Healthy arteries may be possible with aging

Having the blood vessels of a healthy 20-year-old into one's 70s is possible but difficult in Western culture, according to new research in the American Heart Association's journal Hypertension.

"For the most part, it's not genetic factors that stiffen the body's network of blood vessels during aging. Modifiable lifestyle factors -- like those identified in the American Heart Association's Life's Simple 7 -- are the leading culprits," said study author Teemu J. Niiranen, M.D., research fellow at Boston University School of Medicine, Framingham Heart Study, Framingham, Massachusetts.

"Vascular aging is thought of as normal aging. As people get older, their arteries become stiffer and they develop high blood pressure. In fact, that's what happens to most people beyond age 70. But it doesn't have to happen," Niiranen said.

Niiranen and colleagues studied 3,196 adults ages 50 and older from the Framingham Heart Study. They defined healthy vascular aging for people 50 years old or older as having both normal blood pressure and pulse-wave velocity near the level of healthy people age 30 or younger. Pulse-wave velocity is a measurement of stiffness in the blood vessels.

Researchers found that overall, 566 (17.7 percent) of the participants studied had healthy vascular aging. The group most likely to have healthy vascular aging was the youngest. More than 30 percent of those 50 to 59 years old in the sample met the standards for healthy vascular aging. Only 1 percent of those 70 and older had healthy vascular aging, and they were more likely to be women.

The most important factors of achieving healthy vascular function were staying lean, or having a low body mass index, and avoiding diabetes, according to Niiranen.

The other lifestyle measures, such as maintaining favorable cholesterol levels, also came into play, according to Niiranen. In fact, the researchers found that those who achieved six out of seven of the American Heart Association's Life Simple 7 healthy heart goals were 10 times more likely to achieve healthy vascular aging than those who achieved zero to one of the measures.

The researchers also found that people with healthy vascular aging were at a 55 percent lower risk of developing cardiovascular disease, according to Niiranen.

"Western culture that includes poor diets and sedentary lifestyles is a hurdle for maintaining healthy blood vessels. Age-associated high blood pressure, for example, is not common in indigenous hunter-gatherer populations," according to Niiranen.

"Unfortunately, there is still no magic pill that helps achieve healthy vascular aging. Achieving Life's Simple 7 increases the odds of keeping healthy blood vessels even into old age," he said. "For the population's health, healthy vascular aging should be considered a universal goal."

Rutgers study indicates that washing for 10 seconds eliminates harmful bacteria

We all know that washing our hands can keep us from spreading germs and getting sick. But a new Rutgers-New Brunswick study found that cool water removes the same amount of harmful bacteria as hot.

"People need to feel comfortable when they are washing their hands but as far as effectiveness, this study shows us that the temperature of the water used didn't matter," said Donald Schaffner, distinguished professor and extension specialist in food science.

In the Rutgers study, published in the June issue of the Journal of Food Protection, high levels of a harmless bacteria were put on the hands of 21 participants multiple times over a six-month period before they were asked to wash their hands in 60-degree, 79-degree or 100-degree water temperatures using 0.5 ml, 1 ml or 2 ml volumes of soap.

"This study may have significant implications towards water energy, since using cold water saves more energy than warm or hot water," said Schaffner. "Also we learned even washing for 10 seconds significantly removed bacteria from the hands."

While the study indicates that there is no difference between the amount of soap used, more work needs to be done to understand exactly how much and what type of soap is needed to remove harmful microbes from hands, said co-author Jim Arbogast, vice president of Hygiene Sciences and Public Health Advancements for GOJO. "This is important because the biggest public health need is to increase handwashing or hand sanitizing by foodservice workers and the public before eating, preparing food and after using the restroom," Arbogast said.

These findings are significant, particularly to the restaurant and food industry, because the U.S. Food and Drug Administration issues guidelines, every four years, to states. Those guidelines currently recommend that plumbing systems at food establishments and restaurants deliver water at 100 degrees Fahrenheit for handwashing.

Schaffner said the issue of water temperature has been debated for a number of years without enough science to back-up any recommendation to change the policy guidelines or provide proof that water temperature makes a difference in hand hygiene. Many states, in fact, interpret the FDA guidelines as a requirement that water temperature for handwashing must be 100 degrees, he said.

The FDA is scheduled to hold a conference in 2018 to discuss the existing code and any modifications that should be made and Schaffner would like to see the water temperature policy revised at that time.

"I think this study indicates that there should be a policy change," said Schaffner. "Instead of having a temperature requirement, the policy should only say that comfortable or warm water needs to be delivered. We are wasting energy to heat water to a level that is not necessary."

Awareness, adherence key to improved osteoporosis care

According to the National Center for Biotechnology Information, approximately 1.5 million Americans suffer osteoporosis-related fractures each year. Although comprehensive care for fragility fractures is available to patients, their understanding of risk factors, treatment adherence and the use of preventive screening remains low. Researchers at the University of Missouri School of Medicine reviewed recent osteoporosis treatment and management options with the goal of preventing complications from the disease.

"A fracture is the only true symptom of osteoporosis, and typically, that's how the disease is diagnosed," said Brett Crist, M.D., associate professor of orthopaedic surgery at the MU School of Medicine and senior author of the review. "Knowing risk factors - age, gender and family history - allows us to screen for osteoporosis and prevent complications. However, in our review, we found that preventable complications, such as secondary fractures, are more common than they should be. The reality is that death and disability associated with osteoporosis affect more people than most cancers. Previous research shows that the mortality rate for the elderly is 30 percent up to one year following a hip fracture."

Crist, who also serves as an orthopaedic trauma surgeon at MU Health Care, said that several factors can lead to preventable secondary fractures.

"The use of preventive screening for osteoporosis is low," Crist said. "The risk of decreased bone density starts at age 50, so it's appropriate to start screening patients then to maximize the benefit and cost-effectiveness of fracture prevention. However, less than 27 percent of patients ages 65 to 79 are screened for the disease. Screening rates are even lower for both younger and older patient populations. Screening methods should include questionnaires and available tests for measuring bone density, such as a DEXA scan."

Medication cost is another factor that can inhibit osteoporosis care. Although newer medications that require fewer doses and have fewer side effects are available, their use is relatively low because of their cost.

"Getting patients to follow their care plan sometimes can be a challenge, especially when it comes to prescribed medications," Crist said. "Cost is definitely a factor. For example, a newer medication called Teriparatide increases bone density in patients with osteoporosis. However, a month's supply of this medication without insurance costs about $3,000. The more cost-effective drugs often carry greater side effects and a more difficult dosing regimen."

Calcium and Vitamin D are commonly prescribed for the treatment and management of osteoporosis. However, recent studies have called into question their effectiveness.

"These supplements are relatively inexpensive, over-the-counter treatment options," Crist said. "For those reasons, patients tend to take them as suggested by their physician. However, some studies question the benefits of calcium supplements and suggest they may have unwanted side effects in some patients. More research is definitely needed in the area of calcium supplementation as a treatment option."

Ultimately, Crist said that physicians need to have conversations with their patients about recent advances in osteoporosis treatment and management.

"Patients sometimes view osteoporosis as part of the normal aging process," Crist said. "However, they take a significant risk if they don't fully understand the consequences of their diagnosis. The development of an interdisciplinary care plan that meets the expectations and needs of the patient is the goal."

The review, "Osteoporosis: A Discussion on the Past 5 Years," recently was published in Current Reviews in Musculoskeletal Medicine.

Vitamin D in pregnancy may help prevent childhood asthma

A new study published today in the Journal of Allergy and Clinical Immunology has found that taking Vitamin D supplements in pregnancy can positively modify the immune system of the newborn baby, which could help to protect against asthma and respiratory infections, a known risk factor for developing asthma in childhood.

The team of researchers from King's College London looked at the effect that taking a supplement of 4,400 IU vitamin D3 per day during the second and third trimesters of pregnancy versus the recommended daily intake (RDI) of 400 IU/day, had on the immune system of the newborn.

Participants were randomised at 10 - 18 weeks of pregnancy to high or low doses of vitamin D supplements. The team then took umbilical cord bloods from 51 pregnant women to test the responsiveness of the newborn's innate immune system, which form the body's first line of defence to infection, and T lymphocyte responses, which provide longer-lasting protection.

They found that blood samples from babies born to mothers supplemented with higher vitamin D3 responded to mimics of pathogen stimulation by greater innate cytokine responses and greater IL-17A production in response to T lymphocyte stimulation. Both types of response are predicted to improve neonatal defence to infection. Given the evidence for strong immune responses in early life being associated with decreased development of asthma, the team believe the effect will likely lead to improved respiratory health in childhood.

"The majority of all asthma cases are diagnosed in early childhood implying that the origin of the disease stems in foetal and early life," said lead researcher, Professor Catherine Hawrylowicz from King's College London.

"Studies to date that have investigated links between vitamin D and immunity in the baby have been observational. For the first time, we have shown that higher Vitamin D levels in pregnancy can effectively alter the immune response of the newborn baby, which could help to protect the child from developing asthma. Future studies should look at the long-term impact on the immunity of the infant."

Dr Samantha Walker, Director of Research and Policy at Asthma UK, said "Vitamin D is a promising area of research for asthma, however this study is just the first step of many needed to explore this topic. Although this study shows that vitamin D supplementation in pregnancy may improve immune responses, much more research is needed to prove whether this does in fact lead to reduced asthma rates later in life.

Statins associated with improved heart structure and function

 Statins are associated with improved heart structure and function, according to research presented today at EuroCMR 2017.1 The benefits were above and beyond the cholesterol lowering effect of statins.

"Statins are primarily used to lower cholesterol," said lead author Dr Nay Aung, a cardiologist and Wellcome Trust research fellow, William Harvey Research Institute, Queen Mary University of London, UK. "They are highly effective in preventing cardiovascular events in patients who have had a heart attack or are at risk of heart disease."

He continued: "Statins have other beneficial, non-cholesterol lowering, effects. They can improve the function of the blood vessels, reduce inflammation, and stabilise fatty plaques in the blood vessels. Studies in mice and small studies in humans have shown that statins also reduce the thickness of heart muscle but this needed to be confirmed in a larger study."

This study investigated the association between statins and heart structure and function. The study included 4,622 people without cardiovascular disease from the UK Biobank, a large community-based cohort study. Cardiac magnetic resonance imaging was used to measure left and right ventricular volumes and left ventricular mass. Information on statin use was obtained from medical records and a self-reporting questionnaire.

The relationship between statin use and heart structure and function was assessed using a statistical technique called multiple regression which adjusts for potential confounders that can have an effect on the heart such as ethnicity, gender, age, and body mass index (BMI).

Nearly 17% of participants were taking statins. Those taking statins were older, had higher BMI and blood pressure, and were more likely to have diabetes and hypertension. "This was not surprising because we prescribe statins to patients at high risk of heart disease and these are all known risk factors," said Dr Aung.

Patients taking statins had a 2.4% lower left ventricular mass and lower left and right ventricular volumes. Dr Aung said: "People using statins were less likely to have a thickened heart muscle (left ventricular hypertrophy) and less likely to have a large heart chamber. Having a thick, large heart is a strong predictor of future heart attack, heart failure or stroke and taking statins appears to reverse the negative changes in the heart which, in turn, could lower the risk of adverse outcomes."

"It is important to note that in our study, the people taking statins were at higher risk of having heart problems than those not using statins yet they still had positive heart remodelling compared to the healthier control group," added Dr Aung.

In terms of how statins might reduce the thickness and volume of the heart, Dr Aung said several studies have demonstrated that statins reduce oxidative stress and dampen the production of growth factors which stimulate cell growth. Statins also increase the production of nitric oxide by the cells lining the blood vessels, leading to vasodilatation, improved blood flow, lower blood pressure, and lower stress on the heart, which is less likely to become hypertrophied.

The findings raise the issue of extending statin prescriptions to anyone above the age of 40, but Dr Aung said that was probably not the way to go.

"There are clear guidelines on who should receive statins," he said. "There is debate about whether we should lower the bar and the question is when do you stop. What we found is that for patients already taking statins, there are beneficial effects beyond cholesterol lowering and that's a good thing. But instead of a blanket prescription we need to identify people most likely to benefit - i.e. personalised medicine."

Dr Aung said: "A dual approach should be considered to identify people who will benefit most from statins. That means looking at not only clinical risk factors such as smoking and high blood pressure, but also genetic (hereditary) factors which can predict individuals' response to statins. This is an area of growing interest and one that we are also investigating in our lab with our collaborators."

Health benefits of moderate drinking may be overstated

The benefits of light alcohol consumption, as well as the risks associated with not drinking at all, might not be as great as previously thought, according to Penn State researchers who examined the drinking habits of middle-aged adults.

The researchers analyzed information about more than 9,000 people across England, Scotland and Wales born in 1958 who are participating in the longitudinal National Child Development Study. The study, based at the University College London Centre for Longitudinal Studies, tracked changes in people's drinking and cigarette smoking habits from age 23 to 55, and linked these changes to mental and physical health.

About one third of men and women who reported drinking at the light-to-moderate level were very unlikely to smoke. While this group of light drinkers and non-smokers enjoyed the best health and quality of life in middle age, three other groups experienced more health problems. These groups were those who drank lightly to moderately but also smoked; those who both drank more heavily and smoked; and those who refrained from drinking alcohol or reduced their drinking over time.

Light-to-moderate drinkers were defined as adults who consumed no more than 14 units of alcohol, which is equivalent to roughly six pints of beer or six medium-sized glasses of wine, per week. This is the current maximum recommended for men and women by the United Kingdom's Department of Health, according to Jeremy Staff, professor of criminology and sociology at Penn State and the study's lead author.

While the supposed benefits of moderate drinking have been widely reported in the media, many reports have failed to take into account other risk factors. For example, light-to-moderate drinkers suffered poor health in midlife if they were former smokers or still had the occasional cigarette. This may be due to a direct effect of smoking or because of other lifestyle-related risks, such as lack of exercise or obesity. Many midlife abstainers also began their adult life in poorer physical or mental health than peers who had completely abstained from alcohol.

"Alcohol abstainers are a diverse group. They include former heavy drinkers who quit due to problems with alcohol, as well as those who quit drinking due to poor health, and not just lifetime abstainers," said Staff. "Medical professionals and public health officials should be wary of drawing conclusions about the so-called 'dangers' of never drinking without more robust evidence."

About 1-in-5 members of 55-year-olds who said they had never drunk alcohol in their lives had previously reported drinking when they were younger. This suggests that those who drink very little may tend to misremember or under-report previous drinking habits. When studies include this group as lifetime abstainers, apparent 'harms' of abstaining may be overestimated, said the researchers.

While modest drinking habits also have been linked with higher levels of education, those with few or no educational qualifications were also among those who did not drink or drank modestly. On the other hand, men and women with the highest educational qualifications at age 23 were more likely than their peers to drink at light-to-moderate rates throughout their adult lives, and were unlikely to smoke.

Jennifer Maggs, professor of human development and family studies at Penn State and another of the study's authors, added, "Evidence continues to grow that alcohol has many health risks, including for cancer. Therefore, it is dangerous to report only benefits of moderate alcohol consumption. Drinking habits are also shaped by our education, health earlier in life, and related lifestyle factors including smoking. These other influences may be the real factors underlying the connection between drinking and midlife health."

According to Sir Ian Gilmore, Chair of the Alcohol Health Alliance in the UK, "This study provides yet more evidence that any benefits associated with drinking alcohol are smaller than previously thought. The most effective ways to reduce harms associated with alcohol consumption are to introduce pricing measures linked to alcohol sales, and enable more informed choices through public education efforts and mandatory labeling of alcohol products."

Just one alcoholic drink a day increases breast cancer risk, exercise lowers risk

Drinking just one glass of wine or other alcoholic drink a day increases breast cancer risk, finds a major new report by the American Institute for Cancer Research (AICR) and the World Cancer Research Fund (WCRF).

The report also revealed, for the first time, that vigorous exercise such as running or fast bicycling decreases the risk of both pre- and post-menopausal breast cancers. Strong evidence confirmed an earlier finding that moderate exercise decreases the risk of post-menopausal breast cancer, the most common type of breast cancer.

"It can be confusing with single studies when the findings get swept back and forth," said Anne McTiernan, MD, PhD, a lead author of the report and cancer prevention expert at the Fred Hutchinson Cancer Research Center.

"With this comprehensive and up-to-date report the evidence is clear: Having a physically active lifestyle, maintaining a healthy weight throughout life and limiting alcohol -- these are all steps women can take to lower their risk."

Brisk Walking, Alcohol and Breastfeeding

Diet, Nutrition, Physical Activity and Breast Cancer systematically collated and evaluated the scientific research worldwide on how diet, weight and exercise affect breast cancer risk in the first such review since 2010. The report analyzed 119 studies, including data on 12 million women and 260,000 cases of breast cancer.

The report found strong evidence that drinking the equivalent of a small glass of wine or beer a day (about 10 grams alcohol content) increases pre-menopausal breast cancer risk by 5 percent and post-menopausal breast cancer risk by 9 percent. A standard drink is 14 grams of alcohol.

For vigorous exercise, pre-menopausal women who were the most active had a 17 percent lower risk and post-menopausal women had a 10 percent lower risk of developing breast cancer compared to those who were the least active. Total moderate activity, such as walking and gardening, linked to a 13 percent lower risk when comparing the most versus least active women.

In addition the report showed that:

Being overweight or obese increases the risk of post-menopausal breast cancer, the most common type of breast cancer.
Mothers who breastfeed are at lower risk for breast cancer.
Greater adult weight gain increases risk of post-menopausal breast cancer.
Breast cancer is the most common cancer in US women with over 252,000 new cases estimated this year. AICR estimates that one in three breast cancer cases in the U.S. could be prevented if women did not drink alcohol, were physically active and stayed a healthy weight.

Emerging Findings: Dairy and Veggies

The report points to links between diet and breast cancer risk. There was some evidence -- although limited -- that non-starchy vegetables lowers risk for estrogen-receptor (ER) negative breast cancers, a less common but more challenging to treat type of tumor.

Limited evidence also links dairy, diets high in calcium and foods containing carotenoids to lowering risk of some breast cancers. Carrots, apricots, spinach and kale are all foods high in carotenoids, a group of phytonutrients studied for their health benefits.

These links are intriguing but more research is needed, says McTiernan. "The findings indicate that women may get some benefit from including more non-starchy vegetables with high variety, including foods that contain carotenoids," she said. "That can also help avoid the common 1 to 2 pounds women are gaining every year, which is key for lowering cancer risk."

Steps Women Can Take

Aside from these lifestyle risk factors, other established causes of breast cancer include being older, early menstrual period and having a family history of breast cancer.

While there are many factors that women cannot control, says Alice Bender, MS, RDN, AICR's Head of Nutrition Programs, the good news from this report is that all women can take steps to lower their breast cancer risk.

"Wherever you are with physical activity, try to nudge it up a bit, either a little longer or a little harder. Make simple food shifts to boost protection -- substitute veggies like carrots, bell peppers or green salad for chips and crackers and if you drink alcohol, stick to a single drink or less," said Bender.

"There are no guarantees when it comes to cancer, but it's empowering to know you can do something to lower your risk."

Recommended daily protein intake too low for the elderly

You can find the recommended dietary allowance (RDA) on the nutrition labels of all your processed food. Food manufacturers are obliged to list the nutritional value of their products, and therefore must mention the percent daily value of the RDA their product meets for certain nutrients.

These RDA guidelines are put together by the Food and Nutrition Board of the National Academy of Sciences' Institute of Medicine. They inform you how much of a specific nutrient your body minimally needs every day. They are set to meet the requirements of 97.5% of the healthy individuals older than 19 years.

The RDA you will find on the nutrition labels on your food, however, were set in 1968, and the ones used by researchers and professionals were set in 2003. A recent review published in Frontiers in Nutrition points out that both these values do not do justice to the protein needs of the elderly and critically ill.

"A big disservice is being done. The prescribed 0.8 g/kg/day just isn't enough protein for the elderly and people with a clinical condition. This shouldn't be communicated as what is 'allowed' or even 'recommended' to eat.", author Stuart Phillips of McMaster University in Canada explains.

In his review, he points out that the quality of proteins should be considered when setting the RDA guidelines and recommending protein supplements. He argues that there should be a stronger focus on leucine; an indispensable amino acid and building block for proteins. The elderly have a higher need for leucine to build muscle proteins, and milk-based proteins (e.g. milk and whey) are a good source for this.

Moreover, it may be highly beneficial for the critically ill patients that rapidly lose lean body mass (i.e. the body weight minus body fat) to increase their protein intake. Again, elderly ill patients would benefit the most from this. "I think it's clear we need some longer-term clinical trials with older people on higher protein intakes. These trials need to consist of around 400 - 500 people.", Phillips argues.

He is not the first researcher to challenge the current protein RDA, and hopes his message does not fall on deaf ears. That is also why he chose to publish Open Access: "I love to publish work that everyone can read. The days of publishing a paper that only people in academic institutions can read are over. I think it is essential that everyone and not only your scientific colleagues can read the work we do."

At his own dinner table, Phillips also puts the focus on proteins. "But not at the expense of other macronutrients. I enjoy a variety of foods, and the only thing I specifically focus on is limiting my intake of sugar and refined carbohydrates. But of course, given the benefits of proteins, they are a big part of what I think about when planning my meals."

Rethinking exercise: Replace punishing workouts with movement that makes you happy

Many women start fitness programs to lose weight, and when they don't, they feel like failures and stop exercising.

And then, months or a year later, they do the same thing again--creating a vicious cycle that fails to consider what might be leading to short-term motivation, says Michelle Segar, director of the University of Michigan's Sport, Health, and Activity Research and Policy Center.

In a new study funded internally by the National Cancer Institute, Segar and co-investigators analyzed what women say makes them feel happy and successful, and how their expectations and beliefs about exercise foster or undermine those things.

"A new understanding of what really motivates women might make an enormous difference in their ability to successfully incorporate physical activity into their daily routine--and have fun doing it," said Segar, who is also a researcher at the U-M Institute for Research on Women and Gender.

The findings, which will appear in the journal BMC Public Health, show that both active and inactive women report the same ingredients for feeling happy and successful:

Connecting with and helping others be happy and successful.

Being relaxed and free of pressures during their leisure time. Accomplishing goals of many sorts (from grocery shopping to career goals).

But the study also found that for inactive women, their beliefs and expectations about exercise actually thwarted the things that make them feel happy and successful:

They believe "valid" exercise must be intense, yet they want to feel relaxed during their leisure time.

They feel pressured to exercise for health or to lose weight, yet during their leisure time they want to be free of pressures. Success comes from achieving goals, yet their expectations about how much, where and how they should be exercising means they can't achieve these goals.

"The direct conflict between what these low-active women believe they should be doing when they exercise, and their desire to decompress and renew themselves during leisure time, demotivates them," Segar said. "Their beliefs about what exercise should consist of and their past negative experiences about what it feels like actually prevents them from successfully adopting and sustaining physically active lives."

Segar and co-investigators Jennifer Taber, Heather Patrick, Chan Thai and April Oh conducted eight focus groups among white, black and Hispanic women aged 22-49 who were either categorized as "high active" or "low active."

While the findings about happiness and success seemed to hold true for both groups in the different demographics, low-active women held distinctly different views than high-active women about exercising.

"We've all been socialized to exercise and be physically active for the last 30 years," said Segar. "The traditional recommendation we've learned to believe is that we should exercise at a high intensity for at least 30 minutes, for the purpose of losing weight or improving our health. Even though there are newer recommendations that permit lower intensity activity in shorter durations most people don't know or even believe it."

This more traditional message has worked for a small minority of the population, but more generally it has failed to increase population physical activity, she says.

"This traditional approach to exercising might actually harm exercise motivation. Our study shows that this exercise message conflicts with and undermines the very experiences and goals most women have for themselves," she said.

The exceptions found in the study were among the more active participants, who held more flexible views of exercise. They expressed that it "was not the end of the world" if they had to skip exercising once in awhile. They made exercise more of a "middle priority," which took the pressure off and left room for compromise when schedules and responsibilities did not permit planned exercise to occur.

The high-active women seemed to have more positive feelings from exercising, in contrast to most of the low-active women, who, in general, tended to dread the very idea of it.

"There are important implications from this study on how we can help women better prioritize exercise in their day-to-day life," Segar said. "We need to re-educate women they can move in ways that will renew instead of exhaust them, and more effectively get the message across that any movement is better than nothing. To increase motivation to be physically active, we need to help women to want to exercise instead of feeling like they should do it."

This can be achieved by:

• Re-educating women that movement can and should feel good to do.
• Promoting physical activity as a way to connect with important others.
• Reframing physical activity as a vehicle that helps women renew and re-energize themselves to better succeed at their daily roles and goals.
• Explain physical activity as a broad continuum that counts all movement as valid and worth doing.

Probiotics may relieve symptoms of depression

Probiotics may relieve symptoms of depression, as well as help gastrointestinal upset, research from McMaster University has found.

In a study published in the medical journal Gastroenterology (May 2), researchers of the Farncombe Family Digestive Health Research Institute found that twice as many adults with irritable bowel syndrome (IBS) reported improvements from co-existing depression when they took a specific probiotic than adults with IBS who took a placebo.

The study provides further evidence of the microbiota environment in the intestines being in direct communication with the brain said senior author Dr. Premysl Bercik, an associate professor of medicine at McMaster and a gastroenterologist for Hamilton Health Sciences.

"This study shows that consumption of a specific probiotic can improve both gut symptoms and psychological issues in IBS. This opens new avenues not only for the treatment of patients with functional bowel disorders but also for patients with primary psychiatric diseases," he said.

IBS is the most common gastrointestinal disorder in the world, and is highly prevalent in Canada. It affects the large intestine and patients suffer from abdominal pain and altered bowel habits like diarrhea and constipation. They are also frequently affected by chronic anxiety or depression.

The pilot study involved 44 adults with IBS and mild to moderate anxiety or depression. They were followed for 10 weeks, as half took a daily dose of the probiotic Bifidobacterium longum NCC3001, while the others had a placebo.

At six weeks, 14 of 22, or 64%, of the patients taking the probiotic had decreased depression scores, compared to seven of 22 (or 32%) of patients given placebo.

Functional Magnetic Resonance Imaging (fMRI) showed that the improvement in depression scores was associated with changes in multiple brain areas involved in mood control.

"This is the result of a decade long journey - from identifying the probiotic, testing it in preclinical models and investigating the pathways through which the signals from the gut reach the brain," said Bercik.

"The results of this pilot study are very promising but they have to be confirmed in a future, larger scale trial," said Dr. Maria Pinto Sanchez, the first author and a McMaster clinical research fellow.

The study was performed in collaboration with scientists from Nestlé.

No benefit from statin for primary cardiovascular prevention in older adults

Analysis of data from older adults who participated in a clinical trial showed no benefit of a statin for all-cause mortality or coronary heart disease events when a statin was started for primary prevention in older adults with hypertension and moderately high cholesterol, according to a new article published by JAMA Internal Medicine.

Many older patients take statins for primary cardiovascular prevention but data are limited on the risks and benefits of statins for primary prevention in this age group. Improving the understanding of preventive interventions in older patients has implications for health care and its costs.

Benjamin H. Han, M.D., M.P.H., of the New York University School of Medicine, and coauthors analyzed data from older adults in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT), which was conducted from 1994 to 2002.

The authors used an analytical sample that included 2,867 adults with hypertension but without baseline atherosclerotic cardiovascular disease (plaque build-up in the arteries). Of the 2,867 adults, 1,467 were in the pravastatin sodium group (40 mg per day) and 1,400 received usual care from their primary care physician to lower cholesterol.

The authors report no benefit of pravastatin for the main outcome of all-cause mortality or secondary outcomes of coronary heart disease events and cause-specific mortality. More deaths occurred in the pravastatin group than in the usual care group (141 vs. 130) among adults 65 to 74 and among adults 75 and older (92 vs. 65). There were 76 CHD events in the pravastatin group compared with 89 in the usual care group among adults 65 to 74 and 31 CHD events compared with 39 among adults 75 and older, according to the results. Stroke, heart failure and cancer rates were similar in the two treatment groups for both age groups.

Authors note limitations of the current study, which include its design as a post hoc secondary analysis of a trial of a subgroup of patients.

"No benefit was found when a statin was given for primary prevention to older adults. Treatment recommendations should be individualized for this population," the article concludes.

Moderate drinking may not ward off heart disease

Many people believe that having a glass of wine with dinner--or moderately drinking any kind of alcohol--will protect them from heart disease. But a hard look at the evidence finds little support for that.

That's the conclusion of a new research review in the May 2017 issue of the Journal of Studies on Alcohol and Drugs.

Over the years, studies have found that adults who drink moderately have lower heart disease rates than non-drinkers. That has spurred the widespread belief that alcohol, in moderation, does a heart good.

But the new analysis, of 45 previous cohort studies, reveals the flaws in that assumption: A central issue is that "non-drinkers" may, in fact, be former drinkers who quit or cut down for health reasons.

Furthermore, seniors who are healthy may be more likely to keep enjoying that glass of wine with dinner.

"We know that people generally cut down on drinking as they age, especially if they have health problems," said researcher Tim Stockwell, Ph.D., director of the Centre for Addictions Research at the University of Victoria, in British Columbia, Canada.

"People who continue to be moderate drinkers later in life are healthier," Stockwell said. "They're not sick, or taking medications that can interact with alcohol."

And in studies, that can lead to a misleading association between moderate drinking and better health.

In their analysis, Stockwell's team found that overall, "current" moderate drinkers (up to two drinks per day) did, in fact, have a lower rate of heart disease death than non-drinkers.

However, that was not the case in studies that looked at people's drinking habits at relatively young ages -- age 55 or earlier -- and followed them to their older years when heart disease might strike. Similarly, studies that rigorously accounted for people's heart health at baseline indicated no benefits from moderate drinking.

According to Stockwell, it all suggests that "abstainers" tend to be less healthy than moderate drinkers--but not because they never drank. Instead, their health may influence their drinking choices. That is, they may not drink because their health is poor.

"We can't 'prove' it one way or the other," Stockwell noted. "But we can say there are grounds for a healthy skepticism around the idea that moderate drinking is good for you."

A second study in the same issue supports that.

That research followed more than 9,100 U.K. adults from the age of 23 to 55. Overall, researchers found that people's drinking habits evolved over time--and few were actually lifelong "abstainers." Nearly all people who were non-drinkers at age 55 had given up alcohol.

What's more, non-drinkers--even those in their 20s--tended to be in poorer physical and mental health compared with those who drank moderately and did not smoke. They were also, on average, less educated, and education is an important factor in lifetime health.

However, no one is saying that people who enjoy alcohol in moderation should stop.

"The risks of low-level drinking are small," Stockwell said. But, he added, people should not drink solely because they believe it wards off disease.

"The notion that one or two drinks a day is doing us good may just be wishful thinking," Stockwell said.

Benefits of fennel in reducing postmenopause symptoms

Fennel, an anise-flavored herb used for cooking, has long been known for its health benefits for a variety of issues, including digestion and premenstrual symptoms. A new study confirms that it is also effective in the management of postmenopause symptoms such as hot flashes, sleeplessness, vaginal dryness, and anxiety, without serious side effects. The study outcomes are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

The use of complementary and alternative medicine for the management of menopause symptoms has surged in recent years as women have attempted to identify alternatives to hormone therapy (HT). Although HT is the most effective treatment for managing most menopause symptoms, some women have turned to herbal medicine because they are either not candidates for HT or are concerned about the negative publicity surrounding potential side effects. Fennel, an herb containing essential oils, has phytoestrogenic properties. Phytoestrogens are estrogen-like chemicals in plants that have been used to effectively treat a wide array of menopause symptoms.

In this small trial of 79 Iranian women aged 45 to 60 years, soft capsules containing 100 mg of fennel were administered twice daily for eight weeks. Improvements were compared between the intervention and placebo groups at four, eight, and 10 weeks, with a significant statistical difference documented. In the end, fennel was concluded to be a safe and effective treatment to reduce menopause symptoms without serious side effects. The study described in the article "Effect of Foeniculum vulgare Mill. (fennel) on menopausal symptoms in postmenopausal women: a randomized, triple-blind, placebo-controlled trial" is one of the first clinical studies to examine the benefits of fennel for managing menopause symptoms, even though it had been previously studied and confirmed to manage premenopause symptoms.

The study was completed in Tehran, Iran, where the average age of women at menopause is younger than in the United States: 48.2 years versus 51 years, respectively. Some of the most common adverse effects of menopause are hot flashes, vaginal dryness, sleep problems, joint and muscular discomfort, exhaustion, irritability, anxiety, and depression.

"This small pilot study found that, on the basis of a menopause-rating scale, twice-daily consumption of fennel as a phytoestrogen improved menopause symptoms compared with an unusual minimal effect of placebo," says Dr. JoAnn Pinkerton, executive director of NAMS. "A larger, longer, randomized study is still needed to help determine its long-term benefits and side effect profile."

Chances of receiving CPR at home decreases with age

The likelihood of a family member or friend stepping in to perform cardiopulmonary resuscitation (CPR) on a person suffering from a sudden cardiac arrest (SCA) at home decreases with the victim's age, suggests a new study from Penn Medicine that also found low CPR training rates among older Americans.

The results were published this week in the Journal of the American Heart Association.

Preliminary findings from the study were presented at the American Heart Association Scientific Sessions in November 2016. At the time, the research team reported that older Americans - those who are most likely to be stricken by SCA - are the least likely to have received CPR training. The full study shows that a victim's chances of receiving bystander CPR decreases significantly by age: for example, a 50 year old who suffers a SCA at home is 62 percent more likely to receive the life-saving technique than an 80-year old, the researchers found.

"The new data affirms the need for targeted training in the older population," said the study's senior author Benjamin Abella, MD, MPhil, director of Penn's Center for Resuscitation Science and an associate professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania. "There is a striking relationship between age and CPR training and delivery that is really important to better understand."

"Most SCAs occur in the home and older victims are less likely to get CPR from a bystander, like a spouse or other family member, making it very likely that the age/training relationship has a big impact on actual CPR delivery, and therefore lives saved or lost," he added.

Over 350,000 Americans suffer from SCAs outside of the hospital every year - and only 32 percent of them receive CPR. Past studies have shown bystander CPR rates are lower in the private residential environment compared with the public setting.

The team sought to identify factors that may influence whether people receive CPR training, by administering a telephone survey. During a two-month period in 2015, 9,022 individuals completed the survey, which included calls to both landline and mobile phone numbers, and were conducted in English or Spanish. Of these participants -- a statistically representative sample of the United States population -- 65 percent had been trained in CPR at some point in their lives and 18 percent has been trained in the last two years.

Older individuals and those with less education and lower household incomes were found to be the least likely to be CPR-trained.

Those who are 60 years and older are roughly 50 percent less likely to be trained in CPR, as compared to those under the age of 49, the researchers reported. Similarly, those whose highest level of education is a high school diploma were more than five times more likely to never have been CPR-trained, as compared to those with graduate degrees. And those with a household income of less than 15,000 were nearly 50 percent less likely to be currently trained in CPR as compared to those with a household income between 30,000 and 74,999.

Using data from the U.S. Resuscitation Outcomes Consortium Epistry data registry (2011-2015), the team also examined the association of bystander CPR delivery during SCA events by victim age. They found a statistically significant association of decreased delivery in the home with increased age. That data mirrored the age/CPR training relationship demonstrated in the survey work.

The same trend cannot be said for events that occur outside the home. Researchers found no association of decreased bystander CPR with victim age in the public setting.

"This is a teachable moment," Abella said. "We need more aggressive, innovative, and creative efforts to reach the population at risk. For example, we should consider training videos while you're waiting for a train, renewing your driving licenses, or in the waiting room before you see your doctor."

Penn offers CPR training for family members and friends of cardiac arrest victims treated at the hospital upon discharge. The study researchers have also been investigating digital strategies and mobile applications to better circulate video-only trainings, said first author Audrey Blewer, MPH, assistant director for Educational Programs in Penn's Center for Resuscitation Science and a doctoral candidate in Epidemiology at Penn.

"There's a real mismatch in the people we know may a have cardiac arrest in the future and who might be CPR trained," Blewer said. "The fact that older Americans are much less likely to be currently CPR trained highlights an important training opportunity and message for the public in general. It's not only the young kids who needs to be CPR trained; it's also the older adults. They are ones who are going home with the people who are at risk for cardiac arrests."

Children and adolescents who eat pasta have better overall diet quality

Pasta is a convenient, nutritious, easy-to-prepare meal for families. Pasta pleases even the pickiest of young eaters. And now, even more good news: new research shows that pasta consumption in children and adolescents is associated with a better diet quality than that of children who do not eat pasta. The research, which was presented at the 2017 Experimental Biology conference at the end of April in Chicago, demonstrated that young pasta-eaters have greater intakes of important vitamins and minerals and lower intakes of saturated fat and total fat in the diet compared to their peers who do not consume pasta.

The research, "Pasta Consumption in American Children and Adolescents is Associated with Greater Daily Intake of Shortfall Nutrients as Defined by the 2015 Dietary Guidelines, Improved Diet Quality and Lower Added Sugar Intake," was conducted by Nutritional Strategies, Inc. on behalf of the National Pasta Association. The study examined associations between pasta consumption, shortfall nutrient intakes as defined by the 2015 Dietary Guidelines (2015 DG) and diet quality in comparison to non-pasta consumption in U.S. children and adolescents (ages 2-18). Pasta consumption was defined as all dry domestic and imported pasta/noodle varieties made with only wheat and no egg. The data review did not look at any health outcomes associated with pasta consumption except for the ones specified below.

From the analysis, researchers identified a number of key positive nutritional dietary patterns associated with children and adolescents who eat pasta as part of their diet compared to those who don't eat pasta. They are:

-Better overall diet quality (as measured by USDA's Healthy Eating Index-2010 scale)
-Greater intake of key shortfall nutrients like dietary fiber, folate, iron, magnesium and vitamin E

-Lower daily intakes of saturated fat and total fat

-No significant associations were seen with body weight, waist circumference and body mass index

Pasta has long been celebrated as one of America's favorite foods and is advocated by nutritionists for its good nutrition.

"Good nutrition is critical to the developing minds and bodies of children and adolescents. Certain grain foods, like pasta, are a great complement to a healthy well-balanced meal and provide plenty of opportunities for improving the diet," explains registered dietitian Diane Welland, Nutrition Communications Manager for the National Pasta Association. "Think of pasta as a canvas from which you can add nutrient-dense, fiber-rich foods like fresh vegetables, fruits, cheese, lean meats and legumes, when creating meals for your family."

Healthy lifestyle helps patients live longer

A study of 992 patients with stage III colon cancer found that those who reported a healthy lifestyle during and following adjuvant (post-surgery) treatment had a 42% lower chance of death and a trend for lower chance of cancer recurrence than those who had less healthy lifestyles. The study will be presented at the upcoming 2017 ASCO Annual Meeting in Chicago.

"There are over 1.3 million colorectal cancer survivors in the United States. These patients need survivorship care, including guidance on what they can do to lower their risk of recurrence," said lead study author Erin Van Blarigan, ScD, Assistant Professor of Epidemiology and Biostatistics, University of California San Francisco. "In response to patient interest and need, the American Cancer Society (ACS) published 'Nutrition and Physical Activity Guidelines for Cancer Survivors' in 2012, but it is not known if following the guidelines after cancer diagnosis is associated with improved outcomes."

This study found that colon cancer patients whose lifestyle matched the ACS guidelines had longer disease-free survival and overall survival.

About the Study

The patients were part of a clinical trial that enrolled from 1999 to 2001 and looked at the effect of two types of adjuvant chemotherapy for colon cancer on cancer recurrence and death. Lifestyle was assessed twice as part of the trial using validated surveys. Patients were assigned a score from 0-6 that measured the degree to which their lifestyle matched the ACS guidelines for cancer survivors. A score of zero indicated no healthy behaviors while a score of six indicated that the patients observed all of the healthy behaviors. Specifically, researchers assessed individuals based on recommendations for:

Maintaining a healthy body weight
Engaging in regular physical activity
Eating a diet rich in whole grains, vegetables, and fruits and low in red meat and processed meat
Alcohol use was also included in the assessment as it is included ACS Guidelines for Cancer Prevention.
Each of the healthy behaviors was equally weighted, but assessing dietary components was a bit more complex as the researchers had to score red and processed meat, whole grains, and vegetables and fruits individually and then build an overall dietary score.

Key Findings

Over a median follow-up of 7 years, the 91 survivors who had the highest healthy lifestyle scores (5-6 points) had a 42% lower risk of death and a trend for reduced chance of recurrence than the 262 survivors with the lowest lifestyle scores (0-1 points). When drinking alcohol was included in the score, the 162 survivors with the highest lifestyle score (6-8 points) had a 51% lower chance of death and a 36% lower chance of cancer recurrence than the 187 survivors who had the lowest healthy lifestyle scores (0-2 points). The associations were not driven by any particular lifestyle factor; body weight, regular physical activity, and a healthy diet were all important.

The researchers note that many cancer survivors have ongoing health problems, such as diabetes or heart disease, and a healthy lifestyle can help improve overall health. They further emphasize that their study's novel findings indicate that a healthy lifestyle may improve colon cancer-specific outcomes as well.

"It should be emphasized that the authors are not suggesting that a healthy life-style alone should be considered a substitute for standard chemotherapy and other treatments for colon cancer, which have dramatically improved survival. Rather, patients with colon cancer should be optimistic, and they should eat a healthy diet and exercise regularly, which may not only keep them healthier, but may also further decrease the chances of the cancer coming back," said Dr. Hayes.

Trans-fatty acids promote cell death

Tohoku University researchers have found that trans-fatty acids promote cell death in a more direct manner than previously thought, leading to the development of atherosclerosis, a major cause of heart attacks and strokes.

Trans-fatty acids are unsaturated fatty acids produced as by-products during food manufacturing. Trans-fatty acid consumption is strongly linked to atherosclerosis, an inflammatory disease in which plaque clogs arteries. Atherosclerosis is a major cause of cardiovascular diseases such as heart attacks and strokes.

During the development of atherosclerosis, white blood cells turn into macrophages, which are immune cells that destroy harmful substances in the body. Those macrophages eventually become foam cells that form plaques and cause inflammation. When macrophages die, they release pro-inflammatory molecules, including 'extracellular ATP' that enhance inflammation and advance the disease.

Although past studies reported the link between the consumption of trans-fatty acids and the development of atherosclerosis, the mechanism behind this remained unknown.

A previous study reported extracellular ATP activates a molecule that generates reactive oxygen species, which trigger an ASK1 kinase involved in the cell death process. This led the researchers to assume that trans-fatty acids accelerate the cell death process by generating more reactive oxygen species.

The Tohoku University team found this process actually happens in a much more direct way. Trans-fatty acids promote cell death by enhancing extracellular ATP, which directly activates the ASK1 kinase, and another kinase called CaMKII, without increasing reactive oxygen species. The finding was published in the Journal of Biological Chemistry.

The researchers, led by Associate Professor Takuya Noguchi and Professor Atsushi Matsuzawa, also found that several trans-fatty acid types -- elaidic acid, linoelaidic acid and trans-vaccenic acid -- stimulate cell death, but not their corresponding cis-fatty acids, which are naturally occurring unsaturated fatty acids with health benefits. The harmful trans-fatty acids are made from these cis-fatty acids through a hydrogenation process commonly used by the food industry. The finding provides insight into the mechanism of disorders caused by trans-fatty acid consumption and suggests potential targets for treatment.

Future studies should further investigate how trans-fatty acids leads to the development of atherosclerosis and cardiovascular diseases at a molecular level.

Eating more fruits and vegetables may lower risk of blockages in leg arteries

Eating three or more servings of fruit and vegetables per day may lower your risk of developing peripheral artery disease (PAD), according to new research in Arteriosclerosis, Thrombosis and Vascular Biology, an American Heart Association journal.

PAD narrows the arteries of the legs, limiting blood flow to the muscles and making it difficult or painful to walk or stand.

Previous studies linked lower consumption of fruits and vegetables with the increased occurrence of coronary heart disease and stroke. However, there has been little research into the association of eating fruits and vegetables and PAD.

After studying data from 3.7 million people, researchers found:

• People who reported eating three or more daily servings of fruits and vegetables had 18 percent lower odds of PAD than those reporting eating less.
• When stratified by smoking status, the association of lower PAD and increased fruits and vegetables was present only among participants who were current or former smokers.
• Overall, 6.3 percent of participants had PAD and 29.2 percent reported eating three or more servings of fruits and vegetables daily.

"Our current study provides important information to the public that something as simple as adding more fruits and vegetables to your diet could have a major impact on the prevalence of life-altering peripheral artery disease," said Jeffrey Berger, M.D., study coauthor and associate professor of medicine and surgery at New York University School of Medicine in New York City.

Participants, who were average age 64 (64 percent women, nearly 90 percent white), completed medical and lifestyle questionnaires and ankle brachial index tests at more than 20,000 sites across America. An ankle brachial index test is a comparison of blood pressure differences between readings at the ankle and the forearm.

Researchers also said their study confirmed that Americans' overall fruit and vegetable intake remains dismally low.

The association of fruit and vegetable intake and lower PAD risk persisted after accounting for age, gender, race, smoking status and multiple other cardiovascular risk factors. Researchers noted older white women were most likely to eat three or more servings of fruits and vegetables daily, while younger black men were the least likely to report daily intake of three or more servings of fruits and vegetables. Low fruit and vegetable intake was particularly associated with PAD among current and former smokers.

"Our study gives further evidence for the importance of incorporating more fruits and vegetables in the diet," said Sean Heffron, M.D., M.S., M.Sc., study coauthor and instructor in medicine at New York University School of Medicine. "One-on-one dietary assessments and counseling for PAD patients, as well as greater public health awareness of the importance of fruit and vegetable consumption, are both needed."

Eating a diet rich in fruit and vegetables could cut obesity risk

Pro-vegetarian diets (with a higher consumption of plant-based foods compared to animal-based foods) could provide substantial protection against obesity, according to new research presented at this year's European Congress on Obesity (ECO) in Porto, Portugal (17-20 May).

This observational study found that people who ate a high pro-vegetarian diet -- rich in food coming from plant sources like vegetables, fruit, and grains -- cut their risk of developing obesity by almost half compared to those who were least pro-vegetarian -- with a dietary pattern rich in animal food like meat, and animal fats.

Current evidence suggests that such a pro-vegetarian diet has a protective role in cardiovascular disease and diabetes, but little is known about its role on the risk of developing obesity in healthy populations.

The study was carried by University of Navarra student Julen Sanz under the supervision of Dr. Alfredo Gea and Professor Maira Bes-Rastrollo from the University of Navarra, and CIBERobn (Carlos III Institute of Health), Spain. They examined the association between varying degrees of pro-vegetarian (plant-based) diet and the incidence of obesity (body mass index; BMI >30) in over 16,000 healthy, non-obese adults from the SUN Cohort (Seguimiento Universidad de Navarra) -- a study tracking the health of Spanish graduates since 1999.

Participants completed detailed food questionnaires at the start of the study, and researchers used a pro-vegetarian diet index (PVI) to score each participant on the types of food they ate. Points were given for eating seven plant food groups -- vegetables, fruits, grains, nuts, olive oil, legumes (such as peas, beans, and lentils) and potatoes. Points were subtracted for five animal groups -- animal fats, dairy, eggs, fish and other seafood, and meat. Based on their scores, participants were categorised into five groups from the 20% with the least pro-vegetarian diet (quintile 1) to the 20% with the most (quintile 5), and followed for an average of 10 years.

During follow-up, 584 participants became obese. The researchers found that participants who closely followed a pro-vegetarian diet were less likely to become obese. Modelling showed that compared to the least-vegetarian participants (quintile 1), the most vegetarian (quintile 5) had a 43% reduced risk of developing obesity. For quintiles 2, 3 and 4, the reduced risk of obesity was 6%, 15% and 17%, respectively, versus quintile 1. The results held true irrespective of other influential factors including sex, age, alcohol intake, BMI, family history of obesity, snacking between meals, smoking, sleep duration, and physical activity.

The authors acknowledge that their findings show observational differences rather than evidence of cause and effect. They conclude: "Our study suggests that plant-based diets are associated with substantially lower risk of developing obesity. This supports current recommendations to shift to diets rich in plant foods, with lower intake of animal foods."

Mindfulness approach helps weight loss

New research presented at this year's European Congress on Obesity (ECO) in Porto, Portugal (17-20 May) suggests using a mindfulness approach is an effective way to aid weight loss. The study is by Dr Carolyn Dunn, North Carolina State University, Raleigh, NC, USA, and colleagues.

Overweight and obesity increase the risk of chronic diseases including hypertension, type 2 diabetes, and cardiovascular disease. A "small changes approach" is one possible weight management strategy, which emphasises the combination of diet and physical activity and suggests reductions in energy intake and increases in energy expenditure to prevent weight gain and or promote weight reduction.

In recent years, mindful eating (increasing one's awareness and focus on eating) has been introduced as a possible strategy for weight management. The primary purpose of the present study was to examine the effectiveness of a program called Eat Smart, Move More, Weigh Less (ESMMWL) in increasing mindful eating. The secondary objective was to investigate the relationship between mindful eating and weight loss.

ESMMWL was developed by researchers at North Carolina State University and North Carolina Division of Public Health and employs the theory of planned behaviour to help participants change behaviours that have been associated with weight management. One of these behaviours is to increase mindful eating as measured by the Mindful Eating Questionnaire (MEQ), a 28-item questionnaire that assesses five domains of mindful eating. ESMMWL is delivered using synchronous distance technology, as such a cohort of participants take the class from a live instructor at the same time each week on a computer or mobile device.

Mindful eating includes paying attention to hunger and fullness (satiety) cues, planning meals and snacks, eating as a singular activity as opposed to eating while doing other activities, and paying special attention to how food tastes. Mindful eating may also include having just one or two bites of special higher calorie foods and savouring the flavour.

A total of 80 participants were part of a randomised controlled trial evaluating the effectiveness of ESMMWL, an online, 15-week weight management program. Participants enrolled in ESMMWL were asked if they would be willing to participate in the study. Willing participants were then randomised to the intervention (n = 42) or wait list control (n = 38).

Participants that completed ESMMWL (n = 28) lost more weight than participants in the waitlist control group (n = 36). Mean weight loss for ESMMWL participants was 1.9 kg compared to 0.3 kg for participants in the waitlist control group -- a statistically significant result. For all subscales and the summary score, participants who completed ESMMWL had a significantly larger increase in their mindfulness scores than those in the waitlist control group.

The authors say: "Results suggest that there is a beneficial association between mindful eating and weight loss. The current study contributes to the mindfulness literature as there are very few studies that employed rigorous methodology to examine the effectiveness of an intervention on mindful eating."

The authors are continuing to employ the strategy of mindfulness, specifically mindful eating, in their work in the area of weight management. They are currently studying mindful eating as part of a diabetes prevention program.

Healthy brain aging is linked to omega-3 and omega-6 fatty acids in the blood

Two new studies link patterns of polyunsaturated fatty acids in the blood to the integrity of brain structures and cognitive abilities that are known to decline early in aging.

The studies add to the evidence that dietary intake of omega-3 and omega-6 fatty acids can promote healthy aging, the researchers said. Further research is needed to test this hypothesis, they said.

The brain is a collection of interconnected parts, each of which ages at its own pace. Some brain structures, and the abilities they promote, start to deteriorate before others, said University of Illinois M.D./Ph.D student Marta Zamroziewicz, who led the new research with psychology professor Aron Barbey.

"We studied a primary network of the brain -- the frontoparietal network - that plays an important role in fluid intelligence and also declines early, even in healthy aging," Zamroziewicz said. Fluid intelligence describes the ability to solve problems one has never encountered before.

"In a separate study, we examined the white matter structure of the fornix, a group of nerve fibers at the center of the brain that is important for memory," she said.

Previous research has shown that the fornix is one of the first brain regions to be compromised in Alzheimer's disease.

In both studies, the researchers looked for patterns of polyunsaturated fatty acids in the blood of adults ages 65 to 75. They analyzed the relationship between these nutrient patterns and subjects' brain structure and performance on cognitive tests. This research differs from other such studies, which tend to focus on only one or two polyunsaturated fatty acids, Zamroziewicz said.

"Most of the research that looks at these fats in health and healthy aging focuses on the omega-3 fatty acids DHA and EPA, but those come from fish and fish oil, and most people in the Western Hemisphere don't eat enough of those to really see the benefits," she said. Other fatty acids, like alpha-linolenic acid and stearidonic acid, are precursors of EPA and DHA in the body. Those fats can be derived from land-based foods such as nuts, seeds and oils.

"A central goal of research in nutritional cognitive neuroscience is to understand how these nutrients affect brain health," Zamroziewicz said. "Some of these nutrients are thought to be more beneficial than others."

In a study reported in the journal Nutritional Neuroscience, the researchers looked for relationships between several omega-3 fatty acids in the blood, the relative size of structures in the frontal and parietal cortices of the brain, and performance on tests of fluid intelligence in healthy elderly adults.

The team found correlations between blood levels of three omega-3 fatty acids -- ALA, stearidonic acid and ecosatrienoic acid -- and fluid intelligence in these adults. Further analyses revealed that the size of the left frontoparietal cortex played a mediating role in this relationship. People with higher blood levels of these three nutrients tended to have larger left frontoparietal cortices, and the size of the frontoparietal cortex predicted the subjects' performance on tests of fluid intelligence.

"A lot of research tells us that people need to be eating fish and fish oil to get neuroprotective effects from these particular fats, but this new finding suggests that even the fats that we get from nuts, seeds and oils can also make a difference in the brain," Zamroziewicz said.

In the second study, the team found that the size of the fornix was associated with a balance of omega-3 and omega-6 fatty acids in the blood, and that a more robust fornix coincided with memory preservation in older adults. Again, the researchers saw that brain structure played a mediating role between the abundance and balance of nutrients in the blood and cognition (in this case, memory). The findings are reported in the journal Aging & Disease.

"These findings have important implications for the Western diet, which tends to be misbalanced with high amounts of omega-6 fatty acids and low amounts of omega-3 fatty acids," Zamroziewicz said.

"These two studies highlight the importance of investigating the effects of groups of nutrients together, rather than focusing on one at a time," Barbey said. "They suggest that different patterns of polyunsaturated fats promote specific aspects of cognition by strengthening the underlying neural circuits that are vulnerable to disease and age-related decline."

Another reason to exercise: Burning bone fat -- a key to better bone health

It's a fat-burning secret anyone interested in bone health should know. For the first time, UNC School of Medicine researchers show that exercising burns the fat found within bone marrow and offers evidence that this process improves bone quality and the amount of bone in a matter of weeks.

The study, published in the Journal of Bone and Mineral Research, also suggests obese individuals - who often have worse bone quality - may derive even greater bone health benefits from exercising than their lean counterparts.

"One of the main clinical implications of this research is that exercise is not just good, but amazing for bone health," said lead author Maya Styner, MD, a physician and assistant professor of endocrinology and metabolism at the University of North Carolina at Chapel Hill. "In just a very short period of time, we saw that running was building bone significantly in mice."

Although research in mice is not directly translatable to the human condition, the kinds of stem cells that produce bone and fat in mice are the same kind that produce bone and fat in humans.

In addition to its implications for obesity and bone health, Styner said the research also could help illuminate some of the factors behind bone degradation associated with conditions like diabetes, arthritis, anorexia, and the use of steroid medications.

In her patients, Styner is all too familiar with the chronic toll of osteoporosis and fractures. This new evidence shows it's possible to use exercise to reverse some of the effects on bones.

"I see a lot of patients with poor bone health, and I always talk to them about what a dramatic effect exercise can have on bones, regardless of what the cause of their bone condition is," said Styner. "With obesity, it seems that you get even more bone formation from exercise. Our studies of bone biomechanics show that the quality and the strength of the bone is significantly increased with exercise and even more so in the obese exercisers"

Getting to the marrow of the matter

Bone and marrow are more dynamic than you might think. Marrow, in particular, is a hub of activity, coordinating the formation of bone and cartilage while simultaneously churning out blood cells, immune cells, and cancerous cells.

Marrow also produces fat, which has a lot to do with its vaunted status in cuisines around the world. But the physiological role of bone marrow fat in the body - and even whether it is beneficial or harmful for one's health - has remained somewhat mysterious.

Generally, marrow fat has been thought to comprise a special fat reserve that is not used to fuel energy during exercise in the same way other fat stores are used throughout the body during exercise. The new study offers evidence to the contrary.

Styner's work also offers fundamental insights on how marrow fat forms and the impact it has on bone health. Previous studies have suggested that a higher amount of marrow fat increases the risk of fractures and other problems.

"There's been intense interest in marrow fat because it's highly associated with states of low bone density, but scientists still haven't understood its physiologic purpose," said Styner. "We know that exercise has a profound effect on fat elsewhere in the body, and we wanted to use exercise as a tool to understand the fat in the marrow."

Vanishing fat cells

The researchers performed their experiments in two groups of mice. One group was fed a normal diet (lean mice) and the other received a high-fat diet (obese mice) starting a month after birth. When they were four months old, half the mice in each group were given a running wheel to use whenever they liked for the next six weeks. Because mice like to run, the group with access to a wheel tended to spend a lot of time exercising.

The researchers analyzed the animals' body composition, marrow fat and bone quantity at various points. Predictably, the obese mice started with more fat cells and larger fat cells in their marrow. After exercising for six weeks, both obese and lean mice showed a significant reduction in the overall size of fat cells and the overall amount fat in the marrow. In these respects, the marrow fat of exercising obese mice looked virtually identical to the marrow fat of lean mice, even those that exercised.

Perhaps more surprising was the dramatic difference in the number of fat cells present in the marrow, which showed no change in lean mice but dropped by more than half in obese mice that exercised compared to obese mice that were sedentary. The tests also revealed that exercise improved the thickness of bone, and that this effect was particularly pronounced in obese mice.

According to Styner, all of this points to the conclusion that marrow fat can be burned off through exercise and that this process is good for bones.

"Obesity appears to increase a fat depot in the bone, and this depot behaves very much like abdominal and other fat depots," said Styner. "Exercise is able to reduce the size of this fat depot and burn it for fuel and at the same time build stronger, larger bones."

Setting the stage

The research leaves a few lingering mysteries. A big one is figuring out the exact relationship between burning marrow fat and building better bone. It could be that when fat cells are burned during exercise, the marrow uses the released energy to make more bone. Or, because both fat and bone cells come from parent cells known as mesenchymal stem cells, it could be that exercise somehow stimulates these stem cells to churn out more bone cells and less fat cells.

More research will be needed to parse this out. "What we can say is there's a lot of evidence suggesting that marrow fat is being used as fuel to make more bone, rather than there being an increase in the diversion of stem cells into bone," said Styner.

But marrow fat, being encased in bone, isn't easy to study. The team's new research represents a leap forward not only in understanding bone marrow fat but also in the tools to study it.

The group's previous work relied on micro CT imaging, which requires the use of a toxic tracer to measure marrow fat. In the new study, they took advantage of UNC's 9.4 TMRI, a sophisticated MRI machine of which there are only a few around the country. Using MRI to assess marrow fat eliminates the need for the toxic tracer and allows highly detailed imaging of living organisms.

"If we want to take this technique to the human level, we could study marrow fat in humans in a much more reliable fashion now," said Styner. "And our work shows this is possible."

The team also developed techniques to perform a much more detailed assessment of the number and size of fat cells within the marrow, and even examined some of the key proteins involved in the formation and reduction of bone marrow fat.

Styner is now working with collaborators to adapt these methods for studying the bone marrow dynamics that might be at work in other conditions, including anorexia and post-menopausal osteoporosis.

Educating older adults on outdoor fall prevention

Many older adults have fallen outdoors but lack an understanding of the risks for falling and how to prevent them, warranting efforts for outdoor fall prevention, finds a new study by New York University researchers.

"Despite their frequency, outdoor falls receive little attention when it comes to education and prevention," said Tracy Chippendale, assistant professor of occupational therapy at NYU Steinhardt School of Culture, Education, and Human Development and the study's lead author.

The findings of this study, published in the Archives of Gerontology and Geriatrics, are being used to develop and pilot an outdoor fall prevention program, which is currently underway in New York City.

Approximately 30 percent of adults age 65 and older fall each year, with serious consequences for both the individual and the health care system. Although falls have been well studied, the focus has been on indoor rather than outdoor falls. Yet, research shows that 48 percent of the most recent falls among older adults and up to 72 percent among middle aged adults occur outdoors.

Although there are similarities in the risk factors for falling indoors and outdoors, such as depression, fall history, and use of certain medications, there are also a number of differences. People who fall outdoors are more likely to be male, younger, active, and fast walkers.

In addition to physical injuries such as open wounds, head injuries, and fractures, outdoor falls can have emotional consequences, including fear and anxiety about falling again.

This study sought to explore the experiences and fall prevention knowledge of older adults living in the community, not in housing for seniors. Using random digit telephone dialing, the researchers surveyed 120 adults age 55 and older across the five boroughs of New York City.

A high proportion of adults surveyed - 85 people or 71 percent - had fallen outdoors in their adult years. Of those who had experienced an outdoor fall, 28 had minor injuries such as scrapes and bruises, 18 had moderate injuries with prolonged pain or soreness, and nine had severe injuries such as fractures, rotator cuff injuries, or injuries requiring stitches or surgery.

Beyond physical injuries, participants commonly described having an emotional response to a fall, including fear of falling again or embarrassment, which may affect one's willingness to disclose a fall or seek medical attention.

The participants attributed their falls to a number of causes. Environmental factors included objects (e.g. metal post, branch, stones), surface conditions (e.g. slippery or uneven), and stairs, particularly at entranceways. A number of people surveyed reported falls caused by otherwise healthy activities such as exercising or walking a dog. Many participants attributed falls in part to their own practices, such as wearing ill-fitting or inappropriate shoes, not paying attention, or walking too fast.

In addition, those surveyed frequently described multiple factors that contributed to their fall, such as rushing on an icy surface or being distracted on an uneven surface.

Overall, the survey revealed a number of unmet education and training needs for outdoor fall prevention among community-dwelling older adults. For example, older adults should be educated on the importance of wearing single vision glasses and proper footwear, which have been flagged as common causes for falls. They should also be educated on the risks associated with recreation areas and parking lots or garages, since these have been shown to be common fall locations.

Adults could also benefit from training on fall prevention strategies, including safety during routine activities such as carrying items on uneven surfaces, going up and down stairs, and opening or closing doors. Education around safe outdoor walking strategies (e.g. avoiding distractions, navigating sloped and uneven surfaces, and walking slower) would also be beneficial.

Positive relationships between omega-3 EPA+DHA status and cognition

In a new article published in the Journal of Alzheimer's Disease, researchers have found a statistically significant correlation between higher blood flow and higher Omega-3 Index. In addition, they evaluated the neuropsychological functions of the subjects and found that omega-3 levels also correlated with various psychological feelings using a standardized test battery (WebNeuro).

This study drew from a random sample of 166 participants from a psychiatric referral clinic for which Omega-3 Index results were available. The participants were categorized into two groups of higher EPA+DHA concentrations (>50th percentile) and lower concentrations (<50th 128="" and="" br="" brain="" brains="" completed="" computerized="" conducted="" each="" neurocognitive="" of="" on="" participant="" percentile="" quantitative="" regions="" spect="" status.="" testing="" their="" was="">
Results indicated statistically significant relationships between the Omega-3 index, regional perfusion on brain SPECT in areas involved with memory, and neurocognitive testing.

Overall, the study showed positive relationships between omega-3 EPA+DHA status, brain perfusion, and cognition. Lead author Daniel G. Amen, MD, of the Amen Clinics Inc., Costa Mesa, CA, adds, "This is very important research because it shows a correlation between lower omega-3 fatty acid levels and reduced brain blood flow to regions important for learning, memory, depression and dementia."

Co-author William S. Harris, PhD, University of South Dakota School of Medicine. Vermillion, SD, lends this perspective, "Although we have considerable evidence that omega-3 levels are associated with better cardiovascular health, the role of the 'fish oil' fatty acids in mental health and brain physiology is just beginning to be explored. This study opens the door to the possibility that relatively simple dietary changes could favorably impact cognitive function."

Tens of millions of Americans drink alcohol at dangerously high levels

Nearly 32 million adults in the United States (13 percent of the U.S. population aged 18 and older) consumed more than twice the number of drinks considered binge drinking on at least one occasion, according to a 2013 survey that asked about past-year drinking. This higher level of drinking is associated with increased health and safety risks. A report of the findings is online in the American Journal of Preventive Medicine. The study was conducted by researchers at the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.

“This important study reveals that a large number of people in the United States drink at very high levels and underscores the dangers associated with such ‘extreme’ binge drinking,” said NIAAA Director George F. Koob, Ph.D. “Of the nearly 90,000 people who die from alcohol each year, more than half, or 50,000, die from injuries and overdoses associated with high blood alcohol levels.”

Binge drinking, defined as having four or more drinks on an occasion for women, or five or more drinks on an occasion for men, can produce blood alcohol levels greater than 0.08 percent, which is the legal limit for driving in the United States. Reaching this level is well known to increase the risk of harms to the drinker and others. However, evidence suggests that many people drink far beyond four or five drinks per occasion, defined as extreme binge drinking. The current study analyzed three levels of past-year binge drinking - Levels I, II, and III. These levels were defined as four to seven drinks, eight to 11 drinks, and 12 or more drinks on a single occasion for women; and five to nine drinks, 10-14 drinks, and 15 or more drinks on a single occasion for men.

Researchers, led by Ralph Hingson, Sc.D., director of the NIAAA Division of Epidemiology and Prevention Research, analyzed data from two waves of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which is a series of large epidemiologic surveys that examine alcohol use and its co-occurrence with drug use and related psychiatric conditions. In the 2001–2002 and 2012–2013 waves of NESARC, 42,748 and 36,083 U.S. adults, respectively, reported the maximum number of drinks they consumed on any day in the past year.

The researchers found that in the 2012–2013 survey, 39 percent of adult males and 27 percent of adult females reported Level I binge drinking during the previous year. Eleven percent of males reported Level II binge drinking (two times the binge drinking threshold for adult males) at least once in the past year, and 7 percent reported Level III binge drinking (three times the binge threshold) at least once in the past year. Five percent of females reported Level II binge drinking (two times the binge drinking threshold for adult females) at least once in the past year, and 3 percent reported Level III binge drinking (three times the binge threshold) at least once in the past year.

After controlling for age, race, sex, marital status, education, drug use, and smoking, compared to people who did not binge drink, people who drank at the various binge levels were much more likely to experience an alcohol-related emergency department visit; have an alcohol use disorder; be injured because of drinking; be arrested or have legal problems resulting from alcohol use; or be the driver in an alcohol-related traffic crash. Compared to non-binge-drinkers, Level I binge drinkers were 13 times more likely, Level II binge drinkers were 70 times more likely, and Level III binge drinkers were 93 times more likely, to have an alcohol-related emergency department visit. 

Comparing data from the 2001–2002 and 2012–2013 NESARC waves, the researchers found that the prevalence of drinking at levels two and three times or more the standard binge thresholds in the past year was significantly higher in the most recent NESARC wave, suggesting that more adults are engaging in extreme binge drinking now than a decade earlier. <

“As a society, we are justifiably concerned about extreme binge drinking among underage individuals and college students. This study indicates that other groups in the U.S. population also engage in this harmful behavior and are at increased risk for adverse consequences,” says Hingson.

Extreme binge drinking was particularly common among study participants who used other drugs. This is a concern because combining alcohol with other drugs can increase the risk of injuries and overdose deaths.

“Drinking at such high levels can suppress areas of the brain that control basic life-support functions such as breathing and heart rate, thereby increasing one’s risk of death,” said senior author, Aaron White, Ph.D., Senior Scientific Advisor to the NIAAA Director. “The risk increases further if other sedative drugs, particularly opioids or benzodiazepines, are added to the mix.”

The researchers noted that their findings highlight the need to identify interventions to reduce extreme binge drinking and its negative consequences. Additional research is needed to determine how questions about peak alcohol consumption levels can be valuable in screening for alcohol misuse, as well as in assessing gender-specific risk factors and harms for drinking at extreme levels.

Any amount of exercise will boost your mood

You don't have to spend hours at the gym or work up a dripping sweat to improve your mood and feel better about yourself, researchers at the University of Connecticut say in a new study.

If you lead a sedentary lifestyle -- spending large parts of your day sitting at home or at work - simply getting out of your chair and moving around can reduce depression and lift your spirits.

"We hope this research helps people realize the important public health message that simply going from doing no physical activity to performing some physical activity can improve their subjective well-being," says Gregory Panza, a graduate student in UConn's Department of Kinesiology and the study's lead author.

"What is even more promising for the physically inactive person is that they do not need to exercise vigorously to see these improvements," Panza continues. "Instead, our results indicate you will get the best 'bang for your buck' with light or moderate intensity physical activity."

For those keeping score, light physical activity is the equivalent of taking a leisurely walk around the mall with no noticeable increase in breathing, heart rate, or sweating, says Distinguished Kinesiology Professor Linda Pescatello, senior researcher on the project. Moderate intensity activity is equivalent to walking a 15-20-minute mile with an increase in breathing, heart rate, and sweating, yet still being able to carry on a conversation. Vigorous activity is equivalent to a very brisk walk or jogging a 13-minute mile with a very noticeable increase in breathing, heart rate, and sweating to the point of being unable to maintain a conversation.

The study looked at 419 generally healthy middle-aged adults who wore accelerometers on their hips to track physical activity over four days. Participants also completed a series of questionnaires asking them to describe their daily exercise habits, psychological well-being, depression level, pain severity, and extent to which pain interfered with their daily activities.

Here's what the researchers learned:

People who reported higher levels of sedentary behavior also reported lower levels of subjective well-being, meaning those who sat around a lot were the least happiest. Subjective well-being is defined as the positive and negative evaluations that people make of their own lives. These results confirmed previous studies.
In general, physical activity improved people's sense of well-being. Yet, different intensities of physical activity were more beneficial to some people than others. For instance, people who participated in light-intensity physical activity reported higher levels of psychological well-being and lower levels of depression. People who participated in moderate-ntensity physical activity reported higher levels of psychological well-being and lower levels of pain severity.
People who led sedentary lives and engaged in light or moderate physical activity showed the greatest improvement in overall sense of well-being. "The 'more is better' mindset may not be true when it comes to physical activity intensity and subjective well-being," says Panza. "In fact, an 'anything is better' attitude may be more appropriate if your goal is a higher level of subjective well-being."
While light and moderate physical activity clearly made some people feel better about themselves, when it came to vigorous activity, the results were neutral. There was no positive or negative association found between high intensity physical activity and subjective well-being.
The last finding is actually good news for folks who enjoy hard, calorie-burning workouts, as it doesn't support a widely reported recent study that found high intensity workouts significantly lowered some people's sense of well-being.

"Recent studies had suggested a slightly unsettling link between vigorous activity and subjective well-being," says Beth Taylor, associate professor of kinesiology and another member of the research team. "We did not find this in the current study, which is reassuring to individuals who enjoy vigorous activity and may be worried about negative effects."

Many previous studies have attempted to identify the best exercise regimen to improve people's sense of well-being. Yet no clear consensus has emerged. Some studies say moderate or vigorous activity is best. Others say low intensity exercise is better. The differences, the UConn researchers say, may be due to the way the studies were designed and possible limitations in how people's well-being and levels of physical activity were measured.

The UConn study is believed to be the first of its kind to use both objective (accelerometers) and subjective (questionnaires) measurements within a single group to examine the relationship between physical activity intensity and well-being.

Yet the UConn research also has its limits, Panza says.

All of the individuals who participated in the UConn study had a generally positive sense of well-being going into the project and were generally physically active. So their answers in the questionnaires need to be framed in that context. Whether the same results would hold true for people with lower subjective well-being or lower levels of physical activity is unknown, Panza says.

Also, the conclusions formed in the UConn study are based on information gathered at a single point in time. A longitudinal study that tracks people's feelings and physical activity over time would go a long way toward helping determine what exercise regimen might be best for different populations, Panza said.

"If it doesn't make us feel good, we don't want to do it," says Taylor. "Establishing the link between different types, doses, and intensities of physical activity on well-being is a very important step in encouraging more people to exercise."

The study was published in the Journal of Health Psychology in February.