Friday, June 30, 2017

The mere presence of your smartphone reduces brain power

Your cognitive capacity is significantly reduced when your smartphone is within reach -- even if it's off. That's the takeaway finding from a new study from the McCombs School of Business at The University of Texas at Austin.

McCombs Assistant Professor Adrian Ward and co-authors conducted experiments with nearly 800 smartphone users in an attempt to measure, for the first time, how well people can complete tasks when they have their smartphones nearby even when they're not using them.

In one experiment, the researchers asked study participants to sit at a computer and take a series of tests that required full concentration in order to score well. The tests were geared to measure participants' available cognitive capacity -- that is, the brain's ability to hold and process data at any given time. Before beginning, participants were randomly instructed to place their smartphones either on the desk face down, in their pocket or personal bag, or in another room. All participants were instructed to turn their phones to silent.

The researchers found that participants with their phones in another room significantly outperformed those with their phones on the desk, and they also slightly outperformed those participants who had kept their phones in a pocket or bag.

The findings suggest that the mere presence of one's smartphone reduces available cognitive capacity and impairs cognitive functioning, even though people feel they're giving their full attention and focus to the task at hand. "We see a linear trend that suggests that as the smartphone becomes more noticeable, participants' available cognitive capacity decreases," Ward said. "Your conscious mind isn't thinking about your smartphone, but that process -- the process of requiring yourself to not think about something -- uses up some of your limited cognitive resources. It's a brain drain."

In another experiment, researchers looked at how a person's self-reported smartphone dependence -- or how strongly a person feels he or she needs to have a smartphone in order to get through a typical day -- affected cognitive capacity. Participants performed the same series of computer-based tests as the first group and were randomly assigned to keep their smartphones either in sight on the desk face up, in a pocket or bag, or in another room. In this experiment, some participants were also instructed to turn off their phones.

The researchers found that participants who were the most dependent on their smartphones performed worse compared with their less-dependent peers, but only when they kept their smartphones on the desk or in their pocket or bag.

Ward and his colleagues also found that it didn't matter whether a person's smartphone was turned on or off, or whether it was lying face up or face down on a desk. Having a smartphone within sight or within easy reach reduces a person's ability to focus and perform tasks because part of their brain is actively working to not pick up or use the phone.

"It's not that participants were distracted because they were getting notifications on their phones," said Ward. "The mere presence of their smartphone was enough to reduce their cognitive capacity."

Thursday, June 29, 2017

Cocoa and chocolate are not just treats -- they are good for your cognition

A balanced diet is chocolate in both hands - a phrase commonly used to justify ones chocolate snacking behavior. A phrase now shown to actually harbor some truth, as the cocoa bean is a rich source of flavanols: a class of natural compounds that has neuroprotective effects.

In their recent review published in Frontiers in Nutrition, Italian researchers examined the available literature for the effects of acute and chronic administration of cocoa flavanols on different cognitive domains. In other words: what happens to your brain up to a few hours after you eat cocoa flavanols, and what happens when you sustain such a cocoa flavanol enriched diet for a prolonged period of time?

Although randomized controlled trials investigating the acute effect of cocoa flavanols are sparse, most of them point towards a beneficial effect on cognitive performance. Participants showed, among others, enhancements in working memory performance and improved visual information processing after having had cocoa flavanols. And for women, eating cocoa after a night of total sleep deprivation actually counteracted the cognitive impairment (i.e. less accuracy in performing tasks) that such a night brings about. Promising results for people that suffer from chronic sleep deprivation or work shifts.

It has to be noted though, that the effects depended on the length and mental load of the used cognitive tests to measure the effect of acute cocoa consumption. In young and healthy adults, for example, a high demanding cognitive test was required to uncover the subtle immediate behavioral effects that cocoa flavanols have on this group.

The effects of relatively long-term ingestion of cocoa flavanols (ranging from 5 days up to 3 months) has generally been investigated in elderly individuals. It turns out that for them cognitive performance was improved by a daily intake of cocoa flavanols. Factors such as attention, processing speed, working memory, and verbal fluency were greatly affected. These effects were, however, most pronounced in older adults with a starting memory decline or other mild cognitive impairments.

And this was exactly the most unexpected and promising result according to authors Valentina Socci and Michele Ferrara from the University of L'Aquila in Italy. "This result suggests the potential of cocoa flavanols to protect cognition in vulnerable populations over time by improving cognitive performance. If you look at the underlying mechanism, the cocoa flavanols have beneficial effects for cardiovascular health and can increase cerebral blood volume in the dentate gyrus of the hippocampus. This structure is particularly affected by aging and therefore the potential source of age-related memory decline in humans."

So should cocoa become a dietary supplement to improve our cognition? "Regular intake of cocoa and chocolate could indeed provide beneficial effects on cognitive functioning over time. There are, however, potential side effects of eating cocoa and chocolate. Those are generally linked to the caloric value of chocolate, some inherent chemical compounds of the cocoa plant such as caffeine and theobromine, and a variety of additives we add to chocolate such as sugar or milk."

Nonetheless, the scientists are the first to put their results into practice: "Dark chocolate is a rich source of flavanols. So we always eat some dark chocolate. Every day."

This research was published in the Research Topic "Chocolate and Health: Friend or Foe?". This Topic gathered papers covering the functional properties of cocoa, to unravel the pro and cons of cocoa in relation to human health.

Çarrying extra weight offer better survival following a stroke

Despite the fact that obesity increases both the risk for stroke and death, a new study has found that people who are overweight or even mildly obese survive strokes at a higher rate as compared to those with a normal body weight.

The findings, which appear in the Journal of the American Heart Association, adds to the 'obesity paradox' seen in previous studies where increased body weight appears to have a protective effect on certain groups of patients.

A stroke occurs when blood flow to an area of the brain is cut off and brain cells are deprived of oxygen and begin to die. Each year about 185,000 people die from a stroke, the fifth leading cause of death in the U.S. and a leading cause of adult disability.

A group of participants from the Framingham Heart Study (FHS) were followed over time, including measuring their body mass index (BMI) prior to their stroke. The researchers then matched these stroke cases to other FHS participants of similar age, sex and BMI category (normal weight, overweight or obese). They then separately analyzed both groups to see if overweight or obesity had any effect on survival over 10 years, compared to the people who were normal weight. "We found that participants who were overweight or mildly obese had better survival after stroke than normal weight participants and the survival benefit was strongest in males or in those younger than age 70," explained corresponding author Hugo J. Aparicio, MD, MPH, assistant professor of neurology at Boston University School of Medicine and FHS investigator.

According to the researcher, while the study controlled for factors such as smoking, cancer, dementia and 'vascular risk factors' like high blood pressure, diabetes and cholesterol, there may still be unhealthy aspects associated with a normal weight, like relative frailty, differences in nutrient intake or unidentified conditions that could lead to worse mortality.

The researchers caution that these results do not show that obesity is protective in the overall population. They stress that there may be some mechanism by which increased weight can help survival after stroke, whether from having the extra 'metabolic reserve' following a severe disease, or other influences such as medication use, avoidance of smoking or some aspect of their diet. "Nonetheless, observing this so-called 'obesity paradox' has important clinical implications and it is essential for clinicians and researchers to better understand the role of body weight in recovery after stroke so that they can make proper recommendations on weight loss or weight maintenance," said Aparicio.

Why does acupuncture work?

The use of acupuncture to treat pain dates back to the earliest recorded history in China. Despite centuries of acupuncture, it's still not clear why this method of applying and stimulating tiny needles at certain points on the body can relieve pain. Recent studies have raised additional questions, with some finding acupuncture reduced chronic pain while others showed that acupuncture has little, if any, impact on pain.

A new study from LA BioMed researchers offers some answers for why acupuncture may help and why clinical trials have produced mixed results. The researchers found the proper use of acupuncture (with the reinforcement method or coupled with heat, which is often used in acupuncture treatments) can lead to elevated levels of nitric oxide in the skin at the "acupoints" where the needles were inserted and manipulated. They noted that nitric oxide increases blood flow and encourages the release of analgesic or sensitizing substances, which causes the skin to feel warmer and contributes to the beneficial effects of the therapies.

"Our lab has developed a painless, non-invasive biocapture device that can sample human biomolecules over specific skin regions," said Sheng-Xing Ma, MD, PhD, an LA BioMed lead researcher and corresponding author of the study published in Evidence-based Complementary and Alternative Medicine, Volume 2017. "With this tool, we were able to obtain the first evidence that nitric oxide is released from the human skin surface at a higher level with the proper acupuncture methodology and the use of heat."

Dr. Ma said several acupuncture clinical trials by conventional researchers have produced negative results, finding little difference in pain relief between the use of acupuncture and "sham acupuncture," in which needles are manufactured and/or inserted unsystematically. He said these studies have puzzled the acupuncture community and led many to question whether the proper acupuncture methodologies were used.

For the latest study, the LA BioMed researchers used a low force and rate/reinforcement method of acupuncture. They gently inserted acupuncture needles into the skin of 25 men and women, aged 18-60 years, and delicately twisted the needles for two minutes or until they achieved a sensation of "de qi" (soreness, numbness, distension or pain). They then manipulated the needles using gentle amplitude and moderate speed for two minutes every five minutes for a total of 20 minutes.

They also applied electrical heat for 20 minutes and found elevated levels of nitric oxide at the acupoints. To further validate their findings, they conducted the test with high-frequency and force, which is known as a reduction method, and found nitric oxide levels over the areas of the skin region were reduced.

Dr. Ma said his team will continue to explore the differences in these two acupuncture techniques to determine the effectiveness of each in pain relief and better understand the cellular and molecular mechanisms involved.

"Based on traditional Chinese medicine, acupuncture reinforcement is attained by slowly twisting or rotating the needle with gentle force or by heat," Dr. Ma said. "Reduction is attained by rapidly twisting or rotating the needle with great force. Reinforcement results in local feeling of warmness, but reduction causes a local feeling of coldness."

Barbecue Basics: Tips to Prevent Foodborne Illness

It’s the season for picnics, cookouts, and other outdoor parties. But eating outdoors in warm weather presents a food safety challenge. Bacteria in food multiply faster at temperatures between 40°F and 140°F, so summer heat makes the basics of food safety especially important.

“Fortunately, there are a lot of steps consumers can take to keep family and friends from becoming ill,” says Marjorie Davidson, Ph.D., education team leader in FDA’s Center for Food Safety and Applied Nutrition.

Wash hands.

It seems basic, but not everyone does it. Wash hands well and often with soap and water for at least 20 seconds, especially after using the bathroom and before cooking or eating. If you’re in an outdoor setting with no bathroom, use a water jug, some soap, and paper towels. Consider carrying moist disposable towelettes for cleaning your hands.
Keep raw food separate from cooked food.

Don’t use a plate that previously held raw meat, poultry, or seafood for anything else unless the plate has first been washed in hot, soapy water. Keep utensils and surfaces clean.
Marinate food in the refrigerator, not out on the counter.

And if you want to use some of the marinade as a sauce on the cooked food, reserve a separate portion. Don’t reuse marinade that contained raw meat.
Cook food thoroughly.

To kill any harmful bacteria that may be present, use a food thermometer. Hamburgers should be cooked to 160°F. If a thermometer is not available, make sure hamburgers are brown all the way through, not pink. Chicken should be cooked to at least 165°F. If you partially cook food in the microwave, oven or stove to reduce grilling time, do so immediately before the food goes on the hot grill.
Refrigerate and freeze food promptly.

It can be hard to remember while a party is going on, but food should not be left out of the cooler or off the grill for more than two hours. Never leave food out for more than one hour when the temperature is above 90°F.
Keep hot food hot.

Hot food should be kept at or above 140°F. Hot food should be wrapped well and placed in an insulated container. If bringing hot take-out food such as fried chicken or barbecue to an outdoor party, eat it within two hours of purchase. In addition to bringing a grill and fuel for cooking to an outdoor location, remember to pack a food thermometer to check that your meat and poultry reach a safe internal temperature. When re-heating food at the outing, be sure it reaches 165°F.
Keep cold food cold.

Cold food should be held at or below 40°F. Foods like chicken salad and desserts that are in individual serving dishes can be placed directly on ice or in a shallow container set in a deep pan filled with ice. Drain off water as ice melts and replace ice frequently.

Wednesday, June 28, 2017

Following a friend leads to unsafe driving behavior

Have you ever tried following a friend in a car? It can stressful; if you don't keep up, you are likely to get lost. To avoid this, you may make unsafe driving manoeuvres to keep sight of the car ahead.

A new study, published in the open-access journal Frontiers in Psychology provides scientific proof to show that drivers who follow another car to a destination are more likely to drive dangerously.

"We have found that when someone is asked to follow another vehicle, it can lead to them engaging in risky driving behavior, such as driving faster, making more erratic turns and following too close to the car in front. This is most likely caused by a fear of getting lost," says Robert Gray, a Professor in Human Systems Engineering, who carried out this research with his team at the Arizona State University, USA.

He continues, "This study was actually inspired by an accident analysis I was doing for a court case, where a driver was seriously injured in a 'following a friend' scenario. Although most people have an intuition it can be dangerous, we couldn't find any research to back this up."

Professor Gray and his colleagues decided to test this intuition by recruiting students with a valid driving licence to participate in a driving simulation. Initially, they were asked to drive wherever they wanted in the simulated city to get an idea of their basic driving behaviour. This was compared to how they drove when guided by a navigation system and also to their driving behaviour when asked to 'follow your friend in the car in front'. As well assessing their general speed, distance to the car in front and the time it took to move lanes; hazards were presented to see if their behaviour changed under different driving scenarios.

"We observed changes in behaviour that increased the likelihood of being involved in an accident," reveals Professor Gray.

When drivers were 'following a friend', they drove faster and more erratically, closer to the car in front and made quicker lane changes, compared to how they drove under normal conditions or with a guided navigation system. In addition, when confronted with hazards in the 'following a friend' simulation, the drivers were more likely to cut in front of a pedestrian crossing a road and speed through traffic lights turning red.

"It is important to note that in our simulation, the leader and other vehicles around them did not break any laws, so the follower was not just copying the risky driving behavior they saw from someone else," says Professor Gray.

By using a computerized driving simulation, the study was able to eliminate the contagious effect, where driver behaviour can be influenced by the traffic around them. Drivers often feel a social pressure to keep pace with other traffic and run traffic lights when other vehicles do the same.

Professor Gray concludes by offering some advice when a friend offers to show you the way. "If you are faced with this situation, get the address from the lead driver and use a map or navigation device so you know how to get there yourself. In the future, we plan to investigate whether some knowledge about the location of the destination can get rid of these dangerous effects."

Taking 2-minute brisk walks every 30 minutes and a half-hour walk each day reduces blood lipid levels

Many people spend increasing time sitting during their work days, but breaking things up with regular brisk walks, while also taking daily 30-minute walks, significantly lowers levels of fatty acids that lead to clogged arteries, researchers from New Zealand's University of Otago have found in a first-of-its-kind study.

Increased sitting is known to be associated with an increased risk of a cardiovascular disease, diabetes and death from all causes. Otago scientists have previously established that office workers taking brisk walks for two minutes every half hour lower their blood glucose and insulin levels.

Now, the most recent Otago study shows this sort of activity also reduces triglyceride (lipid) levels when measured in response to a meal consumed around 24 hours after starting the activity. High levels of triglycerides are linked to hardening of the arteries and other cardiovascular conditions.

The research recently appeared in the Journal of Clinical Lipidology. Recent Otago MSc graduate Ashleigh Homer's work on the study led to an Australian government-funded scholarship to complete her PhD with sedentary behaviour researcher Professor David Dustan at the Baker Heart and Diabetes Institute in Melbourne.

Study lead author Dr Meredith Peddie of Otago's Department of Human Nutrition says that earlier international research had overwhelmingly failed to detect evidence that regular walking breaks affect lipid levels, but this is likely due to the effect generally not being immediate.

In what is known as a randomised crossover trial, 36 participants completed four two-day interventions in the Otago study:

  • Prolonged sitting
  • Prolonged sitting with 30 minutes of continuous walking at the end of the first day
  • Sitting with two minutes of moderate intensity walking every 30 minutes
  • A combination of the continuous walking and regular activity breaks described above
  • Blood levels of triglycerides, which are non-esterified fatty acids (otherwise known as free fatty acids), glucose, and insulin responses were measured in the participants over five hours on the second day of the experiment.

The researchers found that, overall, short regular walking breaks, 30 minutes of continuous physical activity -- and especially the two combined -- appear to have good potential to improve people's metabolic health, Dr Peddie says.

"We believe there is an important health message here -- the traditional half-hour block of moderate to vigorous activity is important, but so is limiting long periods of sitting by undertaking regular short bouts of activity throughout the day.

"This approach, if maintained over months or years, may be enough to explain why individuals who regularly break up sedentary time have better cardio-metabolic health outcomes."

The link between slowed walking and mental decline

The connection between slowed walking speed and declining mental acuity appears to arise in the right hippocampus, a finger-shaped region buried deep in the brain at ear-level, according to a 14-year study conducted by scientists at the University of Pittsburgh Graduate School of Public Health.

The finding, published today in Neurology, the medical journal of the American Academy of Neurology, indicates that older patients may benefit if their doctors regularly measure their walking speed and watch for changes over time, which could be early signs of cognitive decline and warrant referral to a specialist for diagnostic testing.

"Prevention and early treatment may hold the key to reducing the global burden of dementia, but the current screening approaches are too invasive and costly to be widely used," said lead author Andrea Rosso, Ph.D., M.P.H., assistant professor in Pitt Public Health's Department of Epidemiology. "Our study required only a stopwatch, tape and an 18-foot-long hallway, along with about five minutes of time once every year or so."

Rosso and her colleagues assessed 175 older adults ages 70 to 79 when they enrolled in the Health, Aging and Body Composition (Health ABC) study in Pittsburgh or Memphis, Tennessee. At the beginning of the study, the participants were all in good mental health and had normal brain scans. Multiple times over 14 years, the participants walked an 18-foot stretch of hallway at what they deemed a normal walking pace while a research assistant timed them. At the conclusion of the study, the participants were tested again for their mental acuity and received brain scans.

As previous studies have shown, slowing in the participants' gait, or walking speed, was associated with cognitive impairment. However, Rosso's research determined that participants with a slowing gait and cognitive decline also experienced shrinkage of their right hippocampus, an area of the brain important to both memory and spatial orientation. It was the only area of the brain where the researchers found a shrinking volume to be related to both gait slowing and cognitive impairment.

Rosso's study also found gait slowing over an extended period of time to be a stronger predictor of cognitive decline than simply slowing at a single time point, which is what other, similar research evaluated. All the participants slowed over time, but those who slowed by 0.1 seconds more per year than their peers were 47 percent more likely to develop cognitive impairment. The finding held even when the researchers took into account slowing due to muscle weakness, knee pain and diseases, including diabetes, heart disease and hypertension.

"A fraction of a second is subtle, but over 14 years, or even less, you would notice," said Rosso, also an assistant professor in Pitt's Clinical and Translational Science Institute. "People should not just write off these changes in walking speed. It may not just be that grandma's getting slow--it could be an early indicator of something more serious."

While the team noted that slowing gait speed is not a sensitive enough measure to diagnose a cognitive issue, they argue that it should be included in regular geriatric evaluations to determine if there's a need for further testing. If cognitive decline can be detected early, there are therapies that can delay its onset, and the extra time could allow patients and families to plan for the eventual need for assisted care.

"Typically when physicians notice a slowing gait in their patients, they'll consider it a mechanical issue and refer the patient to physical therapy," said Rosso. "What we're finding is that physicians also should consider that there may be a brain pathology driving the slowing gait and refer the patient for a cognitive evaluation.

No detectable limit to how long people can live

New study finds no evidence that maximum lifespan has stopped increasing

Emma Morano passed away last April. At 117 years old, the Italian woman was the oldest known living human being.

Super- centenarians, such as Morano and Jeanne Calment of France, who famously lived to be 122 years old, continue to fascinate scientists and have led them to wonder just how long humans can live. A study published in Nature last October concluded that the upper limit of human age is peaking at around 115 years.

Now, however, a new study in Nature by McGill University biologists Bryan G. Hughes and Siegfried Hekimi comes to a starkly different conclusion. By analyzing the lifespan of the longest-living individuals from the USA, the UK, France and Japan for each year since 1968, Hekimi and Hughes found no evidence for such a limit, and if such a maximum exists, it has yet to be reached or identified, Hekimi says.

"Far into the foreseeable future"

"We just don't know what the age limit might be. In fact, by extending trend lines, we can show that maximum and average lifespans, could continue to increase far into the foreseeable future," Hekimi says. Many people are aware of what has happened with average lifespans. In 1920, for example, the average newborn Canadian could expect to live 60 years; a Canadian born in 1980 could expect 76 years, and today, life expectancy has jumped to 82 years. Maximum lifespan seems to follow the same trend.

It's impossible to predict what future lifespans in humans might look like, Hekimi says. Some scientists argue that technology, medical interventions, and improvements in living conditions could all push back the upper limit.

"It's hard to guess," Hekimi adds. "Three hundred years ago, many people lived only short lives. If we would have told them that one day most humans might live up to 100, they would have said we were crazy."

Teenage weight gain linked to increased stroke risk as an adult

Kids who become overweight during their teenage years may be more likely to develop a stroke decades later than kids who did not become overweight during those years, according to a study published in the June 28, 2017, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"The stroke rate has been increasing among young adults even while it has been decreasing for older people," said study author Jenny M. Kindblom, MD, PhD, of the University of Gothenburg in Sweden. "While we don't know the reasons for this increase, it has occurred at the same time as the obesity epidemic."

The study involved 37,669 Swedish men whose body mass index (BMI) was measured at age 8 and again at age 20. From age 20, they were followed for an average of 38 years. During that time, 918 men had strokes.

Men with excessive BMI increase from childhood to age 20 had a higher risk of stroke than men with average BMI increase. For every two-point increase in BMI, men were 20 percent more likely to have a stroke.

Men who were normal weight at age 8 but overweight at age 20 were 80 percent more likely to have a stroke. Of the 1,800 in this group, 67 had a stroke, or 3.7 percent.

Men who were overweight at both time points were 70 percent more likely to have a stroke. Of the 990 people in this group, 36 had a stroke, or 3.6 percent.

BMI at childhood was not on its own associated with an increased risk of stroke. Men who were of normal weight at both age 8 and age 20 and men who were overweight at age 8 but normal weight at age 20 did not have any increased risk of stroke. Of the 33,511 men who were of normal weight both at age 8 and age 20, 779 had a stroke during the study, or 2.3 percent. Of the 1,368 men who were overweight at age 8 and normal weight at age 20, 36 had a stroke, or 2.6 percent.

Kindblom noted that the study was observational and does not prove that the increase in BMI causes the increase in stroke, it just shows the association.

The study also found that people with high increases in BMI from age 8 to age 20 also were more likely to have high blood pressure as adults. People with high blood pressure are more likely to have stroke.

Kindblom said limitations of the study include that researchers could not control for important risk factors for stroke such as smoking, exercise and high cholesterol and that the participants were mainly white men and the results may not apply to other groups. She also noted that the obesity rates in the study group of men born in 1945 to 1961 were lower than current obesity rates.

"Today's environment that is so conducive to obesity may even further heighten the relationship we saw between increase in BMI and risk of stroke," she said.

Male infertility could be linked to noisy bedrooms, study suggests

Long-term exposure to a noisy environment, particularly at night, is linked to infertility in men, according to a study in Environmental Pollution. The researchers found that exposure above the WHO night noise level (55 dB - equivalent to the noise of a suburban street) is linked to a significant increase in infertility.

The scientists behind the study, from Seoul National University in the Republic of Korea, say it is important to consider noise when assessing environmental conditions that contribute to infertility.

Noise can be annoying - it breaks your concentration and disrupts your sleep. But noise has also been linked to health problems, such as heart disease and mental illness, and has been shown to change social behavior and interfere with the performance of complex tasks. Previous research focused on fertility in women has shown a link between exposure to noise and birth-related problems, such as premature birth, spontaneous abortion and congenital malformations.

The new study reveals that long-term exposure to relatively low levels of noise, particularly at night, may contribute to the development of infertility in men.

"Infertility is becoming a significant public health issue because of unexpected adverse effects on the health and quality of life and heavy expenditures on the health system," said Dr. Jin-Young Min, the study's co-author. "We know noise exposure has an effect on male fertility in animals, but our study is the first to show the risk of exposure to environmental noise on male infertility in humans."

Worldwide infertility problems affect one in six couples at least once in their lifetime, either temporarily or permanently. This may be down to a variety of causes, such as genetic abnormalities, infectious disease, environmental agents or certain behaviors. Dr. Min wanted to find out whether environmental exposure to noise, for example at work, has an impact on male infertility.

The researchers analyzed a health insurance dataset, focusing on 206,492 men aged 20-59. They calculated the levels of noise exposure using information from the National Noise Information System combined with the men's postal codes. In the eight years covered by the study (2006-2013), 3,293 had an infertility diagnosis.

After adjusting the data for variables like age, income, BMI and smoking, they found the chances of being diagnosed infertile were significantly higher in men exposed to noise over 55 dB at night (about as noisy as a suburban street or an air conditioner).

"One of the biggest problems the world is facing today is environmental pollution; my special concern is what Theo Colborn described in her book Our Stolen Future: that the rapid decline in men's sperm counts in the 20th century was due to environmental pollution," commented Dr. Min. "If this trend continues, humans in the future will not be able to have normal pregnancy and childbirth. If you are a man and suffer from infertility, you need to consider exposure to environmental pollution as a risk factor."

Longer reproductive years linked to lower cardiovascular & cerebrovascular risk in women

A new study has shown that every 1 year increase in reproductive duration--years from menarche to menopause--was associated with a 3% reduction in a woman's risk of angina or stroke. These results, demonstrated in women 60 years of age and older, support a protective role for estrogen, as reported in an article in Journal of Women's Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Women's Health website until July 28, 2017.

Coauthors Hend Mansoor, PharmD, Islam Elgendy, MD, Richard Segal, PhD, and Abraham Hartzema, PhD, University of Florida, Gainesville, present their findings in the article entitled "Duration of Reproductive Years and the Risk of Cardiovascular and Cerebrovascular Events in Older Women: Insights from the National Health and Nutrition Examination Survey." The researchers compared cardiovascular and cerebrovascular events among women divided into two groups, longer reproductive duration (<30 5-year="" analysis="" and="" beginning="" br="" duration="" end="" for="" from="" group.="" in="" increments="" longer="" menstruation="" of="" performing="" reproduction="" shorter="" subgroup="" the="" to="" years="">
"By evaluating women's risk of cardiovascular and cerebrovascular events based on the duration of their reproductive years, rather than just their age at menarche or their age at menopause as individual variables, Mansoor et al. take into account the effect of cumulative exposure to sex hormones such as estrogen," says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women's Health, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA, and President of the Academy of Women's Health.

Tuesday, June 27, 2017

African-Americans with healthier lifestyles had lower risk of high blood pressure

Among African Americans, small health improvements were associated with lower risk of developing high blood pressure, according to new research in the American Heart Association's journal Hypertension. African Americans who had at least two modifiable healthy behaviors at the beginning of the study, compared to those with one or none, researchers found the risk of high blood pressure at follow-up was reduced by 20 percent.

Researchers also found that there was a 90 percent lower risk for high blood pressure among African Americans who had at least six of seven modifiable healthy behaviors that are defined as part of the American Heart Association's Life's Simple 7 compared with participants who followed none or one.2

The Life's Simple 7 was developed by the American Heart Association to monitor cardiovascular health in US adults and to help demonstrate that small changes can lead to a big impact in improving heart health. The Life's Simple 7 includes: not smoking; maintaining a healthy weight; eating healthy; being physically active; maintaining healthy blood sugar levels; controlling cholesterol levels and managing blood pressure to reduce the risk of heart attack and stroke.

Compared with whites, African Americans have a greater risk for developing high blood pressure.4 According to the American Heart Association, currently one out of three adults in America has high blood pressure. Among non-Hispanic blacks, 45 percent of men and nearly half (46.3 percent) of women have high blood pressure.

"The Life's Simple 7, an approach used by the American Heart Association to monitor cardiovascular health, can also be used to monitor high blood pressure risk in African Americans, a major risk factor for cardiovascular disease," said John N. Booth, III, MS, lead study author and PhD student in the Department of Epidemiology at the University of Alabama at Birmingham. "We found that even small improvements in cardiovascular health can reduce risk for developing high blood pressure."

These latest findings are based on the Jackson Heart Study, a community-based study designed to assess cardiovascular risk among African Americans. Blood pressure, blood sugar and cholesterol were measured in more than 5,000 study participants (5,306 total). They were also asked about their exercise, eating and smoking habits at the beginning of the study and followed up about 8 years later.

Among the study group researchers found:

  • More than half (50.3 percent) developed high blood pressure.
  • Eight out of 10 (81.3 percent) who followed only one or none of the healthy behaviors developed high blood pressure compared with only 1 in 10 (11.1 percent) of participants who followed six of the behaviors. None of the participants followed all seven healthy behaviors at the beginning of the study.9
  • Overall, participants who followed more ideal health behaviors were younger and more likely to be women and to have at least a high school education and a household income of at least $25,000 a year.

Eating more vegetable protein may protect against early menopause

Results of a new study from epidemiologists at the University of Massachusetts Amherst and Harvard T.H. Chan School of Public Health suggest that long-term, high intake of vegetable protein from such foods as whole grains, soy and tofu, may protect women from early menopause and could prolong reproductive function.

Consuming enriched pasta, dark bread and cold cereal were especially associated with lower risk, while they observed no similar relation to eating animal sources of protein.

"A better understanding of how dietary vegetable protein intake is associated with ovarian aging may identify ways for women to modify their risk of early onset menopause and associated health conditions," write first author and then-graduate student Maegan Boutot, with her advisor, professor Elizabeth Bertone-Johnson. Details appear in the current early online edition of the American Journal of Epidemiology.

Early menopause, the cessation of ovarian function before age 45, affects about 10 percent of women and is associated with higher risk of cardiovascular disease, osteoporosis and early cognitive decline, the authors note. Few studies have evaluated how protein intake is associated with menopause timing, they add, and to their knowledge this is the first to look specifically at early menopause.

Boutot, Bertone-Johnson and colleagues in the School of Public Health and Health Sciences at UMass Amherst, with others, evaluated the relationship between diet and risk of early menopause among members of the Nurses' Health Study II (NHS2), an ongoing prospective study of 116,000 women aged 25-42 when they entered it in 1989.

Participants were asked to report how often they ate a single serving of 131 foods, beverages and supplements over the previous year, from "never or less than once a month" to "6+ per day." They observed that women consuming approximately 6.5 percent of their daily calories as vegetable protein had a significant 16 percent lower risk of early menopause compared to women whose intake was approximately 4 percent of calories.

For a woman with a 2,000 calorie per day diet, the authors explain, this is equal to three to four servings of such foods as enriched pasta, breakfast cereal, tofu and nuts, or about 32.5 grams a day. They adjusted for age, smoking, body mass index and other possible confounding factors.

Boutot and Bertone-Johnson add, "Though relatively few women in our study consumed very high levels of vegetable protein and our power for analyses of more extreme intake levels was limited, women consuming 9 or more percent of their calories from vegetable protein had a hazard ratio of 0.41 (95 percent confidence interval = 0.19-0.88)" compared to those eating less than 4 percent.

Others on the study team were from Brigham and Women's Hospital and Harvard Medical School. The study was supported by a grant from NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development.

For the NHS2, follow-up questionnaires have assessed nurses' lifestyle behaviors and medical conditions every two years. Nearly 90 percent have continued to participate in followup. Diet was assessed five times over the 20-year study, allowing the researchers to capture within-person variation in changes in food and nutrient intake over times, Boutot explains. Participants in the study contributed more than 1 million person-years of follow-up, during which 2,041 women experienced early menopause.

Boutot and Bertone-Johnson suggest that more prospective studies of their findings are warranted, including studies that compare soy-based and non-soy vegetable proteins.

People living at home with dementia at risk of potentially dangerous antipsychotic usage

Off-label use of antipsychotic medications to treat patients with dementia has reduced dramatically in recent years due to education programs warning of increased risk of death. However, those campaigns have not focused on care settings outside of nursing homes, leaving community-dwelling adults with dementia at risk of potentially fatal side effects, according to research published in The Journal of the American Osteopathic Association.

As a result, physicians are still prescribing off-label antipsychotics to help families manage the behavioral and psychologic symptoms of dementia (BPSD)--potentially unaware these medications drive mortality rates 1.6 times higher in elderly people with dementia. With more than 1.2 million Medicare Part D enrollees residing in the general community with dementia-- 14 percent of whom are given antipsychotics--this poses a significant risk.

There is no FDA-approved treatment for BPSD, which include verbal and physical aggression, agitation, oppositional behavior, delusions, hallucinations, sleep disturbances and wandering. About 90 percent of patients with dementia will exhibit at least one of those symptoms, which can create a danger to the patient and others, sometimes resulting in a transfer to a nursing home, said author Rengena Chan-Ting, DO, of the Department of Geriatrics and Gerontology at Rowan University School of Osteopathic Medicine.

"Physicians are often limited in the medication treatments that are available for a patient suffering from behavioral and psychological symptoms of dementia, especially for a community dwelling patient. It's not unreasonable for them to try antipsychotic medications, with caveats. However, older patients are especially vulnerable to the adverse effects of these medications, which greatly increase their risk of death," Dr. Chan-Ting said. "There is a growing body of evidence that non-drug approaches can be more effective than antipsychotics, which benefit only 20-30% of patients."

The research notes that few studies address the off-label use of antipsychotics for the management of dementia, but Medicare Part D spending on those drugs prescribed to older adults with dementia totaled $363 million in 2012, with nearly $171 million spent on patients living in their community. Generally, 37 percent of spending on antipsychotic medications goes to off-label use.

The non-drug interventions showing the greatest promise are behavior management, cognitive or emotional therapy and sensory stimulation, according to Dr. Chan-Ting. Reminiscence therapy, like reading old newspaper clippings or sorting photographs, can be effective, along with calming techniques like aroma therapy, massage or music.

"I recommend physicians partner with the patient and caregivers to find the best combination of approaches, involving the patient, and team involved, in decision making to the fullest extent possible," she added.

Greater muscle strength -- better cognitive function for older people

Greater muscle strength is associated with better cognitive function in ageing men and women, according to a new Finnish study. The association of extensively measured upper and lower body muscle strength with cognitive function was observed, but handgrip strength was not associated with cognitive function. Cognition refers to brain functions relating to receiving, storing, processing and using information. The findings were published in European Geriatric Medicine.

The study population comprised 338 men and women with an average age of 66 years. Their muscle strength was measured utilising handgrip strength, three lower body exercises such as leg extension, leg flexion and leg press and two upper body exercises such as chest press and seated row. Sum scores to depict lower body and upper body muscle strength were calculated separately, and cognitive function was assessed using the CERAD neuropsychological test battery with calculated total score.

Handgrip strength is relatively easy and fast to measure, and it has been widely used as a measure of muscle strength in various studies. However, this new study could not demonstrate an association between muscle strength and cognitive function when using a model based on mere handgrip strength and age. Instead, an association between muscle strength and cognitive function was observed only when sum scores depicting upper or lower body muscle strength were included in the model.

"The findings suggest that it may be justified to go beyond the handgrip and to include the upper and lower body when measuring muscle strength, as this may better reflect the association between muscle strength and cognition," says Early Stage Researcher Heikki Pentikäinen, the first author of the article, who is currently preparing a PhD thesis on the topic for the University of Eastern Finland.

Exercise is known to have various health benefits, and strength training is a way for practically everyone to increase muscle mass and enhance muscle strength. However, the association of muscle strength with various aspects of cognitive function is a relatively under-researched area. The study provided new insight into the methodology of measuring muscle strength and into the role of muscle strength in cognitive function. The study constituted part of the extensive, population-based DR's EXTRA study, which was a four-year randomised and controlled intervention study analysing the effects of exercise and nutrition on endothelial function, atherosclerosis and cognition.

The study was carried out at Kuopio Research Institute of Exercise Medicine in 2005-2011 and it involved more than 1,400 men and women living in the eastern part of Finland.

Why osteoarthritis is more common in females

Researchers have more evidence that males and females are different, this time in the fluid that helps protect the cartilage in their knee joints.

They have found in the synovial fluid of this joint, clear differences in the messages cells are sending and receiving via tiny pieces of RNA, called microRNA, in males and females with the common and debilitating condition osteoarthritis.

The differences may help explain why the disease is more common in women as it points toward a more targeted way to diagnose and treat this "wear and tear" arthritis, said Dr. Sadanand Fulzele, bone biologist in the Department of Orthopaedic Surgery at the Medical College of Georgia at Augusta University.

Osteoarthritis, which affects more than 30 million Americans, is fundamentally a destruction of the cartilage that provides padding between our bones.

"It's a huge problem," says Dr. Monte Hunter, chair of the MCG Department of Orthopaedic Surgery and a coauthor of the study in the journal Scientific Reports. Today's treatment addresses symptoms, like inflammation and pain, and the bottom line for some patients is knee replacement. Clinicians like Hunter would like to provide patients additional options for diagnosing and treating this common malady of aging.

Synovial fluid is known to provide clues about joint health, so MCG researchers decided to look at what messages cells in the region were sending and receiving by looking inside traveling compartments in the fluid called exosomes, says Fulzele, corresponding author.

"What we found is there is no change in the number of exosomes, but a change in the microRNA cargo they carry," Fulzele says.

They isolated the mostly round exosomes in discarded human synovial fluid from patients with and without osteoarthritis. They found in the males that 69 microRNAs were significantly downregulated and 45 were upregulated. In females, however there were 91 downregulated versus 53 upregulated.

Females just seemed more impacted: In total, they had more than 70 biological processes altered compared to males who had closer to 50, the researchers report.

Fulzele and Hunter suspect that the gender differences they found in exosome content helps explain gender differences in disease incidence and that estrogen was key to the differences.

Particularly in the females, they found microRNA that should be sending messages that are good for the joints, like promoting estrogen signaling and collagen-producing cells, turned off or otherwise altered.

Lower estrogen levels, like those that occur following menopause, prompt production of more cells that destroy bone. In this environ, those bone-consuming cells also tend to live longer, which can result in a net bone loss. Conversely, reduced osteoarthritis risk is considered a benefit or hormone replacement therapy.

MCG researchers' hypothesize that estrogen plays an important role in determining which microRNAs the exosomes contain. In fact, when they used aromatase inhibitors to reduce the availability of estrogen, they found a small lineup of microRNAs decreased in number. When they treated cartilage cells from healthy females with exosomes from males and females with osteoarthritis, significantly fewer healthy cartilage cells lived after exposure to the exosomes from patients with disease. Expression of genes that make the extracellular matrix that is the framework of cartilage went down while expression of genes that promote inflammation increased.

They only found one microRNA, MiR-504-3p upregulated in both male and female osteoarthritis patients. Although it's unclear what MiR-504-3p does, Fulzele thinks it degenerates cartilage, which is the crux of osteoarthritis. In future studies, they will use MIR-504-3p inhibitors to remove it from the equation and try to determine the function of this tiny piece of RNA.

All cells excrete exosomes as one way to communicate. They carry cargo like protein, lipids as well as microRNA, which can impact the expression and actions of many different genes. In the case of the synovial fluid, Fulzele says the exosome source is likely cells in the synovial membrane that lines the joints and produces the fluid. Wear and tear that comes with aging, and can be accelerated and aggravated by injury, can inflame the membrane, which may alter the cargo in the exosomes and the messages they carry, Fulzele says.

Knee replacement becomes the endgame for patients whose dwindling cartilage can literally translate to one bone rubbing against another.

"People understand bone on bone when they hear that," Hunter says of the potentially excruciating and debilitating pain that may result. Early interventions include icing a swollen knee, taking anti-inflammatories and avoiding activities that are hard on the joints, says Hunter. They can also inject hyaluronic acid, the major component of synovial fluid, into the knee in an attempt to normalize the environment.

Today, a diagnosis is made based on the joint pain and stiffness patients report, a physical exam and X-ray. Physicians also often examine the synovial fluid, Hunter says. When a knee is swollen and warm to the touch, they will extract some of the fluid to look for problems other than wear and tear, like an infection and/or uric acid crystals, Hunter says. The crystals could be an indicator of gout, a type of arthritis that results from the body's reaction to excessive levels of uric acid, which results from the breakdown of purines, chemicals found in meat, poultry and seafood.

Hunter hopes that soon he and his colleagues will also examine exosomes in the fluid for indicators of that patient's specific instigators of cartilage destruction. They then hope to devise a cocktail - potentially a mix of microRNA inhibitors and joint health promoting microRNA mimics delivered in manmade exosomes - that can be injected into the knee to target and help resolve the debilitating destruction.

MCG researchers already are exploring ways to block the microRNAs that are causing destruction.

Other key collaborators include Dr. Ravindra Kolhe, molecular pathologist in the MCG Department of Pathology, and Dr. Mark Hamrick, bone biologist in the MCG Department of Cellular Biology and Anatomy.

While osteoarthritis is considered normal wear and tear, it's multifactorial, says Hunter, the Dr. Charles Goodrich Henry and Carolyn Howell Henry Distinguished Chair at MCG. "There is a genetic component. Some of us have stronger cartilage than others. Some of us are made differently so the angle of our joints puts more pressure in some places."

Risk factors include injury, overuse, increasing age, obesity, a family history, as well as being female, according to the Centers for Disease Control and Prevention. Sports with repetitive high impact, like running and basketball, can increase the risk.

Exposure to light causes emotional and physical responses in migraine sufferers

People experiencing migraines often avoid light and find relief in darkness. A new study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has revealed a previously unknown connection between the light-sensitive nerve cells in the eye and centers in the brain that regulate mood and a host of physical parameters such as heart rate, shortness of breath, fatigue, congestion and nausea. The findings, which explain how light can induce the negative emotions and unpleasant physical sensations that often accompany migraine, were published online today in Proceedings of the National Academy of Sciences.

"While studying the effects of color on headache intensity, we found that some patients reported finding light uncomfortable even when it didn't make their headaches worse," said lead author Rami Burstein, PhD, Vice Chairman of research in the Department of Anesthesia, Critical Care and Pain Medicine at BIDMC and professor of anesthesia Harvard Medical School. "We found that exposure to different colors of light could make patients experiencing a migraine feel irritable, angry, nervous, depressed and anxious. These patients also reported feeling physical discomfort, including tightness in the chest or throat, shortness of breath, light-headedness and nausea."

Burstein and colleagues showed different colored lights to 81 people who frequently experienced migraines and 17 people who had never had a migraine and asked them to describe what they experienced. The effects of light and color were tested three times: once for those who never experience migraines and twice for patients with migraines - once during an attack and once between attacks.

The researchers found that all colors of light triggered unpleasant physiological sensations in patients with migraines both during and between attacks. Additionally, migraine sufferers reported intense emotional responses such as anger, nervousness, hopeless, sadness, depression, anxiety and fear when exposed to all light colors except green. Participants who did not suffer from migraines did not report a strong physiological response when exposed to any color of light, but they did report that all colors of light evoked pleasant emotions.

"These findings explained accounts from earlier work from blind migraine sufferers in a previous study," said Burstein. "We had noticed that light exacerbated headache intensity in participants who perceive light but have no sight as a result of loss of rods and cones, but not in those who lack light perception because of optic nerve degeneration. This suggested the nerves relaying signals from the eye to the brain played a critical role in the discomfort associated with migraine."

In a pre-clinical experiment with albino rats, first author Rodrigo Noseda, PhD, researcher at BIDMC and assistant professor of anesthesia Harvard Medical School, identified previously unknown connections between nerve cells in the retina - the back of the eye where light is detected - and neurons extending into regions of the brain that regulate physiological, autonomic, endocrine and emotional responses to changes in the external environment.

"We now have a physical explanation of why migraine patients have negative reactions to light," said Burstein. "And now we are working on ways to use this information in hopes that soon migraine sufferers will be able to avoid not only the pain but also the negative emotions and physical discomfort that light creates for them."

These findings build on research published by Burstein and colleagues last year, which reported that migraine headache intensity increases with blue, red, amber and white lights but decreases with a specific wavelength of green light. This green light, they discovered, activates the neurons in the retina and the brain to a lesser extent than blue, red, amber and white lights do, and is therefore less likely to trigger the physiological, autonomic, endocrine and emotional responses migraine sufferers often report.

Lack of sleep + spat with spouse = potential health problems

A lack of sleep doesn't just leave you cranky and spoiling for a fight. Researchers at The Ohio State University Institute for Behavioral Medicine Research say it also puts you at risk for stress-related inflammation.

This type of inflammation is associated with higher risk of cardiovascular disease, diabetes, arthritis and other diseases.

"We know sleep problems are also linked with inflammation and many of the same chronic illnesses. So we were interested to see how sleep related to inflammation among married couples, and whether one partner's sleep affected the other's inflammation," said Stephanie Wilson, lead researcher on the study.

Results of the study were published in the journal Psychoneuroendocrinology.

The research team recruited 43 couples who completed two study visits. Each time, the couples provided blood samples and said how many hours they had slept the previous two nights. Then researchers had the couples try to resolve a topic that sparks conflict in their marriage. Blood samples were taken again following the discussion.

"We found that people who slept less in the past few nights didn't wake up with higher inflammation, but they had a greater inflammatory response to the conflict. So that tells us less sleep increased vulnerability to a stressor," Wilson said.

If both partners got less than seven hours of sleep the previous two nights, the couple was more likely to argue or become hostile. For every hour of sleep lost, the researchers noted that levels of two known inflammatory markers rose 6 percent. Couples who used unhealthy tactics in their disagreement had an even greater inflammatory response--about a 10 percent increase with each hour of less sleep.

"Any increase isn't good, but a protracted increase that isn't being addressed is where it can become a problem," Wilson said. "What's concerning is both a lack of sleep and marital conflict are common in daily life. About half of our study couples had slept less than the recommended seven hours in recent nights."

That's higher than the current national average. The CDC reports 35 percent of Americans get less than seven hours of sleep per night.

"Part of the issue in a marriage is that sleep patterns often track together. If one person is restless, or has chronic problems, that can impact the other's sleep. If these problems persist over time, you can get this nasty reverberation within the couple," said Janice Kiecolt-Glaser, senior author and director of the Institute for Behavioral Medicine Research.

Researchers were encouraged to see that there was a protective effect if one of the partners was well-rested, or discussed conflict in a healthy way. They tended to neutralize the disagreement that might be stirred by the sleep-deprived partner.

"We would tell people that it's important to find good ways to process the relationship and resolve conflict -- and get some sleep," Kiecolt-Glaser said.

Brains evolved to need exercise

Mounting scientific evidence shows that exercise is good not only for our bodies, but for our brains. Yet, exactly why physical activity benefits the brain is not well understood.

In a new article published in the journal Trends in Neurosciences, University of Arizona researchers suggest that the link between exercise and the brain is a product of our evolutionary history and our past as hunter-gatherers.

UA anthropologist David Raichlen and UA psychologist Gene Alexander, who together run a research program on exercise and the brain, propose an "adaptive capacity model" for understanding, from an evolutionary neuroscience perspective, how physical activity impacts brain structure and function.

Their argument: As humans transitioned from a relatively sedentary apelike existence to a more physically demanding hunter-gatherer lifestyle, starting around 2 million years ago, we began to engage in complex foraging tasks that were simultaneously physically and mentally demanding, and that may explain how physical activity and the brain came to be so connected.

"We think our physiology evolved to respond to those increases in physical activity levels, and those physiological adaptations go from your bones and your muscles, apparently all the way to your brain," said Raichlen, an associate professor in the UA School of Anthropology in the College of Social and Behavioral Sciences.

"It's very odd to think that moving your body should affect your brain in this way -- that exercise should have some beneficial impact on brain structure and function -- but if you start thinking about it from an evolutionary perspective, you can start to piece together why that system would adaptively respond to exercise challenges and stresses," he said.

Having this underlying understanding of the exercise-brain connection could help researchers come up with ways to enhance the benefits of exercise even further, and to develop effective interventions for age-related cognitive decline or even neurodegenerative diseases such as Alzheimer's.

Notably, the parts of the brain most taxed during a complex activity such as foraging -- areas that play a key role in memory and executive functions such as problem solving and planning -- are the same areas that seem to benefit from exercise in studies.

"Foraging is an incredibly complex cognitive behavior," Raichlen said. "You're moving on a landscape, you're using memory not only to know where to go but also to navigate your way back, you're paying attention to your surroundings. You're multitasking the entire time because you're making decisions while you're paying attention to the environment, while you are also monitoring your motor systems over complex terrain. Putting all that together creates a very complex multitasking effort."

The adaptive capacity model could help explain research findings such as those published by Raichlen and Alexander last year showing that runners' brains appear to be more connected than brains of non-runners.

The model also could help inform interventions for the cognitive decline that often accompanies aging -- in a period in life when physical activity levels tend to decline as well.

"What we're proposing is, if you're not sufficiently engaged in this kind of cognitively challenging aerobic activity, then this may be responsible for what we often see as healthy brain aging, where people start to show some diminished cognitive abilities," said Alexander, a UA professor of psychology, psychiatry, neuroscience and physiological sciences. "So the natural aging process might really be part of a reduced capacity in response to not being engaged enough."

Reduced capacity refers to what can happen in organ systems throughout the body when they are deprived of exercise.

"Our organ systems adapt to the stresses they undergo," said Raichlen, an avid runner and expert on running. "For example, if you engage in exercise, your cardiovascular system has to adapt to expand capacity, be it through enlarging your heart or increasing your vasculature, and that takes energy. So if you're not challenging it in that way -- if you're not engaging in aerobic exercise -- to save energy, your body simply reduces that capacity."

In the case of the brain, if it is not being stressed enough it may begin to atrophy. This may be especially concerning, considering how much more sedentary humans' lifestyles have become.

"Our evolutionary history suggests that we are, fundamentally, cognitively engaged endurance athletes, and that if we don't remain active we're going to have this loss of capacity in response to that," said Alexander, who studies brain aging and Alzheimer's disease as a member of the UA's Evelyn F. McKnight Brain Institute. "So there really may be a mismatch between our relatively sedentary lifestyles of today and how we evolved."

Alexander and Raichlen say future research should look at how different levels of exercise intensity, as well as different types of exercise, or exercise paired specifically with cognitive tasks, affect the brain.

For example, exercising in a novel environment that poses a new mental challenge, may prove to be especially beneficial, Raichlen said.

"Most of the research in this area puts people in a cognitively impoverished environment. They put people in a lab and have them run on a treadmill or exercise bike, and you don't really have to do as much, so it's possible that we're missing something by not increasing novelty," he said.

Alexander and Raichlen say they hope the adaptive capacity model will help advance research on exercise and the brain.

"This evolutionary neuroscience perspective is something that's been generally lacking in the field," Alexander said. "And we think this might be helpful to advance research and help develop some new specific hypotheses and ways to identify more universally effective interventions that could be helpful to everyone."

New study links hot flashes with depression

With age comes a greater risk of depression, especially in women. With 15% of the female population in the US being 65 or older, and the number expected to double in the next 50 years, there is a major focus on age-related disorders, including depression. A new study published in Menopause, the journal of The North American Menopause Society (NAMS), documents an association between hot flashes and a greater risk of depression.

Although previous studies have shown an association between hot flashes and depressive symptoms, this new study specifically looked at the impact of hot flashes, along with a number of other independent factors, on the risk of depression in women 65 or older. The study results included in the article titled "Vasomotor symptoms are associated with depressive symptoms in community-dwelling old women" were based on an analysis of more than 1,500 Australian women aged 65 to 79 years.

Among other findings, the study documented that a number of risk factors are independently associated with moderate-to-severe depressive symptoms, including persistent hot flashes. Other factors included living in financially insecure housing, serving as a caregiver to another person, being a smoker, having pelvic floor dysfunction, or experiencing vaginal dryness during intercourse. Women with partners and those employed were less susceptible to depression. Of no surprise was the fact that moderate-to-severe depressive symptoms were more common among women using antidepressants compared with nonusers.

"Older women need to be assessed for depression, particularly if they have housing issues or caregiving responsibilities and complain of hot flashes, vaginal dryness, or pelvic floor issues," says Dr. JoAnn Pinkerton, NAMS executive director.

Yoga more risky for causing musculoskeletal pain than you might think

Yoga causes musculoskeletal pain in 10 per cent of people and exacerbates 21 per cent of existing injuries, University of Sydney research shows.

Published in the Journal of Bodywork and Movement Therapies, the findings come from the first prospective study to investigate injuries caused from recreational participation in yoga.

Yoga is an increasingly popular complementary or alternative therapy for musculoskeletal disorders, with millions of people practicing worldwide.

"While yoga can be beneficial for musculoskeletal pain, like any form of exercise, it can also result in musculoskeletal pain," said lead researcher Associate Professor Evangelos Pappas from the University's Faculty of Health Sciences, who conducted the study with Professor Marc Campo from Mercy College, New York.

"Our study found that the incidence of pain caused by yoga is more than 10 per cent per year, which is comparable to the injury rate of all sports injuries combined among the physically active population. However people consider it to be a very safe activity. This injury rate is up to 10 times higher than has previously been reported.

"We also found that yoga can exacerbate existing pain, with 21 per cent of existing injuries made worse by doing yoga, particularly pre-existing musculoskeletal pain in the upper limbs.

"In terms of severity, more than one-third of cases of pain caused by yoga were serious enough to prevent yoga participation and lasted more than 3 months.

"The study found that most "new" yoga pain was in the upper extremities (shoulder, elbow, wrist, hand) possibly due to downward dog and similar postures that put weight on the upper limbs.

"It's not all bad news, however, as 74 per cent of participants in the study reported that existing pain was improved by yoga, highlighting the complex relationship between musculoskeletal pain and yoga practice.

"These findings can be useful for clinicians and individuals to compare the risks of yoga to other exercise enabling them to make informed decisions about which types of activity are best.

"Pain caused by yoga might be prevented by careful performance and participants telling their yoga teachers of injuries they may have prior to participation, as well as informing their healthcare professionals about their yoga practice.

"We recommend that yoga teachers also discuss with their students the risks for injury if not practiced conscientiously, and the potential for yoga to exacerbate some injuries.

"Yoga participants are encouraged to discuss the risks of injury and any pre-existing pain, especially in the upper limbs, with yoga teachers and physiotherapists to explore posture modifications that may results in safer practice," Associate Professor Pappas said.

More than half of all opioid prescriptions go to people with mental illness

Fifty-one percent of all opioid medications distributed in the U.S. each year are prescribed to adults with mood disorders such as depression and anxiety, according to new research from the University of Michigan and the Geisel School of Medicine at Dartmouth.

"Despite representing only 16 percent of the adult population, adults with mental health disorders receive more than half of all opioid prescriptions distributed each year in the United States," said Matthew Davis, lead author of the study and assistant professor at the U-M School of Nursing.

Overall, of the 115 million prescriptions written for opiates each year, 60 million are written for adults with mental illness.

The study, "Prescription opioid use among adults with mental health disorders in the United States," is among the first to show the extent to which the population of Americans with mental illness use opioids. It will be published online July 6 in the Journal of the American Board of Family Medicine.

Researchers found that among the 38.6 million Americans diagnosed with mental health disorders, more than 7 million, or 18 percent, are prescribed opioids each year. By comparison, only 5 percent of adults without mental disorders are likely to use prescription opioids.

"Because of the vulnerable nature of patients with mental illness, such as their susceptibility for opioid dependency and abuse, this finding warrants urgent attention to determine if the risks associated with such prescribing are balanced with therapeutic benefits," said study co-author Brian Sites, an anesthesiologist at Dartmouth-Hitchcock Medical Center.

The connection between mental illness and opioid prescribing is particularly concerning because mental illness is also a prominent risk factor for overdose and other adverse opioid-related outcomes, Sites and Davis say.

Older obese adults can benefit from moderate exercise

Moderate-intensity exercise can help even extremely obese older adults improve their ability to perform common daily activities and remain independent, according to researchers at Wake Forest Baptist Medical Center.

Findings from the National Institutes of Health-funded study are published in the July issue of the journal Obesity.

In the United States, obesity affects nearly 13 million adults age 65 and older. Both overall obesity and abdominal obesity are strongly associated with the development of major mobility disability (MMD), the inability to walk a quarter of a mile, according to the study's lead author, Stephen Kritchevsky, Ph.D., director of the Sticht Center for Healthy Aging and Alzheimer's Prevention at Wake Forest Baptist.

Previous data on older populations had suggested that obesity may lessen the beneficial effects of physical activity on mobility. However, this research, which analyzed data from the multicenter Lifestyle Interventions and Independence for Elders (LIFE) study, showed that a structured physical activity program reduced the risk of MMD even in older adults with extreme obesity.

"The inability to walk a quarter of a mile is a proxy for common daily activities, such as the inability to walk a block around the neighborhood or to walk several street blocks to go to a store," Kritchevsky said. "Having a major mobility disorder can really affect the quality of life and independence for older people, but we showed that moderate exercise was a safe and effective way to reduce that risk even in severely obese people."

The LIFE study was a large clinical trial that enrolled 1,635 sedentary men and women age 70 to 89. The participants were randomized to a moderate intensity physical activity program or a health education program to test if the physical activity program would reduce the rate of MMD compared to the education program. Major mobility disability was defined as the inability to walk 400 meters (about a quarter of a mile) without sitting and without help from another person or a walker, Kritchevsky said.

Participants were divided into four groups according to body mass index (BMI) - a measure of body fat based on height and weight - and waist circumference: non-obese with BMI less than 30; non-obese with high waist circumference of more than 40 inches for men and 34 inches for women; class 1 obese with BMI between 30 and 35; and class 2 obese with BMI of 35 or higher.

The physical activity program focused on walking, strength, balance and flexibility training. The goal for participants was to be able to walk at moderate intensity for 30 minutes and perform 10 minutes of lower-extremity strength training with ankle weights and 10 minutes of balance training in a single session. Participants attended two center-based training sessions per week and performed at-home activities three to four times per week during the two-year study.

The health education program involved in-person group workshops focused on aging-relevant topics such as nutrition, safety and legal/financial issues. Sessions included lectures and interactive discussions and five to 10 minutes of upper body stretching exercises.

While there was no significant difference between obesity category and intervention effect, those in the class 2 obesity group showed the greatest benefit from the physical activity program, reducing their risk of MDD by 31 percent, Kritchevsky said.

Older adults who take 5+ medications walk slower than those who take fewer medications

"Polypharmacy" is the term used when someone takes many (usually five or more) different medications. Experts suggest that, for most older adults, taking that many medications may not be medically necessary. Taking multiple medications also can be linked to problems such as falls, frailty, disability, and even death. Polypharmacy also is a problem for older adults due to side effects or interactions resulting from the use of different medications. Older adults may have difficulties taking the medications properly, and the medications may interfere with a person's ability to function well.

The ability to walk well is a sign of independence and good health for older adults, for example, and it may be affected by the use of multiple medications. Although healthcare providers know that some treatments can slow or hamper an older person's ability to walk, little is known about the effects of polypharmacy on walking while performing other tasks, like talking. In a new study, researchers examined how polypharmacy affected walking while talking. They published their study in the Journal of the American Geriatrics Society.

The researchers examined information from 482 people age 65 and older who were enrolled in the "Central Control of Mobility in Aging" study. That study's main purpose was to determine how changes to the brain and our central nervous system occur during aging, and how they might impact an older person's ability to walk.

Researchers confirmed the medications (prescriptions as well as herbal and other over-the-counter supplements) study participants were taking. The researchers defined "polypharmacy" as using five or more of these treatments.

Participants took detailed exams assessing physical health, mental well-being, and mobility at the start of the study and at yearly follow-up appointments. Among other evaluations, the researchers measured the participants' walking speed. None of the participants used walking aides (such as canes or walkers) or monitors. The participants were asked to walk at their normal pace on a special 20-foot long walkway, and to walk while talking. The research team also interviewed the participants to learn about their medical conditions, ability to think and make decisions, and brain function.

Among the 482 participants in the study, 34 percent used five or more medications during the study period (June 2011-February 2016); 10 percent used more than eight medications. The participants were mostly in their late 70s.

People in the polypharmacy group were more likely to have high blood pressure, congestive heart failure, diabetes, and a history of heart attacks. They were also more likely to have had a fall within the last year and were more overweight than people in the non-polypharmacy group.

After accounting for chronic health problems, a history of falls, and other issues, the people in the polypharmacy group had a slower walking speed (or gait) than the people in the non-polypharmacy group. Those who took 8 or more medications had slower walking speed when walking while talking. The researchers concluded that there was a link between polypharmacy and walking speed, and that more studies would be needed to follow-up on their findings and the effect specific medications might have on overall well-being.

The researchers also noted that at their check-ups, older adults should be asked about all the medications they take, including herbal and other over-the-counter supplements. They also suggested that healthcare professionals measure walking speed during regular check-ups.

Magnesium supplements an option for treating depression

Depression presents an enormous disease burden, with a reported 350 million people worldwide suffering from the disease, but traditional SSRI treatments carry a burden of their own - in dollars and side effects. New clinical research published today in PLoS One shows that over-the-counter magnesium appears safe and effective to treat mild to moderate depression.

Critical to such body functions as heart rhythm, blood pressure and bone strength, the mineral magnesium plays a role in combating inflammation in the body and has been proven to have an association with depression. However, few clinical trials have studied the supplement's effects.

Emily Tarleton, MS, RD, CD, a graduate student in Clinical and Translational Science and the bionutrition research manager in the University of Vermont's Clinical Research Center, and colleagues conducted a clinical trial of over-the-counter oral magnesium tablets for mild-to-moderate depression. Their results showed that magnesium is safe and effective and comparable to prescription SSRI treatments in effectiveness.

The researchers at the University of Vermont's Larner College of Medicine conducted an open-label, blocked, randomized cross-over trial involving 126 adults in outpatient primary care clinics. The study participants, who were currently experiencing mild-to-moderate depression, had a mean age of 52, with 38 percent of them male. Participants in the active arm of the study received 248 milligrams of elemental magnesium per day over six weeks, while those in the control arm received no treatment. Depression symptom assessments were conducted on all participants on a bi-weekly basis.

The study team found that in 112 participants with analyzable data, consumption of magnesium chloride for six weeks resulted in a clinically significant improvement in measures of depression and anxiety symptoms. In addition, these positive effects were shown quickly, at two weeks, and the supplements were well tolerated and similarly effective regardless of age, sex, or use of antidepressants, among other factors.

"This is the first randomized clinical trial looking at the effect of magnesium supplementation on symptoms of depression in U.S. adults," says Tarleton. "The results are very encouraging, given the great need for additional treatment options for depression, and our finding that magnesium supplementation provides a safe, fast and inexpensive approach to controlling depressive symptoms."

Tarleton and colleagues say the next step is to see if their promising results can be replicated in a larger, more diverse population.

Friday, June 23, 2017

Frequent sexual activity can boost brain power in older adults

More frequent sexual activity has been linked to improved brain function in older adults, according to a study by the universities of Coventry and Oxford.

Researchers found that people who engaged in more regular sexual activity scored higher on tests that measured their verbal fluency and their ability to visually perceive objects and the spaces between them.

The study, published today in The Journals of Gerontology, Series B: Psychological and Social Sciences, involved 73 people aged between 50 and 83.

Participants filled in a questionnaire on how often, on average, they had engaged in sexual activity over the past 12 months -- whether that was never, monthly or weekly -- as well as answering questions about their general health and lifestyle.

The 28 men and 45 women also took part in a standardized test, which is typically used to measure different patterns of brain function in older adults, focusing on attention, memory, fluency, language and visuospatial ability.

This included verbal fluency tests in which participants had 60 seconds to name as many animals as possible, and then to say as many words beginning with F as they could -- tests which reflect higher cognitive abilities.

They also took part in tests to determine their visuospatial ability which included copying a complex design and drawing a clock face from memory.

It was these two sets of tests where participants who engaged in weekly sexual activity scored the most highly, with the verbal fluency tests showing the strongest effect.

The results suggested that frequency of sexual activity was not linked to attention, memory or language. In these tests, the participants performed just as well regardless of whether they reported weekly, monthly or no sexual activity.

This study expanded on previous research from 2016, which found that older adults who were sexually active scored higher on cognitive tests than those who were not sexually active.

But this time the research looked more specifically at the impact of the frequency of sexual activity (i.e. does it make a difference how often you engage in sexual activity) and also used a broader range of tests to investigate different areas of cognitive function.

The academics say further research could look at how biological elements, such as dopamine and oxytocin, could influence the relationship between sexual activity and brain function to give a fuller explanation of their findings.

Lead researcher Dr Hayley Wright, from Coventry University's Centre for Research in Psychology, Behaviour and Achievement, said:

"We can only speculate whether this is driven by social or physical elements -- but an area we would like to research further is the biological mechanisms that may influence this.

"Every time we do another piece of research we are getting a little bit closer to understanding why this association exists at all, what the underlying mechanisms are, and whether there is a 'cause and effect' relationship between sexual activity and cognitive function in older people.

"People don't like to think that older people have sex -- but we need to challenge this conception at a societal level and look at what impact sexual activity can have on those aged 50 and over, beyond the known effects on sexual health and general wellbeing."

Thursday, June 22, 2017

Greater emphasis on preventing, treating heart disease in women needed

Women and physicians do not put enough emphasis on cardiovascular disease in women, and a social stigma regarding body weight may be a primary barrier to these important discussions, according to research publishing today in the Journal of the American College of Cardiology.

Cardiovascular disease is the number one cause of death in the United States, accounting for nearly 400,000 deaths and killing more women than all types of cancer combined. Although there has been a decline in overall mortality from heart disease, this decrease has been smaller for women compared to men and the death rate in women younger than 55 years old has increased.

"Increasing awareness of cardiovascular disease in women has stalled with no major progress in almost 10 years, and little progress has been made in the last decade in increasing physician awareness or use of evidence-based guidelines to care for female patients," said Bairey Merz, director of the Barbra Streisand Women's Heart Center in the Cedars-Sinai Heart Institute and the study's lead author.

For this study, researchers from the Women's Heart Alliance interviewed 1,011 U.S. women aged 25-60 years and collected physician survey data from 200 primary care physicians and 100 cardiologists. The goal of the surveys was to determine knowledge, attitudes and beliefs regarding heart disease in women.

The researchers found that 45 percent of women were unaware that heart disease is the number one killer of women in the U.S. Awareness level was lower in women with lower levels of education and income and in ethnic minorities. Nearly 71 percent of women almost never brought up the issue of heart health with their physician, assuming their doctor would raise the issue if there was a problem. However, physicians were more likely to discuss cardiovascular health if prompted by the patient or due to the presence of a risk factor.

Physicians often did not discuss cardiovascular disease because the patient had a more immediate health issue or did not fully report their symptoms, indicating that prevention prior to symptoms was not a priority. Women who knew someone with heart disease were more likely to express concern and bring this issue up with their physician or to discuss heart disease with a friend thought to be at risk for having or developing heart disease.

While a majority of women reported having a routine physical or wellness exam in the past year, only 40 percent reported having a heart health assessment. While 74 percent reported having at least one risk factor for heart disease, just 16 percent were told by their doctor that they were at risk. Sixty-three percent of women admitted to putting off going to the doctor at least sometimes and 45 percent of women canceled or postponed an appointment until they lost weight. Many women reported being embarrassed or overwhelmed by their heart disease and many also cited difficulties in losing weight or finding time to exercise.

Only 22 percent of primary care physicians and 42 percent of cardiologists felt well prepared to assess cardiovascular risk in women. Additionally, only 16 percent of primary care physicians and 22 percent of cardiologists fully implemented guidelines for risk assessment.

"These findings suggest a need to destigmatize cardiovascular disease for women and counteract stereotypes with increased objective risk factor evaluation education to improve treatment by physicians," Bairey Merz said. "National action campaigns should work to make cardiovascular disease 'real' to American women and destigmatize the disease by promoting the use of cardiovascular risk assessment to counter stereotypes with facts and valid assessments."

In an editorial comment published with the paper, Jennifer G. Robinson, MD, MPH, from the College of Public Health at the University of Iowa discusses the importance of developing healthy lifestyle habits early in life to reduce the risk for cardiovascular disease.

"Helping women overcome barriers to increasing physical activity and healthier eating habits may help to avoid the stigma of focusing on weight loss," she said. "Women are often the gate-keepers for family meals, activities and health care, and a focus on healthy lifestyle habits may also encourage early prevention in the family as a whole."

Accentuate the positive to reduce risk of chronic disease

People who experience not just positive emotions but a diversity of positive emotions appear to have lower levels of systemic inflammation, which may reduce their risk for chronic diseases such as diabetes and heart disease, according to research published by the American Psychological Association.

"There is growing evidence that inflammatory responses may help explain how emotions get under the skin, so to speak, and contribute to disease susceptibility," said lead author Anthony Ong, PhD, of Cornell University and Weill Cornell Medical College. "Our findings suggest that having a rich and diverse positive emotional life may benefit health by lower circulating levels of inflammation."

The research was published in the APA journal Emotion.

Ong and his colleagues sought to build upon previous research suggesting that people who experience more positive emotions tend to have better health outcomes over time. They specifically sought to determine whether range and variety of emotions that individuals experience--what they dubbed "emodiversity"--would be related to an objective biological indicator -- namely, inflammation. High levels of systemic inflammation have been associated with chronic disease (e.g., atherosclerosis, Type 2 diabetes, osteoporosis) and increased risk of premature death, according to Ong.

The researchers followed 175 participants, ages 40 to 65, from the Phoenix metropolitan area for 30 days. During that period, participants used a tablet computer given to them for the study to keep a daily record of their emotional experiences. Six months later, blood samples were taken and tested for markers of inflammation (i.e., IL-6, CRP, fibrinogen).

"Greater diversity in day-to-day positive emotions was related to lower systemic inflammation," said Ong. "This association remained significant after accounting for average levels of positive or negative emotions, differences in demographic characteristics, body mass index, personality, medication use and medical conditions."

It is important to note that this effect was only found for diversity of positive emotions, according to Ong, a finding that was surprising to the researchers because they had expected to find similar associations for negative and overall emotional diversity as well.

To determine positive emotional diversity, the researchers had participants indicate their experience of 16 different positive emotions (enthusiastic, interested, determined, excited, amused, inspired, alert, active, strong, proud, attentive, happy, relaxed, cheerful, at ease, calm) across the 30-day period. Diversity was measured not only by the number of discrete emotions experienced but by overall distribution and the number of times each emotion was experienced.

"Specifically, low emodiversity is characterized by emotional experiences that are relatively homogeneous and concentrated in a few emotion categories, whereas high emodiversity reflects emotional experiences that are relatively diverse and distributed more evenly across categories," said Ong.

While previous studies have looked at the independent role of positive and negative emotions on inflammation, Ong believes this may be the first to look at the role of the diversity of emotion as well. He warns, though, that the findings, which specifically focus on middle-aged individuals from a single geographic area, need to be replicated in larger, more culturally diverse samples.

The link between job stress, junk food and sleep

Stress during the workday can lead to overeating and unhealthy food choices at dinnertime, but there could be a buffer to this harmful pattern.

A good night's sleep can serve as a protecting factor between job stress and unhealthy eating in the evening, indicates a new study co-authored by a Michigan State University scholar.

The study, published online in the Journal of Applied Psychology, is one of the first to investigate how psychological experiences at work shape eating behaviors.

"We found that employees who have a stressful workday tend to bring their negative feelings from the workplace to the dinner table, as manifested in eating more than usual and opting for more junk food instead of healthy food," said Chu-Hsiang "Daisy" Chang, MSU associate professor of psychology and study co-author.

"However, another key finding showed how sleep helped people deal with their stressful eating after work," she added. "When workers slept better the night before, they tended to eat better when they experienced stress the next day."

The research involved two studies of 235 total workers in China. One study dealt with information-technology employees who regularly experienced high workload and felt there was never enough time in the workday. The second study involved call-center workers who often got stressed from having to deal with rude and demanding customers.

In both cases, workday stress was linked to employees' negative mood while on the job, which in turn was linked to unhealthy eating in the evening, said Yihao Liu, co-author and assistant professor at the University of Illinois.

The study proposed two potential explanations, Liu said.

"First, eating is sometimes used as an activity to relieve and regulate one's negative mood, because individuals instinctually avoid aversive feelings and approach desire feelings," he said. "Second, unhealthy eating can also be a consequence of diminished self-control. When feeling stressed out by work, individuals usually experience inadequacy in exerting effective control over their cognitions and behaviors to be aligned with personal goals and social norms."

Chang said the finding that sleep protects against unhealthy eating following workday stress shows how the health behaviors are related.

"A good night's sleep can make workers replenished and feel vigorous again, which may make them better able to deal with stress at work the next day and less vulnerable to unhealthy eating," she said.

To address the problem, companies should emphasize the importance of health management for their employees and consider sleep-awareness training and flexible scheduling.

Companies should also reconsider the value of food-related job perks, which have become very common.

"Food-related perks may only serve as temporary mood-altering remedies for stressed employees," Chang said, "and failure to address the sources of the work stress may have potential long-term detrimental effects on employee health."