Tuesday, July 18, 2017

Grapefruit Juice and Some Drugs Don't Mix



Grapefruit juice and the actual grapefruit can be part of a healthy diet. Grapefruit has vitamin C and potassium—nutrients your body needs to work properly.

But it isn’t good for you when it affects the way your medicines work, especially if you have high blood pressure or arrhythmia (irregular or abnormal heart beat).

This food and drug interaction can be a concern, says Shiew Mei Huang, PhD, of the U.S. Food and Drug Administration. The FDA has required that some prescription and over-the-counter (OTC) drugs taken by mouth include warnings against drinking grapefruit juice or eating grapefruit while taking the drug, Huang says.

Here are examples of some types of drugs that grapefruit juice can cause problems with (interact):
  • Some statin drugs to lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin).
  • Some drugs that treat high blood pressure, such as Procardia and Adalat CC (both nifedipine).
  • Some organ-transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine).
  • Some anti-anxiety drugs, such as buspirone.
  • Some corticosteroids that treat Crohn’s disease or ulcerative colitis, such as Entocort EC and Uceris (both budesonide).
  • Some drugs that treat abnormal heart rhythms, such as Pacerone and Nexterone (both amiodarone).
  • Some antihistamines, such as Allegra (fexofenadine).
Grapefruit juice does not affect all the drugs in the categories above. The severity of the interaction can be different depending on the person, the drug, and the amount of grapefruit juice you drink. Talk to your doctor, pharmacist or other health care provider and read any information provided with your prescription or OTC drug to find out:
  • If your specific drug may be affected.
  • How much, if any, grapefruit juice you can have.
  • What other fruits or juices may also affect your drug in a similar way to grapefruit juice.
How Grapefruit Juice Can Interfere With Medications

With most drugs that interact with grapefruit juice, “the juice lets more of the drug enter the blood,” Huang says. “When there is too much drug in the blood, you may have more side effects.”
For example, if you drink a lot of grapefruit juice while taking certain statin drugs to lower cholesterol, too much of the drug may stay in your body, increasing your risk for liver and muscle damage that can lead to kidney failure.

Many drugs are broken down (metabolized) with the help of a vital enzyme called CYP3A4 in the small intestine. Grapefruit juice can block the action of CYP3A4, so instead of being metabolized, more of the drug enters the blood and stays in the body longer. The result: too much drug in your body.

The amount of the CYP3A4 enzyme in the intestine varies from person to person, says Huang. Some people have a lot of enzymes and others just a little. So grapefruit juice may affect people differently even when they take the same drug.

Although scientists have known for several decades that grapefruit juice can cause too much of certain drugs in the body, Huang says more recent studies have found that the juice has the opposite effect on a few other drugs.

“Grapefruit juice can cause less fexofenadine to enter the blood,” decreasing how well the drug works, Huang says. Fexofenadine (brand name Allegra) is available as both prescription and OTC to relieve symptoms of seasonal allergies. Fexofenadine may also not work as well if taken with orange or apple juice, so the drug label states “do not take with fruit juices.”

Why this opposite effect? Instead of changing metabolism, grapefruit juice can affect proteins in the body known as drug transporters, which help move a drug into our cells for absorption. As a result, less of the drug enters the blood and the drug may not work as well, Huang says.


Poor sleep = poor physical and mental health


More than a third of Americans don't get enough sleep, and growing evidence suggests it's not only taking a toll on their physical health through heart disease, diabetes, stroke, and/or other conditions, but hurting their mental health as well.

According to a recent study led by Postdoctoral FellowIvan Vargas, PhD, in the journal Cognitive Therapy and Research, those who are sleep deprived lose some of their ability to be positive-minded people. That may not sound serious, but medical experts say an inability to think positively is a serious symptom of depression that could be dangerous if left unaddressed. An estimated 16.1 million adults experienced a major depressive episode in 2014.

"In general, we have a tendency to notice positive stimuli in our environment," said Vargas. "We tend to focus on positive things more than anything else, but now we're seeing that sleep deprivation may reverse that bias."

In their study, Vargas and his team took 40 healthy adults, and randomized them to either 28 consecutive hours awake, or a full eight hours of sleep. All participants participated in a computer test measuring their accuracy and response time at identifying happy, sad and neutral faces to assess how they pay attention to positive or negative information.

The team found that those who were acutely sleep deprived were less likely to focus on the happy faces. They didn't necessarily focus more on the negative, but were less likely to focus on the positive. The study may have implications for those experiencing depression and/or anxiety.
There are many symptoms of depression -- including feeling sad and no longer being able to enjoy things you typically would, but poor sleep is associated with a particularly serious sign of the condition.

"Depression is typically characterized as the tendency to think and feel more negatively or sad, but more than that, depression is associated with feeling less positive, less able to feel happy," Vargas says, "Similarly, if you don't get enough sleep, it reduces your ability to attend to positive things, which over time may confer risk for depression."

Interestingly enough, in the present study, those with a history of insomnia symptoms were less sensitive to the effects of the sleep loss. The authors believe this might be because those with a history of insomnia symptoms have more experience being in sleep-deprived conditions and have developed coping methods to modulate the effect of sleep loss.

Vargas and colleagues recently presented a related study at SLEEP 2017, the 31st Annual Meeting of the Associated Professional Sleep Societies LLC, on the association of insomnia and suicide, finding that people who suffer from insomnia are three times more likely to report thoughts of suicide and death during the past 30 days than those without the condition.

The study comes amid a growing body of knowledge associating sleep disorders and depression. For example, ongoing research presented this year at SLEEP 2017 from a multi-center NIH-sponsored "Treatment of Insomnia and Depression" study (abstract 0335 here) suggests that cognitive-behavioral therapy for insomnia (CBT-I) may help achieve depression remission in those suffering from both depression and insomnia who sleep at least 7 hours each night. (A clinical practice guideline published in 2016 in Annals of Internal Medicine recommends CBT-I (not sleep medications) as the initial treatment for chronic insomnia.

Additionally, a new study in the journal Child Development furthers our understanding of the connection between late night cell phone use, mental health, and disrupted sleep, finding that using a cell phone at night can increase depression in teenagers and lower their self-esteem.
 
 
 

Long working hours increases the risk of developing atrial fibrillation



People who work long hours have an increased risk of developing an irregular heart rhythm known as atrial fibrillation, according to a study of nearly 85,500 men and women published in the European Heart Journal.
The study showed that, compared to people who worked a normal week of between 35-40 hours, those who worked 55 hours or more were approximately 40% more likely to develop atrial fibrillation during the following ten years. For every 1000 people in the study, an extra 5.2 cases of atrial fibrillation occurred among those working long hours during the ten-year follow-up.

Prof Kivimaki and colleagues from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium analysed data from 85,494 men and women from the UK, Denmark, Sweden and Finland who took part in one of eight studies in these countries. They assessed the participants' working hours when they joined the studies between 1991 and 2004. Working hours were classified as less than 35 hours a week, 35-40 hours, which was considered as the standard working hours of full-time workers, 41 to 48 hours, 49 to 54 hours, and 55 hours or more a week. None of the participants had atrial fibrillation at the start of the studies.

During the ten-year follow-up period, there were 1061 new cases of atrial fibrillation. This gave an incidence rate of 12.4 per 1000 people in the study, but among the 4,484 people working 55 hours or more, the incidence was 17.6 per 1000. "Those who worked long hours had a 1.4 times higher risk of developing atrial fibrillation, even after we had adjusted for factors that could affect the risk, such as age, sex, socioeconomic status, obesity, leisure time physical activity, smoking and risky alcohol use," said Prof Kivimaki.

"Nine out of ten of the atrial fibrillation cases occurred in people who were free of pre-existing or concurrent cardiovascular disease. This suggests the increased risk is likely to reflect the effect of long working hours rather than the effect of any pre-existing or concurrent cardiovascular disease, but further research is needed to understand the mechanisms involved.

"A 40% increased extra risk is an important hazard for people who already have a high overall risk of cardiovascular disease due to other risk factors such as older age, male sex, diabetes, high blood pressure, high cholesterol, overweight, smoking and physical inactivity, or living with an established cardiovascular disease. For a healthy, young person, with few if any of these risk factors, the absolute increased risk of atrial fibrillation associated with long working hours is small."

The study does have some limitations, including the fact that working hours were only assessed once at the beginning of the study and that the type of job (for instance, whether it involved working night shifts) was not recorded.

However, Prof Kivimaki said: "The great strength of our study was its size, with nearly 85,000 participants, which makes it large by the standard of any study in this field. Obviously, monitoring of working hours over several years would be more ideal than a one-off measurement at the start of the study. However, I do not think the results would have been dramatically different with repeat measurements of working hours because people tend to keep their working patterns. In the current absence of trials with atrial fibrillation as the primary outcome in the general population, findings from observational studies such as this are particularly important in offering insights into the lifestyle determinants of this condition."

In an accompanying editorial, Dr Bakhtawar Mahmoodi and Dr Lucas Boersma, of St Antonius Hospital, Nieuwegein, The Netherlands, write: "The authors should be congratulated for the impressive collaborative effort required to integrate patient level data from multiple studies to increase the power. However, despite the efforts of the authors to thoroughly assess the reported association between long working hours and atrial fibrillation, there are many inherent limitations of the data that preclude from definite conclusions on acknowledging long working hours as an independent risk factor for atrial fibrillation."

They highlight the long, ten-year follow-up time during which there was no updated information on working hours and other factors that Prof Kivimaki and colleagues took into account in their analyses and which could have changed over this time. The type of jobs (office versus construction work) and irregular working hours, including night shifts, were not explored in the analyses, and these could have an impact on the risk of atrial fibrillation too. However, they conclude that the study "addresses an important topic and expands the literature on the aetiology of atrial fibrillation."

Monday, July 17, 2017

Artificial sweeteners linked to risk of weight gain, heart disease and other health issues


Artificial sweeteners may be associated with long-term weight gain and increased risk of obesity, diabetes, high blood pressure and heart disease, according to a new study published in CMAJ (Canadian Medical Association Journal)

Consumption of artificial sweeteners, such as aspartame, sucralose and stevia, is widespread and increasing. Emerging data indicate that artificial, or nonnutritive, sweeteners may have negative effects on metabolism, gut bacteria and appetite, although the evidence is conflicting.

To better understand whether consuming artificial sweeteners is associated with negative long-term effects on weight and heart disease, researchers from the University of Manitoba's George & Fay Yee Centre for Healthcare Innovation conducted a systematic review of 37 studies that followed over 400 000 people for an average of 10 years. Only 7 of these studies were randomized controlled trials (the gold standard in clinical research), involving 1003 people followed for 6 months on average.

The trials did not show a consistent effect of artificial sweeteners on weight loss, and the longer observational studies showed a link between consumption of artificial sweeteners and relatively higher risks of weight gain and obesity, high blood pressure, diabetes, heart disease and other health issues.

"Despite the fact that millions of individuals routinely consume artificial sweeteners, relatively few patients have been included in clinical trials of these products," said author Dr. Ryan Zarychanski, Assistant Professor, Rady Faculty of Health Sciences, University of Manitoba. "We found that data from clinical trials do not clearly support the intended benefits of artificial sweeteners for weight management."

"Caution is warranted until the long-term health effects of artificial sweeteners are fully characterized," said lead author Dr. Meghan Azad, Assistant Professor, Rady Faculty of Health Sciences, University of Manitoba. Her team at the Children's Hospital Research Institute of Manitoba is undertaking a new study to understand how artificial sweetener consumption by pregnant women may influence weight gain, metabolism and gut bacteria in their infants.

"Given the widespread and increasing use of artificial sweeteners, and the current epidemic of obesity and related diseases, more research is needed to determine the long-term risks and benefits of these products," said Azad.

The study was conducted by researchers from the University of Manitoba's George & Fay Yee Centre for Healthcare Innovation and the Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba.


Plant-based diets with high intake of sweets, refined grains may increase heart disease risk


Plant-based diets are recommended to reduce the risk of heart disease; however, some plant-based diets are associated with a higher risk of heart disease, according to a study published today in the Journal of the American College of Cardiology.

In prior studies of the impact of a plant-based diet, there were several limitations. Plant-based diets were defined as "vegetarian" which consist of a variety of dietary patterns that exclude some or all animal foods. These studies treat all plant foods equally, even though certain plant foods like refined grains and sugar sweetened beverages are associated with a higher risk of cardio-metabolic disease.

To overcome these limitations, the researchers created three versions of a plant-based diet: an overall plant-based diet which emphasized the consumption of all plant food and reduced (but did not eliminate) animal food intake; a healthful plant-based diet that emphasized the intake of healthy plant foods such as whole grains, fruits and vegetables; and an unhealthful plant-based diet which emphasized consumption of less healthy plant foods such as refined grains.

Researchers used a baseline sample of 73,710 women from the Nurses' Health Study, 92,320 women from the Nurses' Health Study 2 and 43,259 men from the Health Professionals Follow-Up Study. These participants responded to a follow-up questionnaire every two years for over two decades on lifestyle, health behaviors and medical history. Participants with coronary heart disease at baseline were excluded, as were participants with cancer, stroke and coronary artery surgery.

During follow-up, 8,631 participants developed coronary heart disease. Overall, adherence to a plant-based diet was associated with a lower risk of heart disease. A higher intake of a more healthful plant-based diet - one rich in whole grains, fruits, vegetables, etc. - was associated with a substantially lower risk of heart disease. However, a plant-based diet that emphasized less healthy plant foods like sweetened beverages, refined grains, potatoes and sweets had the opposite effect.

"When we examined the associations of the three food categories with heart disease risk, we found that healthy plant foods were associated with lower risk, whereas less healthy plant foods and animal foods were associated with higher risk," said Ambika Satija, ScD, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health in Boston and the study's lead author. "It's apparent that there is a wide variation in the nutritional quality of plant foods, making it crucial to take into consideration the quality of foods in a plant-based diet."

In an accompanying editorial, Kim Allan Williams, MD, MACC, chair of the division of cardiology at Rush University Medical Center in Chicago, said the study adds to the substantial evidence that a predominately plant-based diet reduces heart disease risk. Not all plant-based foods are equally healthy, but plant-based diets with whole grains, unsaturated fats and an abundance of fruits and vegetables "deserve more emphasis in dietary recommendations."

Williams said, the long-term follow up allowed authors to examine dietary patterns and analyze the effect of gradual adherence to a plant-based diet through reduced animal food intake and increased plant food intake on heart disease risk. They said "just as physical activity is a continuum, perhaps an emphasis on starting with smaller dietary tweaks rather than major changes would be more encouraging and sustainable."

Limitations of the study include its observational nature and the self-reported diet assessments. However, these diet assessments were validated against multiple week diet records and biomarkers.


Daily crosswords linked to sharper brain in later life


The more regularly people report doing word puzzles such as crosswords, the better their brain function in later life, a large-scale and robust online trial has found.

Experts at the University of Exeter Medical School and Kings College London analysed data from more than 17,000 healthy people aged 50 and over, submitted in an online trial. In research presented at the Alzheimer's Association International Conference (AAIC) 2017, the team asked participants how frequently they played word puzzles such as crosswords.

The study, one of the largest of its kind, used tests from the CogTrackTM and PROTECT online cognitive test systems to assess core aspects of brain function. They found that the more regularly participants engaged with word puzzles, the better they performed on tasks assessing attention, reasoning and memory.

From their results, researchers calculate that people who engage in word puzzles have brain function equivalent to ten years younger than their age, on tests of grammatical reasoning speed and short term memory accuracy.

Keith Wesnes, Professor of Cognitive Neuroscience at the University of Exeter Medical School, said: "We found direct relationships between the frequency of word puzzle use and the speed and accuracy of performance on nine cognitive tasks assessing a range of aspects of function including attention, reasoning and memory. Performance was consistently better in those who reported engaging in puzzles, and generally improved incrementally with the frequency of puzzle use. For example, on test measures of grammatical reasoning speed and short-term memory accuracy, performing word puzzles was associated with an age-related reduction of around 10 years. We now need to follow up this very exciting association in a clinical trial, to establish whether engaging in puzzles results in improvement in brain function."

The study used participants in the PROTECT online platform, run by the University of Exeter and Kings College London. Currently, more than 22,000 healthy people aged between 50 and 96 are registered in the study, which is planning further expansion. The online platform enables researchers to conduct and manage large-scale studies without the need for laboratory visits. PROTECT is a 10 year study with participants being followed up annually to enable a better understanding of cognitive trajectories in this age range. PROTECT is funded by the Alzheimer's Society and the National Institute for Health Research (NIHR) Bioresource, including through its NIHR Clinical Research Network (CRN).

Clive Ballard, Professor of Age-Related Diseases at the University of Exeter Medical School, said: "We know that many of the factors involved in dementia are preventable. It is essential that we find out what lifestyle factors really make a difference to helping people maintain healthy brains to stop the soaring rise of the disease. We can't yet say that crosswords give you a sharper brain - the next step is to assess whether encouraging people to start playing word games regularly could actually improve their brain function."

Dr Doug Brown, Director of Research of Alzheimer's Society, said: "We know that keeping an active mind can help to reduce decline in thinking skills.

"This new research does reveal a link between word puzzles, like crosswords, and memory and thinking skills, but we can't say definitively that regular 'puzzling' improves these skills.

"To be able to say for sure, the crucial next step is to test if there are benefits in people who take up word puzzles.

"In the meantime our top tips to reduce the risk of developing dementia are keeping physically active, avoiding smoking and eating a healthy balanced diet."

Happiness can affect physical health


A new review indicates that subjective well-being--factors such as life satisfaction and enjoyment of life--can influence physical health. The review's investigators also examine why this is so and conditions where it is most likely to occur.

Subjective well-being may exert its effects on physical health through health behaviors, as well as through the immune and cardiovascular systems. Although scientists still are exploring and debating when happiness most affects health, there is no doubt that it can do so.

With more research, it may one day be informative for clinicians to monitor individuals' subjective well-being just as other factors are currently assessed. Individuals should also take responsibility for their health by developing happy mental habits.

"We now have to take very seriously the finding that happy people are healthier and live longer, and that chronic unhappiness can be a true health threat. People's feelings of well-being join other known factors for health, such as not smoking and getting exercise," said Prof. Ed Diener, co-author of the Applied Psychology: Health and Well-Being article. "Scores of studies show that our levels of happiness versus stress and depression can influence our cardiovascular health, our immune system strength to fight off diseases, and our ability to heal from injuries."

Friday, July 14, 2017

Fermented red clover extract stops menopausal hot flushes and symptoms


The vast majority of women in the menopause are familiar with the status of Red Clover as an herbal medicine that soothes hot flush symptoms and hormonal fluctuations. This holds true, new research shows, if the red clover is taken in a fermented form. Fermented Red Clover extract is demonstrated to decrease significantly both the number and severity of daily hot flushes.

The study also found that the extract prevents the normally accelerated menopausal bone loss affecting one in three women over the age of 50 (e.g. results showed treatment blunted bone loss in the spine completely). These findings are very promising as the benefits take place without any of the side effects of traditionally proscribed hormone therapies that increase the risk of cancers and cardiovascular diseases.

The above is the most important information from the scientific article "Combined Red Clover isoflavones and probiotics potently reduce memopausal vasomotor symptoms", that researchers at the Dept. of Endocrinology and Internal Medicine under the Dept. Clinical Medicine at Aarhus University/ Aarhus University Hospital have published in the journal PLOS one.

The study lead Professor Per Bendix Jeppesen has previously presented partial unpublished data to the media. These findings have rapidly been miss-reported to mean "Red Clover works", which as Per Bendix Jeppesen and his colleague Ph.D. Max Norman Tandrup Lambert explain, "is an oversimplification that is very close to being incorrect".

"It is the fermentation process of the Red Clover extract that makes the difference, as the lactic acid fermentation increases the bioavailability of the bioactive estrogen-like compounds (known as isoflavones or phytoestrogens) that Red Clover has in abundance," explains Max Norman Tandrup Lambert.

"The challenge with isoflavones is that they can be difficult to digest as they naturally occur in the plant bound to sugar molecules which prevent absorption. Hence, a large proportion of the isoflavones that are consumed (e.g. as a pill or capsule) can pass through the intestine without entering circulation. This problem is bypassed when the Red Clover extract undergoes a fermentation process. To be technical the process separates the sugar molecules from the isoflavones, thereby increasing bioavailability," explains Max Norman Tandup Lambert.

Max and Per Bendix Jeppesen are aware that the research findings inadvertently provide an invaluable seal of approval to an ecological farmer and business owner Michael Mohr Jensen, who has patented the production process of the fermented Red Clover extract. Michael Mohr Jensen sells the product from his private company "Herrens Mark" on Fyn. Presumably, the goal from the researchers perspective is to promote research that can help women in the menopause that also has a commercial side.

"That characterization does not apply to me," says Per Bendix Jeppesen. "For me, when I can see that research has a realistic use practically I get extra curious. The fact that the research we have contributed has direct practical application is a great positive, it doesn't happen enough even with all the universities talking about becoming more business orientated and the necessity of collaboration with businesses," says Per Bendix Jeppesen.

Interestingly, it was Michael Mohr Jensen who contacted Per Bendix Jeppesen to ask if he and other researchers from the Dept. of Endocrinology and Internal Medicine would investigate his hypothesis regarding fermented Red Clover extract as a healthier alternative to traditional estrogen therapy proscribed by doctors. In the ensuing collaboration it was Per Bendix Jeppesen and Max Norman Tandrup Lambert that advised the farmer in fine-tuning his Red Clover extract to improve the gastro-intestinal uptake of the active isoflavone compounds.

The fermentation development was a success and the results are now tested in Max Norman Tandrup Lambert's Ph.D. project - a study that recruited 130 women with menopause symptoms, of which 60 were selected based on criteria of at least five severe hot flushes per day and blood tests (including FSH, that indicates the "stage" of menopause).

"The women were separated into two groups of 30, so 30 drank 150ml Red Clover extract per day for 12 weeks, whilst the other 30 drank a masked placebo product. After 12 weeks we tested again and were speechless about the data. There was a much greater effect than we had hoped for." Says Max Norman Tandrup Lambert.

Per Bendix Jeppesen also emphasizes that the research project has avoided relying only on "self reports", which can be a considerable source of error in investigations into whether a treatment works. For example in this study the women's' hot flush symptoms were measured using a so called 'skin conductor', a device that is applied to the underside of the wrist that can determine the number hot flush events and their severity objectively based on sweat secretion. Similarly, the effect of the Red Clover extract on bone health has been tested via so-called DXA scans of the spine and hips.

All measurements are taken in the same way before and after 12 weeks of treatment; this enhances the credibility of the findings, as menopause symptoms are particularly difficult to measure.

###

Facts: Its just a phase, but...

  • 75 % of women experience menopause symptoms, for some it can be debilitating.
  • The primary symptoms of menopause are hot flushes, sweating, disrupted sleep and vaginal dryness.
  • Secondary symptoms are tiredness, poor memory, headache, joint pain, weight gain, decreased libido, anxiety and depression.
  • The most frequent menopause associated disease is osteoporosis, which affects one in three women over 50, where loss of bone density of a magnitude of around 4-6% can take place. The lifetime risk of developing osteoporosis for women is one in three.
  • Other menopause associated risk factors are cardiovascular disease and negative changes to fat metabolism and profile.


Not all muscle building supplements are equal




Popular muscle building supplements, known as branched-chain amino acids (BCAA) are ineffective when taken in isolation, according to new research from the University of Stirling.

The study, involving the universities of Exeter and Birmingham and published in Frontiers in Physiology, show that while BCAA supplements do stimulate the muscle building response in individuals after they lift weights, other muscle-building supplements are far more effective.

Other supplements that contain all necessary amino acids stimulate a greater muscle growth response, which suggests that taking BCAA supplements alone is not the best way to optimize muscle growth with weight training.

The scientists also investigated how effective the supplements were at stimulating the machinery inside the muscle itself that leads to muscle growth.

They found that while BCAA drinks stimulate the body's muscle building systems, they lack some essential amino acids that are necessary to support a maximal muscle growth response.

Professor Kevin Tipton, Chair in Sport, Health and Exercise Sciences at the University of Stirling, said: "Amino acids are the building blocks of proteins and the special class of amino acids, known as BCAA, stimulate the muscle growth response. These supplements are considered to be an important part of the nutrition plan for many bodybuilders, weightlifters and others seeking muscle growth.

"Our results show that the common practice of taking BCAA supplements in isolation will stimulate muscle protein synthesis - the metabolic mechanism that leads to muscle growth - but the total response will not be maximal because BCAA supplements do not provide other amino acids essential for the best response.

"A sufficient amount of the full complement of amino acids is necessary for maximum muscle building, following exercise. Athletes interested in enhancing muscle growth with training should not rely on these BCAA supplements alone."

The BCAA supplement enhanced the muscle growth response slightly compared to a placebo, however the muscle's response was more than double when a whey protein supplement containing the equivalent amount of BCAA that included the other amino acids, was taken.

A group of trained weightlifters took part in the study. They took the supplement in a dose equivalent to 20 grams of whey protein, after a resistance training session in the gym.


Thursday, July 13, 2017

Yoga could be a way to protect against cognitive decline in old age



Scientists in Brazil have imaged elderly female yoga practitioners' brains and found they have greater cortical thickness in the left prefrontal cortex, in brain areas associated with cognitive functions like attention and memory. The results suggest that yoga could be a way to protect against cognitive decline in old age.

As we age, the structure and functionality of our brains change and this often leads to cognitive decline, including impaired attention or memory. One such change in the brain involves the cerebral cortex becoming thinner, which scientists have shown is correlated with cognitive decline. So, how can we slow or reverse these changes?

You might think medication would be required, but surprisingly, the answer could lie in contemplative practices like yoga. Yoga practitioners consciously maintain postures, and perform breathing exercises and meditation.

"In the same way as muscles, the brain develops through training," explains Elisa Kozasa of Hospital Israelita Albert Einstein in São Paulo, Brazil, a researcher involved in the study, which was recently published in Frontiers in Aging Neuroscience. "Like any contemplative practice, yoga has a cognitive component in which attention and concentration are important."

Previous studies have suggested that yoga can have greater health benefits than similar aerobic exercises, and yoga practitioners have shown improved awareness, attention and memory. Older adults with mild cognitive impairment have also shown improvements after a short yoga training program.

But can practicing yoga over several years significantly shape your brain and if so, could it offset some of the changes that happen in the aging brain? The research team wanted to see if elderly long-term yoga practitioners had any differences in terms of brain structure compared with healthy elderly people who had never practiced yoga.

They recruited 21 female yoga practitioners (also known as yoginis) who had practiced yoga at least twice a week for a minimum of 8 years, although the group had an average of nearly 15 years of yoga practice. The researchers compared the yoginis with another group of 21 healthy women, who had never practiced yoga, meditation or any other contemplative practices, but who were well-matched to the yoginis in terms of their age (all the participants were 60 or over) and levels of physical activity. For more consistent results, the researchers only recruited women, and the participants completed surveys to see if there were any other factors at work that could affect brain structure, such as depression or level of formal education.

The researchers scanned the participants' brains using magnetic resonance imaging to see if there were any differences in brain structure. "We found greater thickness in the left prefrontal cortex in the yoginis, in brain regions associated with cognitive functions such as attention and memory," says Rui Afonso, another researcher involved in the study. As the groups were well-matched in terms of other factors that can change brain structure, such as education and levels of depression, yoga practice appears to underlie the yoginis' different brain structure.

The results suggest that practicing yoga in the long-term can change the structure of your brain and could protect against cognitive decline in old age. However, the team plan to carry out more studies to see if these brain changes result in enhanced cognitive performance in elderly yoginis.

Another possibility is that people with these brain features are more likely to be attracted to yoga. "We have compared experienced yoginis with non-practitioners, so we do not know if the yoginis already had these differences before they started yoga," explains Afonso. "This can only be confirmed by studying people for a few years from the time they start yoga."


Wednesday, July 12, 2017

Improving diet quality over time linked with reduced risk of premature death


People who improve the quality of their diets over time, eating more whole grains, vegetables, fruits, nuts, and fish and less red and processed meats and sugary beverages, may significantly reduce their risk of premature death, according to a new study from Harvard T.H. Chan School of Public Health. It is the first study to show that improving diet quality over at least a dozen years is associated with lower total and cardiovascular mortality, and underscores the importance of maintaining healthy eating patterns over the long term.

The study will be published in the July 13, 2017 issue of the New England Journal of Medicine.

"Overall, our findings underscore the benefits of healthy eating patterns including the Mediterranean diet and the DASH diet. Our study indicates that even modest improvements in diet quality could meaningfully influence mortality risk and conversely, worsening diet quality may increase the risk," said lead author Mercedes Sotos-Prieto, who worked on the study while a postdoctoral fellow in the Harvard Chan School Department of Nutrition and who is currently an assistant professor of nutrition at Ohio University.

Sotos-Prieto and colleagues analyzed the association between changes in diet quality among nearly 74,000 adults over a 12-year period (1986-1998) and their risk of dying over the subsequent 12 years (1998-2010). Data came from two long-term studies, the Nurses' Health Study and the Health Professionals' Follow-up Study, in which participants answered questions about their diets every four years and about their lifestyle and health every two years.

The researchers assessed people's diet quality by using three different scoring methods: the 2010 Alternate Healthy Eating Index, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. Each of these methods assigns scores to various types of food or nutrients; less healthy foods or nutrients have lower scores and healthier foods or nutrients have higher ones.

The study found that improved diet quality over a 12-year period was associated with reduced risk of death in the subsequent 12 years, no matter which score was used. Food groups that contributed most to an improvement in diet quality were whole grains, fruits, vegetables, and fish or n-3 fatty acids.

A 20-percentile increase in diet-quality scores--the kind of increase that can be achieved by swapping out just one serving of red or processed meat for one daily serving of nuts or legumes--was linked with an 8%-17% reduction in the risk of death, depending on the diet score. In contrast, worsening diet quality was associated with a 6%-12% increase in the risk.

Among those who maintained higher rather than lower scores according to any of the three healthy diet patterns for 12 years, there was a 9%-14% reduction in mortality from any cause. Among those who had relatively unhealthy diets at the beginning of the study but whose diet scores improved the most, the risk of death in subsequent years was also significantly reduced.

"Our results highlight the long-term health benefits of improving diet quality with an emphasis on overall dietary patterns rather than on individual foods or nutrients. A healthy eating pattern can be adopted according to individuals' food and cultural preferences and health conditions. There is no one-size-fits-all diet," said Frank Hu, professor and chair of the Harvard Chan School Department of Nutrition and senior author of the study.


Surgery for early prostate cancer may not save lives


A major 20-year study provides further evidence that prostate cancer surgery offers negligible benefits to many men with early-stage disease. In such men, who account for most cases of newly diagnosed prostate cancer, surgery did not prolong life and often caused serious complications such as infection, urinary incontinence and erectile dysfunction.

The study, by a national research team including Washington University School of Medicine in St. Louis, was led by the Minneapolis Veterans Administration Health Care System. It is published July 13 in The New England Journal of Medicine.

In men with early prostate cancer, the study compared surgery with observation. With the latter, men only were treated if they developed bothersome symptoms, such as urinary difficulty or bone pain. Such symptoms may indicate progression of the cancer. Many men in the observation group received no treatment at all because early-stage prostate cancer often grows slowly and rarely causes symptoms.

"The findings will go a long way in helping to improve prostate cancer care," said co-author Gerald L. Andriole, MD, director of Washington University's Division of Urologic Surgery. "About 70 percent of patients newly diagnosed with prostate cancer cases are in the early stages, meaning the cancer is confined to the prostate gland, and they have nonaggressive tumors. As such, these patients have an excellent prognosis without surgery. This study confirms that aggressive treatment usually is not necessary. We hope the findings will steer doctors away from recommending surgery or radiation to their patients with nonaggressive early-stage prostate cancer and patients away from thinking it's necessary."

The American Cancer Society ranks prostate cancer as the second most common cancer in men and the third-leading cause of cancer deaths among men, after lung and colorectal cancer. In 2017, about 161,360 men will be diagnosed with prostate cancer, and 26,730 will die from it.

The study, known as the Prostate Cancer Intervention Versus Observation Trial, or PIVOT, is one of the largest and longest involving cancer patients. It got underway in 1994 just as the prostate-specific antigen blood test for prostate cancer became routine. With many more men diagnosed with prostate cancer, the standard treatment for all prostate cancers became surgery or radiation, with the thinking that removing or irradiating the tumor would increase survival. But over the next decade, reports of treatment-related complications raised concerns, as did data indicating that most early-stage cancers grew so slowly they were unlikely to cause health problems.

To evaluate any potential benefits of surgery, the researchers randomly assigned 731 men in the U.S. with localized prostate cancer to receive either surgery or observation at one of 44 Department of Veteran Affairs Health Care Centers or eight academic medical centers, including Washington University. The average age of men in the study was 67 at the time of enrollment.

Of the men who had prostate cancer surgery, 223 (61 percent) died of other causes after up to 20 years of follow-up, compared with 245 men (66 percent) in the observation group - a difference that is not statistically different. Further, 27 (7 percent) men in the surgery group died of prostate cancer, compared with 42 men (11 percent) in the observation group, but that difference also is not statistically significant.

However, the data show that surgery may have a mortality benefit in some men, particularly those with a long life expectancy and intermediate-risk prostate cancer. (Such men generally have PSA scores of 10-20 ng/ml and a Gleason score of seven. The latter score signifies tumor aggressiveness.)

"It would be a disservice to dismiss surgery as a viable option for patients with intermediate-risk prostate cancer," said Andriole, the School of Medicine's Robert K. Royce Distinguished Professor of Urologic Surgery. He treats patients at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University. "For these patients, and for some men with high-risk prostate cancer, surgery is often beneficial, as are other other treatments such as radiation."

Technology has advanced since the study began, allowing physicians to more accurately classify tumors and avoid overtreating patients who have prostate cancer.

Of the 364 men treated with surgery, 53 (15 percent) suffered from erectile dysfunction, and 63 (17 percent) reported having incontinence. Another 45 developed other complications.

"The benefits of surgery also need to be balanced against the negative long-term consequences of surgery that occur early and often," said senior author Timothy Wilt, MD, a physician-researcher with the Center for Chronic Disease Outcomes Research at the Minneapolis VA Health Care System and a professor of medicine at the University of Minnesota. "Our results demonstrate that for the majority of men with localized prostate cancer, selecting observation for their treatment choice can help them live a similar length of life, avoid death from prostate cancer and prevent harms from surgical treatment. Physicians can use information from our study to confidently recommend observation as the preferred treatment option for men with early prostate cancer."

Cognitive behavioral therapy improves functioning for people with chronic pain


Cognitive Behavioral Therapy (CBT) is the most frequently used psychological intervention for people with chronic pain, and new approaches for improving CBT outcomes may be found in the psychological flexibility model and Acceptance and Commitment therapy (ACT), according to research reported in The Journal of Pain.

Acceptance and Commitment Therapy (ACT) is based on the psychological flexibility model, which includes a therapeutic process known as "self-as-context" (SAC). Contextual self refers to a sense of self that is not based on self-evaluations. It is similar to being an observer of one's own psychological experiences. Researchers in the United Kingdom writing in The Journal of Pain examined whether ACT influences SAC and if changes in measures of SAC are associated with treatment outcomes.

"Psychological flexibility is the ability to be more aware, more focused on goals and more engaged. Another aspect of psychological flexibility pertinent to chronic pain, and supported by SAC, is called committed action, which involves goal-directed, flexible persistence," said co-author Lance M. McCracken, Professor of Behavioral Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London. "For pain management, ACT is an approach based on the psychological flexibility model and focuses on building effective patterns of behavior change rather than symptom reduction."

Four hundred twelve adults referred to a pain management center at Guy's and St. Thomas' Hospital in London were subjects for the study. They completed measures of treatment processes, such as SAC and committed action, and outcomes (pain-related interference, work and social adjustment, depression) before treatment, upon treatment completion and after nine months.

Wider outcomes research suggests that ACT is effective for enhancing daily functioning and for decreasing psychological distress. A study published in 2011 assessed the long-term efficacy of acceptance and commitment therapy in more than 100 people with chronic pain. The evidence showed at three-year follow-up that 65 percent of study subjects had reliably improved in at least one key clinical domain, and improvements in psychological flexibility were associated with improvements in outcomes measures.

Results of the current Kings College study showed that scores from both the process and outcomes measures significantly improved after treatment and were maintained at nine-month follow-up. The ACT-oriented treatment was associated with improved SAC as well as improved functioning. Changes in SAC were associated with changes in pain-related interference, work and social adjustment and depression.

"Greater psychological flexibility is associated with less pain-related anxiety and avoidance, less depression, less physical and psycho-social disability and other measures of patient function," said McCracken. "Based on studies of forms of CBT that did not include ACT, acceptance of pain, one component of psychological flexibility, may be a general mechanism by which CBT treatments achieve improvements in functioning, and more specific targeting of pain-related acceptance may lead to further improvement is CBT outcomes."

The authors concluded that that the study results are consistent with an increasing number of longitudinal and mediation studies showing that ACT for chronic pain improves patient functioning, specifically through enhanced psychological flexibility.


Tuesday, July 11, 2017

Stop eating tilapia ASAP


Eating seafood is a great way to get vital nutrients and vitamins. Tilapia is the most popular farmed fish in America because of its affordability. But health experts are warning consumers to stay as far away as possible from Tilapia.

Tilapia Contains Few Nutrients


Researchers from the Wake Forest University School of Medicine released a report on the omega-3 fatty acid content in popular fish. Tilapia scored far lower than most other fish on the list. Omega-3 fatty acids give fish most of their benefits, including Alzheimer’s risk reduction. Tilapia contains a TON of omega-6 fatty acids, which are terrible for you. The quantity of omega-6 in tilapia is higher than a hamburger or bacon.

Tilapia Could Cause Alzheimer


One of the omega-6 fatty acids in tilapia goes by the name of arachidonic acid – a compound which significantly increases the type of inflammatory damage that precedes Alzheimer’s. So while eating healthy fish like mackerel, halibut and sardines would reduce your risk of developing Alzheimer’s, this fish actually increases it.

Most Tilapia Is Farmed


Tilapia is the second most commonly farmed fish in the world. This is largely due to the fish’s hardiness; it can eat just about anything. Good for farmers, bad for consumers. It means they don’t have to spend lots of money on fish food as they would were they raising salmon. Farmers commonly feed the fish chicken and pig poop. The fish are also stuffed with antibiotics and genetically modified to grow faster.

Tilapia May Cause Cancer

Tilapia can carry up to 10 times the amount of carcinogens as other fish. This is because of the food the farmers feed the fish – poop, pesticides and industrial-grade chemicals. One toxic chemical researchers have found in the fish is dioxin, which is linked to the development and progression of cancer.

What’s more, your body doesn’t actually flush out dioxin for a whopping 7-11 years.

People who drink coffee live longer


Drinking coffee was associated with a lower risk of death due to heart disease, cancer, stroke, diabetes, and respiratory and kidney disease for African-Americans, Japanese-Americans, Latinos and whites.

People who consumed a cup of coffee a day were 12 percent less likely to die compared to those who didn't drink coffee. This association was even stronger for those who drank two to three cups a day -- 18 percent reduced chance of death.

Lower mortality was present regardless of whether people drank regular or decaffeinated coffee, suggesting the association is not tied to caffeine, said Veronica W. Setiawan, lead author of the study and an associate professor of preventive medicine at the Keck School of Medicine of USC.

"We cannot say drinking coffee will prolong your life, but we see an association," Setiawan said. "If you like to drink coffee, drink up! If you're not a coffee drinker, then you need to consider if you should start."

The study, which will be published in the July 11 issue of Annals of Internal Medicine, used data from the Multiethnic Cohort Study, a collaborative effort between the University of Hawaii Cancer Center and the Keck School of Medicine.

The ongoing Multiethnic Cohort Study has more than 215,000 participants and bills itself as the most ethnically diverse study examining lifestyle risk factors that may lead to cancer.

"Until now, few data have been available on the association between coffee consumption and mortality in nonwhites in the United States and elsewhere," the study stated. "Such investigations are important because lifestyle patterns and disease risks can vary substantially across racial and ethnic backgrounds, and findings in one group may not necessarily apply to others."

Since the association was seen in four different ethnicities, Setiawan said it is safe to say the results apply to other groups.

"This study is the largest of its kind and includes minorities who have very different lifestyles," Setiawan said. "Seeing a similar pattern across different populations gives stronger biological backing to the argument that coffee is good for you whether you are white, African-American, Latino or Asian."

Benefits of drinking coffee

Previous research by USC and others have indicated that drinking coffee is associated with reduced risk of several types of cancer, diabetes, liver disease, Parkinson's disease, Type 2 diabetes and other chronic diseases.

Setiawan, who drinks one to two cups of coffee daily, said any positive effects from drinking coffee are far-reaching because of the number of people who enjoy or rely on the beverage every day.

"Coffee contains a lot of antioxidants and phenolic compounds that play an important role in cancer prevention," Setiawan said. "Although this study does not show causation or point to what chemicals in coffee may have this 'elixir effect,' it is clear that coffee can be incorporated into a healthy diet and lifestyle."

About 62 percent of Americans drink coffee daily, a 5 percent increase from 2016 numbers, reported the National Coffee Association.

As a research institution, USC has scientists from across disciplines working to find a cure for cancer and better ways for people to manage the disease.

The Keck School of Medicine and USC Norris Comprehensive Cancer Center manage a state-mandated database called the Los Angeles Cancer Surveillance Program, which provides scientists with essential statistics on cancer for a diverse population.

Researchers from the USC Norris Comprehensive Cancer Center have found that drinking coffee lowers the risk of colorectal cancer.

But drinking piping hot coffee or beverages probably causes cancer in the esophagus, according to a World Health Organization panel of scientists that included Mariana Stern from the Keck School of Medicine.

Hearing from the WHO

In some respects, coffee is regaining its honor for wellness benefits. After 25 years of labeling coffee a carcinogen linked to bladder cancer, the World Health Organization last year announced that drinking coffee reduces the risk for liver and uterine cancer.

"Some people worry drinking coffee can be bad for you because it might increase the risk of heart disease, stunt growth or lead to stomach ulcers and heartburn," Setiawan said. "But research on coffee have mostly shown no harm to people's health."

Coffee by the numbers

Setiawan and her colleagues examined the data of 185,855 African-Americans (17 percent), Native Hawaiians (7 percent), Japanese-Americans (29 percent), Latinos (22 percent) and whites (25 percent) ages 45 to 75 at recruitment. Participants answered questionnaires about diet, lifestyle, and family and personal medical history.

They reported their coffee drinking habits when they entered the study and updated them about every five years, checking one of nine boxes that ranged from "never or hardly ever" to "4 or more cups daily." They also reported whether they drank caffeinated or decaffeinated coffee. The average follow-up period was 16 years.

Sixteen percent of participants reported that they did not drink coffee, 31 percent drank one cup per day, 25 percent drank two to three cups per day and 7 percent drank four or more cups per day. The remaining 21 percent had irregular coffee consumption habits.

Over the course of the study, 58,397 participants -- about 31 percent -- died. Cardiovascular disease (36 percent) and cancer (31 percent) were the leading killers.

The data was adjusted for age, sex, ethnicity, smoking habits, education, preexisting disease, vigorous physical exercise and alcohol consumption.

Setiawan's previous research found that coffee reduces the risk of liver cancer and chronic liver disease. She is currently examining how coffee is associated with the risk of developing specific cancers.


Poor sleep associated with the development of dementias such as Alzheimer's

 
Research from Washington University School of Medicine in St. Louis, Radboud University Medical Centre in the Netherlands, and Stanford University shows that disrupting just one night of sleep in healthy, middle-aged adults causes an increase in a brain protein associated with Alzheimer's disease. Further, a week of poor sleep leads to an increase in another brain protein that has been linked to brain damage in Alzheimer's and other neurological diseases. Shown are brain waves during slow-wave sleep, measured as a study participant slept.
 
A good night's sleep refreshes body and mind, but a poor night's sleep can do just the opposite. A study from Washington University School of Medicine in St. Louis, Radboud University Medical Centre in the Netherlands, and Stanford University has shown that disrupting just one night of sleep in healthy, middle-aged adults causes an increase in amyloid beta, a brain protein associated with Alzheimer's disease. And a week of tossing and turning leads to an increase in another brain protein, tau, which has been linked to brain damage in Alzheimer's and other neurological diseases.

"We showed that poor sleep is associated with higher levels of two Alzheimer's-associated proteins," said David M. Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor, head of the Department of Neurology and the study's senior author. "We think that perhaps chronic poor sleep during middle age may increase the risk of Alzheimer's later in life."

These findings, published July 10 in the journal Brain, may help explain why poor sleep has been associated with the development of dementias such as Alzheimer's.

More than 5 million Americans are living with Alzheimer's disease, which is characterized by gradual memory loss and cognitive decline. The brains of people with Alzheimer's are dotted with plaques of amyloid beta protein and tangles of tau protein, which together cause brain tissue to atrophy and die. There are no therapies that have been proven to prevent, slow or reverse the course of the disease.
Previous studies by Holtzman, co-first author Yo-El Ju, MD, an assistant professor of neurology, and others have shown that poor sleep increases the risk of cognitive problems. People with sleep apnea, for example, a condition in which people repeatedly stop breathing at night, are at risk for developing mild cognitive impairment an average of 10 years earlier than people without the sleep disorder. Mild cognitive impairment is an early warning sign for Alzheimer's disease.

But it wasn't clear how poor sleep damages the brain. To find out, the researchers -- Holtzman; Ju; co-first author and graduate student Sharon Ooms of Radboud; Jurgen Claassen, MD, PhD, of Radboud; Emmanuel Mignot, MD, PhD, of Stanford; and colleagues -- studied 17 healthy adults ages 35 to 65 with no sleep problems or cognitive impairments. Each participant wore an activity monitor on the wrist for up to two weeks that measured how much time they spent sleeping each night.
After five or more successive nights of wearing the monitor, each participant came to the School of Medicine to spend a night in a specially designed sleep room. The room is dark, soundproof, climate-controlled and just big enough for one; a perfect place for sleeping, even as the participants wore headphones over the ears and electrodes on the scalp to monitor brain waves.

Half the participants were randomly assigned to have their sleep disrupted during the night they spent in the sleep room. Every time their brain signals settled into the slow-wave pattern characteristic of deep, dreamless sleep, the researchers sent a series of beeps through the headphones, gradually getting louder, until the participants' slow-wave patterns dissipated and they entered shallower sleep.
The next morning, the participants who had been beeped out of slow-wave sleep reported feeling tired and unrefreshed, even though they had slept just as long as usual and rarely recalled being awakened during the night. Each underwent a spinal tap so the researchers could measure the levels of amyloid beta and tau in the fluid surrounding the brain and spinal cord.

A month or more later, the process was repeated, except that those who had their sleep disrupted the first time were allowed to sleep through the night undisturbed, and those who had slept uninterrupted the first time were disturbed by beeps when they began to enter slow-wave sleep.

The researchers compared each participant's amyloid beta and tau levels after the disrupted night to the levels after the uninterrupted night, and found a 10 percent increase in amyloid beta levels after a single night of interrupted sleep, but no corresponding increase in tau levels. However, participants whose activity monitors showed they had slept poorly at home for the week before the spinal tap showed a spike in levels of tau.

"We were not surprised to find that tau levels didn't budge after just one night of disrupted sleep while amyloid levels did, because amyloid levels normally change more quickly than tau levels," Ju said. "But we could see, when the participants had several bad nights in a row at home, that their tau levels had risen."

Slow-wave sleep is the deep sleep that people need to wake up feeling rested. Sleep apnea disrupts slow-wave sleep, so people with the disorder often wake up feeling unrefreshed, even after a full eight hours of shut-eye.

Slow-wave sleep is also the time when neurons rest and the brain clears away the molecular byproducts of mental activity that accumulate during the day, when the brain is busily thinking and working.

Ju thinks it is unlikely that a single night or even a week of poor sleep, miserable though it may be, has much effect on overall risk of developing Alzheimer's disease. Amyloid beta and tau levels probably go back down the next time the person has a good night's sleep, she said.
"The main concern is people who have chronic sleep problems," Ju said. "I think that may lead to chronically elevated amyloid levels, which animal studies have shown lead to increased risk of amyloid plaques and Alzheimer's."

Ju emphasized that her study was not designed to determine whether sleeping more or sleeping better reduce risk of Alzheimer's but, she said, neither can hurt.

"Many, many Americans are chronically sleep-deprived, and it negatively affects their health in many ways," Ju said. "At this point, we can't say whether improving sleep will reduce your risk of developing Alzheimer's. All we can really say is that bad sleep increases levels of some proteins that are associated with Alzheimer's disease. But a good night's sleep is something you want to be striving for anyway."
 
 
 

Monday, July 10, 2017

Why strength depends on more than muscle


A recent study from the University of Nebraska-Lincoln has given new meaning to the concept of brain power by suggesting that physical strength might stem as much from exercising the nervous system as the muscles it controls.

Over the past few years, researchers have found evidence that lifting more repetitions of lighter weight can build muscle mass just as well as fewer reps of heavier weight. Even so, those who train with heavier weight still see greater gains in strength than those who lift lighter loads.

But if strength differs even when muscle mass does not, what explains the disparity?

Nathaniel Jenkins and his colleagues may have uncovered some answers by measuring how the brain and motor neurons - cells that send electrical signals to muscle - adapt to high- vs. low-load weight training. Their study suggests that high-load training better conditions the nervous system to transmit electrical signals from the brain to muscles, increasing the force those muscles can produce to a greater extent than does low-load training.

Muscles contract when they receive electrical signals that originate in the brain's neuron-rich motor cortex. Those signals descend from the cortex to the spinal tract, speeding through the spine while jumping to other motor neurons that then excite muscle fibers.

Jenkins found evidence that the nervous system activates more of those motor neurons - or excites them more frequently - when subjected to high-load training. That increased excitation could account for the greater strength gains despite comparable growth in muscle mass.

"If you're trying to increase strength - whether you're Joe Shmoe, a weekend warrior, a gym rat or an athlete - training with high loads is going to result in greater strength adaptations," said Jenkins, an assistant professor of exercise physiology at Oklahoma State University who conducted the research for his dissertation at Nebraska.

The dissertation randomly assigned 26 men to train for six weeks on a leg-extension machine loaded with either 80 or 30 percent of the maximum weight they could lift. Three times per week, the participants lifted until they could not complete another repetition. Jenkins was able to replicate the findings of several previous studies, seeing similar growth in muscle between the two groups but a larger strength increase - roughly 10 pounds' worth - in the high-load group.

But the researchers also supplied an electric current to the nerve that stimulates the quadriceps muscles used in leg extensions. Even at full effort, most people do not generate 100 percent of the force their muscles can physiologically produce, Jenkins said. By comparing the force of a participant's "hardest" unassisted kick with the maximum force they can generate when aided by electric current, scientists can determine how much of that capacity a person has reached - a measure known as voluntary activation.

When adjusting for baseline scores, the researchers found that the voluntary activation of the low-load group increased from 90.07 to 90.22 percent - 0.15 percent - over a three-week span. The high-load group saw their voluntary activation jump from 90.94 to 93.29 percent, a rise of 2.35 percent.

"During a maximal contraction, it would be advantageous if we are activating - or more fully activating - more motor units," Jenkins said. "The result of that should be greater voluntary force production - an increase in strength. That's consistent with what we're seeing."

Jenkins also tested his hypothesis another way, asking participants from both groups to kick out at 10-percent intervals of their baseline strength - from 10 percent all the way up to 100 percent - after three and six weeks. If high-load training does improve muscle efficiency better than low-load training, he reasoned, then high-load lifters should also use a smaller proportion of their strength - that is, exhibit lower voluntary activation - when lifting the same relative weight.

That's what the data generally showed. Voluntary activation in the low-load group did decrease slightly, from an average of about 56 percent at baseline to 54.71 percent after six weeks. But it decreased more in the high-load group, dropping from about 57 to 49.43 percent.

"If we see a decrease in voluntary activation at these sub-maximal force levels, that suggests that these guys are more efficient," Jenkins said. "They are able to produce the same force, but they activate fewer motor units to do it."

Placing electrodes on the participants to record the electrical signatures of their quadriceps reinforced those results. High-load training led to a substantially larger drop in electrical activity after six weeks, the study reported, and that activity was lower across most levels of exertion.

"From a practical standpoint, that should make the activities of daily living easier," Jenkins said. "If I'm lifting sub-maximal loads, I should be able to do more repetitions with fewer motor units active, so maybe I fatigue a little bit slower."

Jenkins maintained that low-load training remains a viable option for those looking to simply build mass or avoid putting extreme stress on joints, a priority for older adults and people rehabbing from injury. Still, he said, the new study lends even greater credence to the notion that when it comes to building strength - especially amid a busy schedule - heavier is better.

"I don't think anybody would argue (with the idea) that high-load training is more efficient," Jenkins said. "It's more time-efficient. We're seeing greater strength adaptations. And now we're seeing greater neural adaptations."

Jenkins detailed his findings in the journal Frontiers in Physiology. He authored the paper with former doctoral adviser Joel Cramer, associate professor of nutrition and health sciences; Terry Housh, professor of nutrition and health sciences; Nebraska doctoral students Amelia Miramonti, Ethan Hill, Cory Smith; and doctoral graduate Kristen Cochrane-Snyman, now at California State Polytechnic University.

Age and obesity conspire to damage the tiny blood vessels that feed the heart, causing heart failure


Age and obesity appear to create a perfect storm that can reduce blood flow through the tiny blood vessels that directly feed our heart muscle and put us at risk for heart failure, scientists report.

They call it "aged fat" and scientists now have evidence that the inflammation created by both age and fat have an additive effect that can thicken the walls of our coronary microvasculature without any evidence of the classic atherosclerotic plaque that many of us associate with heart disease.

"Older obese patients and sometimes women who suffer heart failure go to the cardiac catheterization lab and the cardiologist finds nothing that would explain their heart failure," said Dr. Zsolt Bagi, vascular biologist in the Vascular Biology Center at the Medical College of Georgia at Augusta University. "They have normal large blood vessels in the heart still the heart failure has developed."

What isn't readily seen with these routine exams is the thickened walls that can hinder dilation of the small capillaries fed by these bigger vessels, a condition called coronary microvascular dysfunction, or cardiac syndrome X, says Bagi, corresponding author of the study in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

In patients and animal models, who are both older and obese, Bagi has found a key dynamic in the dysfunction is an enzyme called ADAM17, which is involved in a huge variety of functions like releasing growth factors as we develop, but also implicated in diseases from Alzheimer's to arthritis.

ADAM17 levels increase in obesity while levels of its natural inhibitor, the protein caveolin-1, decrease with age, enabling the perfect storm.

ADAM17 was discovered 20 years ago for its ability to cut and release previously inactive tumor necrosis factor, or TNF, from the cell membrane. TNF is a multifunctional protein, or cytokine, that gets its name from its skill at killing tumors and is a major promoter of inflammation that also directly impacts the function of the endothelial cells that line blood vessels.

The MCG scientist found that ADAM17 cleaves TNF from fat, releasing it into the bloodstream where it preferentially targets the heart.

The bottom line: the walls of the hair-sized microvasculature become thicker, less elastic, less able to dilate and to properly sustain the heart.

His research team found ADAM17 highly expressed in fat and even higher in the blood vessels of aged human fat. The protein level was increased in younger mice on a high-fat diet, but the significant increase in its activity came with age and fat.

In humans, they looked at small pieces of heart tissue as well as fat from around the heart removed during surgery by MCG cardiothoracic surgeons Drs. Vijay Patel and M. Vinayak Kamath. They also studied a combination of mice that included young and obese, old and obese, and just obese or just old. "We tried to examine every possible scenario," Bagi says.

"We were able to show that exactly the same thing happens with the small blood vessels in a mouse and man when they are both older and obese," he says.

In humans, they saw the ability of the tiny vessels to dilate in response to bradykinin - a peptide used to lower blood pressure because of its ability to dilate blood vessels - significantly reduced in those ages 69 and older and further reduced in older individuals - males and females - who also were obese.

They found ADAM17 present in the fat of young and old mice on high-fat diets compared to normals, but it was only significantly active in the older mice on a high-fat diet. When they looked at younger and older obese patients, again much like the mice, they found high levels of expression of ADAM17 in the lining of blood vessel walls.

When they transplanted fat from aged obese mice to younger mice, it increased circulating levels of proinflammatory factors and impaired dilation of the coronary microvasculature. "It basically mimicked the old vascular phenotype in the young animals," he says.

One of the future studies they want to do is transplant younger fat to old, obese animals to also measure its impact. Others have evidence that transfusing young blood to older animals, can slow aging, Bagi notes.

Bagi and his colleagues' previous studies have shown that mice missing the ADAM17 inhibitor, caveolin1, also have impaired ability to dilate the larger coronary arteries as well as hypertension when fed a high-fat diet. Related human studies have shown that the reactive oxygen species generated in diabetes disrupt caveolae, or "little caves" in the lining of the blood vessels. Caveonlin-1 is the main component of caveolae.

Being female, a family history of heart failure, diabetes and high blood pressure all are associated with coronary microvascular dysfunction. Its potential result, heart failure, is an impaired ability of the heart muscle to pump. Symptoms can include fatigue, shortness of breath that make everyday activities difficult as well as coughing.

Rather than having trouble with the heart contracting so it can pump blood out to the body, older, obese individuals in heart failure tend to have issues with the heart muscle being able to relax and fill efficiently, called diastolic heart failure, Bagi says. Relaxation actually requires more energy than contracting, and the scientist hopes his studies will help this patient population, for which currently there are no good, targeted treatment options. He has begun looking at antibodies that would directly target and ideally reduce levels of ADAM17 in the face of aged fat and at least delay development of small vessel disease.

Bagi thinks a similar process may happen in the brains of older obese individuals, so also has ongoing studies of how microvascular disease can lead to Alzheimer's in these individuals.

He notes that young, obese individuals could help themselves avoid this and likely other diseases like diabetes, by losing weight while they are young. Activities like walking can also help even the tiniest blood vessels become more accustomed to handling more blood flow.

In the nearly 70-year-old Framingham Heart Study, a higher risk of heart failure was identified in 732 older subjects with inflammatory mediators like TNF and interleukin-6 who never even had a heart attack. Others have shown that elevated levels of TNF in the blood and fat strongly correlate with the severity of coronary artery disease in the elderly.

Cranberries may aid the gut microbiome


Many scientists are paying new attention to prebiotics, that is, molecules we eat but cannot digest, because some may promote the growth and health of beneficial microorganisms in our intestines, says nutritional microbiologist David Sela at the University of Massachusetts Amherst. In a new study, he and colleagues report the first evidence that certain beneficial gut bacteria are able to grow when fed a carbohydrate found in cranberries and further, that they exhibit a special nontypical metabolism.

Findings could add value to future food products or lead to a new supplement based on the cranberry, of which Massachusetts is a major producer. Details appear this week in the current early online edition of Applied and Environmental Microbiology, where the editors feature it in the "Spotlight" section that calls attention to "research articles in the upcoming issue that have been deemed of significant interest."

What we eat not only nourishes us but also feeds the beneficial bacteria, the microbiome, in our intestines, Sela points out, and food scientists are increasingly interested in these less obvious benefits of food. There are thought to be as many bacterial cells in our bodies as our own human cells, he points out, "so we're basically eating for two. These gut bacteria are extremely significant to us, they really are very important. Our food makes a difference for us as well as the beneficial microbes that we carry around with us."

Further, "a lot of plant cell walls are indigestible," he explains, "and indeed we cannot digest the special sugars found in cranberry cell walls called xyloglucans. But when we eat cranberries, the xyloglucans make their way into our intestines where beneficial bacteria can break them down into useful molecules and compounds."

Using the model beneficial bacterium bifidobacteria, Sela, an expert in the human gut microbiome, and colleagues tested the hypothesis that cranberries, a research topic at UMass Amherst for more than 60 years, might be a candidate for a new supplement to boost gut health. To obtain a supply of purified xyloglucan for these experiments, not an easy task, he enlisted help from Ocean Spray, Inc., who provided the original research material, and collaborating experts David Rowley and Jiadong Sun at the University of Rhode Island (URI).

Sela and his Ph.D. student and first author Ezgi Özcan could then feed this purified plant sugar as the only carbohydrate available to the bifidobacteria living in 96-well plates in an anaerobic environment in the laboratory.

Bifidobacteria are found in adults to some degree but the highest concentrations are found in the gut microbiome of newborn, breast-fed babies, Sela says. This study provides the first evidence that certain bifidobacteria do consume xyloglucans, and the ones that do exhibit a special metabolism that is not typical. Specifically, these bifidobacteria produce formic acid while consuming xyloglucans and less lactic acid than is typically secreted.

It is not clear yet what the impacts to health are, but the authors suspect this unusual production has implications for the rest of the microbial community in the gut. "This is not traditional food science," says Sela, a food scientist who has adjunct appointments in microbiology at UMass Amherst and in microbiology and physiological systems at UMass Medical School. The work was supported by a $64,000 grant from Ocean Spray, Inc. to Sela and $25,000 from the President's Enhancement Fund at the Graduate School of the University of Massachusetts Amherst.

Sela believes that there is stronger motivation for both researchers and consumers in studying prebiotics than probiotics. "With probiotics, we are taking extra doses of beneficial bacteria that may or may not help our gut health," he explains. "But with prebiotics, we already know that we have the beneficial guys in our guts, so let's feed them! Let's give them more nutrients and things that they like."

"They make molecules and compounds that help us, or they make it to help some of the hundreds of other kinds of beneficial members of the community. They are consuming things we can't digest, or they are helping other beneficial microbes that we find it hard to introduce as probiotics, or their presence can help keep pathogens away," he adds.

"Prebiotics and probiotics might interact with our own physiology to help balance the microbiome, and we already know that when things are not in balance you can get problems like inflammation. Underlying chronic inflammation can lead to or worsen many different medical conditions. That's the health side of this kind of study of microbiology, food and health."

He suggests that their next series of studies might look at the interaction of cranberry xyloglucans with other bacterial species and strains. Sela is also interested in other cranberry molecules interacting with bifidobacteria and other members of the gut microbiome. "We also found certain genes turned on that are consistent with xyloglucan metabolism," Sela notes. "This is another good place to pursue our findings further."


Friday, July 7, 2017

Healthy lifestyle may help older adults preserve their independence


In a study of men with an average age of 71 years, lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese were associated with survival and high functionality over the next 16 years.

The study included 1104 men who completed a questionnaire. High functionality was defined as preserved ability in personal activities of daily living and cognitive function.

Additional studies are needed to investigate whether lifestyle changes after the age of 70 years may also lead to preserved independence.

The findings are published in the Journal of the American Geriatrics Society.


Well-being in later life: The mind plays an important role


"Ageing itself is not inevitably associated with a decline in mood and quality of life," says Prof. Karl-Heinz Ladwig, summarizing the results. "It is rather the case that psychosocial factors such as depression or anxiety impair subjective well-being*, the Head of the Mental Health Research Group at the Institute of Epidemiology II, Helmholtz Zentrum München and Professor of Psychosomatic Medicine at the TUM University Hospital explains. "And in the case of women, living alone also plays an important role."

"To date the impact of emotional stress has barely been investigated"

For the current study, Prof. Ladwig and his team relied on data derived from about 3,600 participats with an average age of 73 who had taken part in the population-based KORA-Age Study**. "What made the study particularly interesting was the fact that the impact of stress on emotional well-being has barely been investigated in a broader, non-clinical context," explains PD Dr. Karoline Lukaschek, epidemiologist in the Mental Health Research Group and lead author of the paper. "Our study therefore explicitly included anxiety, depression and sleep disorders."

Generally high levels of well-being but...

To ascertain levels of subjective well-being, the scientists used a questionnaire devised by the World Health Organization (the WHO-5 Well-Being Index) with a score range of 0 to 100. For the purpose of analysis, they divided the respondents' results into two categories: 'high' (score > 50) and 'low' (score ? 50). The subsequent evaluation revealed a high level of subjective well-being in the majority (79 percent) of the respondents. The average values were also above the threshold set by the WHO. In the 'low' group, however, there was a conspicuously high number of women: about 24 percent compared to 18 percent for men.

Depression and anxiety disorders are the biggest risk

Trying to uncover the most important causes for subjective well-being, the scientists mainly identified psychosocial factors: above all, depression and anxiety disorders had the strongest effect on well-being. Low income and sleep disorders also had a negative effect. However, poor physical health (for example, low physical activity or so-called multimorbidity) seemed to have little impact on perceived life satisfaction. Among women, living alone also significantly increased the probability of a low sense of well-being.

"The findings of the current study clearly demonstrate that appropriate services and interventions can play a major role for older people, especially for older women living on their own," Prof. Ladwig says, categorizing the results. "And this is all the more important, given that we know that high levels of subjective well-being are linked to a lower mortality risk."

Further Information

* "Subjective well-being" (SWB) is a term used to describe the way in which individuals experience happiness or life satisfaction. There are also measures of objective well-being, which attempt to record a person's quality of life based, for example, on the availability of material and immaterial things.

** For almost 30 years, the Cooperative Health Research in the Region of Augsburg (KORA) has been examining the health of thousands of citizens in Augsburg and environs. The aim of the project is to increase understanding of the impact of environmental factors, behaviour and genes on human health. The KORA studies focus on matters relating to the development and progression of chronic diseases, in particular myocardial infarction and diabetes mellitus. To that end, research is conducted into risk factors arising from lifestyle factors (including smoking, diet and exercise), environmental factors (including air pollution and noise) and genetics. Questions relating to the use and cost of health services are examined from the point of view of health services research. http://www.helmholtz-muenchen.de/kora

Background:

The stability of high levels of SWB in spite of age-related ailments and/or the social losses of aging has also been coined "the age paradox". Further studies are needed in order to examine the apparent discrepancy between actual (high) biological age and subjectively experienced (high) levels of well-being, and to identify the resources that enable people to maintain a positive attitude towards life, despite declining health and dwindling social contacts.



Thursday, July 6, 2017

High doses of vitamin D reduce swelling, inflammation from sunburn,


High doses of vitamin D taken one hour after sunburn significantly reduce skin redness, swelling, and inflammation, according to double-blinded, placebo-controlled clinical trial out of Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. The trial results were recently published in the Journal of Investigative Dermatology.

In the study, 20 participants were randomized to receive a placebo pill or 50,000, 100,000, or 200,000 IU of vitamin D one hour after a small UV lamp "sunburn" on their inner arm. Researchers followed up with the participants 24, 48, 72 hours and 1 week after the experiment and collected skin biopsies for further testing. Participants who consumed the highest doses of vitamin D had long-lasting benefits -- including less skin inflammation 48 hours after the burn. Participants with the highest blood levels of vitamin D also had less skin redness and a jump in gene activity related to skin barrier repair.

"We found benefits from vitamin D were dose-dependent," said Kurt Lu, MD, senior author on the study and Assistant Professor of Dermatology at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. "We hypothesize that vitamin D helps promote protective barriers in the skin by rapidly reducing inflammation. What we did not expect was that at a certain dose, vitamin D not only was capable of suppressing inflammation, it was also activating skin repair genes."

The trial is the first to describe acute anti-inflammatory benefits from taking vitamin D. According to the authors, despite widespread attention given to vitamin D deficiency, "there is a lack of evidence demonstrating that intervention with vitamin D is capable of resolving acute inflammation." By measuring gene activity in the biopsies, the researchers also uncovered a potential mechanism behind how vitamin D aids skin repair. The results suggest vitamin D increases skin levels of an anti-inflammatory enzyme, arginase-1. The enzyme enhances tissue repair after damage and helps activate other anti-inflammatory proteins.

The study may have people flocking to vitamin supplement aisles, but Lu stresses that the trial tested very high doses of vitamin D that far exceed daily allowances. The Food and Drug Administration's recommended adult daily allowance for vitamin D is 400 IU. Said Lu, "I would not recommend at this moment that people start taking vitamin D after sunburn based on this study alone. But, the results are promising and worthy of further study." Lu and colleagues are planning additional studies that could inform treatment plans for burn patients.



Falls lead to declines in seniors


More than half of elderly patients (age 65 and older) who visited an emergency department because of injuries sustained in a fall suffered adverse events -- including additional falls, hospitalization and death -- within 6 months. The results of a study examining how risk factors predict recurrent falls and adverse events were published online yesterday in Annals of Emergency Medicine ("Revisit, Subsequent Hospitalization, Recurrent Fall and Death within 6 Months after a Fall among Elderly Emergency Department Patients").

"Our study shows an even higher rate of adverse events than previous studies have," said lead study author Jiraporn Sri-on, MD, of Navamindradhiraj University in Bangkok, Thailand. "Patients taking psychiatric and/or sedative medications had even more adverse events. This is concerning because these types of drugs are commonly prescribed for elderly patients in community and residential care settings."

Of patients who visited the emergency department for injuries sustained in a fall, 7.7 percent developed adverse events within 7 days, 21.4 percent developed adverse events within 30 days and 50.3 percent developed adverse events within 6 months. Within 6 months, 22.6 percent had at least one additional fall, 42.6 percent revisited the emergency department, 31.1 percent had subsequent hospitalization and 2.6 percent had died.

Risk factors associated with adverse events within 6 months of an emergency department visit for a fall included diabetes, polypharmacy (five or more medications), and psychiatric and/or sedative medications.

"Emergency physicians have a tremendous opportunity to reduce the very high adverse event rate among older emergency patients who have fallen," said Dr. Sri-on. "Fall guidelines exist and work needs to be done to increase their implementation in emergency departments so patients can be educated on how not to fall again once they have been discharged from the emergency department."

Wednesday, July 5, 2017

Lutein from brightly colored vegetables and fruits can suppress inflammation,


Lutein, a nutrient found in several highly colored vegetables and fruits, can suppress inflammation, according to a new study by researchers at Linkoping University, Sweden. The results, published in Atherosclerosis, suggest that lutein itself has anti-inflammatory effects in patients with coronary artery disease.

Inflammation is a key factor in many types of coronary artery disease, such as myocardial infarction and angina.

"A considerable number of patients who have experienced myocardial infarction still have low-level chronic inflammation in the body, even after receiving effective treatment with revascularisation, drugs and lifestyle changes. We know that chronic inflammation is associated with a poorer prognosis," says Lena Jonasson, professor in the Department of Medical and Health Sciences and consultant in cardiology, who has led the study.

Previous research has suggested that our diet influences inflammatory processes in the body. One group of substances that may be interesting are the carotenoids, a large family of fat-soluble natural colouring agents found in plants. Beta-carotene and lycopene are among the more well-known substances in the family. Several previous studies have shown that the levels of carotenoids are inversely correlated with inflammation markers. The question has thus arisen whether carotenoids themselves have anti-inflammatory effects.

Most previous studies into the relationship between carotenoids and inflammation have been carried out on animals or healthy human volunteers. However, the cells of the immune system in people with low-level inflammation are more prone to stimulation, and may react differently than the corresponding cells in healthy people. The researchers who carried out the new study, therefore, wanted to investigate whether carotenoid has anti-inflammatory effects in patients with coronary artery disease.

"Our study confirms that one particular carotenoid, lutein, can suppress long-term inflammation in patients with coronary artery disease. We have also shown that lutein is absorbed and stored by the cells of the immune system in the blood," says Rosanna Chung, postdoc at the Department of Medical and Health Sciences at Linkoping University.

The researchers started by measuring the levels of the six most common carotenoids in blood from 193 patients with coronary artery disease. At the same time, they measured the level of inflammation in the blood using the inflammatory marker interleukin-6, IL-6. Lutein was the only carotenoid whose level was correlated with IL-6. The higher the level of lutein in the blood, the lower the level of IL-6.

"The patients were receiving the best possible treatment for their disease according to clinical guidelines, but even so, many of them had a persistent inflammation. At the same time, the patients had lower levels of lutein," says Lena Jonasson.

This led the researchers to investigate whether lutein can influence the cells in the blood that are involved in inflammatory processes. They collected cells of the immune system from blood from patients with coronary artery disease. They found that the inflammatory activity of the cells became significantly lower when they were treated with lutein.

The researchers now plan to investigate whether increased intake of food rich in lutein has a positive effect on the immune system in patients with coronary artery disease. Vegetables with dark-green leaves, such as spinach, are particularly rich in lutein.


Monday, July 3, 2017

Mediterranean diet colorectal protection: fish and fruit, and cutting back on soft drinks most important


The benefits of a "Mediterranean diet" (MD) are well-known when it comes to colorectal protection, but it's hard to know specifically what elements of the diet are the healthiest.

Now a new study, presented today at the ESMO 19th World Congress on Gastrointestinal Cancer suggests loading up on fish and fruit, and cutting back on soft drinks are the three most important things.

"We found that each one of these three choices was associated with a little more than 30% reduced odds of a person having an advanced, pre-cancerous colorectal lesion, compared to people who did not eat any of the MD components. Among people who made all three healthy choices the benefit was compounded to almost 86% reduced odds," said Naomi Fliss Isakov, PhD fromTel-Aviv Medical Center, in Tel Aviv, Israel.

Colorectal cancer (CRC) develops from intestinal polyps and has been linked to a low-fibre diet heavy on red meat, alcohol and high-calorie foods, said Fliss Isakov.

And while the Mediterranean diet has been associated with lower rates of colorectal cancer, the definition of what elements in the diet are the most beneficial, has not always been clear.

Using dietary questionnaires from 808 people who were undergoing screening or diagnostic colonoscopies, the research team was able to dig down to look at the fine details of their daily meals.

All subjects were between 40 and 70 years old, without high risk of CRC, and answered a food frequency questionnaire.

Adherence to the MD components was defined as consumption levels above the group median for fruits, vegetables and legumes, nuts and seeds, whole grains, fish and poultry and a high ratio of monounsaturated to saturated fatty acids, as well consumption below the median of red meat, alcohol, and soft drinks.

The investigators found that compared to subjects with clear colonoscopies, those who had advanced polyps reported fewer components of the Mediterranean diet (a mean of 1.9 versus 4.5 components). Yet even consumption of two to three components of the diet, compared to none, was associated with half the odds of advanced polyps.

Odds were reduced in a dose response manner with additional MD components - meaning that the more MD components people adhered, the lower their odds of having advanced colorectal polyps.

After adjusting to account for other CRC risk factors, including other dietary components, the researchers narrowed in on high fish and fruit and low soft drinks as the best combo for reduced odds of advanced colorectal polyps.

The next step will be to see whether the MD is linked to lower risk of CRC in higher risk groups, she concluded.

Commenting on the study, ESMO spokesperson Dirk Arnold, MD, PhD, from Instituto CUF de Oncologia in Lisbon, Portugal, said "this large population-based cohort-control study impressively confirms the hypothesis of an association of colorectal polyps with diets and other life-style factors. This stands in line with other very recent findings on nutritive effects, such as the potential protective effects of nut consumption and Vitamin D supplementation which have been shown earlier this year. However, it remains to be seen whether these results are associated with reduced mortality, and it is also unclear if, and when a dietary change would be beneficial. Despite this lack of information, it makes sense to consider this diet for other health-related reasons also."