Thursday, June 26, 2014

r Continued use of low-dose aspirin may lower pancreatic cancer risk



The longer a person took low-dose aspirin, the lower his or her risk for developing pancreatic cancer, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

"We found that the use of low-dose aspirin was associated with cutting the risk of pancreatic cancer in half, with some evidence that the longer low-dose aspirin was used, the lower the risk," said Harvey A. Risch, MD, PhD, professor of epidemiology in the Department of Chronic Disease Epidemiology at the Yale School of Public Health in New Haven, Connecticut. "Because about one in 60 adults will get pancreatic cancer and the five-year survival rate is less than 5 percent, it is crucial to find ways to prevent this disease."

Men and women who took low-dose aspirin regularly had 48 percent reduction in their risk for developing pancreatic cancer. Protection against pancreatic cancer ranged from 39 percent reduction in risk for those who took low-dose aspirin for six years or less, to 60 percent reduction in risk for those who took low-dose aspirin for more than 10 years.

"Older studies of aspirin use have been clouded by the use of [regular- or high-dose] aspirin for pain relief from conditions that themselves might be related to the risk for pancreatic cancer. Only recently have people been using low-dose aspirin for long enough times [to prevent cardiovascular disease] that the use might bear on risk of pancreatic cancer development," explained Risch.

"There seems to be enough evidence that people who are considering aspirin use to reduce the risk for cardiovascular disease can feel positive that their use might also lower their risk for pancreatic cancer, and quite certainly wouldn't raise it," Risch added.

Study subjects were recruited from the 30 general hospitals in Connecticut between 2005 and 2009. There were 362 pancreatic cancer cases and 690 controls. Study subjects were interviewed in person to determine when they started using aspirin, the number of years they used aspirin, the type of aspirin they used (low versus regular dose), and when they stopped using aspirin, among other things. Confounding factors, including body mass index, smoking history, and history of diabetes, were taken into account.

Of the study participants, 57 percent were men, about 92 percent were non-Hispanic white, about 49 percent were former or current smokers, and 19 percent had been diagnosed with diabetes within the three years prior to this study.

A dose of 75 to 325 mg of aspirin per day was considered as low-dose aspirin (usually taken for heart-disease prevention), and a dose higher than that, generally taken every four to six hours, was considered as regular-dose aspirin taken for pain or anti-inflammation purposes.

Of the participants, 96 percent of low-dose aspirin users and 92 percent of regular-dose aspirin users reported daily aspirin use.

The earlier a person started regularly taking low-dose aspirin, the greater the pancreatic cancer risk reduction, ranging from 48 percent reduction in those who started three years before the study, to 60 percent in those who started taking it 20 years before the study. On the other hand, discontinuation of aspirin use within two years prior to the study was associated with a threefold increased risk for pancreatic cancer compared with continuing use.

"People who are developing pancreatic cancer have various physiologic changes, including taste disorders, starting to occur two to three years before pancreatic cancer is diagnosed. Such individuals are more likely to quit using aspirin. So it may be tricky to separate the various aspects of patterns of aspirin use and risk of pancreatic cancer," noted Risch.

"Aspirin use has potential risks of its own, and thus the risks and benefits for each person have to be evaluated based on personal characteristics and considerations," added Risch. "For the small subset of individuals with strong family histories of pancreatic cancer or who otherwise have been evaluated to be at substantially increased risk of pancreatic cancer, aspirin use could be part of a regimen designed to reduce their risk."

Watching too much TV may increase risk of early death in adults


Adults who watch TV for three hours or more each day may double their risk of premature death compared to those who watch less, according to new research published in the Journal of the American Heart Association.

“Television viewing is a major sedentary behavior and there is an increasing trend toward all types of sedentary behaviors,” said Miguel Martinez-Gonzalez, M.D., Ph.D., M.P.H., the study’s lead author and professor and chair of the Department of Public Health at the University of Navarra in Pamplona, Spain. “Our findings are consistent with a range of previous studies where time spent watching television was linked to mortality.”

Researchers assessed 13,284 young and healthy Spanish university graduates (average age 37, 60 percent women) to determine the association between three types of sedentary behaviors and risk of death from all causes: television viewing time, computer time and driving time. The participants were followed for a median 8.2 years. Researchers reported 97 deaths, with 19 deaths from cardiovascular causes, 46 from cancer and 32 from other causes.

The risk of death was twofold higher for participants who reported watching three or more hours of TV a day compared to those watching one or less hours. This twofold higher risk was also apparent after accounting for a wide array of other variables related to a higher risk of death.

Researchers found no significant association between the time spent using a computer or driving and higher risk of premature death from all causes. Researchers said further studies are needed to confirm what effects may exist between computer use and driving on death rates, and to determine the biological mechanisms explaining these associations.

“As the population ages, sedentary behaviors will become more prevalent, especially watching television, and this poses an additional burden on the increased health problems related to aging,” Martinez-Gonzalez said. “Our findings suggest adults may consider increasing their physical activity, avoid long sedentary periods, and reduce television watching to no longer than one to two hours each day.”

The study cited previous research that suggests that half of U.S. adults are leading sedentary lives.


Causal link between vitamin D deficiency and hypertension


New genetic research provides compelling evidence that low levels of vitamin D have a causal role in the development of high blood pressure (hypertension). The findings, published in The Lancet Diabetes & Endocrinology, suggest that vitamin D supplementation could be effective in combating some cases of hypertension.

"In view of the costs and side effects associated with antihypertensive drugs, the potential to prevent or reduce blood pressure and therefore the risk of hypertension with vitamin D is very attractive", explains study leader Professor Elina Hyppönen from the University of South Australia.

There has been considerable interest in the role of vitamin D in hypertension, but until now, a direct causal link has not been shown. Results from observational studies have suggested a strong association between low vitamin D levels and increases in blood pressure and hypertension, but randomised trials have not provided consistent evidence.

This Mendelian randomisation study used genetic data from the D-CarDia collaboration, involving over 146 500 individuals of European ancestry from across Europe and North America.

Researchers used two common genetic variants that affect circulating 25-hydroxyvitamin D or 25(OH)D concentrations (which are generally used to determine a person's vitamin D status), to measure the causal effect between vitamin D status and blood pressure and hypertension risk. They found that for each 10% increase in 25(OH)D concentration there was a drop in diastolic blood pressure (-0.29 mm Hg) and systolic blood pressure (-0.37 mm Hg), and an 8.1% decrease in the odds of developing hypertension.

According to Professor Hyppönen, "Mendelian randomisation helps to determine cause and effect because by using genetic data we can better avoid confounding, reverse causation, and bias. However, because we cannot exclude the possibility that our findings were caused by chance, they need to be replicated in an independent, similarly powered study. Further studies using randomised controlled trials are also needed to confirm causality and the potential clinical benefits of vitamin D supplementation."*

Writing in a linked Comment, Dr Shoaib Afzal and Dr Børge Nordestgaard from Copenhagen University Hospital and the University of Copenhagen in Denmark say, "Although [this] study is an important step towards delineation of the role of low vitamin D concentrations in the pathogenesis of hypertension, much remains unknown. Confirmation of these results in independent, similarly powered studies will be necessary, as will evidence of a corresponding benefit for the prevention of diseases caused by hypertension such as stroke. Finally, randomised intervention trials will be needed to determine whether vitamin D supplementation can be used to prevent or treat hypertension before such a strategy can be used clinically."


Wednesday, June 25, 2014

TREE NUTS MAY HELP REDUCE THE RISK OF CORONARY HEART DISEASE IN PEOPLE WITH TYPE 2 DIABETES


Findings from a new study published in Nutrition, Metabolism & Cardiovascular Diseases show that the fatty acids in nuts have the potential to help reduce the risk of coronary heart disease (CHD) in people with type 2 diabetes.

Researchers from the University of Toronto and St. Michael’s Hospital in Toronto, Canada, found that incorporating about two ounces of tree nuts (almonds, Brazils, cashews, hazelnuts, pecans, pine nuts, pistachios, macadamias and walnuts) and peanuts into the diet of people with diabetes, was inversely associated with CHD risk factors and 10-year CHD risk.

According to Cyril Kendall, Ph.D., co-investigator of the study, “While a number of studies have shown that nuts can help reduce the risk of CHD and diabetes, no research to date has looked at the how nuts alter the fatty acid profile in people with diabetes and how this relates to cardiovascular health.”

This study is a secondary analysis of the 2011 nuts and diabetes study by the same researchers.  The original study was a 3-month parallel design with 117 non-insulin dependent adults with diabetes (men and women with a mean age of 62 years) who were all being treated with oral hypoglycemic medications. The subjects were randomized to one of three diets for three months. The first diet included a supplement of 75g (~2½ ounces or ½ cup) of mixed nuts; the second diet included 38g (~1⅓ ounces or ¼ cup) of mixed nuts and half portion of muffins; and the third diet contained a full portion of muffins.  Each supplement provided approximately 475 calories per 2,000 calorie diet. All of the diets contained roughly the same number of calories but the nuts provided more unsaturated (i.e. healthy) fat and less carbohydrate.

“The results of our current study indicate that by incorporating nuts into a diabetes diet, one can modify the fatty acid profile of adults with type 2 diabetes by modestly increasing the unsaturated fatty acid content of blood lipids,” explained Dr. Kendall. “This in turn has the potential to contribute to the total reduction of CHD risk in those same individuals.”

Numerous studies have shown that consuming tree nuts may reduce the risk of heart disease. In 2003 tree nuts received a qualified health claim from the U.S. Food and Drug Administration (FDA) which states, “Scientific evidence suggests but does not prove that eating 1.5 ounces per day of most nuts, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease.”  Interestingly, individuals with Type 2 diabetes have a 2-4 fold higher risk of cardiovascular disease (CVD) compared with nondiabetic individuals of similar age, sex and ethnicity.

Lifetime of Learning Might Thwart Dementia; Beginning Late Helps Too


A lifetime engaging in intellectually stimulating pursuits may significantly lower your risk for dementia in your golden years, new research suggests.

Even people with relatively low educational and professional achievements can gain protection against late-life dementia if they adopt a mentally stimulating lifestyle -- reading and playing music and games, for example -- by the time they enter middle-age, the new study contends.

"In terms of preventing cognitive [mental] impairment, education and occupation are important," said study lead author Prashanthi Vemuri, an assistant professor of radiology at the Mayo Clinic and Foundation in Rochester, Minn. "But so is intellectually stimulating activity during mid- to late life," she added.

"This is very encouraging news, because even if you don't have a lot of education, or get exposure to a lot of intellectual stimulation during non-leisure activity, intellectual leisure activity later in life can really help," she said.

Artistic endeavors -- including crafts -- participation in group activities and computer work also benefit the aging brain, according to the study, published in the June 23 online issue of JAMA Neurology.

Seniors in the United States accounted for roughly 35 million people in 2000, and that figure is projected to more than double by 2030, the study authors said. Keeping seniors' brains healthy is considered a public health imperative.

To explore how routine intellectual "exercise" might translate into a lower risk for age-related dementia, the team tracked nearly 2,000 men and women between the ages of 70 and 89, who enrolled in a Mayo Clinic aging investigation between 2004 and 2009.

Initial testing revealed that more than 1,700 of the participants were "cognitively normal" at enrollment, while nearly 300 had "mild cognitive impairment." Cognition refers to thinking and memory abilities.

All participants were subsequently "scored" on their level of past educational achievements, while occupational histories were ranked by degree of intellectual complexity.

Participants also completed questionnaires designed to pinpoint how much they engaged in intellectually demanding activities during the prior 12 months and during middle age (from age 50 to 65).

Lastly, all were examined to see if they carried a specific variant of the APOE gene, considered the most significant genetic risk factor for late-onset Alzheimer's.

At the time of the study's launch, mental functioning was lower among carriers of the APOE4 genotype, and among those who scored lowest on education, job, and/or activity measures, the researchers determined. Lower mental functioning scores were also seen among older participants and men.

However, APOE4 carriers who ranked near the top in terms of all measures of lifetime intellectual engagement -- including education, occupation and activity routines -- saw their risk for dementia delayed by nearly nine years, compared with those whose intellectual stimulation ranking hovered near the bottom.

Digging deeper, Vemuri and her associates also found that regardless of educational and professional background, all participants who routinely engaged in intellectually stimulating activities in middle-age and their later years also ended up seeing their relative risk for dementia drop.

The dementia protection afforded by routine intellectual activity alone was weaker than when intellectual activity was also paired up with stimulating jobs and education.

But in a twist, the authors found that those with the lowest educational and occupational scores actually gained the most protection against dementia by embarking on intellectual activities from middle-age onward.

"This was a little surprising," said Vemuri. "But it turns out that even if you don't have a lifetime of educational and occupational development, intellectual activity in later life can really help -- perhaps delaying cognitive impairment by at least three years."

Cheryl Grady, a professor with the University of Toronto's department of psychology and psychiatry, said the findings are both "interesting" and encouraging.

"The association between lower cognitive function and lower education has been known for some time," she said. "But as far as I know no one has [previously] shown that midlife cognitive activity and education interact."

However, the association seen in this study does not prove a cause-and-effect relationship.

But, Grady added, "It looks like the bottom-line is that it's never too late to exercise your brain, and that is good news."

Friday, June 20, 2014

Depression linked to higher heart disease death risk in younger women



 Women  55 and younger are twice as likely to suffer a heart attack, die or require artery-opening procedures if they’re moderately or severely depressed, according to new research (June 2014) in the Journal of the American Heart Association.

“Women in this age group are also more likely to have depression, so this may be one of the ‘hidden’ risk factors that can help explain why women die at a disproportionately higher rate than men after a heart attack,” said Amit Shah, M.D., M.S.C.R., study author and assistant professor of Epidemiology at Emory University in Atlanta, Ga.

Investigators assessed depression symptoms in 3,237 people with known or suspected heart disease (34 percent women, average age 62.5 years) scheduled for coronary angiography, an X-ray that diagnoses disease in the arteries that supply blood to the heart. After nearly three years of follow-up, researchers found:

    * In women 55 and younger, after adjusting for other heart disease risk factors, each 1-point increase in symptoms of depression was associated with a 7 percent increase in the presence of heart disease.
    * In men and older women, symptoms of depression didn’t predict the presence of heart disease.
    * Women 55 and younger were 2.17 times as likely to suffer a heart attack, die of heart disease or require an artery-opening procedure during the follow-up period if they had moderate or severe depression.
    * Women 55 and younger were 2.45 times as likely to die from any cause during the follow-up period if they had moderate or severe depression.

“All people, and especially younger women, need to take depression very seriously,” Shah said. “Depression itself is a reason to take action, but knowing that it is associated with an increased risk of heart disease and death should motivate people to seek help.”

“Providers need to ask more questions. They need to be aware that young women are especially vulnerable to depression, and that depression may increase the risk to their heart,” Shah said.

“Although the risks and benefits of routine screening for depression are still unclear, our study suggests that young women may benefit for special consideration” remarked Viola Vaccarino, M.D., Ph.D., senior author of the study and Wilton Looney Chair of Epidemiology at Emory University. “Unfortunately, this group has largely been understudied before.”

In 2008, the American Heart Association issued a scientific statement recommending that depression be formally considered as a risk factor, like diabetes or hypertension, for increased heart disease risk. “Our data are in accordance with this recommendation, but suggest that young/middle aged women may be especially vulnerable to depression as a risk factor,” Vaccarino added.”

The research group is examining whether women have more cardiovascular changes than men in response to a short-term mental stress, such as giving a public speech.

Feel-good hormones could cause UV addiction


Sun lovers eagerly flock to the beach every summer, despite widespread awareness of the risk of skin cancer. A study published June 19th by Cell Press in the journal Cell reveals that chronic exposure to ultraviolet (UV) radiation causes the release of feel-good hormones called endorphins, which act through the same pathway as heroin and related drugs, leading to physical dependence, tolerance, and addiction-like behavior in rodents. The findings could explain why people have an instinctive desire to be in the sun, despite its known health risks.

"This information might serve as a valuable means of educating people to curb excessive sun exposure in order to limit skin cancer risk as well as accelerated skin aging that occurs with repeated sun exposure," says senior study author David Fisher of Massachusetts General Hospital and Harvard Medical School. "Our findings suggest that the decision to protect our skin or the skin of our children may require more of a conscious effort rather than a passive preference."

Skin cancer is the most common form of cancer in the United States, and UV-seeking behavior is a major risk factor. Many UV seekers meet clinical criteria for a substance-related disorder, but the mechanisms underlying such an addiction have been unclear. One potential clue is that UV exposure stimulates the production of endorphins, which relieve pain by activating opioid receptors through the same pathway activated by prescription painkillers, morphine, and heroin.

In the new study, Fisher and his team examined whether this pathway could underlie UV addiction. They exposed shaved mice to UV light for 6 weeks and found that endorphin levels in the bloodstream increased within 1 week. After the 6 week period ended, treatment with an opioid-blocking drug caused withdrawal symptoms, including shaking, tremors, and teeth chattering, in mice that had been exposed to UV light. As a result, these mice avoided locations where they had been given the drug, suggesting that chronic UV exposure produces physical dependence and addiction-like behavior.

"It's surprising that we're genetically programmed to become addicted to something as dangerous as UV radiation, which is probably the most common carcinogen in the world," Fisher says. "We suspect that the explanation involves UV's contribution to vitamin D synthesis in the skin. However, in the current time, there are much safer and more reliable sources of vitamin D that do not come with carcinogenic risk, so there is real health value in avoiding sunlight as a source of vitamin D."

Children consuming a Mediterranean Diet are 15% less likely to be overweight



A study of 8 European countries presented at this year’s European Congress on Obesity (ECO)in Sofia, Bulgaria, shows that children consuming a diet more in line with the rules of the Mediterranean one are 15% less likely to be overweight or obese than those children who do not.

The researchers used data from the IDEFICS study (Identification and Prevention of Dietary – and lifestyle – induced health effects in Children and infantS), funded by the European Commission. Weight, height, waist circumference, and percent body fat mass were measured in children from these eight countries.

Vegetables, fruit, nuts and fish

The parents of these children were interviewed by means of a questionnaire specifically designed for the IDEFICS study and enquiring about the consumption frequency of 43 foods. Additional dietary data have been complemented by a telephone interview performed on a sub-sample of parents.

The adherence to a Mediterranean-like diet was assessed by a score calculating by giving one point for high intakes of each food group which was considered typical of the Mediterranean diet (vegetables, fruit and nuts, fish and cereal grains), as well as one point for low intakes of foods untypical of the Mediterranean diet (such as dairy and meat products). High scoring children were then considered high-adherent and compared to the others.

Swedish children most Mediterranean

Interestingly, the prevalence of high adherence to a Mediterranean-like diet was found to be independent of the geographical distribution, with the Swedish children scoring the highest (followed by the Italians) and the children from Cyprus scoring the lowest.

The team found that children with a high adherence to a Mediterranean-like diet were 15% less likely to be overweight or obese than low-adherent children. The findings were independent of age, sex, socioeconomic status or country of residence.

The children with high adherence at baseline were 10-15% less likely to be among those who went through major increases in BMI, waist circumference and body fat.

“The promotion of a Mediterranean dietary pattern is no longer a feature of Mediterranean countries. Considering its potential beneficial effects on obesity prevention, this dietary pattern should be part of EU obesity prevention strategies and its promotion should be particularly intense in those countries where low levels of adherence are detected.” says Gianluca Tognon, researcher at the Sahlgrenska Academy.

Football improves strength in men with prostate cancer


Research
Men with prostate cancer aged 43‒74 achieve bigger and stronger muscles, improve functional capacity, gain positive social experiences and the desire to remain active through playing football for 12 weeks. These are the findings of the “FC Prostate” trial, jointly conducted by the University Hospitals Centre for Health Care Research at The Copenhagen University Hospital, Rigshospitalet and the Copenhagen Centre for Team Sport and Health at the University of Copenhagen.
Regained body pride and strong social cohesion
The acclaimed Scandinavian Journal of Medicine & Science in Sports is today publishing two articles on recreational football (soccer) for 43‒74-year-old men with prostate cancer. The first article shows that twice-weekly 1-hour football training sessions for 12 weeks produce an increase in muscle mass and muscle strength despite concurrent androgen deprivation therapy. The second article describes how recreational football is a promising novel approach for health promotion in prostate cancer patients as the participants regain pride in their bodies, develop team spirit and mutual concern increasing their motivation for long-term participation in sport.
“This is the first study of its kind in the world, and the results clearly show the potential of recreational football in the rehabilitation of prostate cancer patients,” says project leader Julie Midtgaard, a psychologist at The Copenhagen University Hospital Rigshospitalet. “Just 12 weeks of football training resulted in the men regaining control and developing a unique exchange of feelings and recognition centered around the sport.”
The attendance rate was high over the 12 weeks, and many of the participants are still playing football two years after the project began.
“The provision of football proved to be a good way of developing friendships between the men and a unique model for men with prostate cancer to take responsibility of their own health without giving up their claim to feel and behave like men,” concludes Midtgaard.
Bigger and stronger muscles in spite of anti-hormone treatment
“Androgen deprivation therapy through medical castration is an effective treatment of prostate cancer patients but has adverse effects in the form of reduced muscle mass, higher fat percentage and reduced physical activity,” explains Professor Peter Krustrup, who co-initiated the study with Midtgaard and has been studying the effects of recreational football for the past 10 years.
“Twelve weeks of football training increased muscle mass by half a kilo in the football group in spite of the anti-hormone treatment and contributed to a 15% increase in muscle strength. The players in the FC Prostate team thus achieved excellent gains in functional capacity as a result of 12 weeks of football training, measured among other things as a 8% improvement in performance in the stand-sit test,” says Krustrup.
“Our study also showed that recreational football was fun and inclusive for the participants in FC Prostate, and for every training session the intensity was high, with an average heart rate of 85% of the participants’ maximum heart rate,” says Krustrup.
Football is good rehabilitation for prostate cancer patients
“Previously, we showed that recreational football is effective for preventing and treating lifestyle diseases. With this study, we can add that recreational football can also be used for rehabilitation of a large group of cancer patients,” says Krustrup.
Midtgaard concludes: “The study indicates that men with prostate cancer benefit greatly from recreational football, both physically and mentally. It has also proved to be easy to keep the men involved in physical activity once they have started playing football. They look forward to going to training and enjoy it tremendously when they get there. The next step is to evaluate the effectiveness of football in a more natural setting. Therefore we are delighted that we have received the necessary funding to pursue an even bigger project in collaboration with the Danish Football Association in which more than 300 prostate cancer patients will be invited to play football in local football clubs in Denmark.”


About the study
The training project was a randomised controlled trial involving 57 men aged 67 (range: 43‒74) years who had been undergoing treatment for prostate cancer for an average of 3 years. They were randomly assigned to a football training group or an inactive control group. The football group trained twice a week for 1 hour for 12 weeks.
The training took place on the football pitch of the Department of Nutrition, Exercise and Sports at Nørrebro in Copenhagen. An extensive testing protocol was used before the start of training and on completion of the 12-week training period. The project was implemented jointly by Rigshospitalet, the Copenhagen Centre for Team Sport and Health at the University of Copenhagen and the Department of Cardiology at Gentofte Hospital.
The study was supported by TrygFonden and The Centre for Integrated Rehabilitation of Cancer Patients funded by the Danish Cancer Society and The Novo Nordisk Foundation. With a view to extending football training to a bigger and broader target group of men with prostate cancer, the project will be followed up with new research to test football as a strategy for health promotion in conjunction with the Danish Football Association and TrygFonden.
The two articles are today being published in a special issue of the Scandinavian Journal of Medicine & Science in Sports on the topic of football for health.

Recreational football reduces high blood pressure in mature women



The World Cup in Brazil may be attracting a global armchair audience of millions, but new research has shown that playing football could help lower blood pressure in women aged 35-50.

Women within this age group with mild high blood pressure achieve a significant reduction in blood pressure and body fat percentage through playing recreational football for 15 weeks. This is the finding of a new study conducted in a collaboration between researchers across four countries, including Professor Peter Krustrup of the University of Exeter.

The acclaimed Scandinavian Journal of Medicine & Science in Sports is today publishing two articles on recreational football for older women. The first article shows that 35‒50-year-old untrained women with mild high blood pressure achieve a significant improvement in physical fitness and a considerable reduction in blood pressure and body fat percentage after 3 x 1-hour football training sessions per week over 15 weeks. The second article describes the enthusiasm of women for the recreational football concept Football Fitness, which is currently being rolled out in football clubs across Denmark.

"After 15 weeks of participation in recreational football, systolic and diastolic blood pressure had fallen by 12 and 6 millimetres of mercury (mmHg) and the women had lost 2.3 kg of fat on average," says project leader Magni Mohr. "The football training produced an impressive reduction in blood pressure that was more than twice as big as with swimming performed over the same period as the football."

The researchers also found that women like playing football even if they have no previous experience of the game. Magni Mohr added: "The players faithfully attended training, with an attendance rate of over 90%. In fact, through the project period they came to enjoy playing so much that they have now started up their own football club."

"Our previous studies have shown that 16 weeks of football training reduces blood pressure in 20‒45-year-old women with normal blood pressure, but this is the first study that has looked at the effects of recreational football in women with high blood pressure," says Professor Peter Krustrup, who has been studying the health effects of recreational football and many other forms of physical activity for the past 10 years.

"As well as the impressive effects on blood pressure and body composition, we also saw a drop in cholesterol and a big improvement in physical fitness as a result of the 15 weeks of football training," says Krustrup. "In fact, the women were able to run more than twice as far in a Yo-Yo Intermittent Endurance Test and their heart rate was 14 beats per minute lower when working at moderate intensity. Recreational football is an effective therapy for poor fitness and high blood pressure in 35‒50-year-old women."

"Traditionally, there haven't been so many older female players in English, Faroese or Danish football clubs, but the relatively new Danish initiative of Football Fitness has really caught on with women," says sports sociologist Laila Ottesen, currently engaged in an extensive study of the Football Fitness concept, which was started in 2011 by the Danish Football Association and the Danish Sports Confederation.

"At present, there are 180 football clubs across Denmark offering Football Fitness. In just a few years, the initiative has become hugely popular with women, who currently make up almost 75% of players. Football Fitness is about training in a fun, sociable and healthy way and not about playing matches against local rivals," says Ottesen.

"Matches are not part of the package, and consequently Football Fitness appeals to a lot of women who have never been in a football club before, in Denmark and and probably also many other countries" concludes Ottesen.

In the training project, 41 untrained women aged 35‒50 years with mild high blood pressure of around 140/90 mmHg were randomly assigned to either a football training group or an inactive control group. The football group trained for 1 hour three times a week for 15 weeks. The training was performed on artificial grass in Torshavn in the Faroes. An extensive testing protocol was used before the start of training and on completion of the 15-week period.

The project was conducted as a collaboration between the University of Exeter (UK), the University of Gothenburg (Sweden), University of the Faroe Islands, Faroese National Hospital, The Faroese Football Association, Rigshospitalet and the Copenhagen Centre for Team sport and Health at the University of Copenhagen (Denmark).

The Football Fitness project comprises research into Danish football clubs and was carried out by, among others, associate professor Laila Ottesen and PhD student Søren Bennike of the Copenhagen Centre for Team Sport and Health.




Thursday, June 19, 2014

Calcium supplements may be too much for some older women



Calcium and vitamin D are commonly recommended for older women, but the usual supplements may send calcium excretion and blood levels too high for some women, shows a new study published online in Menopause, the journal of The North American Menopause Society.

This randomized, placebo-controlled trial included 163 older (ages 57 to 90) white women whose vitamin D levels were too low. The women took calcium citrate tablets to meet their recommended intake of 1,200 mg/day, and they took various doses of vitamin D, ranging from 400 to 4,800 IU/day. (The trial was limited by ethnicity because different ethnic groups metabolize calcium and vitamin D differently.)

About 9% of the women developed excess levels of calcium in their blood (hypercalcemia), and 31% developed excess levels in their urine (hypercalciuria), even though they were taking normal doses of the supplements and did not have hyperparathyroidism, a condition in which the body makes too much calcium-regulating hormone. These excess blood and urine calcium levels may lead to kidney stones or other problems.

The good news in this study is that the investigators found a way to predict which women were likely to develop these excess levels. The risk of developing excess urine calcium was 15 times higher for women who started out with a 24-hour urine calcium level above 132 mg than for women with lower levels. And the risk was 20 times higher for women who started with levels above 180 mg than for women with lower levels. But every one-year increase in age reduced the risk by 10%.

"Even a modest calcium supplementation of 500 mg/day may be too high for some women," note the authors, who recommend measuring blood and urine calcium levels before women start using the supplements and again within three months.

"I would recommend that women determine how much calcium they typically get through their food sources before taking a hefty calcium supplement. They may not need as much as they think," says NAMS Executive Director Margery Gass, MD.

Wednesday, June 18, 2014

Low vitamin D linked to high risk of death from all causes including cancer and cardiovascular disease


The main source of vitamin D is its production in skin thanks to the sun. Women are more prone to low vitamin D than men - and due to differing weather conditions, concentrations vary in populations across the world.

Vitamin D deficiency is especially common among the elderly who often have less sun exposure, but it is unclear what effect the production of vitamin D has on death.

So researchers investigated the association of vitamin D with deaths from all-causes, cardiovascular diseases and cancer. They paid particular attention to differences between countries, sexes and age groups.

Data were taken from seven population-based cohorts from the US and across Europe. All study participants were aged 50-79.

Results reported in BMJ-British Medical Journal June 2014 show that there was no clear trend of vitamin D by age, but average levels were consistently lower among women than men. Average levels increased with education, were lowest in obese individuals and higher among subjects who exercised.

During 16 years of follow-up, there were 6,695 deaths in 26,018 patients - 2,624 from cardiovascular diseases and 2,227 from cancer.

An association was found between those with the lowest levels of vitamin D and death from cardiovascular disease - in people with and without a history of the disease- and deaths from cancer in those with a history of the disease. No association was found between low vitamin D levels and deaths from cancer in those without a history of the disease.

The researchers say this shows an important role of vitamin D in the prognosis of cancer, although they add "we cannot exclude reverse causality, that is, that the cancer might have led to low vitamin D levels." There was also a dose-response relationship which was unchanged after excluding patients with a history of cardiovascular disease and cancer.

The researchers say that death from all causes as a result of low vitamin D has "high public health relevance" and should be given high priority. They also ask whether levels of vitamin D in specific countries, different sexes and seasons "should be considered for defining vitamin D deficiency" due to its varying levels.

They conclude that those with the lowest levels of vitamin D had an association "with increased all-cause mortality, cardiovascular mortality, and cancer mortality (in subjects with a history of cancer)." They say these effects were consistent across countries, sexes, age groups, and time of the year when blood tests were done and that "variation by geographic region, sex and season might need to be taken into account."

Monday, June 16, 2014

Benefits of canola oil for people with type 2 diabetes



New research from St. Michael's Hospital suggests canola oil should also be one of the oils of choice for people with Type 2 diabetes. Dr. David Jenkins, head of the hospital's Clinical Nutrition and Risk Factor Modification Centre, compared people with Type 2 diabetes who ate either a low glycemic index diet that included bread made with canola oil, or a whole wheat diet known to reduce the risk of cardiovascular disease.

His study, published June 14, 2014  in the journal Diabetes Care, found that those on the canola bread diet experienced both a reduction in blood glucose levels and a significant reduction in LDL, or "bad," cholesterol.

Even more exciting, he said, was the finding that the canola bread diet seemed to have the most significant impact on people who needed help the most – those whose HbA1c test measuring blood glucose over the previous two or three months was highest.

Dr. Jenkins, who is a professor of both nutritional sciences and medicine at the University of Toronto, said the reduction in LDL cholesterol observed in his study of 141 people could translate into a 7 per cent reduction in cardiovascular events. He said the benefit could also be translated into an additional 20mg dose of one of the cholesterol-reducing drugs known as statins—a doubling of a standard dose.

The word canola is a contraction of Canada and ola, meaning oil. It was developed from rapeseed at the University of Manitoba in the 1970s. Canola oil contains only 7 per cent saturated fat, less than half that of olive oil, widely touted for its health benefits.

Dr. Jenkins said another interesting finding of the study was that patients on the whole wheat diet seemed to have better blood flow after 12 weeks than those on the canola bread diet, as measured by the EndoPat test that uses a cuff on the arm similar to a blood pressure test. He said the significance of that finding was not entirely clear, but this positive result may be an indication of why whole wheat foods have consistently been shown to reduce the risk of cardiovascular disease.

Dr. Jenkins and his colleagues developed the concept of the glycemic index in the early 1980s as a way of explaining how different carbohydrates affect blood glucose and to find out which foods were best for people with diabetes. High GI foods—such as white bread, most breakfast cereals, potatoes and rice — produce a large rise in blood glucose and insulin, which may damage eyes, kidneys and heart. The carbohydrates in low GI foods—including pasta, beans, lentils, berries, apples and certain whole grains such as barley and oats –are broken down more slowly, so that people get more gentle raises in blood glucose and insulin and so get less tissue damage to eyes and kidneys etc.

Other studies have linked low GI diets with a reduction in both diabetes and cardiovascular events, and have shown monounsaturated fats such as canola and olive oil reduced the risk of cardiovascular disease. Dr. Jenkins said the combination of a low GI diet supplemented with canola oil had not been tested before on people with Type 2 diabetes.

Sedentary behavior increases the risk of certain cancers



Physical inactivity has been linked with diabetes, obesity, and cardiovascular disease, but it can also increase the risk of certain cancers, according to a study published June 16, 2014 in the JNCI: Journal of the National Cancer Institute.

To assess the relationship between TV viewing time, recreational sitting time, occupational sitting time, and total sitting time with the risk of various cancers, Daniela Schmid, Ph.D., M.Sc., and Michael F. Leitzmann, M.D., Dr.P.H., of the Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany, conducted a meta-analysis of 43 observational studies, including over 4 million individuals and 68,936 cancer cases. Data in the individual studies had been obtained with self-administered questionnaires and through interviews.

When the highest levels of sedentary behavior were compared to the lowest, the researchers found a statistically significantly higher risk for three types of cancer—colon, endometrial, and lung. Moreover, the risk increased with each 2-hour increase in sitting time, 8% for colon cancer, 10% for endometrial cancer, and 6% for lung cancer, although the last was borderline statistically significant. The effect also seemed to be independent of physical activity, suggesting that large amounts of time spent sitting can still be detrimental to those who are otherwise physically active. TV viewing time showed the strongest relationship with colon and endometrial cancer, possibly, the authors write, because TV watching is often associated with drinking sweetened beverages, and eating junk foods.

The researchers write "That sedentariness has a detrimental impact on cancer even among physically active persons implies that limiting the time spent sedentary may play an important role in preventing cancer…."

In an accompanying editorial, Lin Yang and Graham A. Colditz, M.D., Dr.P.H., of the Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis MO, write that these results "…support a causal relation between sedentary behavior and both colon and endometrial cancers." They comment that cancer prevention requires good evidence, political will, and a social strategy to fund and implement prevention programs.


Omega-3 fights age-related macular degeneration


Age-related macular degeneration (AMD), which is characterized by choroidal neovascularization (CNV), or blood vessel growth, is the primary cause of blindness in elderly individuals of industrialized countries. The prevalence of the disease is projected to increase 50% by the year 2020. There is an urgent need for new pharmacological interventions for the treatment and prevention of AMD.
Researchers from Massachusetts Eye and Ear/Schepens Eye Research Institute, Harvard Medical School and other institutions have demonstrated for the first time that the omega (ω)-3 long-chain polyunsaturated fatty acids (LCPUFAs), DHA and EPA, and their specific bioactive products derived from the cytochrome P450 (CYP) pathway, can influence choroidal neovascularization (CNV) and vascular leakage by modulating micro-environmental immune cell recruitment to the site of these lesions. Their findings were
"These are the first results showing that omega (ω)-3 LCPUFAs and their CYP derived metabolites can regulate choroidal angiogenesis in vivo. The fact that this can be accomplished with physiologically relevant naturally occurring lipid metabolites is of significant clinical interest as these molecules are readily available and considered to be safe. Our findings not only show promising therapeutic potential for resolution of neovascular AMD, but also for other conditions or diseases that involve pathologic angiogenesis and inflammation,” said Kip Connor, Ph.D., Assistant Professor in Ophthalmology at Harvard Medical School and senior author of the paper.
The omega (ω)-3 and ω-6 long-chain polyunsaturated fatty acids (LCPUFAs) are two classes of dietary lipids that are essential fatty acids and have opposing physiological effects. To evaluate the effect of LCPUFAs on CNV development, researchers fed mice one of three experimental diets beginning two weeks before CNV induction by laser photocoagulation. The experimental diets were enriched with either ω-3 or ω-6 LCPUFAs, or in the case of the control diet, devoid of the primary ω-3 or ω-6 LCPUFAs. The lesion size and vascular leakage were significantly smaller in animals fed with ω-3 LCPUFAs. To gain mechanistic insight into the effect of dietary ω-3 LCPUFAs on CNV regression, researchers analyzed the lipid profiles of these mice and identified endogenous CYP-generated metabolites. Specifically, 17,18-EEQ and 19,20-EDP, derived from the CYP-pathway were identified by liquid chromatography- mass spectrometry (LC–MS/MS) and found to confer protection. Systemic immune-cell recruitment and adhesion-molecule regulation were significantly dampened in mice receiving ω-3s, thereby suppressing inflammation that is thought to exacerbate this disease. These findings provide a unique mechanism whereby specific CYP derived lipid metabolites regulate angiogenesis in a mouse model of AMD.
The researchers demonstrated that dietary supplementation of omega (ω)-3 long-chain polyunsaturated fatty acids (LCPUFAs) mediates choroidal neovessel regression in a well-characterized murine model of neovascular AMD. The cytochrome P450 (CYP) enzymes catalyze the epoxidation of these ω-3 LCPUFAs to form the eicosanoids 17,18-epoxyeicosatetraenoic acid (EEQ) and 19,20-epoxydocosapentaenoic acid (EDP), which were identified as key lipid mediators of disease resolution.
Their findings show promising therapeutic potential in AMD disease resolution.
"Given the prevalence of neovascular eye disease, the potential impact of this study is highly significant. We have identified unique endogenous lipid biometabolites that are able to inhibit pathologic retinal angiogenesis, a major driver of vision loss worldwide. It is our hope that future studies will allow us to develop specific therapeutics that harness this knowledge resulting in a greater visual outcome and quality of life for patients suffering from these sight-threatening diseases," said lead author Ryoji Yanai, M.D., Ph.D.

Broccoli Sprout Beverage Enhances Detoxification of Air Pollutants




A clinical trial involving nearly 300 Chinese men and women residing in one of China’s most polluted regions found that daily consumption of a half cup of broccoli sprout beverage produced rapid, significant and sustained higher levels of excretion of benzene, a known human carcinogen, and acrolein, a lung irritant. Researchers from the Johns Hopkins Bloomberg School of Public Health, working with colleagues at several U.S. and Chinese institutions, used the broccoli sprout beverage to provide sulforaphane, a plant compound already demonstrated to have cancer preventive properties in animal studies. The study was published in the June 9, 2014 online edition of the journal Cancer Prevention Research.

“Air pollution is a complex and pervasive public health problem,” notes John Groopman, PhD,  Anna M. Baetjer Professor of Environmental Health at the Johns Hopkins Bloomberg School of Public Health and one of the study’s co-authors. “To address this problem comprehensively, in addition to the engineering solutions to reduce regional pollution emissions, we need to translate our basic science into strategies to protect individuals from these exposures. This study supports the development of food-based strategies as part of this overall prevention effort.”

Air pollution, an increasing global problem, causes as many as seven million deaths a year worldwide, according to the World Health Organization, and has in recent years reached perilous levels in many parts of China. Last year, the International Agency for Research on Cancer classified air pollution and particulate matter (PM) from air pollution as carcinogenic to humans. Diets rich in cruciferous vegetables, of which broccoli is one, have been found to reduce risk of chronic degenerative diseases, including cancer. Broccoli sprouts are a source of glucoraphanin, a compound that generates sulforaphane when the plant is chewed or the beverage swallowed. It acts to increase enzymes that enhance the body’s capacity to expunge these types of the pollutants.

The 12-week trial included 291 participants who live in a rural farming community in Jiangsu Province, China, approximately 50 miles north of Shanghai, one of China’s more heavily industrialized regions. Participants in the control group drank a beverage made of sterilized water, pineapple and lime juice while the beverage for the treatment group additionally contained a dissolved freeze-dried powder made from broccoli sprouts that contained glucoraphanin and sulforaphane. Sixty-two men (21%) and 229 women (79%) with a median age of 53 (ranging from 21 to 65) years were enrolled in the study. Urine and blood samples were taken over the course of the trial to measure the fate of the inhaled air pollutants.

The research team found that among participants receiving the broccoli sprout beverage, the rate of excretion of the carcinogen benzene increased 61% beginning the first day and continuing throughout the 12-week period. In addition, the rate of excretion of the irritant acrolein, rapidly and durably increased 23% during the 12-week trial. Secondary analyses by the investigators indicated that the sulforaphane may be exerting its protective actions by activating a signaling molecule, NRF2, that elevates the capacity of cells to adapt to and survive a broad range of environmental toxins. This strategy may also be effective for some contaminants in water and food.

“This study points to a frugal, simple and safe means that can be taken by individuals to possibly reduce some of the long-term health risks associated with air pollution,” notes Thomas Kensler, PhD, professor at the Johns Hopkins Bloomberg School and one of the study’s co-authors. “This while government leaders and policy makers define and implement more effective regulatory policies to improve air quality.”

The clinical trial targeting prevention is notable in that it evaluated a possible means to reduce the body burden of toxins following unavoidable exposures to pollutants. The majority of clinical trials involve treatments of diseases that have already presented or advanced into later stages. Further clinical trials, to evaluate optimal dosage and frequency of the broccoli sprout beverage, are planned in the same general region of China.

Sleep quality and duration improve cognition in aging populations



 Maybe turning to sleep gadgets -- wristbands, sound therapy and sleep-monitoring smartphone apps -- is a good idea. A new University of Oregon-led study of middle-aged or older people who get six to nine hours of sleep a night think better than those sleeping fewer or more hours.

The study, published in the June issue of the Journal of Clinical Sleep Medicine, reaffirms numerous small-scale studies in the United States, Western Europe and Japan, but it does so using data compiled across six middle-income nations and involving more than 30,000 subjects for a long-term project that began in 2007.

"We wanted to look at aging, particularly dementia and cognitive decline as people get older, and the importance of sleep. Our results provide compelling evidence that sleep matters a lot," said lead author Theresa E. Gildner, a doctoral student in the UO's anthropology department. "In all six countries, which are very different culturally, economically and environmentally -- despite all these differences -- you see similar patterns emerging."

The study, based on the first wave of data from a continuing long-term project, focuses on people 50 years old and older in China, Ghana, India, Mexico, the Russian Federation and South Africa. Among the key findings were:

·      Men reported higher sleep quality than women in all six nations, with men and women in Mexico reporting the highest.

·      Women reported longer sleep durations than men in all countries except Russia and Mexico. Men and women in South Africa slept longer than in any other country. The least sleep hours for both sexes occurred in India.

·      Individuals sleeping less than six hours and more than nine hours had significantly lower cognitive scores compared to those in the intermediate group.

Trained native speakers in each country interviewed the participants, who rated their sleep quality on a five-point scale and the number of hours they'd slept over the two previous nights. That information was averaged. Participants then went through five standard cognitive tests involving immediate recall of a list of presented words, delayed recall of those words later, forward and backward recall of long lists of numbers, and a verbal fluency test in which they listed as many animals as possible without repetition, the use of proper nouns or descriptors.

The study concludes that the findings have important implications for future intervention strategies for dementia. The consistent associations between intermediate sleep durations, high sleep quality and enhanced cognitive performance in these diverse populations suggests that improving sleep patterns may help reduce the level of cognitive decline as seen in older adults.

Another important finding, Gildner said, is the gender difference in all sleep and cognition variables. Citing previous studies, the authors hypothesized that women's sleep patterns reflect postmenopausal changes, increased bladder instability and feelings of isolation after the loss of a spouse or lack of social support. Cognition scores of women may result from their sleep difficulties and/or lower educational levels.

The growing database in the long-term study, known as the Study on global AGEing and adult health (SAGE), is allowing researchers to mine many combinations of variables connected to health and lifestyle, said J. Josh Snodgrass, professor of anthropology at the UO. "It also will allow anthropologists to explore cultural factors that may contribute to sleeping and health patterns."

Snodgrass is a key investigator on SAGE, which is funded by a joint agreement of the National Institutes of Health and the World Health Organization.

"This study is hugely powerful and so different from what's been done in the past, simply because of the consistency of how the data was collected -- multi-national, random samples of people," he said. "Sleep is something that is important but often undervalued in our society.

"From doing this research and being familiar with the literature," he added, "an emphasis on sleep issues by the media in recent years is warranted. Every single piece of evidence that people look at now as they are investigating sleep and different health associations is all showing that sleep really, really, really matters. We're just now scratching the surface on what patterns of sleep normally are, and also what are these associations between sleep and health issues."

Friday, June 13, 2014

Processed red meat linked to higher risk of heart failure, death in men


Men who eat moderate amounts of processed red meat may have an increased risk of incidence and death from heart failure, according to a June 2014 study in Circulation: Heart Failure, an American Heart Association journal.

Processed meats are preserved by smoking, curing, salting or adding preservatives. Examples include cold cuts (ham, salami), sausage, bacon and hot dogs.

“Processed red meat commonly contains sodium, nitrates, phosphates and other food additives, and smoked and grilled meats also contain polycyclic aromatic hydrocarbons, all of which may contribute to the increased heart failure risk,” said Alicja Wolk, D.M.Sc., senior author of the study and professor in the Division of Nutritional Epidemiology at the Institute of Environmental Medicine, Karolinska Institutet in Stockholm, Sweden. “Unprocessed meat is free from food additives and usually has a lower amount of sodium.”

The Cohort of Swedish Men study — the first to examine the effects of processed red meat separately from unprocessed red meat — included 37,035 men 45-79 years old with no history of heart failure, ischemic heart disease or cancer. Participants completed a questionnaire on food intake and other lifestyle factors and researchers followed them from 1998 to the date of heart failure diagnosis, death or the end of the study in 2010.

After almost 12 years of follow-up, researchers found:

    * Heart failure was diagnosed in 2,891 men and 266 died from heart failure.
    * Men who ate the most processed red meat (75 grams per day or more) had a 28 percent higher risk of heart failure compared to men who ate the least (25 grams per day or less) after adjusting for multiple lifestyle variables.
    * Men who ate the most processed red meat had more than a 2-fold increased risk of death from heart failure compared to men in the lowest category.
    * For each 50 gram (e.g. 1-2 slices of ham) increase in daily consumption of processed meat, the risk of heart failure incidence increased by 8 percent and the risk of death from heart failure by 38 percent.
    * The risk of heart failure or death among those who ate unprocessed red meat didn’t increase.

At the beginning of the study, participants completed a 96-item questionnaire about their diet. Processed meat questions focused on consumption of sausages, cold cuts (ham/salami), blood pudding/sausages and liver pate over the last year. Unprocessed meat questions covered pork and beef/veal, including hamburger or ground-minced meat.

Results of the study for total red meat consumption are consistent with findings from the Physicians’ Health Study, in which men who ate the most total red meat had a 24 percent higher risk of heart failure incidence compared to those who ate the least.

“To reduce your risk of heart failure and other cardiovascular diseases, we suggest avoiding processed red meat in your diet, and limiting the amount of unprocessed red meat to one to two servings per week or less,” said Joanna Kaluza, Ph.D., study lead author and assistant professor in the Department of Human Nutrition at Warsaw University of Life Sciences in Poland. “Instead, eat a diet rich in fruit, vegetables, whole grain products, nuts and increase your servings of fish.”

Researchers said they expect to find similar associations in a current study conducted with women.

Almost 6 million Americans have heart failure and about 50 percent die within five years of diagnosis. The healthcare costs and loss of productivity due to heart failure are an estimated $34 billion each year, researchers said.

The American Heart Association recommends that people eat a dietary pattern that emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts while limiting red meat and sugary foods and beverages. For people who eat meat, choose lean meats and poultry without skin and eat fish at least twice a week – preferably fish high in omega-3 fatty acids such as salmon, trout, and herring.


6,000 steps a day keeps knee OA limitations away



A new study shows that walking reduces risk of functional limitation associated with knee osteoarthritis (OA). In fact, the study funded in part by grants from the National Institutes of Health (NIH) and published JUNE 2014 in the American College of Rheumatology (ACR) journal, Arthritis Care & Research, suggests that walking 6,000 or more steps per day may protect those with or at risk of knee of OA from developing mobility issues, such as difficulty getting up from a chair and climbing stairs.

Nearly 27 million Americans age 25 and older are diagnosed with OA according to a prevalence study by Lawrence et al. (Arthritis Rheum, 2008). Previous research reports that knee OA is the leading cause of functional limitation among older adults, making walking and climbing stairs difficult. Moreover, data from the National Health and Nutrition Examination Survey (NHANES III) state that 80% of OA patients have some limitation in movement, with 11% of adults with knee OA needing assistance with personal care assistance.

While walking is a common daily physical activity for older adults, medical evidence reports that two-thirds of U.S. adults with arthritis walk less than 90 minutes each week. "Our study examines if more walking equates with better functioning, and if so, how much daily walking is needed to minimize risk of developing problems with mobility in people with knee OA," said Daniel White, PT, ScD, from Sargent College at Boston University in Massachusetts.

For the present study, researchers measured daily steps taken by 1788 people with or at risk for knee OA, who were part of the Multicenter Osteoarthritis Study. Walking was measured with a monitor over seven days and functional limitation evaluated two years later, defined as a slow walking speed and a Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function score greater than 28 out of 68.

Walking an additional 1,000 steps each was associated with between a 16% to 18% reduction in incident functional limitation two years later. Walking less than 6,000 steps daily was the best threshold for identifying those who developed functional limitation. Dr. White concludes, "Walking is an inexpensive activity and despite the common popular goal of walking 10,000 steps per day, our study finds only 6,000 steps are necessary to realize benefits. We encourage those with or at risk of knee OA to walk at least 3,000 or more steps each day, and ultimately progress to 6,000 steps daily to minimize the risk of developing difficulty with mobility."