' up to sevenfold

Four years of sustained regular physical activity boosted the likelihood of healthy aging sevenfold compared with consistent inactivity, the findings show.

Those who had regularly indulged in moderate or vigorous physical activity at least once a week were three to four times more likely to be healthy agers than those who had remained inactive, after taking account of other influential factors.

Those who became physically active also reaped benefits, compared with those who did nothing. They were more than three times as likely to be healthy agers.

And those who sustained regular physical activity over the entire period were seven times as likely to be healthy agers as those who had consistently remained inactive.

Regular exercise in middle age protects against muscle weakness later in life">

Even small amounts of physical activity may decrease the risk of developing kidney stones, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The study also found that consuming too many calories may increase risk.

People who exercise regularly are better at creative thinking


Aerobic fitness improves memory

I'm glad I eat oatmeal for most breakfasts, often pretty slowly, but I can't say I'm not hungry again soon:

Oatmeal Beats Ready-To-Eat Breakfast Cereal at Improving Appetite Control

Slower-paced meal reduces hunger

Lots of other interesting reports, including:


Importance of Meat and Other Animal Products in Cancer Risk Highlighted

Fructose does not impact triglycerides, an important indicator for cardiovascular disease

Fiber-Rich Foods May Cut Your Risk of Heart Disease

Diet rich in tomatoes may lower breast cancer risk

An Apple a Day Keeps the Doctor Away

Debate continues on impact of artificial sweeteners

Moderate consumption of alcohol can improve immune response

High cholesterol fuels the growth and spread of breast cancer





If you find this report interesting, you will probably enjoy reading these:

Previous Reports


2013

1/5/13

1/29/13

2/23/13

3/20/13

4/13/13

5/4/13

5/24/13

7/6/13

8/3/13

8/27/13


9/21/13


10/14/13

11/8/13

11/23/13

2012

December 1

October 22

September 13

August 10

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June 2

May 18

May 7

April 24

March 28


3/6/12

2/7/12

1/27/12

1/3/12


2011

12/7/11

11/12/11

October 29

October 7

September 19

August 26

August 11

July 22

June 25

June 4

May 21

May 7

April 13

March 29

March 2

Importance of Meat and Other Animal Products in Cancer Risk Highlighted

Other risk factors include smoking, alcohol consumption, and sweeteners, with solar ultraviolet-B radiation reducing risk

A multicountry study just published in Nutrients finds that smoking, diets rich in animal products, and alcohol have the strongest correlations with cancer incidence rates. The cancer incidence rates are from 2008 as assembled by the International Agency for Research on Cancer of the World Health Organization.

This study is an ecological study in which incidence rates for the various types of cancer for males and females from 87 countries with high quality cancer incidence rate data as well as all 157 countries with cancer incidence rate data were compared statistically with indices for various risk modifying factors. Dietary supply data were obtained from the Food and Agriculture Organization of the United Nations. Data for various periods back to 1980 were included since there is generally a lag of up to 20 years between dietary changes and peak cancer rates. The animal products index includes meat, milk, fish, and eggs. Lung cancer incidence rates were used as an index for the effects of smoking and air pollution. This index integrates the effect of all factors contributing to lung cancer and other cancers linked to lifetime smoking and is a much better index than a snapshot of smoking rates. Latitude was used as an index of solar ultraviolet-B irradiance and vitamin D production.

For the 87 countries with high quality cancer data, the smoking and animal products indices explained over half of the cancer incidence rates, with alcoholic beverage supply explaining a smaller amount. For males, the smoking index was twice as important as the animal product index, while for females, the animal product index was twice as important. These two factors explained 70% of the variation in all cancer less lung cancer rates between countries. The range for these cancers for males extends from 75 to 300 cases/100,000/year, while that for females extends from 80 to 260 cases/100,000/year.

The results for some specific cancers are interesting.

The types of cancer for which animal products had the strongest correlation include female breast, corpus uteri, kidney, ovarian, pancreatic, prostate, testicular, thyroid cancer, and multiple myeloma. The reason why animal products increase the risk of cancer is most likely since animal products promote growth of the body as well as tumors through production of insulin-like growth factor-I (IGF-I). For example, older Japanese are generally shorter than Westerners while younger Japanese are about as tall as Westerners. The traditional Japanese diet derived 10% of its calories from animal products, primarily seafood. Japan has made the nutritional transition to the Western diet, with 20% of the calories derived from animal products. Rates of cancer types common in Western countries rose considerably in Japan during the past 20-30 years.

The findings regarding animal products extend the results reported earlier. For example, in 1907 a study reported in the New York Times reported that cancer rates were much higher among people in ethnic groups such as Germans, Irish, Scandinavians, and Slavonians, who were considered meat eaters, while cancer rates were lowest for Italians and Chinese, who were practically vegetarians:

Cancer Increasing among Meat Eaters. New York Times, Sep 24, 1907. _http://query.nytimes.com/gst/abstract.html?res=9502E1D81331E733A25757C2A96F9C946697D6CF (accessed 24 December 2013)

The present study also extends this classic study, which was largely ignored until a few years ago when observational studies on younger women found that meat was a risk factor for breast cancer.

Armstrong B, Doll R. Environmental factors and cancer incidence and mortality in different countries, with special reference to dietary practices. Int J Cancer. 1975;15:617-31.

Observational studies in Uruguay by Eduardo De Stefani and his group have reported meat consumption as an important risk factor for several types of cancer. The papers can be accessed through pubmed.gov.

Also, Seventh-Day Adventists, who are generally vegetarians, have lower cancer rates than other Americans:_Tantamango-Bartley Y, Jaceldo-Siegl K, Fan J, Fraser G. Vegetarian diets and the incidence of cancer in a low-risk population. Cancer Epidemiol Biomarkers Prev. 2013;22:286-94.

Commenting on this study, Neal Barnard, M.D., President of the Physicians Committee and on the faculty of the George Washington University School of Medicine, said "This is an important study showing strong relationships between meaty diets and cancer risk. There's a clear-cut lesson there for national food policies."

Mark McCarty, Research Director of the non-profit Catalytic Longevity, said “This compelling new study clarifies the over-riding impact of smoking and animal product consumption as environmental determinants of global cancer risk. In fact, it’s the most impressive evidence I’ve yet encountered indicting animal products per se as a major cancer risk factor. It’s notable that animal fat consumption did not correlate nearly as tightly with risk as total animal calories; that’s likely because other factors such as high-quality protein, heme iron, mutagens derived from cooked flesh, and possibly bioavailable phosphorus contribute to the impact of dietary animal products on cancer risk. It’s quite fortunate that smoking and animal product consumption are lifestyle choices within our personal control.”

Alcoholic beverage supply was found significantly correlated with only one type of cancer, colorectal.

Lung cancer was associated with animal fat supply in addition to cigarette supply. This finding is consistent with studies from 20-30 years ago noting that although smoking rates in Japan and the United States were similar, lung cancer rates were much higher in the United States.

Added sweeteners were associated with incidence of brain (females), corpus uteri, pancreatic, and prostate cancer.

For several cancers, latitude was significantly correlated with incidence rates: bladder, brain, colorectal (females), Hodgkin’s lymphoma, kidney, and melanoma. Latitude is assumed to be an index of solar ultraviolet-B doses and vitamin D production, and both have been found associated with reduced cancer incidence and/or mortality rates in many studies. See, for example,_Moukayed M, Grant WB. Molecular link between vitamin D and cancer prevention. Nutrients. 2013;5(10):3993-4023._However, the correlation of latitude with melanoma rates is more likely due to variations in skin pigmentation; darker skin pigmentation reduces the penetration of UV to the deeper layers of the skin where it can cause melanoma.

The paper is freely available:_Grant WB. A multicountry ecological study of cancer incidence rates in 2008 with respect to various risk-modifying factors, Nutrients. 2014;6(1):163-189. http://www.mdpi.com/journal/nutrients

The Secret to Fewer Doctor Office Visits after 70 – Play High School Sports

Seventy year olds who don’t frequently visit the doctor have something unexpected in common – most played high school sports. They were active on a team over 50 years ago and are more likely to be active into their late 70s.

The new study, titled “Fit in 50 Years,” was published in BMC Public Health looked at what factors of behavior, background, and personality impact the healthfulness of men over 70. The study was conducted by researchers Brian Wansink PhD of Cornell University's Food and Brand Lab and Simone Dohle PhD of the Swiss Federal Institute of Technology, Zurich.

The study tracked 712 World War II veterans who were healthy as young men – they had passed a rigorous physical exam when being screened for the military—and surveyed them 50 years later at average of 78 years. The most surprising result was that those who had played a high school sport in the 1930s or early 1940s, reported visiting their doctor fewer times a year.

Also, the best predictor of whether a healthy young man would regularly exercise 50 years later was simply whether he had played a team or individual sport in high school. Many of those who played a high school sport were still active compared to those who didn't.


Decreased physical activity among youth is a rising concern in the US. Inactive children are more likely to be obese and suffer from mental and physical health problems. One way to further assess the importance of physical activity in children and adolescents is to look at the long-term impacts of physical activity on overall health and wellbeing, as this study did. The results emphasize the necessity of encouraging youths to regularly engage in athletic programs and other exercise activities such as swimming or dance. Physical activity programs are often hurt by budget cuts, leaving children with fewer or no opportunities to be active on a regular basis. This study provides evidence that can be used to inform schools, youth centers, and program funders about the long-term, hugely positive impact of providing opportunities for children and adolescents to engage in physical activities.

Slower-paced meal reduces hunger but affects calorie consumption differently

Obesity rates in the United States increased from 14.5% of the population in 1971-1974 to 35.9% of the population in 2009-2010. It's believed that one contributing factor to expanding waistlines is the reported increase in energy intake. Research suggests that the ability to control energy intake may be affected by the speed at which we eat, and a high eating rate may impair the relationship between the sensory signals and processes that regulate how much we eat.

In order to learn more about the relationship between eating speed and energy intake, a team of researchers in the Department of Kinesiology at Texas Christian University took a look at how eating speed affects calories consumed during a meal in both normal weight subjects as well as overweight or obese subjects. The investigators also collected data on feelings of hunger and fullness before and after the fast-paced and slow-paced meals and water consumption during the meals. Their results are published in the Journal of the Academy of Nutrition and Dietetics.

While previous studies have reviewed the relationship between eating speed and body weight, most of those studies were conducted with normal-weight individuals. In this new study, investigators asked a group of normal-weight subjects and a group of overweight or obese subjects to consume two meals in a controlled environment. All subjects ate one meal at a slow speed, for which they were instructed to imagine that they had no time constraints, take small bites, chew thoroughly, and pause and put the spoon down between bites, and a second meal at a fast speed, for which they were instructed to imagine that they had a time constraint, take large bites, chew quickly, and not pause and put the spoon down.

At the conclusion of the study, researchers found that only normal-weight subjects had a statistically significant reduction in caloric consumption during the slow compared to the fast meal: 88 kcal less for the normal weight group, versus only 58 kcal less for the overweight or obese group.

"Slowing the speed of eating led to a significant reduction in energy intake in the normal-weight group, but not in the overweight or obese group. A lack of statistical significance in the overweight and obese group may be partly due to the fact that they consumed less food during both eating conditions compared to the normal-weight subjects," explained lead author Meena Shah, PhD, professor in the Department of Kinesiology at Texas Christian University. "It is possible that the overweight and obese subjects felt more self-conscious, and thus ate less during the study."

Despite the differences in caloric consumption between the normal-weight and overweight and obese subjects, the study found some similarities. Both groups felt less hungry later on after the slow meal than after the fast meal. "In both groups, ratings of hunger were significantly lower at 60 minutes from when the meal began during the slow compared to the fast eating condition," added Dr. Shah. "These results indicate that greater hunger suppression among both groups could be expected from a meal that is consumed more slowly."

Also, both the normal weight and overweight or obese groups consumed more water during the slow meal. During the fast condition, participants across the study only consumed 9 ounces of water, but during the slow condition, that amount rose to 12 ounces. "Water consumption was higher during the slow compared to the fast eating condition by 27% in the normal weight and 33% in the overweight or obese group. The higher water intake during the slow eating condition probably caused stomach distention and may have affected food consumption," said Dr. Shah.

With obesity rates continuing to rise among the adult population in the United States, information about how different weight groups approach and consume food will be helpful in crafting strategies to lower energy intake, but for now, Dr. Shah suggested, "Slowing the speed of eating may help to lower energy intake and suppress hunger levels and may even enhance the enjoyment of a meal."

Fructose does not impact emerging indicator for cardiovascular disease

Fructose, the sugar often blamed for the obesity epidemic, does not itself have any impact on an emerging marker for the risk of cardiovascular disease known as postprandial triglycerides, new research has found.

However, overconsumption of calories from fructose can have substantial adverse effects on health, said Dr. John Sievenpiper, a researcher in the Clinical Nutrition and Risk Factor Modification Centre of St. Michael's Hospital.

"This is more evidence that fructose has adverse effects only insofar as it contributes to excess calories," said Dr. Sievenpiper.

Fructose, which is naturally found in fruit, vegetables and honey, is a simple sugar that together with glucose forms sucrose, the basis of table sugar. It is also found in high-fructose corn syrup, the most common sweetener in commercially prepared foods.

Dr. Sievenpiper conducted a meta-analysis of existing studies on fructose and its impact on the level of triglycerides, a fat found in blood, after eating. Testing for these triglycerides—in addition to the standard testing for blood glucose levels—is becoming more common for people trying to determine their risk for cardiovascular disease, although health care professionals remain divided on its usefulness.

Dr. Sievenpiper's results appear in the January 2014 issue of the journal Atheroclerosis.

"Fructose doesn't behave any differently than other refined carbohydrates," he said. "The increases you see are when fructose provides extra calories."

Most clinical studies on vitamins flawed by poor methodology

Most large, clinical trials of vitamin supplements, including some that have concluded they are of no value or even harmful, have a flawed methodology that renders them largely useless in determining the real value of these micronutrients, a new analysis suggests.

Many projects have tried to study nutrients that are naturally available in the human diet the same way they would a powerful prescription drug. This leads to conclusions that have little scientific meaning, even less accuracy and often defy a wealth of other evidence, said Balz Frei, professor and director of the Linus Pauling Institute at Oregon State University, in a new review published in the journal Nutrients.

These flawed findings will persist until the approach to studying micronutrients is changed, Frei said. Such changes are needed to provide better, more scientifically valid information to consumers around the world who often have poor diets, do not meet intake recommendations for many vitamins and minerals, and might greatly benefit from something as simple as a daily multivitamin/mineral supplement.

Needed are new methodologies that accurately measure baseline nutrient levels, provide supplements or dietary changes only to subjects who clearly are inadequate or deficient, and then study the resulting changes in their health. Tests must be done with blood plasma or other measurements to verify that the intervention improved the subjects’ micronutrient status along with biomarkers of health. And other approaches are also needed that better reflect the different ways in which nutrients behave in cell cultures, lab animals and the human body.

The new analysis specifically looked at problems with the historic study of vitamin C, but scientists say many of the observations are more broadly relevant to a wide range of vitamins, micro nutrients and studies.

“One of the obvious problems is that most large, clinical studies of vitamins have been done with groups such as doctors and nurses who are educated, informed, able to afford healthy food and routinely have better dietary standards than the public as a whole,” said Frei, an international expert on vitamin C and antioxidants.

Vitamin or mineral supplements, or an improved diet, will primarily benefit people who are inadequate or deficient to begin with, OSU researchers said. But most modern clinical studies do not do baseline analysis to identify nutritional inadequacies and do not assess whether supplements have remedied those inadequacies. As a result, any clinical conclusion made with such methodology is pretty much useless, they said.

“More than 90 percent of U.S. adults don’t get the required amounts of vitamins D and E for basic health,” Frei said. “More than 40 percent don’t get enough vitamin C, and half aren’t getting enough vitamin A, calcium and magnesium. Smokers, the elderly, people who are obese, ill or injured often have elevated needs for vitamins and minerals.

“It’s fine to tell people to eat better, but it’s foolish to suggest that a multivitamin which costs a nickel a day is a bad idea.”

Beyond that, many scientists studying these topics are unaware of ways in which nutrients may behave differently in something like a cell culture or lab animal, compared to the human body. This raises special challenges with vitamin C research in particular.

“In cell culture experiments that are commonly done in a high oxygen environment, vitamin C is unstable and can actually appear harmful,” said Alexander Michels, an LPI research associate and lead author on this report. “And almost every animal in the world, unlike humans, is able to synthesize its own vitamin C and doesn’t need to obtain it in the diet. That makes it difficult to do any lab animal tests with this vitamin that are relevant to humans.”

Even though such studies often significantly understate the value of vitamin supplements, the largest and longest clinical trial of multivitamin/mineral supplements found a total reduction of cancer and cataract incidence in male physicians over the age of 50. It suggested that if every adult in the U.S. took such supplements it could prevent up to 130,000 cases of cancer each year, Frei said.

“The cancer reduction would be in addition to providing good basic health by supporting normal function of the body, metabolism and growth,” he said. “If there’s any drug out there that can do all this, it would be considered unethical to withhold it from the general public. But that’s basically the same as recommending against multivitamin/mineral supplements.”

Fiber-Rich Foods May Cut Your Risk of Heart Disease

Boosting the amount of fiber in your diet may lower your risk for heart disease, a new study finds.

"With so much controversy causing many to avoid carbohydrates and grains, this trial reassures us of the importance of fiber in the prevention of cardiovascular disease," said one expert not connected to the study, Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital, in New York City.

In the study, researchers led by Diane Threapleton, of the School of Food Science and Nutrition at the University of Leeds, in England, analyzed data from the United States, Australia, Europe and Japan to assess different kinds of fiber intake.

Her team looked at total fiber; insoluble fiber (such as that found in whole grains, potato skins) soluble fiber (found in legumes, nuts, oats, barley); cereal; fruits and vegetables and other sources.

The study also looked at two categories of heart disease. One, "coronary heart disease" refers to plaque buildup in the heart's arteries that could lead to a heart attack, according to the American Heart Association. The second type of heart trouble is called "cardiovascular disease" -- an umbrella term for heart and blood vessel conditions that include heart attack, stroke, heart failure and other problems, the AHA explains.

The more total, insoluble, and fruit and vegetable fiber that people consumed, the lower their risk of both types of heart disease, the study found. Increased consumption of soluble fiber led to a greater reduction in cardiovascular disease risk than coronary heart disease risk. Meanwhile, cereal fiber reduced the risk of coronary heart disease more than the risk of cardiovascular disease, researchers found.

For every additional 7 grams per day of fiber consumed, there was a significantly lower risk of both types of disease, according to the study published online Dec. 19 in BMJ.

Sports dietitian Dana Angelo White said the findings are in line with what nutritionists have long known about the importance of a high-fiber diet.

"The tricky part is finding ways to get Americans to eat more [fiber]," said White, who is also an assistant clinical professor at Quinnipiac University in Hamden, Conn. "The daily recommendation ranges from 20 to 38 grams per day. This may seem like a tall order for most folks, but can be achieved by making some small dietary changes."

The British study found that adding just 7 grams per day of fiber to the diet boosts heart health. According to White, people can get that amount of fiber from the following:

* 1 1/2 cups of cooked oatmeal (7 grams)
* 1 1/4 cups of shredded wheat cereal (8 grams)
* Two slices of whole-wheat bread (6 to 7 grams)
* One large pear (8 grams)
* 1 cup raspberries (8 grams)
* 1/2 cup black beans (7.5 grams)

The study authors said their findings support current recommendations for increased fiber intake and that the reduced heart disease risk associated with consuming more fiber could potentially benefit "many thousands" of people, according to a journal news release.

Steinbaum added that "it's critical that people understand that whole grains -- such as barley, bulgur, millet, quinoa, brown rice, rye, oats and whole wheat, along with fruits, vegetables, nuts and seeds -- are part of a heart-healthy diet."

My Other Health-Related Blogs

1. Pregnancy and Health

2. Hospice Care Research

3. Children's Health and Welfare

4. Complementary and Alternative Medicine

5. Prostate Cancer Research Report

6. My Bad Knees

7. Dental News Report

Some recent posts:

Chewing Gum is Often the Culprit for Migraine Headaches in Teens

Children's Health and Welfare

*Study finds that 87 percent of teens who quit chewing experience significant relief* Teenagers are notorious for chewing a lot of gum. The lip smacking, bubble popping, discarded gum stuck to the sole give teachers and parents a headache. Now, Dr. Nathan Watemberg of Tel Aviv University-affiliated Meir Medical Center has found that gum-chewing teenagers, and younger children as well, are giving themselves headaches too. His findings, published in Pediatric Neurology, could help treat countless cases of migraine and tension headaches in adolescents without the need for additional... more »



Physicians who prefer hospice care for themselves more likely to discuss it with patients

Hospice Care Research
*Despite preferences for their own care, many physicians still delay hospice discussions with patients* Although the vast majority of physicians participating in a multiregional study indicated that they would personally enroll in hospice care if they received a terminal cancer diagnosis, less than one-third would discuss hospice care early in the course of treating a terminally ill cancer patient. A research letter published online in *JAMA Internal Medicine *also identifies factors that increased the likelihood that physicians would choose hospice care for themselves and examine...



Junk food and poor oral health increase risk of premature heart disease

Dental News Report

The association between poor oral health and increased risk of cardiovascular disease should make the reduction of sugars such as those contained in junk food, particularly fizzy drinks, an important health policy target, say experts writing in the *Journal of the Royal Society of Medicine*. Poor oral hygiene and excess sugar consumption can lead to periodontal disease where the supporting bone around the teeth is destroyed. It is thought that chronic infection from gum disease can trigger an inflammatory response that leads to heart disease through a process called atherosclerosi... more

Debate continues on impact of artificial sweeteners

New research from the University of Adelaide has added to the debate about how our bodies respond to artificial sweeteners and whether they are good, bad or have no effect on us.

In a study published in this month's Diabetes Care journal, researchers in the University's School of Medicine and the Nerve-Gut Laboratory have found that artificially sweetened drinks produced no different response in the healthy human gut to a glass of water.

The findings, by PhD student Dr Tongzhi Wu, are contrary to some other studies in humans and in laboratory-based research.

"This is a controversial area because there's a lot of conflicting research into artificial sweeteners," says senior author Associate Professor Chris Rayner, from the University of Adelaide's School of Medicine and Consultant Gastroenterologist at the Royal Adelaide Hospital.

"The scientific debate centers on whether artificial sweeteners have a negative impact on our bodies, such as leading to the storage of fat. There are also questions about whether they have a beneficial impact, such as producing responses that signal fullness to the brain, or if they are inert and produce no impact.

"In our most recent study involving healthy men, we found that the gut's response to artificially sweetened drinks was neutral – it was no different to drinking a glass of water.

"The fact is, the human studies have been unclear as to whether artificial sweeteners have a positive or negative effect, and this is why we're keen to better understand what's happening in our bodies," Associate Professor Rayner says.

Co-author Dr Richard Young, Senior Postdoctoral Researcher in the University's Nerve-Gut Research Laboratory, says population-level studies have yet to agree on the effects of long-term artificial sweetener intake in humans. However, a recent study has shown an increased risk of developing type 2 diabetes in regular and high consumers of artificially sweetened drinks.

"Those studies indicate that artificial sweeteners may interact with the gut in the longer term, but so far no-one's managed to determine the actual mechanisms through which these sweeteners act," Dr Young says.

"It's a complicated area because the way in which the sweet taste receptors in our gut detect and act on sweetness is very complex.

"So far it appears that artificial sweeteners have limited impact in the short term, but in people in a pre-diabetic or diabetic state, who are more likely to be regularly high users of artificial sweeteners, it might be a different story altogether. This is why more research is needed," Dr Young says.

Diet rich in tomatoes may lower breast cancer risk

A tomato-rich diet may help protect at-risk postmenopausal women from breast cancer, according to new research accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Breast cancer risk rises in postmenopausal women as their body mass index climbs. The study found eating a diet high in tomatoes had a positive effect on the level of hormones that play a role in regulating fat and sugar metabolism.

“The advantages of eating plenty of tomatoes and tomato-based products, even for a short period, were clearly evident in our findings,” said the study’s first author, Adana Llanos, PhD, MPH, who is an Assistant Professor of Epidemiology at Rutgers University. Llanos completed the research while she was a postdoctoral fellow with Electra Paskett, PhD, at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. “Eating fruits and vegetables, which are rich in essential nutrients, vitamins, minerals and phytochemicals such as lycopene, conveys significant benefits. Based on this data, we believe regular consumption of at least the daily recommended servings of fruits and vegetables would promote breast cancer prevention in an at-risk population.”

The longitudinal cross-over study examined the effects of both tomato-rich and soy-rich diets in a group of 70 postmenopausal women. For 10 weeks, the women ate tomato products containing at least 25 milligrams of lycopene daily. For a separate 10-week period, the participants consumed at least 40 grams of soy protein daily. Before each test period began, the women were instructed to abstain from eating both tomato and soy products for two weeks.

When they followed the tomato-rich diet, participants’ levels of adiponectin – a hormone involved in regulating blood sugar and fat levels – climbed 9 percent. The effect was slightly stronger in women who had a lower body mass index.

“The findings demonstrate the importance of obesity prevention,” Llanos said. “Consuming a diet rich in tomatoes had a larger impact on hormone levels in women who maintained a healthy weight.”

The soy diet was linked to a reduction in participants’ adiponectin levels. Researchers originally theorized that a diet containing large amounts of soy could be part of the reason that Asian women have lower rates of breast cancer than women in the United States, but any beneficial effect may be limited to certain ethnic groups, Llanos said.

An Apple a Day Keeps the Doctor Away

Prescribing an apple a day to all adults aged 50 and over would prevent or delay around 8,500 vascular deaths such as heart attacks and strokes every year in the UK -- similar to giving statins to everyone over 50 years who is not already taking them -- according to a study in the Christmas edition of The BMJ.

(See my previous summary on the health benefits of apples here)

The researchers conclude that the 150 year old public health message: "An apple a day keeps the doctor away" is able to match more widespread use of modern medicine, and is likely to have fewer side effects. The research takes into account people who are already appropriately taking statins to reduce their risk of vascular disease and therefore the authors stress that no-one currently taking statins should stop, although by all means eat more apples.

In the United Kingdom, lifestyle changes are the recommended first step to prevent heart disease. However, trial data suggest that statins can reduce the risk of vascular events, irrespective of a person's underlying risk of cardiovascular disease. As such, calls are being made for greater use of statins at a population level, particularly for people aged 50 years and over.

Using mathematical models a team of researchers at the University of Oxford set out to test how a 150 year old proverb might compare with the more widespread use of statins in the UK population. They analysed the effect on the most common causes of vascular mortality of prescribing either a statin a day to those not already taking one or an apple a day to everyone aged over 50 years in the UK.

The researchers assumed a 70% compliance rate and that overall calorie intake remained constant.

They estimate that 5.2 million people are currently eligible for statin treatment in the UK and that 17.6 million people who are not currently taking statins would be offered them if they became recommended as a primary prevention measure for everyone over 50.

They calculate that offering a daily statin to 17.6 million more adults would reduce the annual number of vascular deaths by 9,400, while offering a daily apple to 70% of the total UK population aged over 50 years (22 million people) would avert 8,500 vascular deaths.

However, side-effects from statins mean that prescribing statins to everyone over the age of 50 is predicted to lead to over a thousand extra cases of muscle disease (myopathy) and over ten thousand extra diagnoses of diabetes.

Additional modelling showed a further 3% reduction in the annual number of vascular deaths when either apples or statins were prescribed to everybody aged over 30. However the number of adverse events is predicted to double.

"This study shows that small dietary changes as well as increased use of statins at a population level may significantly reduce vascular mortality in the UK," say the authors.

"This research adds weight to calls for the increased use of drugs for primary prevention of cardiovascular disease, as well as for persevering with policies aimed at improving the nutritional quality of UK diets," they conclude.

Dr Adam Briggs of the BHF Health Promotion Research Group at Oxford University said: "The Victorians had it about right when they came up with their brilliantly clear and simple public health advice: "An apple a day keeps the doctor away." It just shows how effective small changes in diet can be, and that both drugs and healthier living can make a real difference in preventing heart disease and stroke.

While no-one currently prescribed statins should replace them for apples, we could all benefit from simply eating more fruit."

Daily multivitamin won't help boost the average American's health

Three new studies find that a daily multivitamin won't help boost the average American's health.

The studies found that popping a daily multivitamin didn't ward off heart problems or memory loss, and wasn't tied to a longer life span.

The studies, published in the Dec. 17 issue of the journal Annals of Internal Medicine, found that multivitamin and mineral supplements did not work any better in these respects than placebo pills.

Regular exercise in middle age protects against muscle weakness later in life

A cross-sectional study by investigators from Tokyo University has found that exercising in middle age is a protective factor against sarcopenia and effective in maintaining muscle strength and physical performance. Sarcopenia is a disease associated with the ageing process, resulting in loss of skeletal muscle mass and muscle strength and/or function in the elderly. The multiple adverse health outcomes include physical disability, poor quality of life and premature death.

The study assessed the prevalence of sarcopenia and its association with physical performance in 1000 elderly Japanese participants (349 men and 651 women aged ≥65 years) enrolled in the Research on Osteoarthritis/Osteoporosis Against Disability (ROAD) Study. Handgrip strength, gait speed, and skeletal muscle mass were measured and other information collected, including exercise habits in middle age.

The prevalence of sarcopenia was 13.8% in men and 12.4% in women, and tended to be significantly higher with increasing age in both sexes. Factors associated with sarcopenia were chair stand time (odds ratio [OR], 1.09; 95% CI, 1.04-1.14), one-leg standing time (OR, 0.97; 95% CI, 0.96-0.99), and exercise habit in middle age (OR, 0.53; 95% CI, 0.31-0.90) after adjusting for age, sex and body mass index (BMI).

Analysis showed that exercise habit in middle age was associated with low prevalence of sarcopenia in older age and was significantly associated with grip strength, gait speed, and one-leg standing time after adjusting for age, sex and BMI.

Moderate consumption of alcohol can improve immune response to vaccination

It's the time of year when many of us celebrate the holidays with festive foods and drinks, including alcohol. No better time then to ask if it is true, as is widely held, that moderate consumption of alcohol is beneficial to health.

A research team led by an immunologist at the University of California, Riverside now has data that could put the question to rest. The researchers found that moderate alcohol consumption could bolster our immune system, and potentially our ability to fight infections.

The finding, published Dec. 17 in the journal Vaccine, can help lead to a better understanding of how our immune system works. It can also pave the way for potentially new interventions to improve our ability to respond to vaccines and infections, benefiting vulnerable populations, such as the elderly for whom the flu vaccine, for example, has been found to be largely ineffective.

"It has been known for a long time that moderate alcohol consumption is associated with lower mortality," said Ilhem Messaoudi, an associate professor of biomedical sciences in the School of Medicine and the lead author of the research paper. "Our study, conducted on non-human primates, shows for the first time that voluntary moderate alcohol consumption boosts immune responses to vaccination."

Messaoudi did the bulk of the research while she was an assistant professor at the Oregon Health and Science University, where she collaborated with Kathleen Grant, a professor of behavioral neuroscience and a coauthor on the research paper. She joined UC Riverside earlier this year.

To study the impact of alcohol consumption on the immune system, the researchers trained 12 rhesus macaques to self-administer/consume alcohol on their own accord. The team first vaccinated the animals (against small pox) and then allowed them to access either 4 percent ethanol (the experimental group) or calorically matched sugar water (the control group). All the animals also had open access to water as an alternative fluid, as well as food. The researchers then proceeded to monitor the animals' daily ethanol consumption for 14 months. The animals were vaccinated one more time, seven months after the experiment began.

The research team found that over nine months of the animals' ethanol self-administration, mean daily ethanol intake varied markedly among them.

"Like humans, rhesus macaques showed highly variable drinking behavior," Messaoudi said. "Some animals drank large volumes of ethanol, while others drank in moderation."

The animals' voluntary ethanol consumption segregated them into two groups: animals in the first group were those that consumed more alcohol, averaged a blood ethanol concentration (BEC) greater than the legal limit of 0.08 percent and were therefore designated 'heavy drinkers'; animals in the second group consumed less alcohol, averaged a BEC of 0.02-0.04 percent and were designated 'moderate drinkers.'

"Prior to consuming alcohol, all the animals showed comparable responses to vaccination," Messaoudi said. "Following exposure to ethanol, however, the animals showed markedly different responses after receiving the booster vaccine."

The researchers found that, as expected based on human epidemiological data, those animals that drank the largest amounts of alcohol showed greatly diminished vaccine responses compared to the control group. In contrast, animals that drank moderate amounts of ethanol displayed enhanced vaccine responses.

"These surprising findings indicate that some of the beneficial effects of moderate amounts of alcohol consumption may be manifested through boosting the body's immune system," Messaoudi said. "This supports what has been widely believed for some time: moderate ethanol consumption results in a reduction in all causes of mortality, especially cardiovascular disease. As for excessive alcohol consumption, our study shows that it has a significant negative impact on health."

Alcohol abuse kills 25,000 Americans annually and is one of the leading causes of preventable death in the country. Two thirds of U.S. adults consume approximately four drinks a week, considered to be a moderate amount by most consumers.

"If you have a family history of alcohol abuse, or are at risk, or have been an abuser in the past, we are not recommending you go out and drink to improve your immune system!" Messaoudi said. "But for the average person that has, say, a glass of wine with dinner, it does seem, in general, to improve heath, and cardiovascular function in particular, and now we can add the immune system to that list."

The study was carried out under strict accordance with the recommendations outlined in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health, the Office of Animal Welfare and the U.S. Department of Agriculture. The study was also approved by the Oregon National Primate Research Center Institutional Animal Care and Use Committee.

"Next, we plan to harness our observations made in this study to address bigger questions on the immune system, such as how can we boost our immune responses to vaccination, a particular challenge for our elderly," Messaoudi said.

Diet and physical activity may affect one's risk of developing kidney stones

Even small amounts of physical activity may decrease the risk of developing kidney stones, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The study also found that consuming too many calories may increase risk.

Over the last 10 to 15 years, research has revealed that kidney stones are more of a systemic problem than previously thought. Their links with obesity, diabetes, metabolic syndrome, and cardiovascular disease demonstrate that the process of stone formation involves more than just the kidneys. As the prevalence of kidney stones has increased dramatically, especially in women, efforts to decrease the risk of stone formation have become even more important.

Mathew Sorensen, MD (University of Washington School of Medicine, and the Puget Sound Department of Veterans Affairs) and his colleagues conducted a study to evaluate whether energy intake and energy expenditure relate to kidney stone formation. They studied 84,225 postmenopausal women participating in the Women's Health Initiative, which has been gathering information such as dietary intake and physical activity in women since the 1990s.

After adjusting for multiple factors including body mass index, the researchers found that physical activity was associated with up to a 31% decreased risk of kidney stones. "Even small amounts of exercise may decrease the risk of kidney stones—it does not need to be marathons, as the intensity of the exercise does not seem to matter," said Dr. Sorensen. Women could get the maximum benefit by performing 10 metabolic equivalents per week, which is the equivalent of about three hours of average walking (2-3 mph), four hours of light gardening, or one hour of moderate jogging (6 mph).

The team also discovered that consuming more than 2200 calories per day increased the risk of developing kidney stones by up to 42%. Obesity was also a risk factor for stone formation.

"Being aware of calorie intake, watching their weight, and making efforts to exercise are important factors for improving the health of our patients overall, and as it relates to kidney stones," said Dr. Sorensen.

In an accompanying editorial, John Lieske, MD (Mayo Clinic) noted that because this study only included postmenopausal women, it will need to be replicated in other populations. He added that it is also possible that women who exercise regularly have other healthy habits that decrease stone risk. "Nevertheless, conservative (nonpharmacologic) counseling for patients with stones often centers almost exclusively on diet, stressing increased fluid intake, normal dietary calcium, lower sodium, moderate protein, and reduced dietary oxalate. The results of Sorensen et al. suggest that a recommendation for moderate physical activity might reasonably be added to the mix," he wrote.

Low vitamin B12 levels increase the risk of fractures in older men

Older men who have low levels of vitamin B12 have a higher risk of having fractures. These are the findings of researchers at the Sahlgrenska Academy as a part of an international study of a total of 1000 older men.

Osteoporosis is one of the world's most widespread diseases, and intensive research is under way worldwide to identify its causes and to be able to prevent fractures.

In an extensive study, researchers at the Sahlgrenska Academy at the University of Gothenburg can now show that low levels of vitamin B12 in the blood increases the risk of fractures in older men.

International research project
This study is a part of an international research project initiated by the National Institutes of Health (NIH) in the US and comprises 11,000 men in total. In their part of the study, the Gothenburg researchers studied 1,000 Swedish men, MrOS Sweden, with an average age of 75, and used various methods to analyze the blood concentrations of the B vitamins B12 and folate, which are found in our food naturally.

Higher fracture risk
The results show that the risk of suffering a fracture six years later was higher among men who had low B12 levels at the beginning of the study than men with normal B12 levels. In the quartile with the lowest B12 content, the risk was elevated by approximately 70 percent compared with the others. The risk increase pertained primarily to fractures in the lumbar region, where the risk increase was up to 120 percent.

"The higher risk also remains when we take other risk factors for fractures into consideration, such as age, smoking, BMI, BMD (bone mineral density), previous fractures, physical activity, the D-vitamin content in the blood and calcium intake," says Catharina Lewerin, researcher at the Sahlgrenska Academy.

Does this mean that older men can prevent fractures by eating more vitamin B12?

"It has not been scientifically established, but such studies are under way, including one large Dutch study where older individuals over the age of 65 are treated with both vitamin B12, folic acid and vitamin D to investigate the occurrence of fractures.

"Right now, there is no reason to eat more vitamin B12, but rather treatment shall only be applied in confirmed cases of deficiencies and in some cases to prevent deficiencies. For anyone who wants to strengthen their bones and prevent fractures, physical activity 30 minutes a day and quitting smoking is good self care," says Catharina Lewerin.

New method

In this study, the researchers used a relatively new method called holotranscobalamin, which measures the amount of vitamin that is taken up in the cells, which is considered to be a more sensitive test for B12 deficiency.

The article was published online in Osteoporosis International.

Father's Diet Before Conception Plays Crucial Role in Offspring's Health

Mothers get all the attention. But a study led by McGill researcher Sarah Kimmins suggests that the father's diet before conception may play an equally important role in the health of their offspring. It also raises concerns about the long-term effects of current Western diets and of food insecurity.

The research focused on vitamin B9, also called folate, which is found in a range of green leafy vegetables, cereals, fruit and meats. It is well known that in order to prevent miscarriages and birth defects mothers need to get adequate amounts of folate in their diet. But the way that a father's diet can influence the health and development of their offspring has received almost no attention. Now research from the Kimmins group shows for the first time that the father's folate levels may be just as important to the development and health of their offspring as are those of the mother. Indeed, the study suggests that fathers should pay as much attention to their lifestyle and diet before they set out to conceive a child as mothers do.

"Despite the fact that folic acid is now added to a variety of foods, fathers who are eating high-fat, fast food diets or who are obese may not be able to use or metabolize folate in the same way as those with adequate levels of the vitamin," says Kimmins. "People who live in the Canadian North or in other parts of the world where there is food insecurity may also be particularly at risk for folate deficiency. And we now know that this information will be passed on from the father to the embryo with consequences that may be quite serious."

The researchers arrived at this conclusion by working with mice, and comparing the offspring of fathers with insufficient folate in their diets with the offspring of fathers whose diets contained sufficient levels of the vitamin. They found that paternal folate deficiency was associated with an increase in birth defects of various kinds in the offspring, compared to the offspring of mice whose fathers were fed a diet with sufficient folate.

"We were very surprised to see that there was an almost 30 per cent increase in birth defects in the litters sired by fathers whose levels of folates were insufficient," said Dr. Romain Lambrot, of McGill's Dept. of Animal Science, one of the researchers who worked on the study. "We saw some pretty severe skeletal abnormalities that included both cranio-facial and spinal deformities."

The research from the Kimmins' group shows that there are regions of the sperm epigenome that are sensitive to life experience and particularly to diet. And that this information is in turn transferred to a so-called epigenomic map that influences development and may also influence metabolism and disease in the offspring in the long-term. (The epigenome is like a switch, which is affected by environmental cues, and is involved in many diseases including cancer and diabetes. The epigenome influences the way that genes are turned on or off, and hence how heritable information gets passed along).

Although it has been known for some time that there is a massive erasure and re-establishment that takes place in the epigenome as the sperm develops, this study now shows that along with the developmental map, the sperm also carries a memory of the father's environment and possibly even of his diet and lifestyle choices.

"Our research suggests that fathers need to think about what they put in their mouths, what they smoke and what they drink and remember they are caretakers of generations to come," said Kimmins. "If all goes as we hope, our next step will be to work with collaborators at a fertility clinic so that we can start assessing the links in men between diet, being overweight and how this information relates to the health of their children."

Acid-Reflux Drugs Tied to Lower Levels of Vitamin B-12

People who take certain acid-reflux medications might have an increased risk of vitamin B-12 deficiency, according to new research.

Taking proton pump inhibitors (PPIs) to ease the symptoms of excess stomach acid for more than two years was linked to a 65 percent increase in the risk of vitamin B-12 deficiency. Commonly used PPI brands include Prilosec, Nexium and Prevacid.

Researchers also found that using acid-suppressing drugs called histamine-2 receptor antagonists -- also known as H2 blockers -- for two years was associated with a 25 percent increase in the risk of B-12 deficiency. Common brands include Tagamet, Pepcid and Zantac.

"This study raises the question of whether or not people who are on long-term acid suppression need to be tested for vitamin B-12 deficiency," said study author Dr. Douglas Corley, a research scientist and gastroenterologist at Kaiser Permanente's division of research in Oakland, Calif.

Corley said, however, that these findings should be confirmed by another study. "It's hard to make a general clinical recommendation based on one study, even if it is a large study," he said.

Vitamin B-12 is an important nutrient that helps keep blood and nerve cells healthy, according to the U.S. Office of Dietary Supplements (ODS). It can be found naturally in meat, fish, poultry, eggs, milk and other dairy products. According to the ODS, between 1.5 percent and 15 percent of Americans are deficient in B-12.

Although most people get enough B-12 from their diet, some have trouble absorbing the vitamin efficiently. A deficiency of B-12 can cause tiredness, weakness, constipation and a loss of appetite. A more serious deficiency can cause balance problems, memory difficulties and nerve problems, such as numbness and tingling in the hands or feet.

Stomach acid is helpful in the absorption of B-12, Corley said, so it makes sense that taking medications that reduce the amount of stomach acid would decrease vitamin B-12 absorption.

More than 150 million prescriptions were written for PPIs in 2012, according to background information included in the study. Both types of medications also are available in lower doses over the counter.

Corley and his colleagues reviewed data on nearly 26,000 people who had been diagnosed with a vitamin B-12 deficiency and compared them to almost 185,000 people who didn't have a deficiency.

While 12 percent of people with a vitamin B-12 deficiency had taken PPIs for more than two years, 7.2 percent of those without a deficiency had taken the medications long-term.

Of those with a deficiency, 4.2 percent took an H2 blocker for two years or longer, while 3.2 percent of those without a deficiency took the drugs for two years or more.

The risk of developing a vitamin B-12 deficiency was 65 percent higher for the long-term PPI users and 25 percent higher for those taking H2 blockers, according to the study.

People who took higher doses were more likely to develop a vitamin B-12 deficiency. People who took an average of 1.5 PPI pills per day had almost double the risk of developing a deficiency compared to those who averaged 0.75 pills per day, the study found.

Women had a greater risk of deficiency than men, and people younger than 30 taking these medications had a greater risk of developing a deficiency than older people, according to the study.

The risk of vitamin B-12 deficiency decreases when you stop taking the medications, but doesn't disappear completely, Corley said.

The study's findings were published in the Dec. 11 issue of the Journal of the American Medical Association. Although the study found an association between taking acid-reflux drugs long-term and having a higher risk of a B-12 deficiency, it didn't establish a cause-and-effect relationship.

If you're taking acid-suppressing medications, Corley said, "our study doesn't recommend stopping those medications, but you should take them at the lowest effective dose." And people shouldn't start taking vitamin B-12 supplements on their own, but should discuss it with their doctor, he said.

One expert had concerns about how frequently acid-suppressing drugs are used.

"This study found an adverse effect associated with taking these drugs," said Victoria Richards, an associate professor of medical sciences at the Frank H. Netter M.D. School of Medicine at Quinnipiac University, in Hamden, Conn. "It's also concerning that these drugs are used at such a high rate. Why do so many people have the need to suppress acid so much?"

The bottom line, Richards said, is that if you are having any symptoms of vitamin B-12 deficiency and you've been taking these medications, talk to your doctor about whether you should be tested for a deficiency. Tell your doctor if you've been taking over-the-counter acid-suppressing medications, so your doctor can properly evaluate your risk.

Vitamin D Supplements Won't Help Prevent Disease: Review

Low levels of vitamin D have been implicated as a potential cause of diseases ranging from cancer to diabetes. Now an extensive review suggests it's really the other way around: Low levels of the "sunshine vitamin" are more likely a consequence -- not a cause -- of illness.

In their review of almost 500 studies, the researchers found conflicting results. Observational studies, which looked back at what people ate or the kinds of supplements they took, showed a link between higher vitamin D levels in the body and better health.

But, in studies where vitamin D was given as an intervention (treatment) to help prevent a particular ailment, it had no effect. The one exception was a decreased death risk in older adults, particularly older women, who were given vitamin D supplements.

"The discrepancy between observational and intervention studies suggests that low [vitamin D] is a marker of ill health," wrote review authors led by Philippe Autier, at the International Prevention Research Institute, in Lyon, France.

Vitamin D is known to play a key role in bone health. Low levels of vitamin D have been found in a number of conditions, including heart disease, autoimmune diseases, diabetes, cancer and Parkinson's disease. These findings may explain why so many Americans are currently taking vitamin D supplements.

It's nicknamed the sunshine vitamin because the body produces vitamin D when exposed to the sun (if someone isn't wearing sunscreen). It's also found in some foods, such as egg yolks and fatty fish, and in foods that have been fortified with vitamin D, such as milk.

The current review, published online Dec. 6 in The Lancet Diabetes & Endocrinology, looked at 290 observational studies. In these studies, blood samples to measure vitamin D levels were taken many years before the outcome of the study occurred. The review also included results of 172 randomized clinical trials of vitamin D. In randomized trials, some people receive a therapy while others do not.

The observational studies showed a potential benefit from vitamin D. For example, vitamin D was associated with a 58 percent reduced risk of cardiovascular events, a 38 percent decreased risk of diabetes and a 34 percent decreased risk of colon cancer in these studies.

But, when the researchers looked to the randomized clinical trials that used vitamin D as a treatment, they failed to find any effect on disease occurrence or severity from raising vitamin D levels.

However, vitamin D did reduce the risk of dying from any cause in older people taking 800 international units a day, according to the review.

Dr. Shaun Jayakar, an internal medicine and geriatric specialist from St. John Hospital and Medical Center in Detroit, said the findings in elderly people "are likely due to a reduction in falls and fractures. Supplementing with vitamin D would lead to stronger bones, which would reduce falls and factures."

Because the majority of interventional trials failed to find any benefit from vitamin D, the review's authors conclude that low vitamin D levels don't lead to ill health, rather they're caused by ill health.

They theorize that inflammation that occurs in many illnesses may be what depletes vitamin D levels.

Dr. Robert Graham, an internist from Lenox Hill Hospital in New York City, said, "This comprehensive review did a really good job at trying to tease out the effects of different study designs, and the findings will be controversial."

He said there are currently five, large ongoing interventional trials that will help to better define vitamin D's role in disease. However, the results of those studies won't be available for a number of years. Until then, he recommended, "Try to achieve homeostasis [equilibrium]. You don't want to get to a low level of vitamin D."

The Institute of Medicine recommends 600 international units of vitamin D for adults, and 800 international units for people over 70.

Both Graham and Jayakar agreed that those are reasonable supplement levels. Jayakar said that for most people, vitamin D supplements are harmless, but added that "it's a pocketbook issue. Almost 50 percent of the population is taking vitamin D supplements. That's a lot of money for something that likely has no benefit," he said.

Jayakar added that this review's findings suggest that low vitamin D levels could be used as a marker -- a sign -- of disease in younger people. "If someone isn't feeling well and they have low vitamin D, maybe we should use that to start searching to see if something else is going wrong," he said.

Grape seed extract effective against cancer cells

A University of Colorado Cancer Center study published online ahead of print in the journal Nutrition and Cancer describes the laboratory synthesis of the most active component of grape seed extract, B2G2, and shows this synthesized compound induces the cell death known as apoptosis in prostate cancer cells while leaving healthy cells unharmed.

“We’ve shown similar anti-cancer activity in the past with grape seed extract (GSE), but now we know B2G2 is its most biologically active ingredient which can be synthesized in quantities that will allow us to study the detailed death mechanism in cancer cells,” says Alpna Tyagi, PhD, of the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. Tyagi works in the lab of CU Cancer Center investigator and Skaggs School of Pharmacy faculty member, Chapla Agarwal, PhD.

The group has spent more than a decade demonstrating the anti-cancer activity of GSE in controlled, laboratory conditions. For example, previous studies have shown the GSE effectiveness against cancer cells and have also shown its mechanism of action. “But until recently, we didn’t know which constituent of GSE created this effect. This naturally occurring compound, GSE, is a complex mixture of polyphenols and also so far it has been unclear about the biologically active constituents of GSE against cancer cells,” Tyagi says.

Eventually the group pinpointed B2G2 as the most active compound, but, “it’s expensive and it takes a long time to isolate B2G2 from grape seed extract,” Tyagi says.

This expense related to the isolation of B2G2 has limited the group’s further exploration. So instead of purifying B2G2 from GSE, the group decided to synthesize it in the lab. The current study reports the success of this effort, including the ability to synthesize gram-quantity of B2G2 reasonably quickly and inexpensively.

In the paper’s second half, the group shows anti-cancer activity of synthesized B2G2 similar in mechanism and degree to overall GSE effectiveness.

“Our goal all along has been a clinical trial of the biologically active compounds from GSE against human cancer. But it’s difficult to earn FDA approval for a trial in which we don’t know the mechanisms and possible effects of all active components. Therefore, isolating and synthesizing B2G2 is an important step because now we have the ability to conduct more experiments with the pure compound. Ongoing work in the lab further increases our understanding of B2G2′s mechanism of action that will help for the preclinical and clinical studies in the future,” Tyagi says.

People who exercise regularly are better at creative thinking

People who exercise regularly are better at creative thinking. This is the outcome of research by Leiden cognitive psychologist Lorenza Colato. She published an article on this subject in the scientific magazine Frontiers in Human Neuroscience.

Taking a stroll

We know that authors like Søren Kierkegaard, Henry James en Thomas Mann used to take a stroll before they sat down behind their writing desk. Apparently, this helped them to get new ideas and insights. But is it possible to prove scientifically that physical exercise makes creative thinking easier?

Divergent and convergent

To find this out, Colzato investigated whether regular exercise may promote the two main ingredients of creativity: divergent thinking and convergent thinking. Divergent thinking means to think up as many solutions as possible for a certain problem. Convergent thinking leads to one single correct solution for a given problem.

Thinking tasks

The psychologist gave thinking tasks to two groups of test persons: people who do physical exercise at least four times a week -- i.e. cycling -- and people who do not exercise on a regular basis. The first assignment was a so-called alternate uses test, in which the participants had to note down all the possible uses for a pen. This was followed by a remote associates task: the test persons were presented with three non-related words, like 'time', 'hair' and 'stretch', and had to come up with the common link, which in this case was 'long'.

Healthy body = sound mind

On the remote associates task, people from the group of frequent exercisers appeared to outperform those who did not exercise regularly. Colzato: 'We think that phsysical movement is good for the ability to think flexibly, but only if the body is used to being active. Otherwise a large part of the energy intended for creative thinking goes to the movement itself.' Colzato believes that these results support the famous classical idea of a 'sound mind in a healthy body': 'Exercising on a regular basis may thus act as a cognitive enhancer promoting creativity in inexpensive and healthy ways.'

Low vitamin D causes damage to the brain.

A new study led by University of Kentucky researchers suggests that a diet low in vitamin D causes damage to the brain.

In addition to being essential for maintaining bone health, newer evidence shows that vitamin D serves important roles in other organs and tissue, including the brain. Published in Free Radical Biology and Medicine, the UK study showed that middle-aged rats that were fed a diet low in vitamin D for several months developed free radical damage to the brain, and many different brain proteins were damaged as identified by redox proteomics. These rats also showed a significant decrease in cognitive performance on tests of learning and memory.

"Given that vitamin D deficiency is especially widespread among the elderly, we investigated how during aging from middle-age to old-age how low vitamin D affected the oxidative status of the brain," said lead author on the paper Allan Butterfield, professor in the UK Department of Chemistry, director of the Center of Membrane Sciences, faculty of Sanders-Brown Center on Aging, and director of the Free Radical Biology in Cancer Core of the Markey Cancer Center. “Adequate vitamin D serum levels are necessary to prevent free radical damage in brain and subsequent deleterious consequences."

Previously, low levels of vitamin D have been associated with Alzheimer's disease, and it's also been linked to the development of certain cancers and heart disease. In both the developed world and in areas of economic hardship where food intake is not always the most nutritious, vitamin D levels in humans are often low, particularly in the elderly population. Butterfield recommends persons consult their physicians to have their vitamin D levels determined, and if low that they eat foods rich in vitamin D, take vitamin D supplements, and/or get at least 10-15 minutes of sun exposure each day to ensure that vitamin D levels are normalized and remain so to help protect the brain.

Aerobic fitness impoves memory

Researchers at Boston University School of Medicine (BUSM) have found further evidence that exercise may be beneficial for brain health and cognition. The findings, which are currently available online in Behavioural Brain Research, suggest that certain hormones, which are increased during exercise, may help improve memory.

Hormones called growth factors are thought to mediate the relationship between exercise and brain health. The hippocampus, a region of the brain crucial for learning and memory, is thought to be uniquely affected by these hormones.

The growth factors brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1), have been implicated in the link between exercise and hippocampal function. BDNF, for example, acts on the nervous system to help regulate communication between existing brain cells (neurons) and stimulate the growth and maturation of new hippocampal neurons and blood vessels.

In this study, the researchers recruited healthy young adults, in whom they measured blood hormone levels together with performance on a recognition memory task and aerobic fitness. The researchers were thus able to correlate the blood hormone levels with aerobic fitness, and subsequently whether there was any effect on memory function.

According to the researchers, BDNF and aerobic fitness predicted memory in an interactive manner, suggesting that at low fitness BDNF levels negatively predicted expected memory accuracy. Conversely, at high fitness resting BDNF levels positively predicted recognition memory. There also was a strong association between IGF-1 and aerobic fitness; however there was no complementary link between IGF-1 and memory function.

"We will be continuing this line of research by testing if memory improves following an exercise training program in both young and geriatric adults, and by adding brain imaging techniques," explained Karin Schon, PhD, assistant professor of anatomy and neurobiology at BUSM, who served as the study's principal investigator.

Bothersome pain afflicts half of older Americans

More than half of older adults in the United States – an estimated 18.7 million people – have experienced bothersome pain in the previous month, impairing their physical function and underscoring the need for public health action on pain. Many of those interviewed by investigators for a study published in the current issue of PAIN® reported pain in multiple areas.

The interviews, which included assessments of cognitive and physical performance, were completed by trained survey research staff in the homes of study participants living in the community or in residential care facilities, such as retirement or assisted-living communities. "Pain is common in older adults and one of the major reasons why we start slowing down as we age," says lead investigator Kushang V. Patel, PhD, MPH, of the Center for Pain Research on Impact, Measurement, and Effectiveness in the Department of Anesthesiology and Pain Medicine at the University of Washington.

The researchers gained several insights from the new study:

- Bothersome pain afflicts half of community-dwelling older adults in the United States.
- The majority of older adults with pain reported having pain in multiple locations, such as in the back, hips, and knees.
- The percentage of people with pain did not differ by age, even when researchers accounted for dementia and cognitive performance.
- Pain was strongly associated with decreased physical capacity. Older adults with pain, particularly those with pain in multiple locations, had weaker muscle strength, slower walking speed, and poorer overall function than those without pain.

The researchers analyzed data from the National Health and Aging Trends Study (NHATS), which was designed to investigate multiple aspects of functioning in later life and is funded by the U.S. National Institute on Aging, part of the National Institutes of Health. Investigators conducted in-person interviews with 7,601 adults ages 65 years and older who were enrolled in the NHATS in 2011. All were Medicare beneficiaries.

The overall prevalence of bothersome pain in the last month in the study group was 52.9%. Pain did not vary across age groups, and this pattern remained unchanged when accounting for cognitive performance, dementia, proxy responses, and residential-care living status. Pain prevalence was higher in women and in older adults with obesity, musculoskeletal conditions, and depressive symptoms. The majority (74.9%) of older adults with pain reported multiple sites of pain.

Several measures of physical capacity, including muscle strength and lower-extremity physical performance, were associated with pain and multisite pain. For example, self-reported inability to walk three blocks was 72% higher in participants with pain than without pain. Participants with one, two, three, and four or more sites were 41%, 57%, 81%, and 105% more likely to report inability to walk three blocks, respectively, than older adults without pain.

"Considering that pain is often poorly managed in the geriatric population, our findings underscore the need for public health action, including additional epidemiologic research and the development and translation of interventions aimed at improving pain and function in older adults," Patel concludes.

Population aging is occurring in nearly every country of the world. Not only are the number and proportion of older adults increasing globally, but the older adult population itself is getting older as well. Gains in life expectancy at older ages have fueled the rapid growth of the oldest-old segment of the population, although it is unclear whether improvements in functional status of older adults have kept pace. Since disability in late life is a major predictor of medical and social service needs, investigating risk factors for functional decline is a major public health priority. Today's published study in PAIN® by Patel and colleagues clearly identifies the high burden of pain in the older adult population.

High cholesterol fuels the growth and spread of breast cancer

A byproduct of cholesterol functions like the hormone estrogen to fuel the growth and spread of the most common types of breast cancers, researchers at the Duke Cancer Institute report.

The researchers also found that anti-cholesterol drugs such as statins appear to diminish the effect of this estrogen-like molecule.

Published in the Nov. 29, 2013, edition of the journal Science, the findings are early, using mouse models and tumor cells. But the research for the first time explains the link between high cholesterol and breast cancer, especially in post-menopausal women, and suggests that dietary changes or therapies to reduce cholesterol may also offer a simple, accessible way to reduce breast cancer risk.

"A lot of studies have shown a connection between obesity and breast cancer, and specifically that elevated cholesterol is associated with breast cancer risk, but no mechanism has been identified," said senior author Donald McDonnell, Ph.D., chair of the Department of Pharmacology and Cancer Biology at Duke. "What we have now found is a molecule – not cholesterol itself, but an abundant metabolite of cholesterol – called 27HC that mimics the hormone estrogen and can independently drive the growth of breast cancer."

The hormone estrogen feeds an estimated 75 percent of all breast cancers. In a key earlier finding from McDonnell's lab, researchers determined that 27-hydroxycholesterol – or 27HC – behaved similarly to estrogen in animals.

For their current work, the researchers set out to determine whether this estrogen activity was sufficient on its own to promote breast cancer growth and metastasis, and whether controlling it would have a converse effect.

Using mouse models that are highly predictive of what occurs in humans, McDonnell and colleagues demonstrated the direct involvement of 27HC in breast tumor growth, as well as the aggressiveness of the cancer to spread to other organs. They also noted that the activity of this cholesterol metabolite was inhibited when the animals were treated with antiestrogens or when supplementation of 27HC was stopped.

The studies were substantiated using human breast cancer tissue. An additional finding in the human tissue showed a direct correlation between the aggressiveness of the tumor and an abundance of the enzyme that makes the 27HC molecule. They also noted that 27HC could be made in other places in the body and transported to the tumor.

"The worse the tumors, the more they have of the enzyme," said lead author Erik Nelson, Ph.D., a post-doctoral associate at Duke. Nelson said gene expression studies revealed a potential association between 27HC exposure and the development of resistance to the antiestrogen tamoxifen. Their data also highlights how increased 27HC may reduce the effectiveness of aromatase inhibitors, which are among the most commonly used breast cancer therapeutics.

"This is a very significant finding," McDonnell said. "Human breast tumors, because they express this enzyme to make 27HC, are making an estrogen-like molecule that can promote the growth of the tumor. In essence, the tumors have developed a mechanism to use a different source of fuel."

McDonnell said the findings suggest there may be a simple way to reduce the risk of breast cancer by keeping cholesterol in check, either with statins or a healthy diet. Additionally, for women who have breast cancer and high cholesterol, taking statins may delay or prevent resistance to endocrine therapies such as tamoxifen or aromatase inhibitors.

The next steps for research include clinical studies to verify those potential outcomes, as well as studies to determine if 27HC plays a role in other cancers, McDonnell said.

Regular physical activity in later life boosts likelihood of 'healthy aging' up to sevenfold

Helps stave off major ill health and dementia even for those getting started relatively late

It's never too late to get physically active, with even those starting relatively late in life reaping significant health benefits, finds research published online in the British Journal of Sports Medicine.

Four years of sustained regular physical activity boosted the likelihood of healthy ageing sevenfold compared with consistent inactivity, the findings show.

The researchers tracked the health of almost 3500 people, whose average age was 64, for more than eight years. All were participants in the English Longitudinal Study of Ageing, which involves a nationally representative sample of the household population of England, born on or before 29 February 1952.

The researchers wanted to quantify the impact of physical activity on the risk of developing long term conditions, depression, and dementia, and on the likelihood of "healthy ageing."

This is usually taken to mean not only an absence of major disease and disability, but also good mental health, the preservation of cognitive abilities, and the ability to maintain social connections/activities.

There's a growing body of evidence to suggest that regular physical activity is essential for the maintenance of good health, while across the developed world, inactivity is ranked alongside smoking, excess drinking, and obesity as a leading cause of reduced life expectancy.

Participants described the frequency and intensity of regular physical activity they did in 2002-3, and then every subsequent two years until 2010-11.

Their responses were categorised as: inactive (no moderate or vigorous activity on a weekly basis); moderately active (at least once a week); and vigorously active (at least once a week).

Any changes in frequency and intensity were noted at the two yearly monitoring sessions: always inactive; became inactive; became active; always active.

Serious ill health, such as heart disease/stroke, diabetes, emphysema, or Alzheimer's disease, was confirmed by medical records.

Cognitive abilities and mental health were assessed using a battery of validated tests, while disability was measured according to participants' responses to questions about the ease with which they were able to carry out routine activities of daily living, and an objective test of walking speed.

Nearly one in 10 of the sample became active and 70% remained active. The rest remained inactive or became inactive.

At the end of the monitoring period almost four out of 10 had developed a long term condition; almost one in five was depressed; a third had some level of disability; and one in five was cognitively impaired.

But one in five was defined as a healthy ager. And there was a direct link to the likelihood of healthy ageing and the amount of exercise taken.

Those who had regularly indulged in moderate or vigorous physical activity at least once a week were three to four times more likely to be healthy agers than those who had remained inactive, after taking account of other influential factors.

Those who became physically active also reaped benefits, compared with those who did nothing. They were more than three times as likely to be healthy agers.

And those who sustained regular physical activity over the entire period were seven times as likely to be healthy agers as those who had consistently remained inactive.

"This study supports public health initiatives designed to engage older adults in physical activity, even those who are of advanced age," conclude the authors.

Drug interactions causing a significant impact on statin use

A new study has found that many people who stopped taking cholesterol-lowering statin drugs were also taking an average of three other drugs that interfered with the normal metabolism of the statins.

The other drugs can contribute to a common side effect of taking statins - muscle pain – and often led people to discontinue use of a medication that could otherwise help save their life, researchers learned.

The interactions of many drugs with statins have been known of for some time, researchers said, but are not being adequately managed by physicians and pharmacists, who could often choose different medications or adjust dosages to retain the value of statin drugs without causing this side effect.

The research, done as part of a survey of more than 10,000 current and former statin users, found that use of medications which interfere with statin metabolism almost doubles the chance that a person will discontinue statin use due to muscle pain.

The issue is of growing importance because statin drugs are some of the most widely used medications in the world, proven to lower LDL, or “bad” cholesterol, and decrease the risk of heart attacks, heart disease, strokes and death. About 20 million people in the U.S. now take statins, and new guidelines have just been issued to further expand the types of health conditions for which statins may be of benefit. Based on those guidelines, the number of statin users could increase to more than 30 million.

The findings were published in the Journal of Clinical Lipidology by scientists from Oregon State University and four other universities or research institutes.

“We’ve known for some time of many medications that can interact with statins, but only now is it becoming clear that this is a significant contributor to the side effects, and often the reason some patients stop taking statins,” said Matt Ito, a professor in the OSU College of Pharmacy and president of the National Lipid Association, which funded this study.

“This issue is something physicians, pharmacists and patients all need to be more aware of,” Ito said. “There’s a lot we can do besides discontinue use of these valuable medications. You can change dosages, use drugs that don’t cause interactions, use different types of statins. Patients need to be proactive in understanding this issue and working with their health care providers to address it.”

Persons who have problems taking statins should discuss options with their physicians or pharmacists, Ito said, and not assume the drug has be to discontinued. A Medscape web site at http://reference.medscape.com/drug-interactionchecker also can help individuals learn more about possible interactions between statins and the full range of medications they may be taking.

Statins are usually well-tolerated, but in the recent survey, a muscle-related side effect was reported by 29 percent of participants. In former statin users, 62 percent of the people said that side effects, mostly muscle pain, were the reason they stopped taking the drugs.

There are many drugs that can interfere with statin metabolism, increase systemic exposure to the statin and raise the risk of this muscle pain, the researchers said in their report. This can include some common antibiotics, cardiovascular drugs, and others taken for treatment of cancer, mental health, HIV treatment and other conditions.

These interactions are not always adequately considered by physicians and pharmacists, however. One recent report found that as many as 20 percent of significant statin-drug interactions were missed in 64 pharmacies.

Besides drug interactions, statin side effects are also more common in women and associated with increasing age, history of cardiovascular disease, and some other conditions. Statin discontinuation has been associated with increased cardiovascular morbidity and death.