Tuesday, January 30, 2018

Mediterranean diet may help women receiving IVF to achieve successful pregnancies


New research has found that women who follow a "Mediterranean" diet in the six months before assisted reproductive treatment have a significantly better chance of becoming pregnant and giving birth to a live baby than women who did not.

Researchers asked women about their diet before they underwent in vitro fertilisation (IVF) treatment and found that those who ate more fresh vegetables, fruit, whole grains, legumes, fish and olive oil, and less red meat, had a 65-68% greater likelihood of achieving a successful pregnancy and birth compared to women with the lowest adherence to the Mediterranean-style diet.

The study, which is published today (Tuesday) in Human Reproduction [1], one of the world's leading reproductive medicine journals, focused on dietary patterns rather than individual nutrients, foods or food groups. It assessed the diet of 244 women via a food frequency questionnaire when they enrolled at an Assisted Conception Unity in Athens, Greece, for their first IVF treatment.

The questionnaire asked them about how often they ate certain groups of food in the preceding six months; the results gave the women a MedDiet Score, which ranged from 0-55 with higher scores indicating greater adherence to the Mediterranean diet. The women were aged between 22-41 and were non-obese (body mass index of less than 30 kg/m2).

Researchers, led by Associate Professor Nikos Yiannakouris at the Department of Nutrition and Dietetics at Harokopio University of Athens, divided the women into three groups depending on their MedDiet Score: the first group had scores between 18 to 30, the second scored between 31-35 and the third group scored between 36 to 47.

They found that compared to the 86 women in the highest scoring group, the 79 women in the lowest scoring group had significantly lower rates of pregnancies (29% versus 50%) and live births (26.6% versus 48.8%). When the researchers looked at women younger than 35 years old, they found that every five-point improvement in the MedDiet Score was linked with an approximately 2.7 times higher likelihood of achieving a successful pregnancy and live birth.

Overall, 229 women (93.9%) had at least one embryo transferred to their wombs; 138 (56%) had a successful implantation; 104 (42.6%) achieved a clinical pregnancy (one that can be confirmed by ultrasound); and 99 (40.5%) gave birth to a live baby.

"The important message from our study is that women attempting fertility should be encouraged to eat a healthy diet, such as the Mediterranean diet, because greater adherence to this healthy dietary pattern may help increase the chances of successful pregnancy and delivering a live baby," said Prof Yiannakouris.

"It should be noted that when it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. Previous work from our research group among the male partners of our study has suggested that adherence to the Mediterranean diet may also help improve semen quality. Taken together, these findings highlight the importance of dietary influences and diet quality on fertility, and support a favourable role for the Mediterranean diet on assisted reproduction performance." [2]

The researchers did not find any association between diet and the chances of successful pregnancies and live births among women aged 35 and older. However, they believe this is because hormonal changes, fewer available eggs and other changes that women experience as they get older could mask the influences of environmental factors such as diet.

Prof Yiannakouris said: "The fact that in our study a favourable effect of the Mediterranean diet was evident only among women younger than 35 years doesn't mean that eating a healthy diet is not as important for older women. Our results suggest the need for additional research not only among older women, but also among women with obesity problems and in women conceiving naturally."

The researchers say that their findings cannot be generalised to all women trying to become pregnant, nor to obese women or women attending other infertility clinics around the world. They point out that their findings show that a Mediterranean diet is only linked to improved IVF outcomes and they cannot show that it causes the improved chances of pregnancy and birth.

"Our findings provide support that couples undergoing infertility treatment may benefit by adhering to the Mediterranean diet (a diet widely accepted for its positive effects on human health); however, whether or not advice to adhere more closely to this traditional diet would improve assisted reproduction performance needs to be addressed in future intervention studies. Moreover, our results should be explored and confirmed in other populations within and beyond the Mediterranean region.

Clearly more research and intervention studies are needed to elucidate the role of diet quality in assisted reproductive performance, to reveal underlying mechanisms, and for developing nutritional guidelines for women to further improve fertility treatment and success rates.

"As more couples worldwide face infertility problems and seek access to assisted reproduction technologies to conceive, it is essential for them to receive counselling on the importance of dietary influences and of adopting a healthy lifestyle," concluded Prof Yiannakouris.

[1] "Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility," by Dimitrios Karayiannis et al. Human Reproduction journal. doi:10.1093/humrep/dey003.
[2] "Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility", by Dimitrios Karayiannis et al. Human Reproduction, Volume 32, Issue 1, 1 January 2017, Pages 215-222; https://doi.org/10.1093/humrep/dew288

Body clock disruptions occur years before memory loss in Alzheimer's


People with Alzheimer's disease are known to have disturbances in their internal body clocks that affect the sleep/wake cycle and may increase risk of developing the disorder. Now, new research at Washington University School of Medicine in St. Louis indicates that such circadian rhythm disruptions also occur much earlier in people whose memories are intact but whose brain scans show early, preclinical evidence of Alzheimer's.
The findings potentially could help doctors identify people at risk of Alzheimer's earlier than currently is possible. That's important because Alzheimer's damage can take root in the brain 15 to 20 years before clinical symptoms appear.

The research is published Jan. 29 in the journal JAMA Neurology.

"It wasn't that the people in the study were sleep-deprived," said first author Erik S. Musiek, MD, PhD, an assistant professor of neurology. "But their sleep tended to be fragmented. Sleeping for eight hours at night is very different from getting eight hours of sleep in one-hour increments during daytime naps."

Previous studies at Washington University, conducted in people and in animals, have found that levels of amyloid fluctuate in predictable ways during the day and night. Amyloid levels decrease during sleep, and several studies have shown that levels increase when sleep is disrupted or when people don't get enough deep sleep, according to research by senior author, Yo-El Ju, MD.

"In this new study, we found that people with preclinical Alzheimer's disease had more fragmentation in their circadian activity patterns, with more periods of inactivity or sleep during the day and more periods of activity at night," said Ju, an assistant professor of neurology.

The researchers tracked circadian rhythms in 189 cognitively normal, older adults with an average age of 66. Some had positron emission tomography (PET) scans to look for Alzheimer's-related amyloid plaques in their brains. Others had their cerebrospinal fluid tested for Alzheimer's-related proteins. And some had both scans and spinal fluid testing.

Of the participants, 139 had no evidence of the amyloid protein that signifies preclinical Alzheimer's. Most had normal sleep/wake cycles, although several had circadian disruptions that were linked to advanced age, sleep apnea or other causes.

But among the other 50 subjects -- who either had abnormal brain scans or abnormal cerebrospinal fluid -- all experienced significant disruptions in their internal body clocks, determined by how much rest they got at night and how active they were during the day. Disruptions in the sleep/wake cycle remained even after the researchers statistically controlled for sleep apnea, age and other factors.

The study subjects, from Washington University's Knight Alzheimer's Disease Research Center, all wore devices similar to exercise trackers for one to two weeks. Each also completed a detailed sleep diary every morning.

By tracking activity during the day and night, the researchers could tell how scattered rest and activity were throughout 24-hour periods. Subjects who experienced short spurts of activity and rest during the day and night were more likely to have evidence of amyloid buildup in their brains.

These findings in people reinforce the mouse research from Musiek's lab. In that study, working with first author Geraldine J. Kress, PhD, an assistant professor of neurology, Musiek studied circadian rhythm disruptions in a mouse model of Alzheimer's. To disrupt the animals' circadian rhythms, his team disabled genes that control the circadian clock.

"Over two months, mice with disrupted circadian rhythms developed considerably more amyloid plaques than mice with normal rhythms," Musiek said. "The mice also had changes in the normal, daily rhythms of amyloid protein in the brain. It's the first data demonstrating that the disruption of circadian rhythms could be accelerating the deposition of plaques."

Both Musiek and Ju said it's too early to answer the chicken-and-egg question of whether disrupted circadian rhythms put people at risk for Alzheimer's disease or whether Alzheimer's-related changes in the brain disrupt circadian rhythms.

"At the very least, these disruptions in circadian rhythms may serve as a biomarker for preclinical disease," said Ju. "We want to bring back these subjects in the future to learn more about whether their sleep and circadian rhythm problems lead to increased Alzheimer's risk or whether the Alzheimer's disease brain changes cause sleep/wake cycle and circadian problems."

Motivational music increases risk-taking but does not improve sports performance


A new study finds that listening to motivational music during sport activities and exercise increases risk-taking behavior but does not improve overall performance. The effect was more noticeable among men and participants who selected their own playlist. The study, published in Frontiers in Psychology, also found that self-selected music had the power to enhance self-esteem among those who were already performing well, but not among participants who were performing poorly.

Listening to motivational music has become a popular way of enhancing mood, motivation and positive self-evaluation during sports and exercise. There is an abundance of anecdotal evidence of music being used in this way, such as the famous Maori "Haka" performed by New Zealand's national rugby team to get into the right mindset before games. However, the psychological processes and mechanisms that explain the motivational power of music are poorly understood.

"While the role of music in evoking emotional responses and its use for mood regulation have been a subject of considerable scientific interest, the question of how listening to music relates to changes in self-evaluative cognitions has rarely been discussed," says Dr. Paul Elvers of the Max Planck Institute for Empirical Aesthetics and one of the study's authors. "This is surprising, given that self-evaluative cognitions and attitudes such as self-esteem, self-confidence and self-efficacy are considered to be sensitive to external stimuli such as music."

The research team investigated whether listening to motivational music can boost performance in a ball game, enhance self-evaluative cognition and/or lead to riskier behavior. The study divided 150 participants into three groups that performed a ball-throwing task from fixed distances and filled in questionnaires while listening to either participant-selected music, experimenter-selected music or no music at all. To assess risk-taking behavior, the participants were also allowed to choose the distances to the basket themselves. The participants received monetarily incentivized points for each successful trial.

The data show that listening to music did not have any positive or negative impact on overall performance or on self-evaluative cognitions, trait self-esteem or sport-related anxiety. However, it did increase the sense of self-esteem in participants who were performing well and also increased risk-taking behavior -- particularly in male participants and participants who could choose their own motivational music. Moreover, the researchers also found that those who made riskier choices earned higher monetary rewards.

"The results suggest that psychological processes linked to motivation and emotion play an important role for understanding the functions and effects of music in sports and exercise," says Dr. Elvers. "The gender differences in risk-taking behavior that we found in our study align with what previous studies have documented."

However, more research is required to fully understand the impact of motivational music on the intricate phenomena of self-enhancement, performance and risky behavior during sports and exercise.

"We gathered evidence of the ability of music to increase risk-taking behavior, but more research is needed to improve the robustness of this finding. Additional research is also needed to address the potential mechanisms that may account for the finding. We believe that music's ability to induce pleasure as well as its function with respect to self-enhancement serve as promising candidates for future investigations," Dr. Elvers concludes.

Painting a realistic picture of the challenges of weight loss can lead to greater long-term outcomes,


To reach your New Year's fitness goals, a bit of reverse psychology might be in order. Telling people that weight loss is extremely challenging -- rather than imparting a "You can do it!" mantra -- motivated them to shed more weight, according to a new study by psychologists at Drexel University. However, the strategy did not compel participants to achieve the goal for which it was originally designed: to modify or replace many of the unhealthy foods in their homes.

The study's findings, published this week in the American Journal of Clinical Nutrition, have conflicting implications, says Michael Lowe, PhD, a professor at Drexel's College of Arts and Sciences.

"On one hand, giving overweight people a realistic sense of the dilemma that they are in and the powerful forces they are up against -- including a genetic predisposition toward obesity and an increased susceptibility to many food cues in the environment -- may actually promote cognitive restraint over their eating in the short-term," Lowe said. "But, on the other hand, this message did not motivate participants to make numerous changes to the foods they surround themselves with."

Lowe and a team of researchers originally set out to determine the effectiveness of three weight loss interventions: behavior therapy, behavior therapy plus meal replacements, or a condition focused on getting people to change foods in their home food environments. They enrolled 262 overweight and obese individuals and assigned them to one of the three methods, while tracking their weight over a three-year period.

Behavior therapy -- the current "gold standard" in weight loss treatment -- involves group support, regular weigh-ins, exercise, explicit goal setting and monitoring food intake, while meal replacement treatment replaces breakfast and lunch with calorie-controlled shakes or nutrition bars.

Behavior therapy is aimed at bolstering someone's internal sense of self-regulation over food intake and exercise. But research has shown that increases in self-control are not sustainable, and lost weight is almost always regained. The powerful lure of foods high in fat, sugar and salt has been well-documented, and existing treatments do not do enough to ensure that foods kept in the home are permanently changed in ways that make self-control more feasible, according to Lowe.

"You can't just give advice," he said. "You have to work with people to eliminate and substitute very specific foods, and teach them to prepare food differently."

That's why his research team hypothesized that modifying the home food environment (or HFE) would be the most effective strategy for losing and maintaining weight loss. Participants in this group were given homework assignments to identify and make numerous changes to specific foods that were still satisfying but less calorically damaging.

"Asking people to make healthy decisions, when there are thousands of food choices available, is both emotionally challenging and also complicated," Lowe said. "HFE treatment is really about mechanically trying to ensure that these changes are made, so the level of chronic temptation generated by foods in their homes is reduced."

Most importantly, the research team repeatedly reminded the HFE group about the challenges associated with weight loss and maintenance. In doing this, the researchers aimed to acknowledge the participants' vulnerability to overconsume favorite foods.

"We said, 'It's impressive and encouraging that you are taking this step to improve your weight and health, but we need to help you understand the daunting challenges you're facing.' The reason we did this was not to discourage them, but to give them a more realistic sense of how crucial it is for them to make lasting changes in their parts of the food environment that they could control," Lowe said.

People struggling with their weight are likely to hold themselves responsible, even though a number of internal (heredity, for example) and external (fast food restaurants) forces are at play and beyond their control, Lowe said. The researchers suggested that by making multiple changes to their food environment, participants would be reducing the need to perpetually exercise self-control to maintain the weight they lost.

In addition to measuring the participants' weights during six assessment sessions over three years, the researchers also assessed conditions such as binge eating, quality of life, cognitive restraint and food cravings by using questionnaires and statistical analysis.

At the end of the three-year study period, the researchers found that those in the HFE group lost more weight than those in the behavior therapy group. However, the differential in weight loss was modest, and all participants showed the familiar trend toward weight regain.

"We failed to get them to translate our warnings into the kind of actions we were trying to get them to take," Lowe said.

The warnings did, however, have a positive -- though unanticipated -- effect. Cognitive restraint -- defined by a participant's ability to actively make healthy choices and measured with mediation analysis -- showed the longest, most prolonged increase in the HFE participants, when compared to the other two treatment groups.

This suggests that the researchers' rhetoric about the difficulties of sustaining weight loss may have actually caused the participants in the HFE group to "push back" against this message and increase their vigilance over their eating, Lowe said.

"That is, by questioning the usefulness of building self-control skills, the HFE treatment may have bolstered the very capacity it was meant to downplay -- stronger self-control with regard to food," the study authors write.

Though surprising, these results have potentially clinically-useful implications. By emphasizing the many factors that make lasting weight loss so difficult, it may help motivate individuals to mentally and behaviorally cope with these factors, according to Lowe.

"Rather than acting as cheerleaders giving facile encouragement, leaders of weight loss groups might serve their clients better by providing a more sobering description of the challenges participants face," Lowe explained.

However, since the participants in the HFE condition did not make greater changes to their home food environment, future studies should examine how to better improve and monitor this weight loss intervention, such as sending dieticians or other practitioners directly to clients' homes for periodic visits.

For Lowe, the study reinforces the challenging reality for those seeking to maintain weight loss -- and makes a strong case for policies (such as Philadelphia's beverage tax) that focus on preventing, rather than treating, the problem of obesity in the United States.

"Once these conditions develop and you are continuing to live in the same obesogenic environment, it is unrealistic to expect that many people will be able to sustain a large weight loss," he said. "Society ultimately needs to prevent these unhealthy weight gains before they occur."

Nutritionally speaking, soy milk is best plant-based milk



IMAGE

Cow's milk is compared with various plant-based milk. view more 
Credit: McGill University
How healthy is your almond milk really? It may taste good and may not cause you any of the unpleasant reactions caused by cow's milk. But though plant-based milk beverages of this kind have been on the market for a couple of decades and are advertised as being healthy and wholesome for those who are lactose-intolerant, little research has been done to compare the benefits and drawbacks of the various kinds of plant-based milk.

A new study from McGill University looks at the four most-commonly consumed types of milk beverages from plant sources around the world - almond milk, soy milk, rice milk and coconut milk - and compares their nutritional values with those of cow's milk. After cow's milk, which is still the most nutritious, soy milk comes out a clear winner.

The researchers compared the unsweetened versions of the various plant-based milks in all cases and the figures below are based on a 240 ml serving.

Soy milk - the most balanced nutritional profile
  • Soy milk is widely consumed for its health benefits linked to the anti-carcinogenic properties of phytonutrients present in the milk known as isoflavones.
  • Has been a substitute for cow's milk for 4 decades.
  • Concerns, however, are the 'beany flavor' and the presence of anti-nutrients (substances that reduce nutrient intake and digestion).
Rice milk - sweet taste and relatively little nutrition
 

  • Lactose free and can act as an alternative for patients with allergy issues caused by soybeans and almonds.
  • Concerns, apart from the high carbohydrate count, is that consumption of rice milk without proper care can result in malnutrition, especially in infants.


  • Coconut milk - no protein and few calories, but most of them from fat
     

  • Widely consumed in Asia and South America
  • Consumption can help reduce levels of harmful low-density lipoproteins (bad cholesterol) that are associated with cardiovascular diseases.
  • Nutritional values are reduced if stored for over 2 months.

  • Almond milk - need for complementary sources of food to provide essential nutrients
     

  • Almonds have a high content of monounsaturated fatty acids (MUFA) that are considered helpful in weight loss and weight management. MUFA also helps in reduction of low-density lipoprotein (bad cholesterol).

  • Cow's milk benefits & drawbacks
     

  • A wholesome, complete food, providing all major nutrients like fat, carbohydrates and proteins.
  • Can help humans by providing a wide range of host-defence proteins because various beneficial anti-microbial effects are found in both human and bovine milks. (E.g., a study shows that in the case of infants, consumption of cow's milk has considerably reduced risk of fever and respiratory infections.)
  • But the presence of various pathogens like Salmonella spp and Escherichia coli O157:H7 in milk have been associated with disease outbreaks around the world.

  • Cow's milk allergy & lactose intolerance
     

  • One of the most common allergies among infants and children affecting 2.2-3.5% of children (a greater percentage than those who are affected by peanuts and tree nut allergies). As many as 35 % of these infants outgrow being allergic to milk by the age of 5-6, and this may increase to 80% by age 16.
  • Lactose intolerance, due to the absence or deficiency of the enzyme lactase in the digestive tract, affects somewhere between 15-75 % of all adults depending on race, food habits and gut health.
  • Some studies have suggested that 80 % of people of African origin and 100 % of those of Asian and Indigenous American origin are lactose intolerant.
  •  
    The researchers add that more work will need to be done to understand the effects of various conventional and novel processing methods on the nutritional profile, flavour and texture of these alternative milks.

    Walk in groups to keep exercise goals on track


    People may be more likely to stick to taking exercise if they walk in groups, according to a paper published in the International Journal of Technology Assessment in Health Care.

    The research, led by Anglia Ruskin University, also found that group walking plays a part in improved physical activity and better quality of life.

    The review analysed 18 studies of physically healthy adults walking in groups compared with walking alone or not at all and found that people who had undertaken group walking were more likely to have kept up the exercise by the end of the study, which was an average of six months later.
    The authors also found that in five of the seven studies that measured quality of life outcomes, those who walked in groups showed significantly improved scores compare with those who did not, while in the other two studies there was no significant difference.

    The World Health Organisation recommends that adults undertake 150 minutes of moderate aerobic physical activity per week. However, only 67% of men and 55% of women in the UK meet these guidelines. Dropout rates for exercise initiatives are also known to be high.

    Lead author Professor Catherine Meads, of Anglia Ruskin University, said:

    "Walking in groups is a safe and inexpensive intervention that can be delivered easily and successfully in the community.

    "At a time when we are being encouraged to meet physical activity guidelines, a large proportion of the public fail to do so. Our review found that people may be more likely to exercise if they have social support.

    "Walking in groups tended to increase life satisfaction and may also improve social connectedness."

    Breastfeeding reduces hypertension risk


    A study published in the American Journal of Hypertension indicates that women who breastfeed more children, and for longer periods of time, are less likely to suffer from hypertension after they reach menopause. This is less true of obese women, however.

    Elevated blood pressure is the greatest single risk factor for disease and mortality. Evidence from epidemiologic data has also shown the beneficial effects of breastfeeding on the health of infants and their mothers. It has been well documented that long-term breastfeeding is associated with reduced children's allergies, celiac disease, obesity, and diabetes mellitus. However, the effects of breastfeeding on maternal health have been little studied compared with the effects on the children.

    Several studies consistently found that absent breastfeeding or premature discontinuation was associated with increased risks of diabetes mellitus, dyslipidemia, metabolic syndrome, coronary heart disease, and cardiovascular diseases. However few studies have established a clear relationship between breastfeeding and hypertension.

    This study population comprised 3,119 non-smoking postmenopausal women aged 50 years or older in the 2010-2011 Korea National Health and Nutrition Examination Survey.

    More children breastfed and longer duration of breastfeeding were associated with lower risk of hypertension in postmenopausal women, and degree of obesity and insulin resistance moderated the breastfeeding-hypertension association. In particular, the highest quintile of number of children breastfed (5 to 11) showed a 51% lower risk of hypertension compared with the lowest quintile (0 to 1). The highest quintile of duration of breastfeeding (96 to 324 months) showed a 45% lower risk of hypertension.

    Although a broad range of chronic diseases are not associated with breastfeeding, some common mechanisms have been proposed to underlie the relationships between breastfeeding and these diseases. First, maternal metabolism (e.g., fat accumulation and insulin resistance) may be "reset" by breastfeeding after pregnancy, which decreases the risk of obesity-related diseases. Second, oxytocin release stimulated by breastfeeding may be associated with the decreased risk of these diseases.

    "Our findings endorsed the current recommendations for breastfeeding for the benefit of maternal health in mothers' later lives," said the paper's lead researcher, Nam-Kyong Choi.

    Mindfulness may help reduce cravings for food and drugs


    Mindfulness strategies may help prevent or interrupt cravings for food and drugs, such as cigarettes and alcohol, by occupying short term memory, according to a new review from City, University of London.

    Looking at experimental studies that have examined the effects of different types of mindfulness strategies on cravings, it was found that in many instances these strategies brought about an immediate reduction in craving. The research was published in Clinical Psychology Review.

    Craving can be defined as an intense, conscious desire, usually to consume a specific drug or food.

    There is also a significant body of research that suggests it is causally linked to behaviour. For example, craving predicts relapse episodes in substance use and food cravings predict both eating and weight gain. As such, cravings are often considered an appropriate target for intervention.

    Mindfulness meditation has a long tradition of being used to address cravings. According to ancient Buddhist texts, craving leads to suffering but can be avoided through mindfulness meditation practice. More recently, mindfulness-based interventions have been used to explicitly target cravings with the aim of bringing about clinically relevant changes to behaviour.

    Mindfulness interventions typically employ a range of different types of strategy, for example they may include exercises designed to promote greater awareness of bodily sensations, to develop an attitude of acceptance toward uncomfortable feelings, or to help individuals see themselves as separate from their thoughts and emotions.

    However, there is currently a limited understanding of the ways in which these different types of strategy may influence craving-related outcomes, either independently, or in combination. As a result, the review aimed to address these limitations by reviewing studies that have examined the independent effects of mindfulness on craving.

    Looking at 30 studies which met the criteria, it was found that some of the beneficial effects seen for mindfulness strategies in relation to craving are likely to stem from interrupting cravings by loading working memory, a part of our short-term memory which is concerned with immediate conscious perceptual and linguistic processing.

    In addition, it was also seen that mindfulness reduced craving over the medium term, most likely due to 'extinction processes'; essentially strategies that result in the individual inhibiting craving-related responses and behaviours which eventually lead to reduced cravings.

    Dr Katy Tapper, author of the review and a Senior Lecturer in the Department of Psychology at City, University of London, said:

    "The research suggests that certain mindfulness-based strategies may help prevent or interrupt cravings by occupying a part of our mind that contributes to the development of cravings. Whether mindfulness strategies are more effective than alternative strategies, such as engaging in visual imagery, has yet to be established. However, there is also some evidence to suggest that engaging in regular mindfulness practice may reduce the extent to which people feel the need to react to their cravings, though further research is needed to confirm such an effect."

    Vitamin D3 could help heal or prevent cardiovascular damage


    A new study conducted by Ohio University scientists suggests that a little more sunlight might help restore damage to your cardiovascular system.

    The study shows that Vitamin D3 - which is made by the body naturally when skin is exposed to the sun - can significantly restore the damage to the cardiovascular system caused by several diseases, including hypertension, diabetes and atherosclerosis. Vitamin D3 supplements are also available over-the-counter.

    The study, by Marvin and Ann Dilley White Chair and Distinguished Professor Dr. Tadeusz Malinski and two graduate students, Alamzeb Khan and Hazem Dawoud, has been published in the International Journal of Nanomedicine.

    "Generally, Vitamin D3 is associated with the bones. However, in recent years, in clinical settings people recognize that many patients who have a heart attack will have a deficiency of D3. It doesn't mean that the deficiency caused the heart attack, but it increased the risk of heart attack," Malinski said. "We use nanosensors to see why Vitamin D3 can be beneficial, especially for the function and restoration of the cardiovascular system."

    Malinski's team has developed unique methods and systems of measurements using nanosensors, which are about 1,000 times smaller in diameter than a human hair, to track the impacts of Vitamin D3 on single endothelial cells, a vital regulatory component of the cardiovascular system. A major discovery from these studies is that vitamin D3 is a powerful stimulator of nitric oxide (NO), which is a major signaling molecule in the regulation of blood flow and the prevention of the formation of clots in the cardiovasculature. Additionally, vitamin D3 significantly reduced the level of oxidative stress in the cardiovascular system.

    Most importantly, these studies show that treatment with vitamin D3 can significantly restore the damage to the cardiovascular system caused by several diseases, including hypertension, atherosclerosis, and diabetes, while also reducing the risk of heart attack. These studies, performed on cells from Caucasian Americans and African Americans, yielded similar results for both ethnic groups.

    "There are not many, if any, known systems which can be used to restore cardiovascular endothelial cells which are already damaged, and Vitamin D3 can do it," Malinski said. "This is a very inexpensive solution to repair the cardiovascular system. We don't have to develop a new drug. We already have it."

    These studies, performed at Ohio University, are the first to identify the molecular mechanism of vitamin D3-triggered restoration of the function of damaged endothelium in the cardiovasculature. While these studies were performed using a cellular model of hypertension, the implication of vitamin D3 on dysfunctional endothelium is much broader. The dysfunction of endothelium is a common denominator of several cardiovascular diseases, particularly those associated with ischemic events.

    Therefore, the authors suggest that vitamin D3 may be of clinical importance in the restoration of dysfunctional cardiac endothelium after heart attack, capillary endothelium after brain ischemia (stroke), hypovolemia, vasculopathy, diabetes and atherosclerosis. This suggestion is strongly supported by several clinical studies which indicate that vitamin D3 at doses higher than those currently used for the treatment of bone diseases, may be highly beneficial for the treatment of the dysfunctional cardiovascular system.

    "Professor Malinksi has an international reputation for outstanding and innovative research related to the cardiovascular system," Ohio University Dean of Arts and Sciences Robert Frank said. "This latest work is yet another example of his impact on this field."

    For children with respiratory infections, antibiotics with narrower targets are better


    When doctors prescribe antibiotics for children with common respiratory infections, a more selective approach is better. Researchers who studied pediatric treatment practices in 30,000 patients with earaches, strep throat and other common infections found that narrow-spectrum antibiotics, which act against a smaller range of bacteria, had fewer adverse effects than broad-spectrum antibiotics, which target a broader variety of bacteria.

    When judged by both practical and clinical outcomes, narrow-spectrum antibiotics performed equally well or better than broad-spectrum ones, with fewer disruptions to family routines.

    The study reflects an "antimicrobial stewardship" approach, guiding healthcare providers to prescribe the most appropriate antibiotic for a patient's specific type of infection, with the aim of improving individual outcomes and reducing the overall risk of antibiotic resistance--in which disease-causing microorganisms develop resistance to commonly used antibiotics.

    "Many children unnecessarily receive broad-spectrum antibiotics for common infections, which can lead to antibiotic resistance and unnecessary side effects," said study leader Jeffrey Gerber, MD, PhD, associate director for Inpatient Research Activities in the Center for Pediatric Clinical Effectiveness at Children's Hospital of Philadelphia (CHOP). "This study showed that inappropriate prescribing of antibiotics also affects families at a much more practical level, such as missed days from school and work, side effects of the drugs, and costs for extra childcare. These can be a real burden for families."
    Gerber and colleagues published their study in the Journal of the American Medical Association on Dec. 19, 2017. An award from the Patient-Centered Outcomes Research Institute (PCORI) funded this study.

    The study team performed two complementary studies in 31 primary care practices in CHOP's pediatric network in Pennsylvania and New Jersey, between January 2015 and April 2016. They drew on electronic health records of infants and children up to age 12 diagnosed with an acute respiratory tract infection (ARTI) and prescribed an oral antibiotic. In a retrospective cohort of approximately 30,000 patients, 14 percent received broad-spectrum drugs and 86 percent received narrow-spectrum drugs.

    The ARTIs in the analysis were acute otitis media (earache), Group A streptococcal pharyngitis (strep throat) and sinusitis (sinus infection). ARTIs account for the majority of antibiotic exposures in children. In addition to assessing clinical outcomes in a retrospective cohort of 30,000 children, the researchers studied a prospective cohort of 2,472 children, doing telephone interviews with caregivers to measure outcomes that parents had identified as their highest concerns: adverse drug effects, additional childcare costs, lingering symptoms and missed school days.

    The study team found a significantly higher risk of adverse events for broad-spectrum antibiotics compared to narrow-spectrum antibiotics (3.7 percent vs. 2.7 percent as documented by clinicians, and 35.6 percent vs. 25.1 percent, as reported by patients and families). The rates of treatment failure were not significantly different between both types of antibiotics.

    CHOP's Center for Pediatric Clinical Effectiveness (CPCE) recently issued a research brief and policy tip sheet summarizing seven years of research to develop a clinical practice model for antibiotic stewardship in pediatric outpatient settings. "Research tells us that antibiotic stewardship programs not only reduce the overall burden of antibiotic resistance, but also improve patient outcomes," said Gerber, who added, "Our previous research has also shown that these programs can lower costs for insurers and families that pay for prescriptions. These programs are a win-win-win for public health, families and insurers."

    Monday, January 29, 2018

    Flu greatly increases heart attack risk


    Chances of a heart attack are increased six-fold during the first seven days after detection of laboratory-confirmed influenza infection, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and Public Health Ontario (PHO).

    "Our findings are important because an association between influenza and acute myocardial infarction reinforces the importance of vaccination," says Dr. Jeff Kwong, a scientist at ICES and PHO and lead author of the study.

    In the study published in the New England Journal of Medicine, the researchers found a significant association between acute respiratory infections, particularly influenza, and acute myocardial infarction.

    The risk may be higher for older adults, patients with influenza B infections, and patients experiencing their first heart attack. The researchers also found elevated risk -- albeit not as high as for influenza -- with infection from other respiratory viruses.

    "Our findings, combined with previous evidence that influenza vaccination reduces cardiovascular events and mortality, support international guidelines that advocate for influenza immunization in those at high risk of a heart attack," says Kwong.

    The researchers looked at nearly 20,000 Ontario adult cases of laboratory-confirmed influenza infection from 2009 to 2014 and identified 332 patients who were hospitalized for a heart attack within one year of a laboratory-confirmed influenza diagnosis.

    "People at risk of heart disease should take precautions to prevent respiratory infections, and especially influenza, through measures including vaccinations and handwashing," says Kwong.
    The researchers add that patients should not delay medical evaluation for heart symptoms particularly within the first week of an acute respiratory infection.

    Friday, January 26, 2018

    Nearly one out of five NSAID users exceed daily limit


    Chances are you or someone you know has used nonsteroidal anti-inflammatory drugs (NSAIDs) within the last month. NSAIDs, such as Advil (ibuprofen), Aleve (naproxen) and Celebrex, are among the most commonly used medicines in the U.S. These drugs can have serious side effects, including GI bleeding and sometimes heart attacks, and are often taken without medical oversight because many are available over-the-counter.

    Now, for the first time, researchers have found that 15 percent of adult ibuprofen users exceed the maximum recommended dose of ibuprofen or other NSAIDs in a one-week period. Exceeding the daily limit often followed taking too much of a single NSAID at one time, taking two different NSAIDs at the same time, or failing to wait long enough before taking another dose.

    "It is important to understand how many users exceed the maximum, how they do it and what characteristics are associated with over-use. This knowledge can help guide consumer interventions to promote safer use," explained lead author David Kaufman, ScD, Director of Boston University's Slone Epidemiology Center and professor of epidemiology at Boston University School of Public Health.

    Approximately 1,300 individuals who reported taking an ibuprofen medication in the preceding month completed a daily diary of their NSAID use for one week, and took ibuprofen during that time. The researchers then were able to compute their ingested daily dosage and compare it with the recommended daily maximum dose.

    Those who exceed the recommended dosage tend to have a combination of medical factors such as chronic pain and poor physical state, attitudes conducive to ignoring the label recommendations, and poor knowledge of those recommendations. The authors suggest that attitudes and knowledge, along with specific dosing behavior and compliance with label directions, are potentially modifiable, which could lead to safer use of NSAIDs.

    Aerobic exercise may mildly delay, slightly improve Alzheimer's symptoms


    Alzheimer's disease (AD) is a brain disorder that destroys memory and thinking skills over time. It is the most common form of dementia in older adults. There is presently no cure for the condition, though treatment options are available. Today, some 5.3 million Americans live with AD, and it is now the sixth leading cause of death in the United States. The number of older adults who will develop AD is expected to more than triple by 2050.

    Geriatrics experts have suggested that exercising can improve brain health in older adults. The World Health Organization (WHO) has recommendations for how much older adults should exercise. They suggest that older adults perform 150 minutes a week of moderate exercise (such as brisk walking), 75 minutes a week of vigorous aerobic training, or a combination of the two types. The WHO also recommends older adults perform muscle-strengthening exercises on at least two or more days a week.

    However, not all studies of exercise and older adults have proven the benefits of exercise. We don't know for sure whether exercise slows mental decline or improves older adults' ability to think and make decisions.

    A team of researchers designed a study to learn whether exercise could delay or improve AD symptoms. They reviewed 19 studies that examined the effect of an exercise training program on cognitive function in older adults who were at risk for or diagnosed with AD. The studies included 1,145 older adults, most of whom were in their mid-to late 70s. Of the participants, 65 percent were at risk for AD and 35 percent had been diagnosed with AD.

    The researchers published their findings in the Journal of the American Geriatrics Society.

    As the researchers examined the studies, they discovered that older adults who did aerobic exercise by itself experienced a three times greater level of improvement in cognitive function than those who participated in combined aerobic training and strength training exercises. The researchers also confirmed that the amount of exercise WHO recommends for older adults was reinforced by the studies they examined.

    Finally, the researchers found that older adults in the no-exercise control groups in the studies faced declines in cognitive function. Meanwhile, the older adults who exercised showed small improvements in cognitive function no matter what type of exercise they did.

    The research team concluded that this study may be the first to show that for older adults who are at risk for or who have AD, aerobic exercise may be more effective than other types of exercise in preserving the ability to think and make decisions.

    The researchers note that their findings need to be confirmed in future studies.

    Everyday exercise has surprisingly positive health benefits



    The benefits of low-intensity physical activity, such as standing, walking or doing household chores, can be more health beneficial than once thought. According to a study from Karolinska Institutet published in the journal Clinical Epidemiology, replacing half an hour’s sedentariness a day with everyday activity reduces the risk of fatal cardiovascular disease by 24 per cent.

    Cardiovascular diseases are the primary cause of death in Sweden, and while it is known that moderate to intense physical activity reduces the risk of cardiovascular disease, the benefits of low-intensity activity have yet to be agreed upon.

    For the present study, the researchers analysed how different levels of physical activity in 1,200 people across Sweden affected the mortality rate due to cardiovascular disease (amongst other causes) 15 years later. Data were gathered from the ABC (Attitude, Behaviour and Change) study, in which the activity level of the participants is measured using motion trackers, and compared them with data on deaths and causes of death from Swedish registries.

    “This is a unique study, since we’ve been able to analyse a large number of people with objective measures of physical activity for up to 15 years,” says study leader Maria Hagströmer, senior lecturer at Karolinska Institutet’s Department of Neurobiology, Care Sciences and Society. “Previous studies asked participants about levels of physical activity, but this can lead to reporting error since it’s hard to remember exactly for how long one has been sitting and moving around.”

    The study shows that there are considerable health benefits to be gained not only from moderate or intense physical activity but also from low-intensity (everyday) activity. Replacing half an hour’s sedentariness a day with such low-level activity can reduce the risk of dying from cardiovascular disease by an estimated 24 per cent.

    Replacing sedentariness with physical activity of at least moderate level equivalent to a brisk walk, or higher intensity training, had, as expected, an even greater effect on cardiovascular-related mortality. Ten minutes of moderate to intense activity a day reduced the risk of death due to cardiovascular disease by 38 per cent, 30 minutes a day by a full 77 per cent, according to their calculations.

    The study adjusted for other potential confounding factors, such as age, sex, smoking habits, educational level and previous morbidity.

    “In an earlier study, we also showed that people who sit still for more than 10 hours a day have a 2.5 times higher risk of early death than people who sit for less than 6.5 hours a day,” says first author Ing-Mari Dohrn, postdoc at Karolinska Institutet’s Department of Neurobiology, Care Sciences and Society.

    Gender, education and class impacts on retirement and quality of life in older age



    Researchers from the University of Birmingham have found that raising your level of education and skills during your working life are key factors in determining your quality of life in retirement and older age.

    The study, led by the University of Birmingham Business School, involved interviewing around 50 retirees from a range of different professions and educational backgrounds. It was found that pathways to retirement and experiences of retirement differed greatly according to profession, gender, class and education.

    The researchers identified 6 groups of workers including the professionals, delayed professionals, those who had disjointed careers, mid-career transformation, administrative careers and semi-skilled careers.

    Experiences of retirement differed greatly according to which group workers fell into; for example, it was found the professionals were more likely to continue working in a part-time capacity (though not for financial gain), while those who had disjointed careers were more likely to continue to work in some capacity, such as in self- employment with retirement not an option to them.

    Meanwhile, those who had administrative careers retired from paid employment but were more likely to stay busy with activities such as helping family and doing volunteering.

    The study showed the importance of external factors throughout working life, such as employment, family caring history, access to resources, particularly material and financial resources, social networks and cultural capital (including education) and physical and mental health in younger and middle ages.

    The research also identified a link between gender and class.  For example, men and women with similar career histories shared similar retirement expectations and experiences, but this relationship was mediated by factors such as gender and class, as well as access to resources.
    Professor Joanne Duberley, University of Birmingham said:

    ‘All of these factors are interlinked, so financial resources can give individuals greater access to social and cultural resources and help maintain physical health.
    ‘While education shapes careers and helps people to amass financial capital.  As such these interlinkages can mean that inequalities in the initial distribution of resources are reinforced, facilitating those in a privileged position and constrain those who are disadvantaged.’

    The researchers identified a range of differing perspectives and feelings about retirement within each group. For example, those who had long professional careers were more likely to be optimistic and contented in retirement.

    Professor Duberley, University of Birmingham added:

    ‘One retiree who had had a professional career used their retirement to set up a cheese making business, something they could afford to do and had the time to do only in their retirement. They saw retirement as an opportunity.’
    ‘In contrast, those who did not embark on professional careers until later in their lives, due to factors such as their earlier caring responsibilities, were more ambivalent about retirement, fearing the loss of work-related identities and financial insecurity.’ 
    The study found those who followed disjointed career paths with periods in and out of work and in different types of employment, including self-employment, could also face financial instability in retirement.

    Women who had worked in administrative jobs, but had also been very involved in family networks, cited feeling more optimistic about retirement because it meant more opportunities to spend time with family and friends.  In contrast, men who had followed semi-skilled careers were more concerned with identity loss and inactivity in retirement.

    The study also highlighted the importance of access to financial resources at all stages of people's lives.

    Those who had access to significant financial resources early on in their lives were found to be more likely to have successful careers - accumulating more financial resources and having excellent financial security in later life -  opening up options for positive retirement experiences.

    However, periods of ill-health, family caring responsibilities for adults as well as children and decisions relating to re-training and learning could change the life course in both negative and positive ways.

    Parental provision of alcohol to teenagers does not reduce risks


    There is no evidence to support the practice of parents providing alcohol to their teenagers to protect them from alcohol-related risks during early adolescence, according to a prospective cohort study in Australia published in The Lancet Public Health journal.

    The six year study of 1927 teenagers aged 12 to 18 and their parents found that there were no benefits or protective effects associated with giving teenagers alcohol when compared to teenagers who were not given alcohol. Instead, parental provision of alcohol was associated with increased likelihood of teenagers accessing alcohol through other sources, compared to teenagers not given any alcohol.

    Alcohol consumption is the leading risk factor for death and disability in 15-24 year olds globally. Drinking during adolescence is of concern as this is when alcohol use disorders (ie, dependence on or abuse of alcohol) are most likely to develop.

    "In many countries, parents are a key provider of alcohol to their children before they are of legal age to purchase alcohol. This practice by parents is intended to protect teenagers from the harms of heavy drinking by introducing them to alcohol carefully, however the evidence behind this has been limited," says lead author Professor Richard Mattick, University of New South Wales, Australia.

    "Our study is the first to analyse parental supply of alcohol and its effects in detail in the long term, and finds that it is, in fact, associated with risks when compared to teenagers not given alcohol. This reinforces the fact that alcohol consumption leads to harm, no matter how it is supplied. We advise that parents should avoid supplying alcohol to their teenagers if they wish to reduce their risk of alcohol-related harms."

    The study recruited teenagers and their parents between 2010 and 2011 from secondary schools in Perth, Sydney and Hobart (Australia). The teenagers and their parents completed separate questionnaires every year from 2010 to 2016 including information about how teenagers accessed alcohol (from parents, other non-parental sources, or both), binge drinking levels (defined as drinking more than four drinks on a single occasion in the past year), experience of alcohol-related harm, and alcohol abuse symptoms.

    In the final two years, teenagers were also asked about symptoms of alcohol dependence and alcohol use disorder that could predict alcohol misuse problems in the future.

    At the start of the study, the average age of the teenagers was 12.9 years old and by the end of the study the average age was 17.8 years old. The proportion of teenagers who accessed alcohol from their parents increased as the teenagers aged, from 15% (291/1910) at the start of the study to 57% (916/1618) at the end of the study, while the proportion with no access to alcohol reduced from 81% (1556/1910) teenagers to 21% (341/1618).

    At the end of the study, 81% (632/784) of teenagers who accessed alcohol through their parents and others reported binge drinking, compared with 62% (224/361) of those who accessed it via other people only, and 25% (33/132) of teens who were given alcohol by their parents only. Similar trends were seen for alcohol-related harm, and for symptoms of possible future alcohol abuse, dependence and alcohol use disorders. The group of teenagers supplied with alcohol from both their parents and other sources were at the greatest risk of the five adverse outcomes, potentially as a result of their increased exposure.

    Importantly, teenagers supplied with alcohol by only their parents one year were twice as likely to access alcohol from other sources the next year. As a result, the authors suggest that having alcohol supplied by parents does not mitigate risk of it being supplied by other people, and that parental provision of alcohol did not appear to help teenagers deal with alcohol responsibly.

    "While governments focus on prevention through school-based education and enforcement of legislation on legal age for buying and drinking alcohol, parents go largely unnoticed. Parents, policy makers, and clinicians need to be made aware that parental provision of alcohol is associated with risk, not with protection, to reduce the extent of parental supply in high-income countries, and in low-middle-income countries that are increasingly embracing the consumption of alcohol." Says Professor Mattick.

    The authors note some limitations, including that teenagers from low socioeconomic status backgrounds -- for whom alcohol-related issues are more common -- were underrepresented in the study. In addition, the binge drinking measure (defined as drinking more than four drinks on a single occasion in the past year) was conservative, which may affect the associations identified.

    Writing in a linked Comment, Professor Stuart Kinner, Murdoch Children's Research Institute, Australia, says:
    "An important strength of the study is the careful adjustment for potential confounders. Nevertheless, it is difficult to exclude the possibility that some parents provided alcohol to their children in response to other, unmeasured risk factors, such as alcohol expectancies… Further research is required to better understand why some parents choose to supply their children with alcohol… The findings by Mattick and colleagues strongly suggest that parental supply of alcohol to adolescents does not protect against future alcohol-related harm, and might in fact increase risk. However, before drawing firm conclusions, it will be important to replicate this finding in larger samples that permit more granular characterisation of both exposures and outcomes, and in samples with at least proportionate representation of socioeconomically disadvantaged families. In view of the substantial role of alcohol in the burden of disease for adolescents, evidence-based prevention of alcohol-related harm across the social gradient is crucial."

    Thursday, January 25, 2018

    Combining drugs that lower blood pressure and cholesterol could do more to prevent stroke


    Combining medication that lowers blood pressure with medication that lowers cholesterol reduced first-time strokes by 44 percent, according to research presented at the American Stroke Association's International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians.

    Seventy-five percent of strokes are first-time strokes. High blood pressure and high cholesterol both increase the risk for stroke, the fifth leading cause of death in America. Yet, it's not known whether combining drugs that lower blood pressure and cholesterol levels can protect individuals from stroke.

    Now, a study involving 12,705 participants from 21 countries shows that individually, drugs that lower blood pressure or cholesterol do indeed reduce stroke risk, but when combined, they offer even greater protection.

    Among the findings:
    • Taking daily doses of two blood pressure drugs (fixed dose candesartan and hydrochlorothiazide) along with a cholesterol-lowering drug (low-dose rosuvastatin), proved to be the most effective, cutting first-time strokes by 44 percent among patients at intermediate risk for heart disease.
    • For those with very high blood pressure -- readings 143.5 mm Hg or higher -- taking 16 milligrams of candesartan plus 12.5 milligrams of hydrochlorothiazide every day reduced stroke by 42 percent.
    • Compared with a placebo, stroke was reduced by 30 percent among participants taking daily doses of 10 milligrams of rosuvastatin.
    "These results indicate that to prevent stroke in those at moderate risk, blood pressure lowering plus cholesterol-lowering should be considered in those with elevated blood pressure, and cholesterol-lowering should definitely be considered for all," said lead study author Jackie Bosch, Ph.D., McMaster University in Hamilton, Ontario, Canada. "These are existing drugs that are well-tolerated, have strong safety profiles and it is easy for patients to stick with them."

    The findings come from the Heart Outcomes Prevention Evaluation Study, a large, international study focused on heart disease and stroke prevention. The average age of the participants was 66 years; 46 percent were women, and 166 strokes occurred during an average follow-up of 5.6 years. At the start of the study, the average blood pressure was 138/82 mm Hg. A normal blood pressure reading is around 120/80 mm Hg.

    Based on these findings, Bosch said researchers are now looking at developing a single pill that produces the same effects as taking multiple pills that lower both blood pressure and cholesterol.

    Study links low carbohydrate intake to increased risk of birth defects


    Women who are pregnant or planning to become pregnant may want to avoid diets that reduce or eliminate carbohydrates, as they could increase the risk of having babies with neural tube birth defects, according to a new study from the University of North Carolina at Chapel Hill.

    The study was published in the journal Birth Defects Research on Jan. 25 and it found that women with low carbohydrate intake are 30 percent more likely to have babies with neural tube defects, such as spina bifida (malformations of the spine and spinal cord) and anencephaly (absence of major portions of the brain and skull), that can lead to lifelong disability and infant death, when compared with women who do not restrict their carbohydrate intake.

    This is the first study to evaluate the relationship between low carbohydrate intake and having children with neural tube defects.

    "We already know that maternal diet before and during early pregnancy plays a significant role in fetal development. What is new about this study is its suggestion that low carbohydrate intake could increase the risk of having a baby with a neural tube defect by 30 percent. This is concerning because low carbohydrate diets are fairly popular," said Tania Desrosiers, PhD, MPH, and research assistant professor of epidemiology at the UNC Gillings School of Global Public Health, who led the study. "This finding reinforces the importance for women who may become pregnant to talk to their health care provider about any special diets or eating behaviors they routinely practice."

    Folic acid is an essential nutrient that minimizes the risk of neural tube defects. More than 20 percent of women in the U.S. have blood folate concentrations below the recommended level to reduce risk of neural tube defects. For this reason, in 1998 the Food and Drug Administration began requiring that folic acid be added to enriched grain products. Desrosiers and her study collaborators found that dietary intake of folic acid among women with restricted carbohydrate intake was less than half of other women.

    The Centers for Disease Control and Prevention recommends that all women who may become pregnant take a daily multivitamin with at least 400 micrograms of folic acid every day before and during pregnancy. However, because almost half of all pregnancies in the U.S. are unplanned, many women do not initiate folic acid supplementation until later in pregnancy, after a neural tube defect may have occurred. This makes fortified foods an important source of folic acid for women who may become pregnant.

    Lifestyle changes prevent cognitive decline even in genetically susceptible individuals


    Enhanced lifestyle counselling prevents cognitive decline even in people who are carriers of the APOE4 gene, a common risk factor of Alzheimer's disease, according to a new study published in JAMA Neurology.

    The two-year FINGER trial involved 60-77 year-old people living in Finland and with risk factors for memory disorders. The study participants were divided into two groups: one of the groups was given regular lifestyle counselling and the other enhanced lifestyle counselling. Enhanced counselling involved nutrition counselling, physical and cognitive exercises, and support in managing the risk of cardiovascular diseases.

    Earlier findings from the FINGER trial have shown that the regular lifestyle counselling group had a significantly increased risk of cognitive and functional impairment compared to the intervention group, i.e. the group receiving enhanced counselling.

    Now the researchers analysed whether the presence of the APOE4 gene affected the intervention results. The analysis included 1,109 persons of whom 362 were carriers of the APOE4 gene. The findings show that enhanced lifestyle counselling prevented cognitive decline despite the presence of the risk gene. Analyses carried out within the groups also indicate that the intervention results might even be better in carriers of the APOE4 gene.

    "Many people worry that genetic risk factors for dementia may thwart potential benefits from healthy lifestyle changes. We were very happy to see that this was not the case in our intervention, which was started early, before the onset of substantial cognitive impairment," says Adjunct Professor Alina Solomon, the lead author of the study.

    Professor Miia Kivipelto, the principal investigator of the FINGER trial, adds: "The FINGER intervention model is now being adapted and tested globally in the World Wide FINGERS initiative. New clinical trials in diverse populations with a variety of geographical and cultural backgrounds will help us formulate global dementia prevention strategies".

    Learning to eat healthy easier than learning to eat smaller portions


    People are often told that eating everything in moderation can help them lose weight, but it is better to choose healthier foods than to try to eat less, according to Penn State researchers.

    In a recent study, researchers measured how much participants ate when given meals that varied in portion size. Despite about one-third of participants having been trained in different strategies to manage food portions during a previous year-long weight loss trial, all participants ate more as portion sizes grew. Although the trained participants ate the same amount as the others, they tended to choose healthier foods and ended up consuming fewer calories overall.

    "The results show that choosing healthy, lower-calorie-dense foods was more effective and more sustainable than just trying to resist large portions of higher calorie options," said Faris Zuraikat, graduate student. "If you choose high-calorie-dense foods but restrict the amount that you're eating, portions will be too small, and you're likely to get hungry."

    Previous research has shown the power of the "portion size effect," which is the tendency for people to eat more when larger portions are served and can result in people consuming more calories than they intended.

    The researchers designed an intervention to help people counteract this effect, in which participants were taught strategies to control food portions and eat healthier. Zuraikat said he and the other researchers wanted to see if this training was effective in helping people control portions.
    "We gathered a group of subjects who had extensive training on portion-control strategies to see if their response to increasing portion size of foods served at a meal differed from untrained individuals," Zuraikat said. "We were also interested in whether those untrained individuals with overweight and obesity or normal weight differed in their response."

    The researchers recruited three groups of women to participate in the study: 34 controls with overweight, 29 controls with normal weight, and 39 who had previously completed a one-year weight loss trial emphasizing portion-control strategies. All participants visited the lab once a week for four weeks. During each visit, the researchers provided the same foods but increased the portion size of the foods in a randomized order across weeks.

    Each meal consisted of foods with higher calorie density, like garlic bread, and lower calorie density, like salad. Foods were weighed before and after the meal to determine how much was eaten, and calorie intake was determined from these measures.

    The researchers found that when they were given larger portions, participants in all three groups ate more. For example, when the portion size was increased 75 percent, the average amount consumed went up 27 percent.

    However, the participants who received training consumed fewer calories overall than those who did not. Even though the participants in all three groups ate similar amounts of food, the participants who received training chose foods lower in calorie density.

    "All the groups were served the same meals, but their food choices differed. The participants who went through the training consumed more of the lower calorie-dense foods and less of the higher calorie-dense foods than the untrained controls," Zuraikat said. "Consequently, trained participants' calorie intake was less than that of the control groups, whose intake didn't differ by weight status."

    The researchers say the study -- published in the journal Appetite -- illustrates the strength of the portion-size effect while also suggesting easier, more sustainable strategies for managing calorie intake.

    "The study supports the idea that eating less of the higher-calorie-dense foods and more of the nutritious, lower-calorie-dense foods can help to manage hunger while consuming fewer calories," said Barbara Rolls, professor and the Helen A. Guthrie Chair of Nutritional Sciences, Penn State. "You still have a full plate, but you're changing the proportions of the different types of foods."

    Curcumin improves memory and mood


    Lovers of Indian food, give yourselves a second helping: Daily consumption of a certain form of curcumin -- the substance that gives Indian curry its bright color -- improved memory and mood in people with mild, age-related memory loss, according to the results of a study conducted by UCLA researchers.

    The research, published online Jan. 19 in the American Journal of Geriatric Psychiatry, examined the effects of an easily absorbed curcumin supplement on memory performance in people without dementia, as well as curcumin's potential impact on the microscopic plaques and tangles in the brains of people with Alzheimer's disease.

    Found in turmeric, curcumin has previously been shown to have anti-inflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India, where curcumin is a dietary staple, have a lower prevalence of Alzheimer's disease and better cognitive performance.

    "Exactly how curcumin exerts its effects is not certain, but it may be due to its ability to reduce brain in?ammation, which has been linked to both Alzheimer's disease and major depression," said Dr. Gary Small, director of geriatric psychiatry at UCLA's Longevity Center and of the geriatric psychiatry division at the Semel Institute for Neuroscience and Human Behavior at UCLA, and the study's first author.

    The double-blind, placebo-controlled study involved 40 adults between the ages of 50 and 90 years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or 90 milligrams of curcumin twice daily for 18 months.

    All 40 subjects received standardized cognitive assessments at the start of the study and at six-month intervals, and monitoring of curcumin levels in their blood at the start of the study and after 18 months. Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months.

    The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not, Small said. In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos.

    The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions.

    Four people taking curcumin, and two taking placebos, experienced mild side effects such as abdominal pain and nausea.

    The researchers plan to conduct a follow-up study with a larger number of people. That study will include some people with mild depression so the scientists can explore whether curcumin also has antidepressant effects. The larger sample also would allow them to analyze whether curcumin's memory-enhancing effects vary according to people's genetic risk for Alzheimer's, their age or the extent of their cognitive problems.

    "These results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years," said Small, UCLA's Parlow-Solomon Professor on Aging.

    Cognitive training helps regain a younger-working brain


    Relentless cognitive decline as we age is worrisome, and it is widely thought to be an unavoidable negative aspect of normal aging. Researchers at the Center for BrainHealth at The University of Texas at Dallas, however, say their research could provide new hope for extending our brain function as we age.

    In a randomized clinical study involving adults age 56 to 71 that recently published in Neurobiology of Aging, researchers found that after cognitive training, participants' brains were more energy efficient, meaning their brain did not have to work as hard to perform a task.

    Dr. Michael Motes, senior research scientist at the Center for BrainHealth and one of the lead authors of the study, said, "Finding a nonpharmacological intervention that can help the aging brain to perform like a younger brain is a welcome finding that potentially advances understanding of ways to enhance brain health and longevity. It is thrilling for me as a cognitive neuroscientist, who has previously studied age-related cognitive decline, to find that cognitive training has the potential to strengthen the aging brain to function more like a younger brain."

    To investigate changes in brain efficiency, the research team studied neural activity while the participant performed a task. For the study, 57 cognitively normal older adults were randomly assigned to a cognitive training group, a wait-listed control group, or physical exercise control group. The cognitive training utilized the Strategic Memory Advanced Reasoning Training (SMART) program developed at the Center for BrainHealth.

    Cognitive training strategies included how to focus on the most relevant information and filter out the less relevant; ways to continually synthesize information encountered in daily life to encourage deeper thinking; and how to inspire innovative thinking through generating diverse interpretations, solutions and perspectives. Because aerobic exercise has been shown to lead to improvements in processing speed and functional changes within the frontal and other brain regions, it was included as one of the study groups.

    The cognitive training was conducted over the course of 12 weeks. Participants in the active control physical exercise program exceeded physical activity guidelines of 150 minutes per week for the 12 weeks.

    Using functional magnetic resonance imaging (fMRI), an imaging technique that measures brain activity, researchers examined all three groups at the beginning (baseline), middle, and end of the study while participants performed computer-based speed tasks in the scanner.

    The fMRI results provided evidence that cognitive training improved speed-related neural activity. While all groups showed faster reaction times across sessions, the cognitive training group showed a significant increase in the association between reaction time and frontal lobe activity. After training, faster reaction times were associated with lower frontal lobe activity, which is consistent with the more energy-efficient neural activity found in younger adults.

    In contrast to the cognitive training group, the wait-listed and physical exercise groups showed significant decreases across sessions in the association between reaction time and frontal lobe activation.

    "This discovery of neural efficiency profiles found in the SMART-trained older adults is promising," said Dr. Sandra Bond Chapman, one of the lead authors, Center for BrainHealth founder and chief director. "If replicated, this work paves the way for larger clinical trials to test the ability to harness the potential of the aging mind and its ability to excel - by working like a younger brain with all the rich knowledge and expertise accrued over time. To counteract the pattern of age-related losses and even enhance the brain's inner workings by 'thinking' in smarter ways is an achievable and highly desirable goal."

    Energy drink use in teens has adverse effects New


    A Chapman University faculty member has published new research in the Journal of Pediatric Emergency Care showing why many teenagers consume energy drinks, how often, the age they started and what influences their choice of brands. Results showed that 40 percent of teens aged 13 to19 reported an adverse effect while ingesting energy drinks.

    Although several of these adverse effects go away on their own, others are potentially serious. The most common side effects included:
    • Insomnia
    • "Jittery"
    • Heart palpitations
    • Abdominal pain
    • Nausea, vomiting, or diarrhea
    • Headache
    • Chest pain
    • Labored breathing
    • Seizures
    Researchers also learned that 15 percent of teens mix alcohol in their energy drinks, while a smaller, yet concerning number used energy drinks with illegal drugs (nine percent) such as cocaine and methamphetamine. Additionally, the researchers were surprised to learn that energy drinks are perceived as healthy and are used for weight loss by some.

    Chapman University's School of Pharmacy Gavin Herbert Endowed Professor of Pharmacy and the lead author on this study, Sean Nordt, MD, PharmD, is an international expert in emergency medicine and toxicology. While acting as a physician, he said many patients questioned him about energy drink use and how much is too much.

    "I started seeing a lot of it and learned this had not been studied before; there was no data on usage," Nordt said. "I conducted one of the first studies evaluating effects of energy drink consumption in adults and realized there is very little data on adolescents using energy drinks."

    In 2017, the global energy drinks market topped $55 billion. With bright packaging and provocative names, teens say they drink these beverages for (in order of appearance) energy, as a study aide, to improve sports performance, "friends drink them," it "feels cool," to lose weight and taste, and while driving.

    Nordt said that he and his colleagues demonstrated that both brand name and packaging, as well as friends' influence played a role in teens' choice of energy drinks. With hundreds of these beverages now on the market, their choices were influenced by flavor, brand name, ease of access, brand friends drink, amount of caffeine, perceived as "healthy," packaging, available at home and cost.

    Eighty-one percent of teens surveyed stated they drank the beverage zero to once a week, while nearly 30 percent reported trying energy drinks for the first time by age 12 or younger. There are currently no age limitations on the sale of energy drinks, although several US cities have considered restricting sales to minors under 18.



    Cruise vacations contribute to well-being


    A new International Journal of Tourism Research study indicates that cruise vacations are not only for fun but can also be beneficial for individuals' happiness and well-being.

    The study identified three dimensions of cruise experience: emotional experience, relational experience, and thinking experience. In the short term, happiness from cruise travel is created mainly through emotional and relational experiences. Conversely, the long-term perceived happiness of cruising is largely derived from thinking experience.

    When considering emotional experience, relaxing and simply ''doing nothing'' is of great importance for many vacationers. The relational experience dimension refers to the social interactions with family, friends, staff, and other vacationers on a cruise.

    Thinking experience consists of the opportunities that people can experience different places and cultures and broaden horizons, as well as contemplative activities that involve introspection and meditation.

    Vitamin D supplements could ease painful IBS symptoms


    Vitamin D supplements could help to ease painful Irritable Bowel Syndrome (IBS) symptoms, a new study from the University of Sheffield has found.

    Scientists from the University's Department of Oncology and Metabolism reviewed and integrated all available research on vitamin D and IBS - a condition which affects two in 10 people in the UK.
    The study showed a high prevalence of vitamin D deficiency in IBS patients - regardless of their ethnicity.

    The Sheffield team also assessed the possible benefits of vitamin D supplements on IBS symptoms. Whilst they believe more research still needs to be conducted, their findings suggested supplements may help to ease symptoms which can include abdominal pain, bloating, diarrhoea and constipation. Vitamin D was shown to have the most benefit on quality of life in IBS.

    Lead author of the study, Dr Bernard Corfe, said: "The study provides an insight into the condition and, importantly, a new way to try to manage it.

    "It is evident from the findings that all people with IBS should have their vitamin D levels tested and a large majority of them would benefit from supplements.

    "IBS is a poorly understood condition which impacts severely on the quality of life of sufferers. There is no single known cause and likewise no single known cure."

    IBS is a debilitating functional disorder of the gastrointestinal (GI) tract. Little is known about why and how the condition develops, although it is known that diet and stress can make symptoms worse.
    The symptoms often cause embarrassment for patients meaning many live with the condition undiagnosed.

    IBS accounts for 10 per cent of visits to GP surgeries and the condition has a significant and escalating burden on society as a consequence of lost work days and time spent on regular hospital appointments.

    Vitamin D is essential for general wellbeing, including bone health, immune function, mental health as well as gut health. Vitamin D inadequacy can be remedied relatively easily with supplements if diagnosed.

    Low vitamin D status has already been associated with the risk of colorectal cancer and has been implicated in inflammatory bowel disease.

    The new study is published today (Thursday 25 January 2018) in the European Journal of Clinical Nutrition.

    The University of Sheffield's Department of Oncology and Metabolism conducts world-class research from basic clinical and translational cancer research to life course research and basic level biology through to diseases such as diabetes and osteoporosis.

    Wednesday, January 24, 2018

    My Supplements


    I take a large number of supplements more or less daily. The three I regard as most essential, whose benefits are well known are

    Aspirin (see http://healthnewsreport.blogspot.com/2016/10/health-benefits-of-aspirin.html)

    Fish oil, (see http://healthnewsreport.blogspot.com/2016/10/health-benefits-of-fish-oil.html)

    Vitamin D-3 (see http://healthnewsreport.blogspot.com/2016/10/heath-benefits-of-vitamin-d.html).

    I began taking Co-enzyme Q10 to fight potential muscle pain from the statin I take, but have discovered substantial offered additional benefits (see http://healthnewsreport.blogspot.com/2015/06/health-benefits-of-coenzyme-q10.html).

    I take B-12 whenever I have a bottle of beer or a glass of wine (see http://healthnewsreport.blogspot.com/2016/10/health-benefits-of-vitamin-b12.html)

    The most interesting new supplement that I take is Nicotinamide riboside (NR)(see http://healthnewsreport.blogspot.com/2016/10/nicotinamide-riboside-supplemeny-safely.html).

    Other supplements recently added: Guarana (see http://healthnewsreport.blogspot.com/2016/08/guarana-found-to-have-higher.html)

    and AMPK (see http://healthnewsreport.blogspot.com/2015/06/ampk-key-to-maintaining-muscle-strength.html)

    I take Grape Seed Extract daily (see http://healthnewsreport.blogspot.com/2016/10/health-benenfits-of-grape-seed-extract.html)

    I also take:

    Beta-sitosterol
    Beta-sitosterol is a substance found in plants. Chemists call it a “plant sterol ester.” It is found in fruits, vegetables, nuts, and seeds. It is used to make medicine.
    Beta-sitosterol is used for heart disease and high cholesterol. It is also used for boosting the immune system and for preventing colon cancer, as well as for gallstones, the common cold and flu (influenza), HIV/AIDS, rheumatoid arthritis, tuberculosis, psoriasis, allergies, cervical cancer, fibromyalgia, systemic lupus erythematosus (SLE), asthma, hair loss, bronchitis, migraine headache, and chronic fatigue syndrome.

    Curcumin
    Turmeric contains the chemical curcumin. Curcumin and other chemicals in turmeric might decrease swelling (inflammation). Because of this, turmeric might be beneficial for treating conditions that involve inflammation.
    L- Citruline
    L-citrulline is a naturally occurring amino acid. It is found in some foods like watermelons and is also produced naturally by the body.
    L-citrulline is used for Alzheimer’s disease, dementia, fatigue, muscle weakness, sickle cell disease, erectile dysfunction, high blood pressure, and diabetes. It is used for heart disease, body building, increasing energy, and for improving athletic performance.
    How does it work?
    L-citrulline is a naturally occurring amino acid found in food, such as watermelons, and also made in the body. Our bodies change L-citrulline into another amino acid called L-arginine and also to nitric oxide. L-citrulline might help increase the supply of ingredients the body needs to making certain proteins. It might also help open up veins and arteries to improve blood flow and reduce blood pressure.

    Fisetin

    Several studies have demonstrated the effects of fisetin against numerous diseases. It is reported to have neurotrophic, anticarcinogenic, anti-inflammatory, and other health beneficial effects. 

    PPQ