Monday, February 29, 2016

1 in 3 Adults Drink Sugar-Sweetened Beverages Daily

Sugar-sweetened beverages (SSBs), such as regular soda, fruit drinks, coffee/tea drinks, or sports and energy drinks, are a significant source of added sugar in the diet of many Americans. Drinking these beverages frequently is linked to poor health conditions like obesity, type 2 diabetes, heart disease, and dental cavities. While consumption of SSBs has decreased modestly in recent years, daily intake of sugary drinks remains high in some states and within certain populations. A new CDC study in 23 states and the District of Columbia shows that 1 in 3 adults, aged 18 years and older, drink SSBs at least once a day.

CDC examined data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) for 23 states and the District of Columbia. Researchers found the following patterns for adults who reported drinking SSBs daily:

  • SSB intake was highest in Mississippi (47.5%), followed by Louisiana (45.5%) and West Virginia (45.2%).
  • Daily SSB consumption was most common among adults aged 18–24 years (43.3%), men (34.1%), Non-Hispanic blacks (39.9%), adults who reported being unemployed (34.4%), and adults who reported having less than a high school education (42.4%).
  • The prevalence of SSB intake one or more times per day among younger adults (18–24 years) was 2.3 times the prevalence among the older adults (aged 55 years and older)—43.3% versus 19.1%, respectively. 
Because of the health problems associated with frequent SSB intake, reducing consumption might help adults with weight management and with lowering the risk for some chronic diseases. People who want to reduce their daily added sugar intake can replace SSBs with healthier beverages, such as plain water or water with fruit.

Sleep loss boosts hunger and unhealthy food choices

Skimping on sleep has long been associated with overeating, poor food choices and weight gain. Now a new study shows how sleep loss initiates this process, amplifying and extending blood levels of a chemical signal that enhances the joy of eating, particularly the guilty pleasures gained from sweet or salty, high-fat snack foods.

The findings were published Feb. 29, 2016, in the journal SLEEP.

Sleep-deprived participants in this study--all young, healthy volunteers--were unable to resist what the researchers called "highly palatable, rewarding snacks," meaning cookies, candy and chips, even though they had consumed a meal that supplied 90 percent of their daily caloric needs two hours before. The effects of sleep loss on appetite were most powerful in the late afternoon and early evening, times when snacking has been linked to weight gain.

"We found that sleep restriction boosts a signal that may increase the hedonic aspect of food intake, the pleasure and satisfaction gained from eating," said Erin Hanlon, PhD, a research associate in endocrinology, diabetes and metabolism at the University of Chicago. "Sleep restriction seems to augment the endocannabinoid system, the same system targeted by the active ingredient of marijuana, to enhance the desire for food intake."

This chemical signal is the endocannabinoid 2-arachidonoylglycerol (2-AG). Blood levels of 2-AG are typically low overnight. They slowly rise during the day, peaking in the early afternoon.

When the study subjects were sleep-deprived, however, endocannabinoid levels rose higher and remained elevated through the evening, beyond the typical 12:30 p.m. peak. During that period, sleep-restricted study subjects reported higher scores for hunger and stronger desire to eat. When given access to snacks, they ate nearly twice as much fat as when they had slept for eight hours.

This increase in circulating endocannabinoid levels, the authors note, "could be a mechanism by which recurrent sleep restriction results in excessive food intake, particularly in the form of snacks, despite minimal increases in energy need."

"The energy costs of staying awake a few extra hours seem to be modest," explained Hanlon. "One study has reported that each added hour of wakefulness uses about 17 extra calories. That adds up to about 70 calories for the four hours of lost sleep. But, given the opportunity, the subjects in this study more than made up for it by bingeing on snacks, taking in more than 300 extra calories. Over time, that can cause significant weight gain."

Obesity and sleep restriction have become extremely common. According to the Centers for Disease Control and Prevention, about a third of Americans get less than seven hours of sleep a night and more than a third of adults in the United States are obese. A 2013 Gallup poll found that U.S. adults sleep an average of 6.8 hours per night. Forty percent of adults report sleeping six hours or less.

Hanlon and colleagues designed the study to help understand how the endocannabinoid system connected short sleep with weight gain. Her team recruited 14 healthy men and women in their 20s as volunteers. The researchers monitored the subjects' hunger and eating habits in two situations: one four-day stay in the University's Clinical Research Center during which they spent 8.5 hours in bed each night (averaging 7.5 hours of sleep), and another four-day stay when they spent only 4.5 hours in bed (4.2 hours asleep).

The participants ate identical meals three times a day, at 9 a.m., 2 p.m., and 7 p.m. Researchers measured levels of the hormone ghrelin, which boosts appetite, and leptin, which signals fullness, in their blood. Previous studies have linked high ghrelin and low leptin levels to reduced sleep time and increased appetite.

For the first time, however, they also measured blood levels of endocannabinoids. After a normal night's sleep, 2-AG levels were low in the morning. They peaked in the early afternoon, soon after lunchtime, then decreased.

After restricted sleep, however, 2-AG levels rose to levels about 33 percent higher than those seen after normal sleep. They also peaked about 90 minutes later, at 2 p.m., and remained elevated until about 9 p.m.

After the period of restricted sleep, study subjects reported a significant increase in hunger levels. This was prominent soon after their second meal of the day, the time when 2-AG levels were highest. Sleep deprived study subjects expressed greater desire to eat. When asked, they estimated that they could eat much more than they predicted the day after a full night's sleep.

After the fourth night of restricted sleep, subjects were offered an array of snack foods. Despite having eaten a large meal less than two hours before being offered snacks, subjects in the restricted sleep phase of the study had trouble limiting their snack consumption. They chose foods that provided 50 percent more calories, including twice the amount of fat, as when they were completing the normal sleep phase.

These results support "the novel insight that sleep restriction leads not only to increased caloric intake," but also to "changes in the hedonic aspects of food consumption," wrote Frank Scheer, PhD, of the Medical Chronobiology Program at Harvard University's Brigham and Women's Hospital, in a commentary. The increase in 2-AG following sleep restriction, he added, "may be part of the mechanism by which people overeat."

Despite the study's limitations--small size, short duration, limited sampling frequency--the findings are clearly significant and consistent with the epidemiologic evidence, the authors note. They are also "relevant to normal life conditions."

This tells us that "if you have a Snickers bar, and you've had enough sleep, you can control your natural response," Hanlon explained. "But if you're sleep deprived, your hedonic drive for certain foods gets stronger, and your ability to resist them may be impaired. So you are more likely to eat it. Do that again and again, and you pack on the pounds."

Quick thinking and feeling healthy predict longer life

Suffering from chronic medical conditions and engaging in unhealthy behaviors are known risk factors for early death, but findings from a longitudinal study of over 6,000 adults suggests that certain psychological factors may be even stronger predictors of how long we'll live.

The findings are published in Psychological Science, a journal of the Association for Psychological Science.

"Our study shows that two psychological variables, lower self-rated health and age-related decrements in processing speed, appear to be especially important indicators of elevated mortality risk in middle-age and older adults," says psychological scientist Stephen Aichele of the University of Geneva in Switzerland. "This information may facilitate diagnostic accuracy and timely interventions."

Aichele and colleagues Patrick Rabbitt (University of Oxford, UK) and Paolo Ghisletta (University of Geneva, Switzerland) were interested in investigating the relative influence of cognitive, demographic, health, and lifestyle variables in predicting mortality risk. While previous research had provided some clues as to the roles played by these variables, comprehensive longitudinal studies were few and far between.

"It has been long known that particular factors such as illnesses, socio-economic disadvantage, cognitive decline, and social support determine how long we survive in old age," explains Aichele. "The problem has been that these and other markers for mortality have been tested separately, rather than together. Given that they are strongly associated with each other, it makes it difficult to determine which variables most influence mortality risk."

To address this gap in the available research, Aichele and colleagues turned to the Manchester Longitudinal Study of Cognition, examining 29 years' worth of data collected from 6,203 adults who ranged in age from 41 to 96 years old when they began the study.

Aggregating data from 15 different tasks, the researchers looked at participants' cognitive performance across five domains of ability: crystallized intelligence, fluid intelligence, verbal memory, visual memory, and processing speed. The tasks--all well-established measures of cognitive ability--were administered up to four times over a 12-year period, allowing the researchers to assess participants' baseline performance and change in performance over time for each domain.

To gauge participants' health, the researchers used the Cornell Medical Index, a measure that includes detailed checklists of a total of 195 pathological symptoms related to physical and psychological disorders.

Finally, the researchers looked at participants' subjective reports of various lifestyle factors, including perceived health, number of prescribed medicines, sleep patterns, hobbies, leisure activities, and social interactions.

Using two types of statistical analysis, the researchers were able to assess the relative importance of a total of 65 different variables in predicting participants' mortality risk.

The results revealed subjective health and mental processing speed to be two of the strongest predictors - that is, better perceived health and smaller decreases in processing speed over time were associated with reduced mortality risk.

Being a woman was also associated with reduced mortality risk, while years of smoking tobacco was linked with an increased risk of early death.

The influence of the two psychological factors relative to known medical risk factors, such as cardiovascular symptoms, came as a surprise:

"The result that psychological variables are so strongly linked to mortality risk is very surprising because much extant evidence supports the hypothesis that the strongest predictors of survival in old age are of medical or physiological nature," explains Aichele.

These findings may provide useful insights to health professionals, who need better methods for identifying individuals at risk of early death.

"Addressing the needs of an aging global population will require accounting for numerous morbidity and mortality risk factors, such as demographic variables, health conditions, functional capacities, mental abilities, and social support," the researchers conclude.

Friday, February 26, 2016

People who exercise have better brains and emotional health

People who exercise have better mental fitness, and a new imaging study from UC Davis Health System shows why. Intense exercise increases levels of two common neurotransmitters -- glutamate and gamma-aminobutyric acid, or GABA -- that are responsible for chemical messaging within the brain.

Published in this week's issue of The Journal of Neuroscience, the finding offers new insights into brain metabolism and why exercise could become an important part of treating depression and other neuropsychiatric disorders linked with deficiencies in neurotransmitters, which drive communications between the brain cells that regulate physical and emotional health.

"Major depressive disorder is often characterized by depleted glutamate and GABA, which return to normal when mental health is restored," said study lead author Richard Maddock, professor in the Department of Psychiatry and Behavioral Sciences. "Our study shows that exercise activates the metabolic pathway that replenishes these neurotransmitters."

The research also helps solve a persistent question about the brain, an energy-intensive organ that consumes a lot of fuel in the form of glucose and other carbohydrates during exercise. What does it do with that extra fuel?

"From a metabolic standpoint, vigorous exercise is the most demanding activity the brain encounters, much more intense than calculus or chess, but nobody knows what happens with all that energy," Maddock said. "Apparently, one of the things it's doing is making more neurotransmitters."

The striking change in how the brain uses fuel during exercise has largely been overlooked in brain health research. While the new findings account for a small part of the brain's energy consumption during exercise, they are an important step toward understanding the complexity of brain metabolism. The research also hints at the negative impact sedentary lifestyles might have on brain function, along with the role the brain might play in athletic endurance.

"It is not clear what causes people to 'hit the wall' or get suddenly fatigued when exercising," Maddock said. "We often think of this point in terms of muscles being depleted of oxygen and energy molecules. But part of it may be that the brain has reached its limit."

To understand how exercise affects the brain, the team studied 38 healthy volunteers. Participants exercised on a stationary bicycle, reaching around 85 percent of their predicted maximum heart rate. To measure glutamate and GABA, the researchers conducted a series of imaging studies using a powerful 3-tesla MRI to detect nuclear magnetic resonance spectra, which can identify several compounds based on the magnetic behavior of hydrogen atoms in molecules.

The researchers measured GABA and glutamate levels in two different parts of the brain immediately before and after three vigorous exercise sessions lasting between eight and 20 minutes, and made similar measurements for a control group that did not exercise. Glutamate or GABA levels increased in the participants who exercised, but not among the non-exercisers. Significant increases were found in the visual cortex, which processes visual information, and the anterior cingulate cortex, which helps regulate heart rate, some cognitive functions and emotion. While these gains trailed off over time, there was some evidence of longer-lasting effects.

"There was a correlation between the resting levels of glutamate in the brain and how much people exercised during the preceding week," Maddock said. "It's preliminary information, but it's very encouraging."

These findings point to the possibility that exercise could be used as an alternative therapy for depression. This could be especially important for patients under age 25, who sometimes have more side effects from selective serotonin reuptake inhibitors (SSRIs), anti-depressant medications that adjust neurotransmitter levels.

For follow-up studies, Maddock and the team hope to test whether a less-intense activity, such as walking, offers similar brain benefits. They would also like to use their exercise-plus-imaging method on a study of patients with depression to determine the types of exercise that offer the greatest benefit.
"We are offering another view on why regular physical activity may be important to prevent or treat depression," Maddock said. "Not every depressed person who exercises will improve, but many will. It's possible that we can help identify the patients who would most benefit from an exercise prescription."

Thursday, February 25, 2016

Physically active individuals cope better with heart attacks

Researchers know that exercise increases a person's chances of surviving a heart attack. Now it turns out that exercise habits also affect how the body handles a heart attack's aftermaths.

Depression is three times more common among people who have experienced a heart attack compared to people who have never been afflicted by one. But the new study shows that people who exercise regularly for a long time before a heart attack occurs are far less likely to be depressed afterwards.

"Physical activity protects people from depression after a heart attack," says Associate Professor Linda Ernstsen. She is the lead author of an article on the results of her research, which stem from her postdoctoral work at the Norwegian University of Science and Technology's (NTNU) Department of Nursing Science.

The connection between health and lifestyle

As their starting point, the researchers used the Nord-Trøndelag HUNT studies that collected data from a total of 120,000 people during three periods (1984-86, 1995-97 and 2006-08).

The surveys have given researchers large volumes of data to work with, which gives them the advantage of seeing how the health of a large group of people has changed over time. These data can then be linked to lifestyle and exercise habits, among other things. The ability to connect this data to data from health registries like the Norwegian Myocardial Infarction Registry also makes the results more reliable.

Researchers studied middle-aged and older individuals who had participated in all three of the HUNT studies, and who experienced their first heart attack after participation in the second HUNT study (1984-86) and before they participated in the third study (2006-08).

In this way, the researchers were able to see how exercise habits over several years affected how people felt after a heart attack.

The researchers relied on the Norwegian physical activity guidelines as the measure of whether people trained or not. The study group that was characterized as physically active exercised a minimum of 150 minutes per week with moderate intensity or 75 minutes with high intensity, which is in accordance with the Norwegian guidelines.

The worst is never having exercised

The study's sample group of 189 individuals is admittedly small, and researchers are being careful not to overstate any claims. But the trend still seems quite clear.

On average, 11 per cent of all participants were depressed by the third HUNT study, but this varied greatly depending on previous training habits. Researchers divided the survey participants into four groups:

Among people who had never exercised, over 17 per cent were depressed after a heart attack. This was by far the most depressed group.

Among those who exercised during the first study period, but who had stopped in the second, 12.5 per cent were depressed after a heart attack.

Participants who didn't exercise to begin with, but who did train during the second study period, fared better, with only 9.1 per cent suffering from depression in the aftermath of the heart attack.

Participants who exercised consistently throughout fared best, with only 7.5 per cent suffering from depression.

Never too late to start exercising

The researchers found that people who exercised regularly over several years were less than half as likely to become depressed after a heart attack than those who never exercised

The survey also provides reason for optimism. It helps if you have exercised and are in good shape from training earlier in life, even if you have since stopped. But it is apparently even better to have started exercising regularly in older age, even if you get off the couch late in life.

"It's never too late to start exercising," Ernstsen says.

Many researchers involved

A large group of scientists are behind this study. Lead author Ernstsen has collaborated with American scientists, researchers from the HUNT studies and from NTNU's K.G. Jebsen Centre for Exercise in Medicine(CERG).

The unique feature of the study is that it provides evidence that our habits over many decades have consequences when serious illness occurs. The study cannot say anything about the causes of depression. But the findings indicate that physical activity over time is associated with the occurrence of depression. So it would appear that the new research gives us one more reason to exercise.

The study results were published in the January 2016 issue of The American Journal of Medicine, and are also available online.

New Penn study links moving more with decreased mortality

That's the take-home message from a new study from Ezra Fishman, a doctoral candidate in demography at the University of Pennsylvania, and colleagues from Johns Hopkins University, the National Cancer Institute, the National Institute on Aging and others.

Even for people who already exercised, swapping out just a few minutes of sedentary time with some sort of movement was associated with reduced mortality, according to the research, published in the journal Medicine & Science in Sports & Exercise.

Fishman, part of Penn's Population Studies Center, and the other researchers looked at data from approximately 3,000 people aged 50 to 79 who participated in the National Health and Nutrition Examination Survey conducted by the Centers for Disease Control and Prevention. For the study, subjects wore ultra-sensitive activity trackers, called accelerometers, for seven days, generating data compiled by the CDC. For these same people, the agency then tracked mortality for the next eight years.

The results were striking. The least active people were five times more likely to die during that period than the most active people and three times more likely than those in the middle range for activity.

"When we compare people who exercise the same amount, those who sit less and move around more tend to live longer," said Fishman, the lead author on the paper. "The folks who were walking around, washing the dishes, sweeping the floor tended to live longer than the people who were sitting at a desk."

Previous activity-tracking studies have drawn similar conclusions. But, according to Fishman, such studies usually ask participants to monitor their own exercise frequency and quantity, numbers they notoriously over-report. Also, the trackers used for NHANES have a higher level of precision than what's typically employed.

"Because the device captures the intensity of activity so frequently, every minute, we can actually make a distinction between people who spent two hours a day doing those activities versus people who spent an hour and a half," he said.

To account for chronic conditions or illness influencing mortality rates, Fishman and colleagues statistically controlled for factors like diagnosed medical conditions, smoking, age and gender. They also completed a secondary examination from which they entirely excluded participants with chronic conditions. Their analysis didn't extend to anyone younger than age 50 because not enough of that subset met the study requirements.

Though the scientists didn't discover any magic threshold for the amount a person needs to move to improve mortality, they did learn that even adding just 10 minutes per day of light activity could make a difference. Replacing 30 minutes of sedentary time with light or moderate-to-vigorous physical activity produced even better results.

"You didn't have to even get a good sweat to experience the reduced likelihood of mortality," Fishman said. "Activity doesn't have to be especially vigorous to be beneficial. That's the public health message."

In an ideal world, Fishman said the research would continue with an experiment that randomly assigned people to two groups -- one that received an incentive to increase physical activity, one that didn't -- to establish conclusively that replacing sedentary behavior with light exercise can reduce mortality risk. He said he would also like to see public health officials get more creative about ways to encourage people to move more. Until these happen, however, it's up to individuals to substitute movement for sitting still.

"When it comes to physical activity," Fishman said, "more is better than less, and anything is better than nothing."

Wednesday, February 24, 2016

Keeping mind active may delay Alzheimer's symptoms, but not underlying disease

Keeping the mind active may delay symptoms of Alzheimer's disease; however, the activity does not change the underlying disease in the brain for most people, according to a study published today in the online edition of Neurology, the medical journal of the American Academy of Neurology.

For people who are carriers of a gene linked to Alzheimer's, the findings differed. People with a gene called APOE4, who had at least 14 years of education and kept mentally active in middle age had lower levels of proteins called amyloid plaques. The proteins can build up in brain tissue and lead to Alzheimer's disease. People with the gene and a high level of education but did not keep mentally active in middle age had higher levels of amyloid plaques.

"When we looked specifically at the level of lifetime learning, we found that carriers of the APOE4 gene who had higher education and continued to learn through middle age had fewer amyloid deposition on imaging when compared to those who did not continue with intellectual activity in middle age," says study author Prashanthi Vemuri, Ph.D., a Mayo Clinic dementia researcher.

Dr. Vemuri said the overall findings for people who do not carry the gene should not discourage people from exercising and taking part in activities, such as reading books and magazines, playing games and using computers. "The takeaway message for the general public is that keeping your mind active is very important in delaying symptoms of Alzheimer's disease," says Dr. Vemuri.

For the study, researchers evaluated 393 people without dementia who were part of the Mayo Clinic Study of Aging. Of those, 53 had mild cognitive impairment. All were 70 or older. They were divided into two groups: those with more than 14 years of education and those with less. Then, researchers used MRI and positron emission tomography scans to look for biomarkers of Alzheimer's disease and questionnaires to evaluate weekly intellectual and physical activity in middle age.

Tuesday, February 23, 2016

Study supports fish consumption during pregnancy

A new study supports the theory that the detrimental effects of low-level exposure to mercury may be outweighed by the beneficial effects of fish consumption.

The study finds little evidence of harm in infants whose mothers had low fish consumption and low mercury exposure. In fact, infants of mothers with higher mercury exposure during pregnancy and who consumed more fish had better attention and needed less special handling during a newborn exam. This likely was due to the beneficial nutritional effects of fish consumption, according to the researchers.

"The better neurobehavioral performance observed in infants with higher mercury biomarkers should not be interpreted as a beneficial effect of mercury exposure, which is clearly neurotoxic," says Kim Yolton, PhD, a researcher at Cincinnati Children's Hospital Medical Center and senior author of the study. "It likely reflects the benefits of polyunsaturated fatty acid intake that also comes from fish and has been shown to benefit attention, memory, and other areas of development in children. In our study, mercury exposure was very low, primarily due to consumption of fish low in mercury, so the detrimental effects might have been outweighed by the beneficial effects of fish nutrition."

The study is published online in Neurotoxicology and Teratology.

The researchers assessed the neurobehavior of 344 5-week-old infants using a standard neurobehavioral scale. Gestational mercury exposure was measured in maternal blood and infant umbilical cord blood. The researchers collected fish consumption information from the mothers and estimated polyunsaturated fatty acid intake based on the type and amount of fish consumed.

Eighty-four percent of mothers reported eating fish during pregnancy but only about two ounces per week on average. Those infants with higher prenatal mercury exposure showed asymmetric, or unequal reflexes. But when fish consumption was taken into account, those whose mothers consumed more fish had better attention and needed less special handling.

In 2014, the FDA and EPA updated their advice to consumers to encourage women to eat more fish (eight to 12 ounces per week) than had previously been recommended and to select fish with the lowest mercury levels. These include salmon, shrimp, pollock, light canned tuna, tilapia, catfish, and cod. They also suggested avoiding fish with the highest mercury levels, including tilefish, shark, swordfish, and mackerel.

"The important thing for women to remember is that fish offers excellent nutritional qualities that can benefit a developing baby or young child," says Dr. Yolton. "Moms just need to be thoughtful about which fish they eat or provide to their child."

Monday, February 22, 2016

Fewer heart problems in people who drink moderately and often

Drinking a little alcohol every day may be part of a healthy lifestyle, according to Imre Janszky, a professor of social medicine at the Norwegian University of Science and Technology (NTNU). He says alcohol does more good than harm for your heart when consumed in moderation.

And, Janszky says, it doesn't matter much whether you drink wine, liquor or beer.

"It's primarily the alcohol that leads to more good cholesterol, among other things. But alcohol can also cause higher blood pressure. So it's best to drink moderate amounts relatively often," he says.

Decreased risk with each additional serving

Along with a number of colleagues from NTNU and the Karolinska Institute in Stockholm, Janszky has published two studies regarding the relationship between alcohol and heart health. One, published in the January 15 issue of the International Journal of Cardiology, is about heart failure. The second, from September 2015, is on acute myocardial infarction (AMI), and has been published in the Journal of Internal Medicine.
In both cases, research shows that people who regularly drink alcohol have better cardiovascular health than those who consume little or no alcohol.

The studies showed that those who drank three to five drinks per week were 33 per cent less prone to heart failure than those who abstained or drank infrequently. In the case of heart attacks, the risk appears to be reduced by 28 percent with each additional one-drink increment.

This does not surprise the researchers at all.

A majority of researchers worldwide seem to think three to five drinks a week can be good for your heart.

Different drinking patterns

"The relationship between alcohol and heart health has been studied in many countries, including the USA and southern European nations. The conclusions have been the same, but the drinking patterns in these countries are very different than in Norway. In countries like France and Italy, very few people don't drink," says Janszky. "It raises the question as to whether earlier findings can be fully trusted, if other factors related to non-drinkers might have influenced research results. It may be that these are people who previously had alcohol problems, and who have stopped drinking completely," he says.

For this reason, the researchers wanted to examine the theory with a Norwegian population where a significant population drinks rarely or not at all. In the myocardial infarction study, 41 per cent of participants reported that they did not drink at all or that they consumed less than half of one alcoholic beverage per week.

Both studies are based on the longitudinal HUNT 2 Nord-Trøndelag Health Study conducted between 1995 and 1997.

The greater the drinking frequency, the lower the risk

The study, which looked at the relationship between heart failure and alcohol, followed 60,665 participants who enrolled in the HUNT study between 1995-1997 and who had no incidence of heart failure at that time. Of those, 1588 of them developed heart failure during the period of the study, which ended in 2008. The risk was highest for those who rarely or never drank alcohol, and for those who had an alcohol problem.

The more often participants consumed alcohol within normal amounts, the lower their risk of heart failure turned out to be. Those who drank five or more times a month had a 21 per cent lower risk compared to non-drinkers and those who drank little, while those who drank between one and five times a month had a two per cent lower risk.

Drinking isn't necessary for a healthy heart

"I'm not encouraging people to drink alcohol all the time. We've only been studying the heart, and it's important to emphasize that a little alcohol every day can be healthy for the heart. But that doesn't mean it's necessary to drink alcohol every day to have a healthy heart," says Janszky.

In the heart attack study, 58,827 participants were categorized by how much and how often they drank. 2966 of the participants experienced an acute myocardial infarction (AMI) between 1995 and the end of 2008. The adjusted analyses showed that each additional one-drink increment decreased the risk of AMI by 28 percent.

Alcohol may increase other problems

The researchers stressed that few participants in the study drank particularly much, so they cannot conclude that high alcohol intake protects against heart attack or heart failure. They also encourage looking at the findings in a larger context, since the risk of a number of other diseases and social problems can increase as a result of higher alcohol consumption.

For example, the researchers observed that the risk of dying from various types of cardiovascular disease increased with about five drinks a week and up, while those who drank more moderate amounts had the lowest risk. High alcohol consumption was also strongly associated with an increased risk of death from liver disease.

Thursday, February 18, 2016

Red meat metabolite levels high in acute heart failure patients

Patients with acute heart failure often have high levels of the metabolite trimethylamine N-oxide (TMAO) - of which red meat is a major dietary source - according to researchers from the University of Leicester.

Red meat, which has been reported to be associated with cardiovascular disease, is a source of L-carnitine which is broken down by gut bacteria to form TMAO.

In previous studies TMAO has been association with mortality risk in chronic heart failure but this association in acute heart failure is still unknown.

The team, led by Professor Toru Suzuki from the University of Leicester's Department of Cardiovascular Sciences and PI within the Leicester Cardiovascular BRU, measured circulating TMAO levels in approximately 1,000 patients admitted to University Hospitals of Leicester NHS Trust with acute heart failure.

The study, published in the journal Heart, was the first to investigate association of TMAO levels in acute heart failure patients, a condition associated with high mortality and morbidity - and suggests involvement of the gut microbiota and diet in outcomes of acute heart failure.

This study shows an association between circulating levels of a metabolite of this process with prognosis of acute heart failure.

Professor Suzuki said: "Patients with acute heart failure showed higher levels of the oxidised metabolite TMAO in those that died or had a repeat admission to hospital with heart failure within the first year.

"Our study shows that higher levels of TMAO, a metabolite of carnitine derived from red meat, is associated with poorer outcomes associated with acute heart failure, one of the main diseases of the heart.

"This metabolic pathway provides a possible link between how red meat is associated with heart disease."

Wednesday, February 17, 2016

Pregnancy in older age increases stroke, heart attack risk years later

Women who become pregnant at age 40 or older face a greater risk of stroke and heart attack later in life than women who become pregnant at a younger age, according to research presented at the American Stroke Association's International Stroke Conference 2016.

"We already knew that older women were more likely than younger women to experience health problems during their pregnancy," said Adnan I. Qureshi, M.D., lead researcher and director of the Zeenat Qureshi Stroke Institute in St. Cloud, Minnesota. "Now, we know that the consequences of that later pregnancy stretch years into the future."

Qureshi added that this finding was especially important because more women are choosing to have children after they turn forty.

Researchers reviewed data from 72,221 women aged 50 to 79 enrolled in the Women's Health Initiative Study. Of those, 3,306 women reported pregnancies at an advanced age, and researchers compared their rates of stroke, heart attack and cardiovascular death over the next 12 years with women who were pregnant at a younger age.

Researchers found that compared to pregnancy at a younger age, pregnancies at age 40 and older increased the risk of:

  • Ischemic stroke (clot caused), the most common type of stroke, from 2.4 percent to 3.8 percent;
  • Hemorrhagic stroke (brain bleed), from 0.5 percent to 1 percent;
  • Heart attack from 2.5 percent to 3 percent; and
  • Death from all forms of cardiovascular disease from 2.3 percent to 3.9 percent.

When researchers checked for well-known risk factors for cardiovascular disease, including high blood pressure, diabetes and high cholesterol, they found these factors explained most of the higher risk the older pregnant women faced. However, these established risk factors did not explain the link between advanced age pregnancy and stroke caused by a brain bleed. Researchers said this link needs further research. Hemorrhagic stroke accounts for about 13 percent of all strokes, according to the American Heart Association's 2016 Statistical Update.

Qureshi also noted that the only cardiovascular risk factor that did not increase with later pregnancies in the study population was smoking. Older pregnant women were less likely to smoke than younger women.

The age of last pregnancy has not been considered a risk factor for stroke, heart attack and other cardiovascular diseases. "However, women with a late pregnancy need to be aware of their increased risk and take steps to improve their cardiovascular health," he said. "And their doctors need to remain vigilant years later in monitoring these women's risk factors through physical examination and, perhaps more tests and earlier interventions to prevent stroke and other cardiovascular events."

U.S. children ages 1-3: sufficient potassium and fiber missing in their diets

U.S. children are not consuming enough vegetables, resulting in an inadequate intake of key nutrients, including potassium and dietary fiber, which are important for growth, development and overall health. Research published (January 2016) in a special supplement of the peer-reviewed journal Advances in Nutrition demonstrated that children ages 1-3 years of age consumed just 67 percent of the dietary reference intakes (DRI) for potassium and 55 percent of the DRI for fiber.

An overarching conclusion from the various papers included in the supplement, "Science and Policy: Adopting a Fruitful Vegetable Encounter for Our Children," is that potatoes are a vegetable that tend to be well-liked by young children and are a good source of potassium and provide 8 percent of the recommended daily value of fiber. In fact, a study of elementary school students demonstrated that students are not consuming the majority of vegetables offered to them in school lunches. However, plate waste for white potatoes was the lowest among any type of vegetables; thus, including potatoes in school meals is one important way to help ensure children receive those key nutrients of concern.

"It's important that consumption of all vegetables, particularly those that are good sources of potassium and dietary fiber, be encouraged in children," says Theresa A. Nicklas, DrPH, USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and one of the supplement's authors. "Dietary habits established during childhood often transition to adulthood, so it is hugely important to encourage children to enjoy vegetables as part of the diet in order to reap the nutrition and health benefits provided by vegetables into adulthood."

The journal supplement features seven papers authored by leading nutrition scientists that explore the state of the science pertaining to vegetable consumption in children. The supplement is the outcome of a November 2014 USDA/ARS Children's Nutrition Research Center at Baylor College of Medicine roundtable on vegetable consumption in children. The forum was supported by the Alliance for Potato Research and Education, a not-for-profit organization dedicated to expanding and translating scientific research into evidence-based policy and education initiatives that recognize the role of all forms of the potato--a nutritious vegetable--in promoting health for all age groups.

The executive summary "Science and Policy: Adopting a Fruitful Vegetable Encounter for Our Children," is available online at

Tuesday, February 16, 2016

Leafy greens are essential for feeding good gut bacteria

A critical discovery about how bacteria feed on an unusual sugar molecule found in leafy green vegetables could hold the key to explaining how 'good' bacteria protect our gut and promote health.

The finding suggests that leafy greens are essential for feeding good gut bacteria, limiting the ability of bad bacteria to colonise the gut by shutting them out of the prime 'real estate'.

Researchers from Melbourne and the UK identified a previously unknown enzyme used by bacteria, fungi and other organisms to feed on the unusual but abundant sugar sulfoquinovose - SQ for short - found in green vegetables.

Each year, leafy green vegetables - such as spinach - produce the sugar on an enormous scale globally, comparable to the world's total annual iron ore production.

The research, published today in the journal Nature Chemical Biology, was led by Dr Ethan Goddard-Borger from the Walter and Eliza Hall Institute, Professor Spencer Williams from the Bio21 Institute and University of Melbourne, and Professor Gideon Davies from the University of York, UK.

Dr Goddard-Borger said the discovery could be exploited to cultivate the growth of 'good' gut bacteria. "Every time we eat leafy green vegetables we consume significant amounts of SQ sugars, which are used as an energy source by good gut bacteria," he said.

"Bacteria in the gut, such as crucial protective strains of E. coli, use SQ as a source of energy. E. coli provides a protective barrier that prevents growth and colonisation by bad bacteria, because the good bugs are taking up all the habitable real estate," Dr Goddard-Borger said.

"E. coli is a key bacterial coloniser needed by our gut. We speculate that consumption of this specific molecule within leafy greens will prove to be an important factor in improving and maintaining healthy gut bacteria and good digestive health."

Professor Williams said the team had revealed how bacteria extract the sugar from plants in order to fuel their growth. "We discovered the enzyme YihQ, which is used by bacteria to absorb and metabolise these sulfur-containing sugars as food," he said.

"Sulfur is critical for building proteins, the essential components of all living organisms. SQ is the only sugar molecule which contains sulfur, and 'digestion' of the molecule by bacteria releases sulfur into the environment, where it re-enters the global 'sulfur cycle' to be reused by other organisms."

Professor Williams said that the pathway was unusual, but abundant in biological organisms.

"This work answers a 50-year mystery that has surrounded how sulfur - an element essential for life on Earth - was used and recycled by living organisms," he said. "What is remarkable is that the YihQ enzyme was hiding in plain sight and is produced by the humble bacterium E. coli, present in nearly every biologist's laboratory."

The discovery also provides crucial insights that may one day be exploited to develop an entirely new class of antibiotics, Dr Goddard-Borger said. "New antimicrobial strategies are desperately needed as more and more bacteria acquire resistance to existing classes of antibiotics."

"We think it will be possible to use these widespread enzymes to enable highly specific delivery of antibiotics to harmful forms of E. coli and other pathogens, such as Salmonella, responsible for food poisoning, while leaving the good gut bacteria untouched."

Friday, February 12, 2016

High-cholesterol diet, eating eggs do not increase risk of heart attack

A new study from the University of Eastern Finland shows that a relatively high intake of dietary cholesterol, or eating one egg every day, are not associated with an elevated risk of incident coronary heart disease. Furthermore, no association was found among those with the APOE4 phenotype, which affects cholesterol metabolism and is common among the Finnish population. The findings were published in the American Journal of Clinical Nutrition.

In the majority of population, dietary cholesterol affects serum cholesterol levels only a little, and few studies have linked the intake of dietary cholesterol to an elevated risk of cardiovascular diseases. Globally, many nutrition recommendations no longer set limitations to the intake of dietary cholesterol. However, in carriers of the apolipoprotein E type 4 allele - which significantly impacts cholesterol metabolism - the effect of dietary cholesterol on serum cholesterol levels is greater. In Finland, the prevalence of the APOE4 allele, which is a hereditary variant, is exceptionally high and approximately one third of the population are carriers. Research data on the association between a high intake of dietary cholesterol and the risk of cardiovascular diseases in this population group hasn't been available until now.

The dietary habits of 1,032 men aged between 42 and 60 years and with no baseline diagnosis of a cardiovascular disease were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. During a follow-up of 21 years, 230 men had a myocardial infarction, and 32.5 per cent of the study participants were carriers of APOE4.

The study found that a high intake of dietary cholesterol was not associated with the risk of incident coronary heart disease - not in the entire study population nor in those with the APOE4 phenotype. Moreover, the consumption of eggs, which are a significant source of dietary cholesterol, was not associated with the risk of incident coronary heart disease. The study did not establish a link between dietary cholesterol or eating eggs with thickening of the common carotid artery walls, either.

The findings suggest that a high-cholesterol diet or frequent consumption of eggs do not increase the risk of cardiovascular diseases even in persons who are genetically predisposed to a greater effect of dietary cholesterol on serum cholesterol levels. In the highest control group, the study participants had an average daily dietary cholesterol intake of 520 mg and they consumed an average of one egg per day, which means that the findings cannot be generalised beyond these levels.

Daily dose of beetroot juice improved endurance and blood pressure

Scientists at Wake Forest Baptist Medical Center have found that a daily dose of beetroot juice significantly improved exercise endurance and blood pressure in elderly patients with heart failure with preserved ejection fraction (HFPEF).

The study is published in the current online edition of the Journal of the American College of Cardiology-Heart Failure.

Exercise intolerance - shortness of breath and fatigue with normal amounts of exertion -- is the primary symptom of HFPEF and is due partly to non-cardiac factors that reduce oxygen delivery to active skeletal muscles. HFPEF is a recently recognized disease that reflects how the left ventricle of the heart pumps with each beat. It occurs primarily in older women and is the dominant form of heart failure, as well as the most rapidly increasing cardiovascular disorder in this country.

Emerging evidence suggests that dietary inorganic nitrate supplementation has beneficial effects on blood pressure control, vascular health, exercise capacity and oxygen metabolism.

The Wake Forest Baptist researchers enrolled 19 people in a double-blinded, randomized safety study to determine which was better at improving exercise intolerance, a single dose or a daily dose of the juice given over multiple days. The beetroot juice used is produced by a company in the United Kingdom and is not commercially available in this country.

First, aerobic endurance and blood pressure were measured after the participants received either a single dose of beetroot juice or a placebo.

The researchers then administered a daily dose of beetroot juice to all 19 patients for an average of seven days, and measured endurance and blood pressure again. The juice dose in the study was equivalent to 2.4 ounces containing approximately 6 millimoles of inorganic nitrate.

The team found that the daily dosing of beetroot juice improved aerobic endurance by 24 percent after one week, as compared to the single dose which produced no improvement. Aerobic endurance was measured as cycling time to exhaustion at a fixed workload lower than their maximum.

Another finding was that consumption of the juice significantly reduced resting systolic blood pressure in both the single and daily dose groups by 5 to 10 mmHg.

No adverse events were associated with either intervention.

"Although larger trials need to be conducted, these initial findings suggest that one week of daily beetroot juice could be a potential therapeutic option to improve aerobic endurance in patients with HFPEF, which has implications for improving everyday activities and quality of life," said Dalane Kitzman, M.D., professor of internal medicine at Wake Forest Baptist and senior author of the study.

Lifelong physical activity increases bone density in men

Men have many reasons to add high-impact and resistance training to their exercise regimens; these reasons include building muscle and shedding fat. Now a University of Missouri researcher has determined another significant benefit to these activities: building bone mass. The study found that individuals who continuously participated in high-impact activities, such as jogging and tennis, during adolescence and young adulthood, had greater hip and lumbar spine bone mineral density than those who did not.

"While osteoporosis is commonly associated with only post-menopausal women, it is, in fact, a serious issue for men as well," said Pamela Hinton, associate professor in the Department of Nutrition and Exercise Physiology in the MU College of Human Environmental Sciences. "Indeed, research has shown that the consequences of osteoporosis can be much worse for men, as they are less likely to be diagnosed and are at a greater mortality risk from fractures that occur as a result of a fall."

In studying factors that protect against osteoporosis for men, Hinton aimed to understand the connection between bone-loading exercise during adolescence and young adulthood when the skeleton is still growing and bone mass in middle age. In the study, Hinton analyzed data from the physical histories of 203 males aged 30-65 years. Participants' sports and exercise histories varied, both in type and level of activity, and the length of time spent doing various physical activities also differed.

Hinton's research found that exercise-associated bone loading during adolescence and young adulthood benefited bone density in adulthood. Moreover, she found that high-impact activity during growth and adulthood is an important determinant for bone health later in life.

"The most important take-away is that if you are healthy, it is never too late to begin high-impact activities or resistance training to improve bone mineral density," Hinton said. "While activity during skeletal growth is significant, we also saw positive associations between such physical activity and bone density at all ages. So even middle-aged men who spent their teenage years sitting on the couch could see benefits from beginning a bone-strengthening exercise program."

The study, "Physical activity-associated bone loading during adolescence and young adulthood is positively associated with adult bone mineral density in men," was published in the American Journal of Men's Health. The National Institutes of Health, the University of Missouri Research Board, and the Department of Nutrition and Exercise Physiology Summer Research Internship provided funds for the study.

Feeling older increases risk of hospitalization

People who feel older than their peers are more likely to be hospitalized as they age, regardless of their actual age or other demographic factors, according to research published by the American Psychological Association.

"How old you feel matters. Previous research has shown it can affect your well-being and other health-related factors and, now we know it can predict your likelihood of ending up in the hospital," said the study's lead author, Yannick Stephan, PhD, of the University of Montpellier in France. The research, which comprised more than 10,000 adults across the U.S., was published in the journal Health Psychology.

Despite previous studies showing an association between health-related issues and subjective age, this is the first study to test whether feeling older is linked to a higher risk of hospitalization, according to the article. Stephan and co-authors Angelina R. Sutin, PhD, and Antonio Terracciano, PhD, of Florida State University, analyzed data from three longitudinal studies conducted from 1995 to 2013 with participants ranging in age from 24 to 102. They found that those who reported feeling older than their actual age had a 10 to 25 percent increased likelihood of being hospitalized over the next two to 10 years when controlling for age, gender, race and education. The findings replicated across the three samples.

Further analysis showed that having more depressive symptoms and poorer health helped explain the link between feeling older and being hospitalized. "Feeling older is associated with poorer physical and mental health, but also with physiological impairments that may result in illness and health service use over time," said Sutin.

Participants were drawn from the Midlife in the United States Survey, the Health and Retirement Study and the National Health and Aging Trends Study. In each sample, the participant's subjective age was assessed by asking each participant how old he or she felt at the beginning of the study. Researchers also asked them to provide information about previously diagnosed health conditions (i.e., high blood pressure, diabetes, cancer, lung disease, heart condition, stroke, osteoporosis or arthritis). Participants also answered a questionnaire designed to assess symptoms of depression. At the beginning and at various follow-up periods, subjects reported if they had been hospitalized for any reason, either over the last year in two samples or over the last two years for the other.

"In addition, individuals with an older subjective age are more likely to be sedentary and to experience faster cognitive decline, all of which may precipitate a hospital stay" said Terracciano.

"Taken as a whole, this study suggests that subjective age, along with demographic, cognitive, behavioral and health-related factors, could be a valuable tool to help identify individuals at risk of future hospitalization," said Stephan. "People who feel older may benefit from standard health treatments -- for example through physical activity and exercise programs, which may reduce their risk of depression and chronic disease, and ultimately their hospitalization risk."

Wednesday, February 10, 2016

Weight loss and improved cholesterol levels with walnut-rich diet

A new study published in the Journal of the American Heart Association found that a diet containing unsaturated fats, such as those found in walnuts and olive oil, has similar weight loss effects as a lower fat, higher-carbohydrate diet.1 The research, led by Dr. Cheryl Rock of the University of California, San Diego School of Medicine, also showed that a diet containing walnuts, which are primarily comprised of polyunsaturated fats, positively impacts heart health markers, such as cholesterol.

"One of the surprising findings of this study was that even though walnuts are higher in fat and calories, the walnut-rich diet was associated with the same degree of weight loss as a lower fat diet," said Dr. Rock. "Considering the results of this study, as well as previous walnut research on heart health and weight, there's something to be said for eating a handful of walnuts a day."

To reach their findings, the research team studied 245 overweight and obese women (22-72 years old) enrolled in a one-year behavioral weight loss intervention. Participants were randomly assigned to three different diets: 1) a lower fat and higher carbohydrate diet, 2) a lower carbohydrate and higher fat diet, or 3) a walnut-rich, higher fat and lower carbohydrate diet. Those prescribed a walnut-rich diet consumed 1.5 ounces per day. Looking at data from the first six months of the intervention, this study found that the average weight loss was nearly eight percent of initial weight for all groups.

The walnut-rich diet participants saw comparable weight loss to the other study groups; however, they exhibited the most improvement in lipid levels, especially in those who are insulin-resistant. In addition to a significant decrease in LDL cholesterol, the walnut participants achieved a greater increase in HDL cholesterol as compared to the other diet groups.

Whereas the lower carbohydrate and higher fat diet participants were encouraged to consume foods higher in monounsaturated fats, the walnut-rich diet provided more polyunsaturated fats. Walnuts are the only nut in which the fat is primarily polyunsaturated fat (13g/oz), including a significant amount of alpha-linolenic acid (ALA), the plant-derived form of omega-3 fatty acids (2.5g/oz).

Recent research from Harvard also shows health benefits of consuming polyunsaturated fats.2 The study suggested that people who replace saturated fats with polyunsaturated fats may live longer and have a lower risk of heart disease. Additionally, the 2015-2020 Dietary Guidelines recommend consumption of polyunsaturated fats as a replacement for saturated fats.3

There are some study limitations that should be considered. The sample only included women, so these results may not be generalizable to men. Although 245 participants were enrolled, the sample sizes for comparisons were reduced because the participants were divided into subgroups. In addition, there is a lack of detailed information about dietary intake and adherence to the diets. Considering the weight loss that was seen in participants, it seems that most were adhering to a reduced calorie diet.

1 Le T, Flatt SW, Rock CL, et al. Effects of Diet Composition and Insulin Resistance Status on Plasma Lipid Levels in a Weight Loss Intervention in Women [published online ahead of print January 25, 2016]. J Am Heart Assoc. doi: 10.1161/JAHA.115.002771.

2 Li Y, Hruby A, Bernstein AM, Hu FB, et al. Saturated fat as compared to unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: A prospective cohort study. J Am Coll Cardiol. 2015;66(14):1538-1548. doi: 10.1016/j.jacc.2015.07.055.

3 U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 - 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at

Social Internet-based activities important for healthy aging

Meaningful and Internet-based activities promote experiences of participation in society and are important for healthy ageing. In a new dissertation at Umeå University in Sweden, occupational therapists are shown to promote participation, reduce experiences of loneliness and strengthen seniors' social network using an Internet-based intervention programme.

"Digitalisation is increasing the risk of excluding seniors who often can have limited experiences of Internet-based activities," says Ellinor Larsson, doctoral student at the Department of Community Medicine and Rehabilitation.

"A steadily increasing amount of everyday activities require access to the Internet, and to achieve increased participation in society, we need to pay attention to an increased inclusion of seniors. The senior citizen can also experience social change at the loss of loved ones, which makes the loneliness more evident. A joint effort focusing on how the well-being of the elderly can be promoted through meaningful Internet-based activities, is becoming more important in order to support the ageing population of today's society."

In her dissertation, which covers interviews and an evaluation of an Internet-based intervention programme, Ellinor Larsson describes how health-promoting efforts aimed at the seniors can be developed. To enable Internet-based social interventions for seniors, a collaboration between several parties in society is needed.

One of the studies showed that seniors who performed daily activities online also sensed a satisfying participation in society. According to the study, the participation in Internet-based activities can be promoted through support and encouragement from people in the person's surroundings, through greater access to technology and by identifying what online activities that are meaningful and important in the senior's everyday life.

The dissertation also shows how an individual and Internet-based occupational therapy intervention was drawn up to support the seniors in the introduction to social Internet-based activities. In an evaluation of the intervention, the participants showed a significant reduction in loneliness. A follow-up study shows that the online social activities constituted a compliment to other social activities and contacts both online and offline.

Exercise and meditation -- together -- help beat depression

Meditation and aerobic exercise done together helps reduce depression, according to a new Rutgers study.

The study, published in Translational Psychiatry this month, found that this mind and body combination - done twice a week for only two months - reduced the symptoms for a group of students by 40 percent.

"We are excited by the findings because we saw such a meaningful improvement in both clinically depressed and non-depressed students," says Brandon Alderman, lead author of the research study. "It is the first time that both of these two behavioral therapies have been looked at together for dealing with depression."

Alderman, assistant professor in the Department of Exercise Science, and Tracey Shors, professor in the Department of Psychology and Center for Collaborative Neuroscience, both in the School of Arts and Sciences, discovered that a combination of mental and physical training (MAP) enabled students with major depressive disorder not to let problems or negative thoughts overwhelm them.

"Scientists have known for a while that both of these activities alone can help with depression," says Shors. "But this study suggests that when done together, there is a striking improvement in depressive symptoms along with increases in synchronized brain activity."

The men and women in the Rutgers study who completed the eight-week program - 22 suffering with depression and 30 mentally healthy students - reported fewer depressive symptoms and said they did not spend as much time worrying about negative situations taking place in their lives as they did before the study began.

This group also provided MAP training to young mothers who had been homeless but were living at a residential treatment facility when they began the study. The women involved in the research exhibited severe depressive symptoms and elevated anxiety levels at the beginning. But at the end of the eight weeks, they too, reported that their depression and anxiety had eased, they felt more motivated, and they were able to focus more positively on their lives.

Depression - a debilitating disorder that affects nearly one in five Americans sometime in their life - often occurs in adolescence or young adulthood. Until recently, Rutgers scientists say, the most common treatment for depression has been psychotropic medications that influence brain chemicals and regulate emotions and thought patterns along with talk therapy that can work but takes considerable time and commitment on the part of the patient.

Rutgers researchers say those who participated in the study began with 30 minutes of focused attention meditation followed by 30 minutes of aerobic exercise. They were told that if their thoughts drifted to the past or the future they should refocus on their breathing - enabling those with depression to accept moment-to-moment changes in attention.

Shors, who studies the production of new brain cells in the hippocampus - the portion of the brain known to be necessary for some types of new learning--says even though neurogenesis cannot be monitored in humans, scientists have shown in animal models that aerobic exercise increases the number of new neurons and effortful learning keeps a significant number of those cells alive.

The idea for the human intervention came from her laboratory studies, she says, with the main goal of helping individuals acquire new skills so that they can learn to recover from stressful life events. By learning to focus their attention and exercise, people who are fighting depression can acquire new cognitive skills that can help them process information and reduce the overwhelming recollection of memories from the past, Shors says.

"We know these therapies can be practiced over a lifetime and that they will be effective in improving mental and cognitive health," says Alderman. "The good news is that this intervention can be practiced by anyone at any time and at no cost."

Tuesday, February 9, 2016

Barley can help improve blood sugar levels and reduce appetite

A recent study from Lund University in Sweden shows that barley can rapidly improve people's health by reducing blood sugar levels and risk for diabetes. The secret lies in the special mixture of dietary fibres found in barley, which can also help reduce people's appetite and risk for cardiovascular disease.

"It is surprising yet promising that choosing the right blend of dietary fibres can -- in a short period of time -- generate such remarkable health benefits", says Anne Nilsson, Associate Professor at the Food for Health Science Centre and one of the researchers behind the study.

The study was conducted with healthy middle-aged participants who were asked to eat bread largely made out of barley kernels (up to 85%) for three days -- at breakfast, lunch and dinner. Approximately 11-14 hours after their final meal of the day participants were examined for risk indicators of diabetes and cardiovascular disease.

The researchers found that the participants' metabolism improved for up to 14 hours, with additional benefits such as decreases in blood sugar and insulin levels, increases in insulin sensitivity and improved appetite control. The effects arise when the special mixture of dietary fibres in barley kernel reaches the gut, stimulating the increase of good bacteria and the release of important hormones.

"After eating the bread made out of barley kernel, we saw an increase in gut hormones that regulate metabolism and appetite, and an increase in a hormone that helps reduce chronic low-grade inflammation, among the participants. In time this could help prevent the occurrence of both cardiovascular disease and diabetes", says Anne Nilsson.

In a previous related study conducted with a team from the University of Gothenburg in Sweden researchers also found that dietary fibres from barley kernel generate an increase of the gut bacteria Prevotella copri, which have a direct regulatory effect on blood sugar levels and help decrease the proportion of a type of gut bacteria that is considered unhealthy.

The effects from barley kernel are influenced by the composition of the individual's gut microbiota, meaning people with low concentrations of the Prevotella copri bacteria experienced less effect from their intake of barley products. Eating more barley could, however, help stimulate growth of the bacteria.

The results are timely as rates of obesity and type 2 diabetes have significantly increased in the past few years. Researchers hope that more knowledge about the impact of specific dietary fibres on people's health will result in stores keeping more food products with healthy properties such as barley kernels. The ambition is also to get more people to use barley in meals, for example in salads, soups, stews, or as an alternative to rice or potatoes.

The researchers' advice for how to maintain a healthy blood sugar level:

  • Choose bread with as much whole grains as possible. Feel free to mix with other grains, for example rye
  • Avoid white flour
  • Add barley kernel grains in soups and stews
  • Replace for example white rice with cooked barley
  • Eat beans and chickpeas with your meal as they too have a good blend of dietary fibres and like barley kernels a low glycaemic index with positive health effects.

The bread used in the study was 85% made out of barley grains, which had been boiled and mixed with wheat flour. If you want to reduce the amount of barley grains, you can replace some of it with whole grains.

Monday, February 8, 2016

Treatments that reduce knee buckling may help prevent falls in older adults

Symptoms of knee instability in older adults may indicate an increased risk of falling and of experiencing the various physical and psychological effects that can result from falling, according to a study published in Arthritis Care & Research, a journal of the American College of Rheumatology (ACR). The findings indicate that determining effective treatments for knee instability should be an important priority as clinicians care for aging patients.

Knee buckling, often described as a knee "giving way," is a symptom of knee instability that frequently affects older individuals, in particular those with knee pain and knee osteoarthritis (OA), and may be caused by muscle weakness and balance difficulties. If knee instability leads to frequent falls and fall-related injuries, exercises and other interventions that stabilize the knee may help maintain older individuals' health and quality of life. To investigate this potential link, Michael Nevitt, PhD, of the University of California, San Francisco, and his colleagues prospectively studied 1842 participants in the Multicenter Osteoarthritis Study (MOST) who were an average of 67 years old at the start and who had, or were at high risk for, knee osteoarthritis.

At the end of 5 years, 16.8 percent reported knee buckling, and at the end of 7 years, 14.1 percent had recurrent (?2) falls. Bucklers at year 5 had a 1.6- to 2.5-times higher likelihood of recurrent falls, fear of falling, and poor balance confidence at year 7. Those who fell when a knee buckled at the start of the study had a 4.5-times, 2-times, and 3-times higher likelihood 2 years later of recurrent falls, significant fall injuries, and fall injuries that limited activity, respectively, and they were 4-times more likely to have poor balance.

"Falls, injury from falls and poor balance confidence are extremely common and debilitating problems in older people. The present study has demonstrated for the first time that knee instability and knee buckling are important causes of these problems in the very large segment of the older population suffering from knee pain," said Dr. Nevitt. "Fortunately, it may be possible to treat knee instability and prevent knee buckling with targeted exercises. Joint replacement surgery can also improve knee stability."

He added that pain is the predominant symptom of knee osteoarthritis, and symptoms of instability such as knee buckling and falls may be overlooked by treating professionals. The most important immediate impact of these findings on patient care is that health professionals should query their patients with knee OA about instability, buckling, and falls, and work with them to take preventive actions, including proper use of walking aids, leg strengthening, and appropriate footwear."

Why repeating exercise leaves you less sore than the first time

The first time back to the gym after a long break usually results in sore muscles. Fortunately, the return trip a few days later--if it happens--is generally less painful.

Scientists have studied this reduced-soreness phenomenon for decades and even have a name for it--the repeated bout effect. Despite all those years of research, they still can't figure out exactly why people feel less sore the second time around.

What they do know is the immune system plays some role in how the muscle repairs itself and protects against additional damage. But now exercise science researchers at BYU have produced evidence that shows for the first time the surprising presence of very specific immune workers: T-cells.

"You think of T-cells as responding to infections, not repairing muscles--but we found a significant accumulation of T-cells infiltrating damaged muscle fibers," said Robert Hyldahl, assistant professor of exercise science at BYU. "Our study is the first to show T-cells present in human muscle in response to exercise-induced damage."

The research appears this month in Frontiers in Physiology and builds off past studies that implicate immune cells in muscle healing. One such study was a 2013 paper out of Harvard showing T-cells active in the skeletal muscles of mice (but not yet humans) after injury.

For the study, researchers, put 14 men and women through two vigorous rounds of exercise on an isokinetic dynamometer machine, 28 days apart. ("All of them got really sore," Hyldahl said.) Before and after each bout of exercise, the team took muscle biopsies from the subjects and then used immunohistochemistry and microscopy to analyze the muscle tissue.

The BYU group found an expected increase in certain white blood cells after the second bout of exercise, but only identified the T-cells after it was suggested by Amanda Gier, one of two undergraduate coauthors on the paper, who was enrolled in an immunology course at the time.

"T-cells, up until recently, were not thought to enter healthy skeletal muscle," said lead author and grad student Michael Deyhle. "We hadn't planned on measuring them because there's no evidence that T-cells play a role in infiltrating damaged muscle tissue. It's very exciting."

The presence of the T-cells suggests that muscles become more effective at recruiting immune cells following a second bout of exercise and that these cells may facilitate accelerated repair. In other words, the muscle seems to remember the damaging insult and reacts similarly to when the immune system responds to antigens--toxins, bacteria or viruses.

The group was also surprised to find inflammation actually increased after the second round of exercise. Hyldahl, his students and many physiologists have long thought inflammation goes down after the second bout of exercise, contributing to that "less sore" effect.

Instead, the slightly enhanced inflammatory response suggests inflammation itself probably does not worsen exercise-induced muscle damage.

"Many people think inflammation is a bad thing," Deyhle said. "But our data suggest when inflammation is properly regulated it is a normal and healthy process the body uses to heal itself."

Adds Hyldahl: "Some people take anti-inflammatory drugs such as Ibuprofen and Aspirin after a workout, but our study shows it may not actually be effective. The inflammation may not be directly causing the pain, since we see that muscle soreness is reduced concurrent with increases in inflammation."

Wholesome wholegrain

Most people are aware that rye bread is healthy, but not many know that what makes bread a healthy food is not only vitamins, minerals, protein and fibre. Rye bread and other wholegrain foods contain a particular group of health-promoting substances. These bioactive go by the name of benzoxazinoids, or BX for short.

Their presence in wholegrain was discovered by scientists from Aarhus University in 2010. Now, the scientists have dug more deeply to discover the BX factor's secrets.

"Certain medicinal plants and green cereals have previously been found to contain BX, but it was a revelation that they are also found in ripened rye and other wholegrains. Not only that -- we also found BX in the final baked bread and other wholegrain products," says Associate Professor Inge S. Fomsgaard from the Department of Agroecology at Aarhus University.

Bread and breakfast

The discovery spurred the scientists on and they began to investigate whether the beneficial substances were absorbed in the body. This was studied in rats, pigs and humans in the project Bread and Breakfast, which was led by Inge S. Fomsgaard.

"We found that the BX compounds pass through the gut wall and circulate in the body in different chemical forms. By comparing the amount that was eaten with the amount circulating in the blood and excreted in urine, we could work out that some of the substances could be transported into some of the organs where they are able to do some good," explains Inge S. Fomsgaard.

The scientists also examined whether BX has an effect against allergies or whether they regulate the immune system. This part of the study was done by examining the blood cells in the laboratory. There was no apparent anti-allergic effect, but there was an effect on the immune system.

"Eating a diet rich in BX compounds made certain immune system cells react more strongly to some types of bacteria," says Inge S. Fomsgaard. She leads another ongoing project -- RyeproC -- where scientists are studying whether benzoxazinoids in rye bread have a beneficial effect on prostate cancer. (Read the article: Rye bread against prostate cancer.)

"Improving our knowledge about the function of benzoxazinoids can lead to the growing of crops that can be converted to food products and beverages with an optimum content and composition of these health-promoting compounds, so that consumers can increase their BX intake without having to eat large quantities of food," says Inge S. Fomsgaard. This does, however, require further verification of the effect of BX in order that the European Food Safety Authority (EFSA) may approve the appraisal of the effect in the retailing of BX-containing foods.

Thursday, February 4, 2016

Physical activity reduces risk of serious falls in older men

Older men who engage in regular physical activity experience far fewer serious fall injuries than those who do not, say Yale researchers. Their findings suggest that moderate exercise can help prevent potentially devastating falls, the leading cause of injury in people age 70 and older.

The study results, published online Feb. 3 in The BMJ, are drawn from the Lifestyle Interventions and Independence for Elders (LIFE) Study, the largest and longest trial of physical activity in older people.

Nearly one-third of older people experience falls, and 10% of those who fall suffer a serious injury. While exercise can help reduce falls, there has been insufficient data to show that physical activity prevents fall injuries. The LIFE Study, conducted in eight research centers in the United States including Yale, evaluated the benefits of physical activity for older people. It compared the impact of a long-term, moderate exercise program versus health education on 1,635 sedentary persons aged 70-89.

The researchers found that while physical activity did not significantly reduce the risk of a serious fall injury, relative to health education, there were notable gender differences. The likelihood of a serious fall injury was reduced 38% in men but not reduced in women. Men in the physical activity group also saw a 53% reduced rate of fall-related fractures, and a 59% reduced rate of fall injuries leading to hospitalization.

"The physical activity program was more effective in reducing the rate of serious fall injuries in men than in women," said Thomas M. Gill, M.D., professor of geriatrics. The physical activity program included moderate walking, and flexibility, strength, and balance training exercises.

The research team noted that the male study participants had increased their physical activity to a greater extent than the women. Men in the study also had greater improvements in their gait, balance, and muscle strength in response to the physical activity program.

While mixed, the results suggest that moderate exercise may be the prescription for preventing life-changing falls in older men, note the researchers.

"The results from the current study support continued evaluation of the physical activity program for possible widespread implementation in the community," Gill said.

Don't use body mass index to determine whether people are healthy, UCLA-led study says

Over the past few years, body mass index, a ratio of a person's height and weight, has effectively become a proxy for whether a person is considered healthy. Many U.S. companies use their employees' BMIs as a factor in determining workers' health care costs. And people with higher BMIs could soon have to pay higher health insurance premiums, if a rule proposed in April by the Equal Employment Opportunity Commission is adopted.

But a new study led by UCLA psychologists has found that using BMI to gauge health incorrectly labels more than 54 million Americans as "unhealthy," even though they are not. The researchers' findings are published online today in the International Journal of Obesity.

"Many people see obesity as a death sentence," said A. Janet Tomiyama, an assistant professor of psychology in the UCLA College and the study's lead author. "But the data show there are tens of millions of people who are overweight and obese and are perfectly healthy."

The scientists analyzed the link between BMI -- which is calculated by dividing a person's weight in kilograms by the square of the person's height in meters -- and several health markers, including blood pressure and glucose, cholesterol and triglyceride levels, using data from the most recent National Health and Nutrition Examination Survey.

The study found that close to half of Americans who are considered "overweight" by virtue of their BMIs (47.4 percent, or 34.4 million people) are healthy, as are 19.8 million who are considered "obese."

Given their health readings other than BMI, the people in both of those groups would be unlikely to incur higher medical expenses, and it would be unfair to charge them more for health care premiums, Tomiyama said.

Among the other findings:

  • More than 30 percent of those with BMIs in the "normal" range -- about 20.7 million people -- are actually unhealthy based on their other health data.
  • More than 2 million people who are considered "very obese" by virtue of having a BMI of 35 or higher are actually healthy. That's about 15 percent of Americans who are classified as very obese.

Tomiyama, who directs UCLA's Dieting, Stress and Health laboratory, also called DiSH, found in previous research that there was no clear connection between weight loss and health improvements related to hypertension, diabetes, and cholesterol and blood glucose levels.

She said she was surprised at the magnitude of the numbers in the latest study.

"There are healthy people who could be penalized based on a faulty health measure, while the unhealthy people of normal weight will fly under the radar and won't get charged more for their health insurance," she said. "Employers, policy makers and insurance companies should focus on actual health markers."

Jeffrey Hunger, a co-author of the paper and a doctoral candidate at UC Santa Barbara, said the research shows that BMI is a deeply flawed measure of health. "This should be the final nail in the coffin for BMI," he said.

Hunger recommends that people focus on eating a healthy diet and exercising regularly, rather than obsessing about their weight, and strongly opposes stigmatizing people who are overweight.

The proposed EEOC rule would allow employers to charge higher insurance rates to people whose BMI is 25 or higher. A BMI between 18.5 and 24.99 is considered normal, but the study emphasizes that normal BMI should not be the primary goal for maintaining good health.

Tomiyama is planning a new study of people with high BMIs who are very healthy. Prospective participants may contact her laboratory for more information.

Tuesday, February 2, 2016

Tall people have a lower risk of cardiovascular disease and type 2 diabetes but a higher cancer risk

Height is largely genetically determined, but in recent decades the height of children and adults has steadily increased throughout the world: In adulthood the children are almost always significantly taller than their parents. The largest increase in height in recent decades is found in the Netherlands. Dutch men are now 20 cm taller than they were 150 years ago. Interestingly, in the Netherlands the per capita consumption of milk and dairy products is the highest in the world.

These observations led the DZD scientists Professor Norbert Stefan and Professor Hans-Ulrich Häring of the Department of Internal Medicine IV in Tübingen and the Institute for Diabetes Research and Metabolic Diseases of Helmholtz Zentrum München at the University of Tübingen (IDM) and Professor Matthias Schulze of the German Institute of Human Nutrition in Potsdam (DIfE), in collaboration with Professor Frank Hu of the Harvard School of Public Health and Medical School in Boston, USA, to analyze the causes and medical effects of this increase in height.

Height influences risk of major non-communicable diseases

The study shows that height has an important impact on the mortality from certain common diseases, irrespective of body fat mass and other modulating factors. Previous studies have shown clearly that tall people, in comparison to short people, have a lower risk of cardiovascular disease and type 2 diabetes but have a higher cancer risk. "Epidemiological data show that per 6.5 cm in height the risk of cardiovascular mortality decreases by six percent, but cancer mortality, by contrast, increases by four percent," Professor Schulze said.

Multiple causes are suspected

The authors suspect that the increase in body height is a marker of overnutrition of high-calorie food rich in animal protein during different stages of growth. Thus, already in utero, lifelong programming might take place that until now has mainly been established for the insulin-like growth factor 1 and 2 and the IGF-1/2 system. Among other consequences, activation of this system causes the body to become more sensitive to insulin action, thus positively influencing the lipid metabolism. "Accordingly, our new data show that tall people are more sensitive to insulin and have lower fat content in the liver, which may explain their lower risk for cardiovascular disease and type 2 diabetes," Professor Stefan added. These findings fit in with published data that suggest that tall people have relative protection against disorders of the lipid metabolism. However, this activation of the IGF-1/2 system and other signaling pathways may be related to an increased risk of certain cancers, especially breast cancer, colon cancer, and melanoma because cell growth is permanently activated, the authors suspect. The result is an inverse association with the risk of cardiovascular disease and type 2 diabetes, but a positive association with the risk of cancer.

Conclusion: Height should be more of a consideration in prevention

The scientists advocate considering the factor growth and adult height more than hitherto in the prevention of the above-mentioned major diseases. In particular, physicians should be made more aware of the fact that tall people - although less often affected by cardiovascular disease or type 2 diabetes - have an increased risk of cancer. Hitherto, the importance of diet has been underestimated, especially during pregnancy and in children and adolescents.

Breakfast high in protein - like eggs - keeps children fuller longer than cereal or oatmeal and they eat fewer calories at lunch

A team of researchers, led by Tanja Kral, PhD, Associate Professor in the Department of Biobehavioral Health Sciences at the University of Pennsylvania School of Nursing, concluded that a breakfast high in protein - like eggs - keeps children fuller longer than cereal or oatmeal, causing them to eat fewer calories at lunch. The study, recently published in Eating Behaviors, also concludes that the effects of a protein-rich meal don't last throughout the day. It only impacts a mid-day meal.

The study recruited forty, 8- to 10-year-old children to consume one of three, 350-calorie breakfasts (eggs, oatmeal, or cereal), then played games with research staff and then ate lunch, once a week for three consecutive weeks. On each occasion, every participant had to eat their entire breakfast, but could eat as much or as little lunch as desired. Throughout the morning, they answered questions like, "How hungry are you?" and "How much food do you think you could eat right now?" Their parents also logged in a food journal what the children ate the remainder of the day.

According to the research, after consuming the egg breakfast (scrambled eggs, whole wheat toast, diced peaches, and one percent milk) children reduced their energy intake at lunch by seventy calories. That's roughly equivalent to one small chocolate-chip cookie.

Moderately active children in the same age range as those who participated in the study generally need between 1,600 and 1,800 calories daily. The 70-calorie drop at one meal equals about four percent of a child's daily caloric needs. Eating beyond the caloric threshold, even by a little, can cause excess weight gain and obesity in children, if sustained.

"I'm not surprised that the egg breakfast was the most satiating breakfast," said Kral. "What does surprise me is the fact that, according to the children's reports, eating the egg breakfast didn't make them feel fuller than cereal or oatmeal, even though they ate less for lunch. We expected that the reduced lunch intake would be accompanied by lower levels of hunger and greater fullness after eating the high protein breakfast, but this wasn't the case."

Future research should study children over a longer period of time as these findings could have important implications for the prevention of obesity, particularly for young people. "Approximately 17 percent of US children and adolescents are considered obese," Kral says. "It's really important that we identify certain types of food that can help children feel full and also moderate caloric intake, especially in children who are prone to excess weight gain."

Seafood consumption was significantly correlated with less Alzheimer disease despite mercury contamination

It's a fishy situation: On the one hand, multiple scientific studies have found that eating seafood helps protect against dementia. On the other hand (or fin), seafood also is a source of the element mercury, which has been thought to cause damage to cells in the brain, contributing to cognitive impairment.

Now a study lead by researchers from Rush University Medical Center has provided the first report on the relationship of brain concentrations of mercury to brain neuropathology and diseases associated with dementia. Study results were published in the Feb. 2 issue of the Journal of the American Medical Association.

Even though mercury levels in the brain increased with seafood consumption, the researchers found that the increase in mercury levels were not associated with increased brain neuropathologies (i.e., harm to the brain). Rather, they found that seafood consumption was associated with less Alzheimer's disease neuropathology despite the increased mercury levels. Further, the protective association of seafood was only observed among individuals with a common genotype (APOE-ε4) that increases the risk of developing Alzheimer's disease. The APOE is a gene involved in cholesterol transport to neurons.

The same research study also found no correlation between consumption of fish oil supplements and brain neuropathologies. However, no firm conclusions can be derived because of the low frequency of fish oil supplement use in this study population.

"Seafood consumption is promoted for its many health benefits even though it's contaminated by mercury," says Martha Clare Morris, ScD, a Rush nutritional epidemiologist who led the study. "Since mercury is a known neurotoxin, we wanted to determine whether seafood consumption is correlated with increased brain mercury levels in older adults, and also whether seafood consumption or brain mercury levels are correlated with brain neuropathologies."

The researchers found that seafood consumption was significantly correlated with less Alzheimer disease pathology, including lower density of amyloid plaques in the brain and less severe and widespread tangles within the neurons.

Whereas plaques and tangles are the defining features of Alzheimer's dementia (characterized clinically by memory loss and decline in other thinking abilities), data suggest that some degree of plaques and tangles accumulate in the brains of most adults, even those without dementia.

The study findings were derived from 286 postmortem brain autopsies performed on a cohort of individuals initially free of dementia that the researchers followed for an average of 4.5 years until their death. Tissue concentrations of mercury and selenium were measured using instrumental neutron activation analyses. The comparatively large number of brains analyzed decreases the likelihood that the findings are due to chance.

The participants' seafood intake was measured by multiple food frequency questionnaires completed in the years before their death. The level of seafood intake in the study population was moderate, and therefore the findings cannot be generalized to populations with higher seafood consumption or to populations with high mercury exposure.

It is likely that the types of fish consumed by the study participants reflect the top 10 consumed species in the U.S., which have low to moderate levels of mercury. Nevertheless, the levels of mercury in the study population were comparable to levels previously reported for cortical brain regions.

Monday, February 1, 2016

Higher dietary fiber intake in young women may reduce breast cancer risk

Boston, MA - Women who eat more high-fiber foods during adolescence and young adulthood--especially lots of fruits and vegetables--may have significantly lower breast cancer risk than those who eat less dietary fiber when young, according to a new large-scale study led by researchers at Harvard T.H. Chan School of Public Health.

The study will be published online February 1, 2016 in Pediatrics.

"Previous studies of fiber intake and breast cancer have almost all been non-significant, and none of them examined diet during adolescence or early adulthood, a period when breast cancer risk factors appear to be particularly important," said Maryam Farvid, visiting scientist at Harvard Chan School and lead author of the study. "This work on the role of nutrition in early life and breast cancer incidence suggests one of the very few potentially modifiable risk factors for premenopausal breast cancer."

The researchers looked at a group of 90,534 women who participated in the Nurses' Health Study II, a large long-running investigation of factors that influence women's health. In 1991, the women--ages 27-44 at the time--filled out questionnaires about their food intake, and did so every four years after that. They also completed a questionnaire in 1998 about their diet during high school. The researchers analyzed the women's fiber intake while adjusting for a number of other factors, such as race, family history of breast cancer, body mass index, weight change over time, menstruation history, alcohol use, and other dietary factors.

Breast cancer risk was 12%-19% lower among women who ate more dietary fiber in early adulthood, depending on how much more they ate. High intake of fiber during adolescence was also associated with 16% lower risk of overall breast cancer and 24% lower risk of breast cancer before menopause. Among all the women, there was a strong inverse association between fiber intake and breast cancer incidence. For each additional 10 grams of fiber intake daily--for example, about one apple and two slices of whole wheat bread, or about half a cup each of cooked kidney beans and cooked cauliflower or squash--during early adulthood, breast cancer risk dropped by 13%. The greatest apparent benefit came from fruit and vegetable fiber.

The authors speculated that eating more fiber-rich foods may lessen breast cancer risk partly by helping to reduce high estrogen levels in the blood, which are strongly linked with breast cancer development.

"From many other studies we know that breast tissue is particularly influenced by carcinogens and anticarcinogens during childhood and adolescence," said Walter Willett, Fredrick John Stare Professor of Epidemiology and Nutrition at Harvard Chan School and senior author of the study. "We now have evidence that what we feed our children during this period of life is also an important factor in future cancer risk."