Healthy lifestyle may buffer against stress-related cell aging

A new study from UC San Francisco is the first to show that while the impact of life's stressors accumulate overtime and accelerate cellular aging, these negative effects may be reduced by maintaining a healthy diet, exercising and sleeping well.

"The study participants who exercised, slept well and ate well had less telomere shortening than 

the ones who didn't maintain healthy lifestyles, even when they had similar levels of stress," said 

lead author Eli Puterman, PhD, assistant professor in the department of psychiatry at UCSF. 

"It's very important that we promote healthy living, especially under circumstances of typical 

experiences of life stressors like death, caregiving and job loss."

The paper will be published in Molecular Psychiatry, a peer-reviewed science journal by 

Nature Publishing Group.

Telomeres are the protective caps at the ends of chromosomes that affect how quickly cells age. 

They are combinations of DNA and proteins that protect the ends of chromosomes and help them 

remain stable. As they become shorter, and as their structural integrity weakens, the cells age and 

die quicker. Telomeres also get shorter with age.

 
In the study, researchers examined three healthy behaviors -physical activity, dietary intake and sleep quality -- over the course of one year in 239 post-menopausal, non-smoking women. The women provided blood samples at the beginning and end of the year for telomere measurement and reported on stressful events that occurred during those 12 months. In women who engaged in lower levels of healthy behaviors, there was a significantly greater decline in telomere length in their immune cells for every major life stressor that occurred during the year. Yet women who maintained active lifestyles, healthy diets, and good quality sleep appeared protected when exposed to stress -- accumulated life stressors did not appear to lead to greater shortening.

"This is the first study that supports the idea, at least observationally, that stressful events can accelerate immune cell aging in adults, even in the short period of one year. Exciting, though, is that these results further suggest that keeping active, and eating and sleeping well during periods of high stress are particularly important to attenuate the accelerated aging of our immune cells," said Puterman.

In recent years, shorter telomeres have become associated with a broad range of aging-related diseases, including stroke, vascular dementia, cardiovascular disease, obesity, osteoporosis diabetes, and many forms of cancer.

Research on telomeres, and the enzyme that makes them, telomerase, was pioneered by three Americans, including UCSF molecular biologist and co-author Elizabeth Blackburn, PhD. Blackburn co-discovered the telomerase enzyme in 1985. The scientists received the Nobel Prize in Physiology or Medicine in 2009 for their work.

"These new results are exciting yet observational at this point. They do provide the impetus to move forward with interventions to modify lifestyle in those experiencing a lot of stress, to test whether telomere attrition can truly be slowed," said Blackburn.

Soy may help women's hearts if they start early

A diet rich in soy may help feminine hearts, but timing matters, finds a new study published in Menopause, the journal of The North American Menopause Society.

Lifelong soy consumption, similar to the diet of women in Asia, produces the least atherosclerosis. Switching to a Western diet after menopause, similar to Asian migrants to North America, leads to just as much atherosclerosis as a lifelong Western diet, and switching to soy from a Western diet after menopause helps only if there isn't much atherosclerosis already.

Researchers at Wake Forest School of Medicine in Winston-Salem, NC, reached those conclusions based on their feeding study of cynomolgus monkeys before and after surgical menopause. They fed premenopausal monkeys a diet with protein derived mainly from animal sources or a diet with protein from high-isoflavone soybeans. After having their ovaries removed, mimicking human menopause, one group of monkeys continued to eat a soy diet, another switched from animal protein to soy, a third group stuck with animal protein, and a fourth switched from animal protein to soy.

After 34 months, cholesterol levels were good in the monkeys who ate soy before and after menopause. And for those that switched to a soy protein diet after menopause, similar to some North American women concerned about their heart health, cholesterol levels did improve significantly (with lower total, LDL, and VLDL and higher HDL). But when it came to how much plaque progressed in the arteries, there weren't any statistically significant differences, despite trends favoring a lifelong soy diet and the switch to soy after menopause.

As far as the total amount of atherosclerosis was concerned, monkeys eating a lifelong soy diet showed a much lower proportion of complicated plaque in the arteries than the other monkeys.

There was a big advantage to a postmenopausal switch to soy for some of the monkeys, however. For those that had small plaques in the arteries at the time of menopause, the switch to soy after menopause markedly reduced the progression of plaque in the arteries.

These findings add to the similar ones from the Women's Isoflavone Soy Health (WISH) clinical trial on atherosclerosis in women after menopause, but this animal study was able to model what the effects of a soy diet or soy supplements may be, based on women's diets and heart health before menopause or very early after menopause, when artery plaques may still be small.

"This study underscores how important it is for women to get into the best cardiovascular shape they can before menopause. The healthy habits they start then will carry them through the years to come," says NAMS Executive Director Margery Gass, MD.

Running reduces risk of death regardless of duration, speed

Running for only a few minutes a day or at slow speeds may significantly reduce a person's risk of death from cardiovascular disease compared to someone who does not run, according to a study published in the Journal of the American College of Cardiology.

Exercise is well-established as way to prevent heart disease and it is component of an overall healthy life, but it is unclear whether there are health benefits below the level of 75 minutes per week of vigorous-intensity activity, such as running, recommended by the U.S. government and World Health Organization.

Researchers studied 55,137 adults between the ages of 18 and 100 over a 15-year period to determine whether there is a relationship between running and longevity. Data was drawn from the Aerobics Center Longitudinal Study, where participants were asked to complete a questionnaire about their running habits. In the study period, 3,413 participants died, including 1,217 whose deaths were related to cardiovascular disease. In this population, 24 percent of the participants reported running as part of their leisure-time exercise.

Compared with non-runners, the runners had a 30 percent lower risk of death from all causes and a 45 percent lower risk of death from heart disease or stroke. Runners on average lived three years longer compared to non-runners. Also, to reduce mortality risk at a population level from a public health perspective, the authors concluded that promoting running is as important as preventing smoking, obesity or hypertension. The benefits were the same no matter how long, far, frequently or fast participants reported running. Benefits were also the same regardless of sex, age, body mass index, health conditions, smoking status or alcohol use.

The study showed that participants who ran less than 51 minutes, fewer than 6 miles, slower than 6 miles per hour, or only one to two times per week had a lower risk of dying compared to those who did not run. DC (Duck-chul) Lee, Ph.D., lead author of the study and an assistant professor in the Iowa State University Kinesiology Department in Ames, Iowa, said they found that runners who ran less than an hour per week have the same mortality benefits compared to runners who ran more than three hours per week. Thus, it is possible that the more may not be the better in relation to running and longevity.

Researchers also looked at running behavior patterns and found that those who persistently ran over a period of six years on average had the most significant benefits, with a 29 percent lower risk of death for any reason and 50 percent lower risk of death from heart disease or stroke.

"Since time is one of the strongest barriers to participate in physical activity, the study may motivate more people to start running and continue to run as an attainable health goal for mortality benefits," Lee said. "Running may be a better exercise option than more moderate intensity exercises for healthy but sedentary people since it produces similar, if not greater, mortality benefits in five to 10 minutes compared to the 15 to 20 minutes per day of moderate intensity activity that many find too time consuming."

Rosemary and oregano contain diabetes-fighting compounds

The popular culinary herbs oregano and rosemary are packed with healthful compounds, and now lab tests show they could work in much the same way as prescription anti-diabetic medication, scientists report. In their new study published in ACS' Journal of Agricultural and Food Chemistry, they found that how the herbs are grown makes a difference, and they also identified which compounds contribute the most to this promising trait.

Elvira Gonzalez de Mejia and colleagues point out that in 2012, type-2 diabetes affected more than 8 percent of Americans and cost the country $175 billion. Some people can manage the disease with exercise and changes to their diet, and others take medication. But not everyone can stick to a new lifestyle or afford the prescription drugs necessary to keep their blood-sugar level in check. Recent research has shown that herbs could provide a natural way to help lower glucose in blood. So Gonzalez de Mejia's team decided to take a closer look.

They tested four different herbs, either greenhouse-grown or dried commercial versions, for their ability to interfere with a diabetes-related enzyme, which is also a target of a prescription drug for the disease.

They found that greenhouse herbs contained more polyphenols and flavonoids compared to the equivalent commercial herbs. But this didn't affect the concentration required to inhibit the enzyme. Commercial extracts of Greek oregano, Mexican oregano and rosemary were better inhibitors of the enzyme, required to reduce risk of type-2 diabetes, than greenhouse-grown herbs. The researchers say more studies are needed to understand the role of these compounds in reducing the risk of type-2 diabetes in humans.

Eating probiotics regularly may improve your blood pressure

American Heart Association Rapid Access Journal Report

Eating probiotics regularly may modestly improve your blood pressure, according to new research in the American Heart Association journal Hypertension.

Probiotics are live microorganisms (naturally occurring bacteria in the gut) thought to have beneficial effects; common sources are yogurt or dietary supplements.

"The small collection of studies we looked at suggest regular consumption of probiotics can be part of a healthy lifestyle to help reduce high blood pressure, as well as maintain healthy blood pressure levels," said Jing Sun, Ph.D., lead author and senior lecturer at the Griffith Health Institute and School of Medicine, Griffith University, Gold Coast, Queensland, Australia. "This includes probiotics in yogurt, fermented and sour milk and cheese, and probiotic supplements."

Analyzing results of nine high-quality studies examining blood pressure and probiotic consumption in 543 adults with normal and elevated blood pressure, researchers found:

• Probiotic consumption lowered systolic blood pressure (the top number) by an average 3.56 millimeters of mercury (mm Hg) and diastolic blood pressure (the lower number) by an average 2.38 mm Hg, compared to adults who didn't consume probiotics.
• The positive effects from probiotics on diastolic blood pressure were greatest in people whose blood pressure was equal to or greater than 130/85, which is considered elevated.
• Consuming probiotics for less than eight weeks didn't lower systolic or diastolic blood pressure.
• Probiotic consumption with a daily bacteria volume of 109-10 12 colony-forming units (CFU) may improve blood pressure. Consumption with less than 109 CFU didn't lower blood pressure. CFU is the amount of bacteria or the dose of probiotics in a product.
• Probiotics with multiple bacteria lowered blood pressure more than those with a single bacteria.

"We believe probiotics might help lower blood pressure by having other positive effects on health, including improving total cholesterol and low-density lipoprotein, or LDL, cholesterol; reducing blood glucose and insulin resistance; and by helping to regulate the hormone system that regulates blood pressure and fluid balance," Sun said.

"The studies looking at probiotics and blood pressure tend to be small," Sun said. "Moreover, two studies had a short duration of three to four weeks of probiotic consumption, which might have affected the overall results of the analysis.

Additional studies are needed before doctors can confidently recommend probiotics for high blood pressure control and prevention, she said.

Lipoic acid helps restore, synchronize the “biological clock”

Lipoic acid helps restore, synchronize the “biological clock”

Researchers have discovered a possible explanation for the surprisingly large range of biological effects that are linked to a micronutrient called lipoic acid: It appears to reset and synchronize circadian rhythms, or the “biological clock” found in most life forms.

The ability of lipoic acid to help restore a more normal circadian rhythm to aging animals could explain its apparent value in so many important biological functions, ranging from stress resistance to cardiac function, hormonal balance, muscle performance, glucose metabolism and the aging process.

The findings were made by biochemists from the Linus Pauling Institute at Oregon State University, and published in Biochemical and Biophysical Research Communications, a professional journal. The research was supported by the National Institutes of Health, through the National Center for Complementary and Alternative Medicine.

Lipoic acid has been the focus in recent years of increasing research by scientists around the world, who continue to find previously unknown effects of this micronutrient. As an antioxidant and compound essential for aerobic metabolism, it’s found at higher levels in organ meats and leafy vegetables such as spinach and broccoli.

“This could be a breakthrough in our understanding of why lipoic acid is so important and how it functions,” said Tory Hagen, the Helen P. Rumbel Professor for Healthy Aging Research in the Linus Pauling Institute, and a professor of biochemistry and biophysics in the OSU College of Science.

“Circadian rhythms are day-night cycles that affect the daily ebb and flow of critical biological processes,” Hagen said. “The more we improve our understanding of them, the more we find them involved in so many aspects of life.”

Almost one-third of all genes are influenced by circadian rhythms, and when out of balance they can play roles in cancer, heart disease, inflammation, hormonal imbalance and many other areas, the OSU researchers said.

Of particular importance is the dysfunction of circadian rhythms with age.

“In old animals, including elderly humans, it’s well-known that circadian rhythms break down and certain enzymes don’t function as efficiently, or as well as they should,” said Dove Keith, a research associate in the Linus Pauling Institute and lead author on this study.

“This is very important, and probably deserves a great deal more study than it is getting,” Keith said. “If lipoic acid offers a way to help synchronize and restore circadian rhythms, it could be quite significant.”

In this case the scientists studied the “circadian clock” of the liver. Lipid metabolism by the liver is relevant to normal energy use, metabolism, and when dysfunctional can help contribute to the “metabolic syndrome” that puts millions of people at higher risk of heart disease, diabetes and cancer.

Researchers fed laboratory animals higher levels of lipoic acid than might be attained in a normal diet, while monitoring proteins known to be affected by disruption of the circadian clock in older animals.

They found that lipoic acid helped remediate some of the liver dysfunction that’s often common in old age, and significantly improved the function of their circadian rhythms.

In previous research, scientists found that the amount of lipoic acid that could aid liver and normal lipid function was the equivalent of about 600 milligrams daily for a 150-pound human, more than could normally be obtained through the diet.

A primary goal of research in the Linus Pauling Institute and the OSU Center for Healthy Aging Research is to promote what scientists call “healthspan” – not just the ability to live a long life, but to have comparatively good health and normal activities during almost all of one’s life. Research on lipoic acid, at OSU and elsewhere, suggests it has value toward that goal.

Continued research will explore this process and its role in circadian function, whether it can be sustained, and optimal intake levels that might be needed to improve health.

8 Ways Zinc Affects the Human Body

Researchers identified zinc as one of the most important essential trace metals in human nutrition and lifestyle in a new review article in Comprehensive Reviews in Food Science and Food Safety, published by the Institute of Food Technologists (IFT). Zinc is not only a vital element in various physiological processes; it is also a drug in the prevention of many diseases.

The adult body contains about two to three grams of zinc. It is found in organs, tissues, bones, fluids, and cells. Foods with high protein content, specifically animal protein, are major sources of zinc in the human diet. Zinc can also be used as fortification for other foods as well. Nearly half of the world’s population is at risk for inadequate zinc intake. The article reviewed numerous studies that showed a relationship between zinc and vital human physiological processes such as the following:

Brain: The blood zinc level is less in patients with Alzheimer’s and Parkinson’s disease (Brewer, and others 2010).In a rodent study, it was observed that zinc behaves like an antidepressant (Nowak and others, 2005).

Cardiovascular System: Zinc performs a noteworthy role in the regulation of arterial blood pressure. Males and females were reported to metabolize zinc differently when suffering from hypertension (Tubek, 2007).

Liver: Zinc deficiency in the liver occurs not only in those with liver cirrhosis, but also in less advanced alcoholic and nonalcoholic liver disease (Bode and others, 1998).

Pregnancy: A mild deficiency of zinc during a pregnancy can cause increased maternal morbidity, abnormal taste sensation, prolonged gestation, inefficient labor, atonic bleeding, and an increased risk to fetuses (Jameson, 1993).

Diabetes: Zinc is very important in the synthesis, storage, and secretion of insulin (Chausmer 1998). A low level of zinc has been shown to play a role in diabetics with associated disease conditions such as coronary artery disease and several related risk factors including hypertension, and elevated levels of triglycerides (Singh and others, 1998).

Endocrine System: Studies show a correlation between zinc deficiency in geriatric patients and reduced activity of the thymus gland and thymic hormones, decreased response to vaccinations, and reduced immunity (Haase and Rink, 2009).

Healing: Zinc deficiency has been linked with delayed wound healing, and has been found to be crucial to the healing of gastric ulcers especially at the early stage (Kennan and Morris, 1993; Andrews and Gallagher-Allred, 1999; Watanabe, 1995).

Pneumonia: Zinc may shorten the duration of severe pneumonia and time in the hospital (Brooks, 2004).

Eating lean beef daily can help lower blood pressure

Contrary to conventional wisdom, a growing body of evidence shows that eating lean beef can reduce risk factors for heart disease, according to recent research by nutritional scientists.

"This research adds to the significant evidence, including work previously done in our lab, that supports lean beef's role in a heart-healthy diet," said Penny M. Kris-Etherton, Distinguished Professor of Nutrition, Penn State. "This study shows that nutrient-rich lean beef can be included as part of a heart-healthy diet that reduces blood pressure, which can help lower the risk for cardiovascular disease."

The DASH eating plan -- Dietary Approaches to Stop Hypertension -- is currently recommended by the American Heart Association to lower blood pressure and reduce risk of heart disease. People following the DASH diet are encouraged to eat fruits, vegetables, low-fat dairy and protein predominantly from plant sources.

Lean beef can be enjoyed as the predominant protein source in a DASH-like diet, along with fruits, vegetables and low-fat dairy, to effectively help lower blood pressure in healthy individuals, the researchers report in the Journal of Human Hypertension. This DASH-like diet is also called the BOLD+ diet -- Beef in an Optimal Lean Diet plus additional protein.

Kris-Etherton and colleagues tested four diets to find the effects on vascular health. The diets tested included the Healthy American Diet -- which served as the control -- the BOLD+ diet, the BOLD diet and the DASH diet.

The control diet consisted of 0.7 ounces of lean beef per day, while the DASH diet included 1.0 ounce. The BOLD diet had 4.0 ounces and the BOLD+ diet included 5.4 ounces of lean beef.

The researchers tested the four different diets with 36 participants, between the ages of 30 and 65. All participants followed each diet at different times throughout the study period. Subjects were randomly assigned an order to follow each of the four diet plans for five weeks each, with a break of one week in between each new plan. Blood pressure was taken at the beginning and end of each diet period.

The BOLD+ diet was more effective at reducing blood pressure when compared to the other diets tested.

"This evidence suggests that it is the total protein intake -- not the type of protein -- that is instrumental in reducing blood pressure, as part of a DASH-like dietary pattern," the researchers stated.

The Beef Checkoff Program and the National Institutes of Health-supported Penn State General Clinical Research Center funded this research.

The 'obesity paradox': Cardiovascular mortality lowest among overweight patients

High body mass index (BMI) is associated with multiple cardiovascular diseases. However, emerging data suggest that there is an "obesity paradox," that being overweight may actually protect patients from cardiovascular mortality. Investigators have now confirmed that the risk of total mortality, cardiovascular mortality, and myocardial infarction is highest among underweight patients, while cardiovascular mortality is lowest among overweight patients, according to two reports published July 16, 2014 in Mayo Clinic Proceedings.

Currently more than two-thirds of adult Americans are classified as overweight or obese. Because of the high prevalence of coronary heart disease (CAD), overweight and obese patients more frequently undergo revascularization procedures such as percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). Obesity has been considered a risk factor for worst clinical outcomes following cardiovascular procedures like these, however, emerging data suggest that higher BMI protects against adverse outcomes in many acute and chronic disease states. This prompted experts to reexamine assumptions about body fat and explore the counterintuitive phenomenon known as the "obesity paradox."

In a landmark meta-analysis of 36 studies, Abhishek Sharma, MD, Cardiology Fellow at the State University of New York Downstate Medical Center in Brooklyn, New York, and colleagues determined that low BMI (less than 20 kg/m2) in tens of thousands of patients with coronary artery disease who underwent coronary revascularization procedures was associated with a 1.8- to 2.7-fold higher risk of myocardial infarction and all-cause and cardiovascular mortality over a mean follow up period of 1.7 years. Conversely overweight and obese patients had more favorable outcomes. Cardiovascular mortality risk was lowest among overweight patients with a high BMI (25-30 kg/m2) compared to people with a normal BMI (20-25 kg/m2). Indeed, in obese and severely obese patients with a BMI in the 30-35 and over 35 kg/m2 range, all-cause mortality was 27% and 22% lower than people with normal BMI.

Dr. Sharma observes, "At this stage we can only speculate on the reasons for this paradox. One explanation may be that overweight patients are more likely to be prescribed cardioprotective medications such as beta blockers and statins and in higher doses than the normal weight population. Further, obese and overweight patients have been found to have large coronary vessel damage, which might contribute to more favorable outcomes. This population may have a higher metabolic reserve, which might act protectively in chronic conditions like CAD. Also, there could be a difference in the pathophysiology of cardiovascular disease in over- and underweight patients. A non-modifiable genetic predisposition may also play a role in underweight patients."

He concludes, "However, this is still speculation. Further prospective studies are needed to investigate this association and explore potential underlying mechanisms."

In a second study published in the same issue, investigators examined the "obesity paradox" from another perspective by evaluating the effects of body composition as a function of lean mass index (LMI) and body fat (BF) on the correlation between increasing BMI and decreasing mortality. They estimated BF and LMI in nearly 48,000 people with a preserved left ventricular ejection fraction of more than 50% and examined the survival advantages of obesity across strata of these body compositions.

This large observational study showed that higher lean body mass was associated with 29% lower mortality, and while higher fat mass also exhibited survival benefits, this advantage disappeared after adjustment for lean body mass, suggesting that non-fat tissue bears the primary role in conferring greater survival.

"Body composition plays a critical role in the obesity paradox," says senior investigator Carl Lavie, MD, FACC, FACP, FCCP, Medical Director of Cardiac Rehabilitation and Preventative Cardiology at the John Ochsner Heart & Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans. "Whenever examining a potential protective effect of body fat, lean mass index – which likely represents larger skeletal muscle mass – should be considered. At higher BMI, body fat is associated with an increase in mortality."

Noted expert Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the Department of Medicine, University of California Irvine Medical Center, Orange, CA, observes that "although the underlying mechanisms of the obesity paradox and reverse epidemiology remain unclear, the consistency of the data is remarkable, leaving little doubt that these observational data are beyond statistical constellations and bear biologic plausibility.

"The findings in these studies should not be considered as an attempt to undermine the legitimacy of the anti-obesity campaign in the best interest of public health. Nonetheless, given the preponderance and consistency of epidemiologic data, there should be little doubt that in certain populations higher BMI, which is associated with higher risk of metabolic syndrome and poor cardiovascular outcomes in the long-term, confers short-term survival and cardiovascular advantages. Metaphorically we can liken cardiovascular risk factors to a friend who is a negative influence, causing you to misbehave and be sentenced to jail, but once imprisoned the friend remains loyal and protects you against poor prison conditions and other inmates."

The Mediterranean Diet Has Varied Effects on Cognitive Decline Among Different Race-Specific Populations

While the Mediterranean diet may have broad health benefits, its impact on cognitive decline differs among race-specific populations, according to a new study published in the Journal of Gerontology.

The team of researchers, including Ben-Gurion University of the Negev (BGU Prof. Danit R. Shahar RD, Ph.D, analyzed an NIH/NIA prospective cohort study [Health ABC] conducted over eight years in the U.S. to measure the effects of adherence to a Mediterranean diet. Prof. Shahar is affiliated with the BGU S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences.

 The Mediterranean-style diet (MedDiet) has fewer meat products and more plant-based foods and monounsaturated fatty acids from olive and canola oil (good) than a typical American diet.

To assess the association between MedDiet score and brain function, the researchers used data of several Modified Mini-Mental State Examinations (3MS) on 2,326 participating older adults (70-79).  The 3MS is an extensively used and validated instrument designed to measure several cognitive domains to screen for cognitive impairment and commonly used to screen for dementia.

"In a population of initially well-functioning older adults, we found a significant correlation between strong adherence to the Mediterranean diet and a slower rate of cognitive decline among African American, but not white, older adults. Our study is the first to show a possible race-specific association between the Mediterranean diet and cognitive decline.”

The researchers note that further studies in diverse populations are necessary to confirm association between the MedDiet and cognitive decline, and to pinpoint factors that may explain these results.

Fish oil supplements reduce incidence of cognitive decline, may improve memory function

Rhode Island Hospital researchers have completed a study that found regular use of fish oil supplements (FOS) was associated with a significant reduction in cognitive decline and brain atrophy in older adults. The study examined the relationship between FOS use during the Alzheimer's Disease Neuroimaging Initiative (ADNI) and indicators of cognitive decline. The findings are published in the journal Alzheimer's & Dementia.

"At least one person is diagnosed every minute with Alzheimer's disease (AD) and despite best efforts, we have not yet found a cure for this pervasive and debilitating disease," said principal investigator Lori Daiello, PharmD, of the Alzheimer's Disease and Memory Disorders Center at Rhode Island Hospital. "The field is currently engaged in numerous studies to find better treatments for people suffering with AD; however, researching ways to prevent AD or slow cognitive decline in normal aging is of utmost importance."

In this retrospective study, older adults involved in the ADNI study were assessed with neuropsychological tests and brain magnetic resonance imaging (MRI) every six months. The group included 229 older adults who were cognitively normal; 397 who were diagnosed with mild cognitive impairment; and 193 with AD.

The study found that fish oil supplement use during the study was associated with significantly lower rates of cognitive decline as measured by the Alzheimer's Disease Assessment Scale (ADAS-cog), and the Mini Mental State Exam (MMSE), but this benefit was observed only for the group of participants without dementia at the time of enrollment.

"Additionally, serial brain imaging conducted during this study showed that the participants with normal cognition who reported taking fish oil supplements demonstrated less brain shrinkage in key neurological areas, compared to those who did not use the supplements," Daiello said. "Also, the positive findings on cognitive testing and brain MRI were only observed in persons who did not carry the best-studied genetic risk factor for AD, APOE-4. More research is needed, but these findings are promising and highlight the need for future studies to expand the current knowledge of the effects of FOS use on cognitive aging and AD."

It is estimated that more than 5 million people in the U.S. have Alzheimer's disease. It is the most common form of dementia and is the sixth leading cause of death in the U.S.

Cognitively Stimulating Activities Are Associated with Greater Brain Volumes and Higher Cognitive Test Scores

Prior studies have suggested that participation in activities that stimulate thought, new ideas, new memories, and that challenge us mentally may encourage brain health as we age and possibly reduce risk of cognitive impairment and dementia. The mechanisms underlying this possible effect are not currently well understood.

At Alzheimer's Association International Conference® 2014 (AAIC® 2014) in Copenhagen., Stephanie Schultz, BSc, and colleagues at the Wisconsin Alzheimer's Institute and the Wisconsin Alzheimer's Disease Research Center reported on the results of a study of 329 cognitively normal middle-aged adults (mean age=60.3 years, 69% women) enrolled in the Wisconsin Registry for Alzheimer's Prevention. Forty percent of the participants were positive for the APOe4 gene and 74 percent had a parental family history of Alzheimer's, both of which are known to increase the risk for developing Alzheimer's.

These at-risk adults reported their current engagement in cognitively-stimulating activities using the Cognitive Activity Scale (CAS), underwent MRI brain imaging, and completed a comprehensive battery of neurocognitive tests. The CAS consists of 10 items that ask individuals how often they participate in various cognitive activities, such as reading books and going to museums. The scientists focused on CAS-Games, which is a single item on the scale that asks participants how often they play games such as cards, checkers, crosswords or other puzzles.

After controlling for factors known to influence brain volume and cognitive test scores, such as age and gender, the researchers found that a higher self-reported frequency of game playing was significantly associated with greater brain volume in several regions involved in Alzheimer's disease (such as the hippocampus) and with higher cognitive test scores on memory and executive function.

"Our findings suggest that, for some individuals, engagement in cognitively stimulating activities, especially those involving games such as puzzles and cards, might be a useful approach for preserving brain structures and cognitive functions that are vulnerable to Alzheimer's disease," said Schultz. "More detailed studies of specific cognitive activities, including games, would help further our understanding of how an active, healthy lifestyle may help delay the development of Alzheimer's."

Moderate Exercise in Middle Age Is Associated with Decreased Risk of Dementia

Of the growing body of research concerning lifestyle and brain health, and also the possibility of reduced risk of Alzheimer's and other dementias, perhaps the strongest and most consistent evidence exists for regular physical activity.

Yonas E. Geda, M.D. and colleagues at the Mayo Clinic investigated the relationship between timing of exercise (mid-life/50-65 vs. late-life/70 and above) and risk of new cases of dementia in 280 older adults (median age=81) with mild cognitive impairment (MCI) from the Mayo Clinic Study of Aging, and reported on their findings at the Alzheimer's Association International Conference® 2014 (AAIC® 2014) in Copenhagen.

A person with mild cognitive impairment (MCI) has a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. These changes are serious enough to be noticed by the individuals experiencing them or to other people, but they are not severe enough to interfere with daily life or independent function. People with MCI are at an increased risk of developing Alzheimer's disease.

Study participants completed a questionnaire on the frequency and intensity of exercise during their lifetime. After following the participants for about three years, the researchers found that a history of moderate physical exercise in middle age was associated with a significantly decreased risk of MCI progressing to dementia. (The association did not hold for either light or vigorous exercise in middle age, or for any level of physical activity in late life.)

In a second study reported at AAIC, the researchers looked at the timing of physical exercise and the risk of new cases of MCI. The study participants were 1,830 older adults with normal cognition from the Mayo Clinic Study of Aging. Participants underwent neurological evaluations, cognitive tests, and a self-reported questionnaire about physical exercise habits in mid-life and late-life, and were followed for an average of 3.2 years. The scientists observed that light physical exercise in mid-life and late-life were associated with decreased risk of incident MCI. Additionally, vigorous mid-life as well as moderate late-life physical exercise were associated with decreased risk of incident MCI.

"In our studies, we found that physical exercise at various levels, especially in mid-life, is beneficial for cognitive function," Geda said. "These are intriguing results, but they are not yet conclusive. More research is needed to determine the extent and nature of physical activity in protecting against MCI and dementia."

Physical Fitness Associated with Less Pronounced Effect of Sedentary Behavior

Physical fitness may buffer some of the adverse health effects of too much sitting, according to a new study by researchers from the American Cancer Society, The Cooper Institute, and the University of Texas. The study appears in the journal Mayo Clinic Proceedings, and finds the association between prolonged sedentary time and obesity and blood markers associated with cardiovascular disease is markedly less pronounced when taking fitness into account.

Sedentary behavior has been linked to an increase risk of obesity, metabolic syndrome, type 2 diabetes mellitus, cardiovascular disease, some cancers, and premature death. But previous studies of the association have not taken into account the protective impact of fitness, a strong predictor of cardiovascular disease incidence and mortality.

For the current study, researchers led by Kerem Shuval, Ph.D., of the American Cancer Society, examined the association of sedentary behavior, physical activity, and fitness to obesity and metabolic biomarkers among 1304 men seen at the Cooper Clinic in Dallas, Texas between 1981 and 2012. Sedentary time was composed of self-reported television viewing time and time spent in a car self-reported on a 1982 survey. Fitness was determined by a treadmill test during the medical examination at clinic visits.

The study showed that more sedentary time was significantly associated with higher levels of systolic blood pressure, and total cholesterol and triglycerides, as well as lower levels of HDL, the “good” cholesterol. It was also associated with BMI, waist circumference, and body fat percentage. But when researchers controlled for fitness, they found prolonged sedentary time was only significantly associated with a higher triglyceride/HDL cholesterol ratio (an indicator of insulin resistance). Sedentary time was not associated with metabolic syndrome (a clustering of risk factors). In comparison, higher fitness levels were associated with reduced adiposity and metabolic measures.

The authors say interpretation of their study’s findings should be tempered by its limitations. For example, sedentary behavior was based on self-report at one point in time, whereas fitness was assessed objectively during clinic visits.

“[A]lthough our findings suggest the need to encourage achieving higher levels of fitness through meeting physical activity guidelines to decrease metabolic risk,” they conclude, “the effects of reducing sedentary time on cardiometabolic risk biomarkers warrant further longitudinal exploration using objective measurement.”

Major study on benefits of organic farming: more antioxidants, fewer pesticides

                                               

The largest study of its kind has found that organic foods and crops have a suite of advantages over their conventional counterparts, including more antioxidants and fewer, less frequent pesticide residues.

The study looked at an unprecedented 343 peer-reviewed publications comparing the nutritional quality and safety of organic and conventional plant-based foods, including fruits, vegetables, and grains. The study team applied sophisticated meta-analysis techniques to quantify differences between organic and non-organic foods.

"Science marches on," said Charles Benbrook, a Washington State University researcher and the lone American co-author of the paper, published in the British Journal of Nutrition. "Our team learned valuable lessons from earlier reviews on this topic, and we benefited from the team's remarkable breadth of scientific skills and experience."

Most of the publications covered in the study looked at crops grown in the same area, on similar soils. This approach reduces other possible sources of variation in nutritional and safety parameters.

The research team also found the quality and reliability of comparison studies has greatly improved in recent years, leading to the discovery of significant nutritional and food safety differences not detected in earlier studies. For example, the new study incorporates the results of a research project led by WSU's John Reganold that compared the nutritional and sensory quality of organic and conventional strawberries grown in California. Responding to the new paper's results, Reganold said, "This is an impressive study, and its major nutritional findings are similar to those reported in our 2010 strawberry paper."

The British Journal of Nutrition study was led by scientists at Newcastle University in the United Kingdom, with Benbrook helping design the study, write the paper, and review the scientific literature, particularly on studies in North and South America. In general, the team found that organic crops have several nutritional benefits that stem from the way the crops are produced. A plant on a conventionally managed field will typically have access to high levels of synthetic nitrogen, and will marshal the extra resources into producing sugars and starches. As a result, the harvested portion of the plant will often contain lower concentrations of other nutrients, including health-promoting antioxidants.

Without the synthetic chemical pesticides applied on conventional crops, organic plants also tend to produce more phenols and polyphenols to defend against pest attacks and related injuries. In people, phenols and polyphenols can help prevent diseases triggered or promoted by oxidative-damage like coronary heart disease, stroke and certain cancers.

Overall, organic crops had 18 to 69 percent higher concentrations of antioxidant compounds. The team concludes that consumers who switch to organic fruit, vegetables, and cereals would get 20 to 40 percent more antioxidants. That's the equivalent of about two extra portions of fruit and vegetables a day, with no increase in caloric intake.

The researchers also found pesticide residues were three to four times more likely in conventional foods than organic ones, as organic farmers are not allowed to apply toxic, synthetic pesticides. While crops harvested from organically managed fields sometimes contain pesticide residues, the levels are usually 10-fold to 100-fold lower in organic food, compared to the corresponding, conventionally grown food.

"This study is telling a powerful story of how organic plant-based foods are nutritionally superior and deliver bona fide health benefits," said Benbrook.

In a surprising finding, the team concluded that conventional crops had roughly twice as much cadmium, a toxic heavy metal contaminant, as organic crops. The leading explanation is that certain fertilizers approved for use only on conventional farms somehow make cadmium more available to plant roots. A doubling of cadmium from food could push some individuals over safe daily intake levels.

More than half the studies in the Newcastle analysis were not available to the research team that carried out a 2009 study commissioned by the UK Food Standards Agency. Another review published by a Stanford University team in 2011 failed to identify any significant clinical health benefits from consumption of organic food, but incorporated less than half the number of comparisons for most health-promoting nutrients.

"We benefited from a much larger and higher quality set of studies than our colleagues who carried out earlier reviews," said Carlo Leifert, a Newcastle University professor and the project leader.

New study shows drinking alcohol provides no heart health benefit

I don't buy this - maybe the gene itself is protective, not the lack of alcohol


Reducing the amount of alcoholic beverages consumed, even for light-to-moderate drinkers, may improve cardiovascular health, including a reduced risk of coronary heart disease, lower body mass index (BMI) and blood pressure, according to a new multi-center study published in The BMJ and co-led by the Perelman School of Medicine at the University of Pennsylvania. The latest findings call into question previous studies which suggest that consuming light-to-moderate amounts of alcohol (0.6-0.8 fluid ounces/day) may have a protective effect on cardiovascular health.

The new research reviewed evidence from more than 50 studies that linked drinking habits and cardiovascular health for over 260,000 people. Researchers found that individuals who carry a specific gene which typically leads to lower alcohol consumption over time have, on average, superior cardiovascular health records. Specifically, the results show that individuals who consume 17 percent less alcohol per week have on average a 10 percent reduced risk of coronary heart disease, lower blood pressure and a lower body mass index.

"These new results are critically important to our understanding of how alcohol affects heart disease. Contrary to what earlier reports have shown, it now appears that any exposure to alcohol has a negative impact upon heart health," says co-lead author Michael Holmes, MD, PhD, research assistant professor in the department of Transplant Surgery at the Perelman School of Medicine at the University of Pennsylvania. "For some time, observational studies have suggested that only heavy drinking was detrimental to cardiovascular health, and that light consumption may actually be beneficial. This has led some people to drink moderately based on the belief that it would lower their risk of heart disease. However, what we're seeing with this new study, which uses an investigative approach similar to a randomized clinical trial, is that reduced consumption of alcohol, even for light-to-moderate drinkers, may lead to improved cardiovascular health."

In the new study, researchers examined the cardiovascular health of individuals who carry a genetic variant of the 'alcohol dehydrogenase 1B' gene, which is known to breakdown alcohol at a quicker pace. This rapid breakdown causes unpleasant symptoms including nausea and facial flushing, and has been found to lead to lower levels of alcohol consumption over time. By using this genetic marker as an indicator of lower alcohol consumption, the research team was able to identify links between these individuals and improved cardiovascular health.

A healthy lifestyle adds years to life

Cardiovascular diseases (CVDs), cancer, diabetes and chronic respiratory disorders - the incidence of these non-communicable diseases (NCDs) is constantly rising in industrialised countries. The Federal Office of Public Health (FOPH) is, therefore, in the process of developing a national prevention strategy with a view to improving the population's health competence and encouraging healthier behaviour. Attention is focusing, amongst other things, on the main risk factors for these diseases which are linked to personal behaviour – i.e. tobacco smoking, an unhealthy diet, physical inactivity and harmful alcohol consumption.

Against this backdrop Private Docent Brian Martin and his colleagues from the Institute of Social and Preventive Medicine (ISPM) at the University of Zurich have examined the effects of these four factors – both individual and combined – on life expectancy. For the first time the consequences of an unhealthy lifestyle can be depicted in numbers. An individual who smokes, drinks a lot, is physically inactive and has an unhealthy diet has 2.5 fold higher mortality risk in epidemiological terms than an individual who looks after his health. Or to put it positively: "A healthy lifestyle can help you stay ten years' younger", comments the lead author Eva Martin-Diener.

Analysis of data from the Swiss Cohort

For the study the researchers used data from the Swiss National Cohort (SNC). The Zurich public health physicians focussed on CVDs and cancer as they account for the most deaths in Switzerland. The researchers succeeded in correlating data on tobacco consumption, fruit consumption, physical activity and alcohol consumption from 16,721 participants aged between 16 and 90 from 1977 to 1993 with the corresponding deaths up to 2008. The impact of the four forms of behaviour was still visible when biological risk factors like weight and blood pressure were taken into account as well.

"The effect of each individual factor on life expectancy is relatively high", states Eva Martin-Diener. But smoking seems to be the most harmful. Compared with a group of non-smokers, smokers have a 57 percent higher risk of dying prematurely. The impact of an unhealthy diet, not enough sport and alcohol abuse results in an elevated mortality risk of around 15 percent for each factor. "We were very surprised by the 2.5 fold higher risk when all four risk factors are combined", explains Brian Martin. Hence, the probability of a 75-year-old man with all risk factors surviving the next ten years is, for instance, 35 percent, without risk factors 67 percent – for a woman 47 and 74 percent respectively.

Effects only appear in later life

According to Martin an unhealthy lifestyle has above all a long-lasting impact. Whereas high wine consumption, cigarettes, an unhealthy diet and physical inactivity scarcely had any effect on mortality amongst the 45 to 55-year-olds, it does have a visible effect on 65 to 75-year-olds. The probability of a 75-year-old man with none of the four risk factors surviving the next ten years is 67 percent, exactly the same as the risk for a smoker who is ten years younger, doesn't exercise, eats unhealthily and drinks a lot.

The social and public health physicians depict the dependency of life expectancy and the four risk behaviours for the age groups in what are known as survival charts. The impact of individual risk factors and their combined effect on mortality are visible at a glance. "In future, doctors will be able to refer to the easily comprehensible charts when giving health counselling to their patients in primary care", comments Eva Martin-Diener with confidence. "Furthermore, they may also be important for the political discussions of prevention strategies for NCDs."

Temperament may contribute to cardiac complications in high blood pressure

Temperament has been traditionally associated with high blood pressure. A new study that has appeared in the July 2014 issue of Psychotherapy and Psychosomatics has substantiated this issue.

Major depression and coronary heart disease have a strong, bidirectional relationship. A type A behavioral pattern, as well as cyclothymic disorder, is a subclinical manifestation of bipolar illness, and in cardiovascular patients may result in extreme behavioral changes detrimental to cardiac prognosis.

To further characterize this most vulnerable group, Authors examined the affective temperamental traits (Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire, TEMPS-A) on depressive, cyclothymic, hyperthymic, irritable and anxious subscales, ICD-10-diagnosed depression and depressive symptoms (Beck Depression Inventory, BDI) in relation to cardiac complications (CC) requiring acute hospitalization (acute coronary syndrome, acute myocardial infarction) in a primary hypertensive outpatient population.

Results showed that patients with CC scored markedly higher on the cyclothymic temperament scale (p = 0.027) than those without CC. Also, cyclothymic temperament significantly predicted CC independently of depression (either ICD-10-diagnosed or depressive symptoms), age, gender and smoking in hypertensive outpatients.

Even though, the study presents some limitations (cross-sectional nature hinders drawing a causal relationship, the relatively small sample size and low proportion of CC restrict generalizability), the findings shed light on the possible role of affective temperaments in cardiovascular morbidity and carry the advantage of exploring trait-like characteristics which precede and also determine the type of depression affecting the clinical outcome. Further research in the field would enrich the preventative options in clinical medicine in the future.

Personality and heart attacks: A new look

A new study published in the July 2014 issue of Psychotherapy and Psychosomatics has addressed the relationship between personality and heart attacks. Distressed (type D) personality (TDP), characterized by high negative affectivity (NA) and social inhibition (SI), along with depression, anxiety and other negative affects (such as demoralization, hopelessness, pessimism and rumination) have been implicated as potential risk factors for coronary artery disease. While some evidence suggests that the NA dimension of TDP overlaps at least partially with depression, other studies underline how 'TDP refers to a chronic, more covert form of distress that is distinct from depression'.

In this study, authors aimed to clarify whether, among never depressed patients at their first acute coronary syndrome (ACS), there is an overlap between the constructs of TDP and depression, evaluating the stability of NA and SI 6 months after the ACS, and their relationship with depressive symptoms. Patients consecutively admitted to the Coronary Intensive Care Unit of the University Hospital of Parma between January 2009 and March 2012 who had their first ACS and no history of major depression (MD) or other psychiatric disorders, were included.

During the follow-up period 30 patients developed depressive symptoms (MD: n = 12; minor depression (md): n = 18), whereas 220 subjects maintained a nondepressive condition throughout the study period. At baseline the NA and SI levels were higher in subjects who developed depression than in patients who did not. However, at the baseline evaluation 19 patients without previous depressive episodes already satisfied the criteria for md. Interestingly, at baseline these subjects showed higher levels of NA and SI than subjects without md. Among patients who developed depression (n = 30) HADS scores significantly changed during the 6-month follow-up: both anxiety and depression scores increased from baseline to the second month of follow-up and then decreased. The same pattern of change was observed for the NA score, whereas the SI score did not vary during follow-up. In nondepressed patients, both HADS depression and anxiety scores and NA score significantly decreased throughout the follow-period, whereas the SI did not change.

In this study, the overlap between depressive psychopathology and NA features is suggested by the course of these two dimensions over time. Indeed, in both depressed and nondepressed patients, NA levels were not stable during the 6-month follow-up, but they changed along with the variation of HADS scores. This finding suggests that the NA dimension is sensitive to mood-state, because its levels increase and decrease according to the fluctuation of severity of depressive and anxious symptoms. This result supports the view that the disposition to experience and report negative emotions (NA) can be sensitive to mood-state. Therefore, the presence of depressive state is crucial when assessing TDP, since NA and anhedonic depression are partially overlapping and co-varying constructs.

Sitting too much, not just lack of exercise, is detrimental to cardiovascular health

Cardiologists at UT Southwestern Medical Center found that sedentary behaviors may lower cardiorespiratory fitness levels. New evidence suggests that two hours of sedentary behavior can be just as harmful as 20 minutes of exercise is beneficial.

The study, published in the July 7, 2014  online edition of Mayo Clinic Proceedings, examined the association between fitness levels, daily exercise, and sedentary behavior, based on data from 2,223 participants in the National Health and Nutrition Examination Survey (NHANES).

Sedentary behavior involves low levels of energy expenditure activities such as sitting, driving, watching television, and reading, among others. The findings suggest that sedentary behavior may be an important determinant of cardiorespiratory fitness, independent of exercise.

"Previous studies have reported that sedentary behavior was associated with an increased risk for cardiovascular outcomes; however, the mechanisms through which this occurs are not completely understood," said Dr. Jarett Berry, Assistant Professor of Internal Medicine and Clinical Science and senior author of the study. "Our data suggest that sedentary behavior may increase risk through an impact on lower fitness levels, and that avoiding sedentary behavior throughout the day may represent an important companion strategy to improve fitness and health, outside of regular exercise activity."

The team of physician-researchers analyzed accelerometer data from men and women between the ages of 12 and 49 with no known history of heart disease, asthma, or stroke, and measured their average daily physical activity and sedentary behavior times. Fitness was estimated using a submaximal treadmill test, and variables were adjusted for gender, age, and body mass index. The findings demonstrate that the negative effect of six hours of sedentary time on fitness levels was similar in magnitude to the benefit of one hour of exercise.

"We also found that when sitting for prolonged periods of time, any movement is good movement, and was also associated with better fitness," said Dr. Jacquelyn Kulinski, a recent graduate from the UT Southwestern Cardiology Fellowship Training Program and first author of the paper. "So if you are stuck at your desk for a while, shift positions frequently, get up and stretch in the middle of a thought, pace while on a phone call, or even fidget."

To stay active and combat sedentary behavior, UT Southwestern preventive cardiologists recommend taking short walks during lunch and throughout the day, using a pedometer to track daily steps, taking the stairs instead of the elevator, hosting walking meetings at work, and replacing a standard desk chair with a fitness ball or even a treadmill desk, if possible.

Almonds reduce the risk of heart disease, research shows

Eating almonds can reduce the risk of heart disease by keeping blood vessels healthy, research has shown. Research found that they significantly increase the amount of antioxidants in the blood stream, reduce blood pressure and improve blood flow. These findings add weight to the theory that Mediterranean diets with lots of nuts have big health benefits.

Scientists have found that eating almonds in your diet can reduce the risk of heart disease by keeping blood vessels healthy.

Research found that they significantly increase the amount of antioxidants in the blood stream, reduce blood pressure and improve blood flow. These findings add weight to the theory that Mediterranean diets with lots of nuts have big health benefits.

The study was led by Professor Helen Griffiths, Professor in Biomedical Sciences and Executive Dean of the School of Life and Health Sciences at Aston University in Birmingham, UK. Researchers tested the effects of a short-term almond-enriched diet on healthy young and middle-aged men as well as on a group of young men with cardiovascular risk factors including having high blood pressure or being overweight.

A control group ate what they normally would, while another group consumed snacks of 50g of almonds a day for one month.

At the end of the study period, the group eating an almond-enriched diet had higher levels of antioxidants (alpha-tocopherol) in their blood stream, improved blood flow and lower blood pressure, potentially reducing their risk of heart disease.

Almonds are known to contain a range of beneficial substances such as vitamin E and healthy fats, fibre which increases the sense of fullness, and flavonoids which may have antioxidant properties. The team believes it is likely to be the combination of all these nutrients working together to create the overall health benefits rather than just one particular nutrient in isolation.

Professor Griffiths said: "Our study confirms that almonds are a superfood. Previous studies have shown that they keep your heart healthy, but our research proves that it isn't too late to introduce them into your diet -- adding even a handful (around 50g) every day for a short period can help. You could replace a daytime snack with a bag of almonds or add them to your regular meals like porridge or muesli to help reduce your risk of heart problems."

Testosterone therapy does not increase heart attack risk

Testosterone prescriptions for older men in the United States have increased more than three-fold over the past decade. Recent studies linking testosterone use with increased risk of heart attack and stroke have caused widespread concern among patients and their families. A new U.S.-based study of more than 25,000 older men shows that testosterone therapy does not increase men's risk for heart attack.

The study, conducted by researchers at the University of Texas Medical Branch at Galveston, examined 25,420 Medicare beneficiaries 66 years or older treated with testosterone for up to eight years. It appears in the July 2 issue of the Annals of Pharmacotherapy.

"Our investigation was motivated by a growing concern, in the U.S. and internationally, that testosterone therapy increases men's risk for cardiovascular disease, specifically heart attack and stroke," said Jacques Baillargeon, UTMB associate professor of epidemiology in the Department of Preventive Medicine and Community Health and lead author of the study. "This concern has increased in the last few years based on the results of a clinical trial and two observational studies," he said. "It is important to note, however, that there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use."

In recent years, the testosterone therapy market has grown to $1.6 billion annually as men seek to supplement low testosterone counts with products that may increase muscle tone and sex drive. Previous safety investigations presented conflicting findings. A few of these studies suggest testosterone is linked with increased risk of heart attack, although some critics have questioned the quality of these data. Doctors, researchers and government agencies all agree that more research into this issue is necessary.

The Food and Drug Administration decided June 20 to expand labeling on testosterone products to include a general warning about the risk of blood clots in veins. The FDA and European Medicines Agency are also further examining the safety of these products. This newest FDA warning comes shortly after the announcement that several testosterone treatment manufacturers, including Abbott Laboratories, AbbVie Inc., Eli Lilly and Company, Pfizer and Actavis, are facing a consolidated multidistrict litigation in Federal Court based on claims that they hid the risks of using testosterone treatments.

This new UTMB study evaluated enrollment and claims Medicare data for a clinically and socioeconomically diverse national sample treated with testosterone from 1997-2005. Men of the same age, race, Medicaid eligibility, and health status who did not receive testosterone therapy were used as a control group for comparison.

The analyses show that testosterone therapy was not associated with an increased risk of heart attack. Further, testosterone users with a higher probability of cardiovascular problems had a lower rate of heart attacks in comparison to equivalent patients who did not receive testosterone therapy.

"This is a rigorous analysis of a large number of patients," said Baillargeon. "Our findings did not show an increased risk of heart attack associated with testosterone use in older men," he said. "However, large–scale, randomized clinical trials will provide more definitive evidence regarding these risks in the coming years."

Adults Can Undo Heart Disease Risk

Picking up healthy habits in your 30s and 40s can slash heart disease risk

The heart is more forgiving than you may think -- especially to adults who try to take charge of their health, a new Northwestern Medicine® study has found.

When adults in their 30s and 40s decide to drop unhealthy habits that are harmful to their heart and embrace healthy lifestyle changes, they can control and potentially even reverse the natural progression of coronary artery disease, scientists found.
The study was published June 30 in the journal Circulation.
“It’s not too late,” said Bonnie Spring lead investigator of the study and a professor of preventive medicine at Northwestern University Feinberg School of Medicine. “You’re not doomed if you’ve hit young adulthood and acquired some bad habits. You can still make a change and it will have a benefit for your heart.”
On the flip side, scientists also found that if people drop healthy habits or pick up more bad habits as they age, there is measurable, detrimental impact on their coronary arteries.
“If you don’t keep up a healthy lifestyle, you’ll see the evidence in terms of your risk of heart disease,” Spring said.
For this paper, scientists examined healthy lifestyle behaviors and coronary artery calcification and thickening among the more than 5,000 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who were assessed at baseline (when participants were ages 18 to 30) and 20 years later.
The healthy lifestyle factors assessed were: not being overweight/obese, being a nonsmoker and physically active and having low alcohol intake and a healthy diet.  By young adulthood (at the beginning of the study), less than 10 percent of the CARDIA participants reported all five healthy lifestyle behaviors. At the 20-year mark, about 25 percent of the study participants had added at least one healthy lifestyle behavior.
Each increase in healthy lifestyle factors was associated with reduced odds of detectable coronary artery calcification and lower intima-media thickness -- two major markers of cardiovascular disease that can predict future cardiovascular events.
“This finding is important because it helps to debunk two myths held by some health care professionals,” Spring said. “The first is that it’s nearly impossible to change patients’ behaviors. Yet, we found that 25 percent of adults made healthy lifestyle changes on their own. The second myth is that the damage has already been done -- adulthood is too late for healthy lifestyle changes to reduce the risk of developing coronary artery disease. Clearly, that’s incorrect. Adulthood is not too late for healthy behavior changes to help the heart.”
The bad news is that 40 percent of this sample lost healthy lifestyle factors and acquired more bad habits as they aged.
“That loss of healthy habits had a measurable negative impact on their coronary arteries,” Spring said. “Each decrease in healthy lifestyle factors led to greater odds of detectable coronary artery calcification and higher intima-media thickness. Adulthood isn’t a ‘safe period’ when one can abandon healthy habits without doing damage to the heart. A healthy lifestyle requires upkeep to be maintained.”
Spring said the healthy changes people in the study made are attainable and sustainable. She offers some tips for those who want to embrace a healthy lifestyle at any age:

• Keep a healthy body weight
• Don’t smoke
• Engage in at least 30 minutes of moderate to vigorous activity five times a week
• No more than one alcoholic drink a day for women, no more than two for men
• Eat a healthy diet, high in fiber, low in sodium with lots of fruit and vegetables