Lots of added sugar in some hard ciders

Autumn is the season for falling leaves, pumpkin-spice-flavored everything and apple cider. Yet new research indicates that, in addition to alcohol, some hard ciders may contain a hefty dose of added sugar, which may not be disclosed on the label. The researchers report their results in ACS' Journal of Agricultural and Food Chemistry.

Hard cider, made by fermenting apples or apple juice concentrate, is growing in popularity in the U.S. Apples contain plenty of natural sugars, so adding sweeteners to cider is usually unnecessary. However, cider makers could add sugar to further sweeten the beverage or speed fermentation.

Although manufacturers are required to list the amount of sugars per serving on the nutrition facts panel, they don't have to discriminate between those that naturally occur in the product in those that are put in later. Consuming excessive amounts of added sugars can increase the risk of developing conditions, such as diabetes and high blood pressure. In light of the World Health Organization's 2015 recommendation to limit added sugars to 25 grams per day, Sheryl Singerling and colleagues wanted to find out if several popular brands of hard ciders contain added sugar not disclosed in the ingredients list.

Sugars from apples have different ratios of carbon-12 and carbon-13 isotopes than sugars from cane or corn syrup because the plants use different photosynthetic pathways. So Singerling (then at the University of New Mexico) and coworkers used mass spectrometry to analyze the carbon isotope compositions of 23 ciders sold in the U.S. Six of the ciders were imported from Europe, while the rest were made domestically. They found that 60 percent of domestic ciders contained added sugars from cane or corn syrup, compared with 20 percent of imported ciders. However, beet sugar is the most common sweetener in Europe, and the method couldn't distinguish between apple and beet sugars or honey. Because of widespread discrepancies between isotope ratios expected from ingredients lists and the observed values, the researchers concluded that labels are not a reliable way to determine whether a cider has added sugar.

Study links cottonseed oil with lower cholesterol

Researchers at the University of Georgia have found that a high-fat diet enriched with cottonseed oil drastically improved cholesterol profiles in young adult men.

The researchers conducted a five-day outpatient feeding trial of 15 healthy, normal weight men to test the effects of diets enriched with cottonseed oil and olive oil on lipid profiles.

Participants showed significant reductions in cholesterol and triglycerides in the cottonseed oil trial compared to minimal changes on the olive oil-enriched diet.

The results appear in the journal Nutrition Research.

"One of the reasons these results were so surprising is because of the magnitude of change observed with the cottonseed oil diet," said Jamie Cooper, an associate professor in the UGA College of Family and Consumer Sciences' department of foods and nutrition and the corresponding author of the journal article. "To see this amount of change in such a short period of time is exciting."

The subjects, all healthy men between the ages of 18 and 45, were provided high-fat meals for five days in two separate, tightly controlled trials, the only difference being the use of either cottonseed oil or olive oil in the meals.

Participants showed an average decrease of 8 percent in total cholesterol on the cottonseed oil diet, along with a 15 percent decrease in low-density lipoprotein, or LDL (the "bad" cholesterol) and a 30 percent decrease in triglycerides.

This diet also increased high-density lipoproteins, or HDL (the "good" cholesterol) by 8 percent.
Researchers suggested a fatty acid unique to cottonseed oil, dihydrosterculic acid, may help prevent the accumulation of triglycerides, a type of fat, in the body.
"By doing that, it pushes the body to burn more of that fat because it can't store it properly, so you have less lipid and cholesterol accumulation," Cooper said.
That mechanism, in addition to the high polyunsatured fat and omega-6 content of cottonseed oil, seems to be a key component to the beneficial effects on lipid profiles, Cooper said.

Researchers plan to expand the study to include older adults with high cholesterol as well as a longer feeding intervention.

Hot brew coffee has higher levels of antioxidants than cold brew

In a new study, Jefferson (Philadelphia University + Thomas Jefferson University) researchers found chemical differences between hot and cold brew coffee that may have health impacts. In particular, the researchers found that hot-brewed coffee has higher levels of antioxidants, which are believed to be responsible for some of the health benefits of coffee.
The study, published Oct. 30 in Scientific Reports, also found that the pH levels of both hot and cold coffee were similar, ranging from 4.85 to 5.13 for all coffee samples tested. Coffee companies and lifestyle blogs have tended to tout cold brew coffee as being less acidic than hot coffee and thus less likely to cause heartburn or gastrointestinal problems.
The study was done by Niny Rao, PhD, associate professor of chemistry, and Megan Fuller, PhD, assistant professor of chemistry, both of them coffee drinkers who wondered whether the chemical make-up of cold brew differed from that of hot coffee.
While the popularity of cold brew coffee has soared in recent years--the U.S. market grew 580 percent from 2011 to 2016--they found almost no studies on cold brew, which is a no-heat, long-steeping method of preparation. At the same time, there is well-documented research that hot-brewed coffee has some measurable health benefits, including lower risk of some cancers, diabetes and depression.
While the overall pH levels were similar, Fuller and Rao found that the hot-brewed coffee method had more total titratable acids, which may be responsible for the hot cup's higher antioxidant levels.
"Coffee has a lot of antioxidants, if you drink it in moderation, research shows it can be pretty good for you," Fuller said. "We found the hot brew has more antioxidant capacity."
And considering hot and cold brews have comparable pH levels, Rao said, coffee drinkers should not consider cold brew a "silver bullet" for avoiding gastrointestinal distress.

Respiratory effects of wood smoke: gender matters

---

Exposure to wood smoke can have different effects on the respiratory immune systems of men and women -- effects that may be obscured when data from men and women are lumped together, according to a study published today in the American Journal of Respiratory and Critical Care Medicine by scientists at the UNC School of Medicine and the UNC Gillings School of Global Public Health.

The scientists exposed men and women volunteers to wood smoke or filtered air prior to inoculating them with a standard dose of the live-attenuated influenza virus vaccine, which causes a natural, yet mild, immune response in the nasal passages. They then later discovered that the men exposed to wood smoke had significantly higher markers of an inflammatory response in cells that line the nasal passages relative to men exposed to filtered air. By contrast, for women, the wood smoke exposure appeared to lower markers of the inflammatory response.
When the researchers averaged out the data from men and women, as these sorts of exposure studies typically do, the analysis gave the false impression that the wood smoke had almost no effect on the immune response to the live-attenuated influenza virus vaccine.
"The upshot is that we really need to consider sex-specific effects when studying wood smoke and other environmental pollutants that threaten public health," said senior author Ilona Jaspers, PhD, a professor of pediatrics in the UNC School of Medicine and director of UNC-Chapel Hill's Curriculum in Toxicology & Environmental Medicine.
Wood smoke is among the most ancient environmental pollutants, and is still considered a significant cause of sickness and death today. Researchers estimate that about 40 percent of the modern human population, roughly 3 billion people, are chronically exposed to smoke from burning wood and related "biomass" combustibles, such as leaves, crop stalks, and dung. Wood smoke contains dozens of known toxins, and epidemiological studies have linked biomass exposures to chronic obstructive pulmonary disorder (COPD) in women who have never smoked and lung cancer in male firefighters. Wood smoke exposure is also expected to become more common as the frequency of wildfires increases.
Epidemiological studies have suggested that wood smoke impairs normal lung functions and the ability of the human airway to defend itself against respiratory infections. But controlled exposure studies directly linking wood smoke exposure and altered responses to respiratory infections had not been completed.
In 2014, Jaspers and colleagues designed their study to explore that impact on airway immune defense. They recruited 39 healthy, young, nonsmoking adults and randomly assigned them to sit for two hours in a chamber filled with dense wood smoke (500 ?g/cm3 wood smoke particle concentration) or in a chamber filled with clean, filtered air. At the end of the two hours, each group received a standard dose of a live-attenuated influenza virus vaccine (FluMist), delivered in a squirt up the nose, to model an ordinary community-acquired respiratory virus infection. Before the wood smoke exposure, on the day after, and on the day after that, the researchers washed airway-lining cells from the noses of the subjects and measured the expression levels of key inflammatory genes and proteins in the cells. The main goal was to see if the wood smoke-exposed subjects had signs of an altered inflammatory response, compared to the filtered-air group.
The researchers unexpectedly found high variability in the data; for some wood smoke-exposed subjects the inflammatory response was greater, while for others it was lower. On average there appeared to be almost no significant difference in response compared to the filtered-air group -- as if the wood smoke on balance had done virtually nothing to change airway antiviral defenses.
"We were very discouraged by these results and had a difficult time understanding the variability in the effects of wood smoke among the subjects," Jaspers said.
A few years later, Jaspers hired postdoctoral researcher Meghan Rebuli, PhD, who has a background in the sex-specific toxicity of endocrine-disrupting compounds, like bisphenol A (BPA). Rebuli, the first author of the current study, re-examined the data and identified a key source of the high variability in the data: sex. Specifically, the wood smoke exposure resulted in higher inflammatory markers for the male subjects and lower inflammatory markers for the female subjects. The effects, which hint at milder responses to viral infection for wood smoke-exposed women compared to wood smoke-exposed men, were so consistently opposite that combining them, without regard to sex, gave the misleading appearance of almost no effect overall.
The scientists aren't yet sure why men and women would differ so starkly in their immunological responses to wood smoke. One possibility is that women and men over thousands of generations have had different evolutionary histories of wood smoke exposure, leading to different evolutionary adaptations. Women, for example, might have had greater and more chronic exposure to smoke from cooking fires, compared to men. Other factors that may have influenced the sex-specific responses include differences in male and female hormone profiles and genetics.
"We wonder if a greater wood smoke exposure has led to evolutionary pressure on women to have a more blunted inflammatory response, which would probably result in less damage to the airway during respiratory virus infection," Jaspers said.
Regardless, this study suggests that any research on environmental exposures should take potential sex differences into account.
"Many researchers still do not treat sex as a factor in their analyses, and this can mask effects like the ones we found," Rebuli said. "This is very important to consider in future clinical studies, as we are just beginning to understand how differently men and women can respond to a variety of exposures."

Older adults: much weaker relationship between what eyes see and their brain activity

Forgetfulness and age-related memory lapses are a common complaint for many older adults, but what is still not understood is what causes these changes.

Recent research published by scientists at Baycrest's Rotman Research Institute (RRI) brings us a step closer to uncovering the answer, which could help with distinguishing signs of dementia earlier.
The study, published in the journal Neuropsychologia, found that among older adults, there is a much weaker relationship between what their eyes see and their brain activity.
"Eye movements are important for gathering information from the world and the memory centre of the brain -- the hippocampus -- is important for binding this data together to form a memory of what our eyes see," says Dr. Jennifer Ryan, RRI senior scientist and Reva James Leeds Chair in Neuroscience and Research Leadership. "But we found that older adults are not building up the memory in the same way as younger adults. Something is falling apart somewhere along the path of taking in visual information through the eyes and storing what is seen into a memory."
Previously, Baycrest researchers had identified a connection between what we see and how we remember -- when the eyes view and process more details of an object in front of them, there is more brain activity in the memory centre of the brain. When the object is seen multiple times, there is a progressive drop in hippocampus activity, indicating that what is seen is no longer new information. But this doesn't happen with older adults.
In the latest study, researchers found that older adults exhibited greater eye movements, but there isn't a corresponding pattern in brain activity.
"These findings demonstrate that the eyes and brain are taking in information from their surroundings, but the linkage aspect of creating a memory appears to be broken," adds Dr. Ryan, who is also a psychology professor at the University of Toronto. "When the memory isn't being created, the object continues to remain unfamiliar to a person, even when they have seen it multiple times."
The study was conducted with 21 older adults (between the ages of 64 and 79) and 20 younger adults (between the ages of 19 and 28). Research participants were briefly shown faces on a screen where some of the images were displayed multiple times. Researchers analyzed the eye movements and brain scans of individuals as they looked at and analyzed the pictures.
As next steps, researchers will continue exploring the triggers of eye movements and related activity in the brain, which could be used to help predict earlier cognitive decline in Alzheimer's disease or other related dementias.
This study was conducted with support from the Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council and the Canada Research Chairs Program.
With additional funding, scientists could continue research that would inform the development of an eye-tracking cognitive assessment that could one day help doctors evaluate cognitive decline in clients.

Tall individuals are more prone to cancer

For most cancers, risk increases dramatically with age.  But what about the effect of having more cells in the body? Might taller people be more prone to cancer because they have more cells?

Yes, according to Leonard Nunney, an evolutionary biologist at the University of California, Riverside, who examined data from four large-scale surveillance projects on 23 cancer categories.

Each of these cancer studies established that tall individuals are at an increased risk of cancer, with overall risk increasing by about 10 percent per 10 centimeter (4 inch) increase in height.

Other researchers have proposed that that factors acting early in life - nutrition, health, social conditions - independently influence height and cancer risk. But Nunney, a professor of biology, challenges this hypothesis.

"I tested the alternative hypothesis that height increases cell number and that having more cells directly increases cancer risk," he said. "The data strongly supported this simple hypothesis. For most cancers, the size of the height effect is predictable from the height-related increase in cell number."

Study results appear in the Proceedings of the Royal Society B.

When Nunney performed a comparison of the observed effect of height on the risk of specific cancers for both women and men, he found that the effect of being tall on the risk of thyroid and skin cancer was high in women; for men, skin cancer stood out.

"Tall individuals are at increased risk of almost all cancers," he said. "But skin cancers - such as melanoma - show an unexpectedly strong relationship to height. This may be because the hormone IGF-1 is at higher levels in taller adults."
IGF-1 is a growth factor that is particularly important in early development, Nunney explained, but IGF-1 has also been linked to a higher rate of cell division in tall adults.
"If your cells divide more often, then that adds to your cancer risk," he said. "If skin cells are dividing more rapidly in tall people due to high levels of IGF-1, then this could account for the increased risk for melanoma."
Of the 18 cancers scored in both sexes, Nunney found only four showed no significant increase with height in either sex: pancreas, esophagus, stomach, and mouth.
"It is possible that these cancers are more strongly associated with environmental factors," he said. "It is possible, too, that in these tissues cell numbers do not scale with body size - but this seems unlikely."
Nunney explained that two factors cause increased cancer risk: one is having more cells; the other is having more cell divisions.
"If you double the cells, you double the cancer risk," he said. "If you double the number of cell divisions, you more than double the cancer risk. Living a long time is the worst thing to do if you want to avoid cancer.  But then what's the alternative?"
Men are taller than women on average, which may account for why men get more cancer than women.
"About a third of this effect can be accounted for by men having more cells," Nunney said. "But something else is going on to explain the rest."
Breeds of dogs also demonstrate cancer's link to height, he added.
"Smaller dogs get less cancer than bigger breeds of dogs."
Next, Nunney plans to explore how different cancers are being prevented in the body by looking at big long-lived animals.
"If all else is equal, large, long-lived animals should experience higher incidence of cancer than small, short-lived animals," he said.  "After all, larger animals have more cells, more divisions, and more mutations.  But they show no such tendency to be more cancer prone. This is called Peto's paradox, and I argue it can be resolved through adaptive evolution, namely, that species subject to selection for larger body size and greater longevity evolve additional layers of cancer suppression. I'm interested in exploring how as a species gets bigger and lives longer, it evolves additional barriers to cancer."

Rich people don't live that much longer than the poor

IMAGE: Life expectancy of 40-year-old male. Previous research methods demonstrated that a 40-year-old man with a high annual income can expect to live six years longer than a same-age low-income man... view more 

Credit: University of Copenhagen, Center for Economic Behaviour and Inequality CEBI

New research results, published in Proceedings of the National Academy of Sciences (PNAS), challenge previous findings of huge differences in life expectancy between the rich and those at the bottom of the income scale. In real life people don´t necessarily stay poor or stay rich, as assumed in previous research, and three economists from the University of Copenhagen have now found a way to take this mobility between income-classes into account providing a more realistic way to calculate life expectancy for people from different walks of society. Their results show that in reality the difference between the lifespan of a rich and a poor person is really not that big.
In 2016 impressive work published in Journal of the American Medical Association by a Harvard research team showed that high-income people in the US can expect to live 6.5 years longer at age 40 than low-income individuals.* This research gave rise to a substantial debate about inequality in health in the US.
The existing method assumes that the poor stay poor and the rich stay rich for the rest of their lives. In reality, however, over a ten-year period half of the poorest people actually move into groups with better incomes and likewise, half of the rich leak down into lower income classes. The mortality of those who move to a different income class is significantly different from those who stay in the same class.
This mobility between income classes has until now been a challenge for the ability to calculate life expectancy across different groups in the population but Danish economists Claus Thustrup Kreiner, Torben Heien Nielsen, and Benjamin Ly Serena from Center for Economic Behavior and Inequality (CEBI) at the University of Copenhagen (UCPH) have now devised a method to account for this income mobility in the relationship between income and life expectancy by incorporating a classic model of social mobility from the literature.
The authors demonstrated their approach by calculating life expectancy at age 40 in Denmark based on official income and mortality records of the entire population of Danish women and men spanning the period 1983-2013, which approximately halved the difference in life expectancy between people in low and high-income groups:
When accounting for income mobility, life expectancy for a 40-year-old man in the upper income groups is 77.6 years compared with 75.2 for a man in poorer groups - a difference of 2.4 years. For women the difference between high and low-income groups is 2.2 years. However, without taking the income mobility into account the life expectancy difference was twice as big - around five years - for both men and women. Using the method, the authors suggest that the difference in the US is three years rather than 6.5.
-Our results reveal that inequality in life expectancy is significantly exaggerated when not accounting for mobility. This result is quintessential not only for our understanding of one of the most important measures of inequality in a society, namely, how long different groups can expect to live. But also by mis-measuring this type of inequality, we get to misleading conclusions about the cost and benefits of public health programs such as Medicare and social security policies. For instance, given the rich live longer, they will also benefit many more years from old-age-pension benefits, says professor Thustrup Kreiner.
The difference is growing
Even though inequality in life expectancy now proves to be only half as big as earlier anticipated, the new UCPH-research funded by the Danish National Research Foundation also shows, that the difference in life expectancy between the rich and the poor has steadily increased over the 30 years represented in the data. This is despite Denmark being a country that is internationally renowned for its free health care and education as well as a finely masked welfare-system that in many respects is thought to make up for differences in income.
The reason for this steady but strikingly growing difference in life expectancy is beyond the scope of this particular project, but the UCPH-economists point out that other research has demonstrated, how individuals that belong to high income/high education-groups also have proven to benefit more from new health technologies and seem to take more advantage of new types of treatment and prevention of disease.

###

*DEFINITION OF LOW-AND HIGH-INCOME PEOPLE
We define low income as people belonging to income percentile 20 and high income as belonging to income percentile 80. Income percentiles are captured in the following way: When dividing people in 100 equally sized income groups (where the 1st group is the poorest and the 100th group is the richest), then percentile 20 refers to the 20th lowest income group and percentile 80 refers to the 20th highest income group.

Exercise may lessen fall risk for older adults with Alzheimer's

Alzheimer's disease (AD) is a brain disease that causes changes that kill brain cells. AD is a type of dementia, which causes memory loss and problems with thinking and making decisions. People with AD and other forms of dementia have difficulties performing the daily activities others might consider routine.
Dementia takes a toll on those who live with it--and it also places a burden on caregivers. Along with problems connected to memory, language, and decision-making, dementia can cause neuropsychiatric symptoms, such as depression, anxiety, changes in mood, increased irritability, and changes in personality and behavior. People who have AD/dementia also have twice the risk for falls compared to people without dementia. About 60 percent of older adults with dementia fall each year.
Researchers suggest that having neuropsychiatric symptoms might predict whether an older person with AD/dementia is more likely to have a fall. We also know that exercise can reduce the number of falls in older adults with dementia. However, we don't know very much about how neuropsychiatric symptoms may increase the risk of falls, and we know even less about how exercise may reduce the risk of falls for people with dementia and neuropsychiatric symptoms. A research team decided to explore whether exercise could reduce the risk of falling among community-dwelling people with AD who also had neuropsychiatric symptoms.
To learn more, the researchers reviewed a study that investigated the effects of an exercise program for older adults with AD (the FINALEX trial). The study included a range of people living with different stages of AD/dementia and with neuropsychiatric symptoms. Their findings were published in the Journal of the American Geriatrics Society.
The original FINALEX study examined and compared older adults who had home- or group-based exercise training with people who didn't exercise but who received regular care. The researchers learned that the people who exercised had a lower risk for falls than those who didn't exercise. There was also a higher risk for falls among those who had lower scores on psychological tests and who didn't exercise.
This study revealed that people with AD/dementia and neuropsychiatric symptoms such as depression and anxiety have a higher risk for falls. Exercise can reduce the risk of falling for older adults with these symptoms. Further studies are needed to confirm these results.

Vitamin D levels in the blood linked to cardiorespiratory fitness

Vitamin D levels in the blood are linked to cardiorespiratory fitness, according to a study published today in the European Journal of Preventive Cardiology, a publication of the European Society of Cardiology (ESC).

"Our study shows that higher levels of vitamin D are associated with better exercise capacity," said Dr Amr Marawan, assistant professor of internal medicine, Virginia Commonwealth University, Virginia, US. "We also know from previous research that vitamin D has positive effects on the heart and bones. Make sure your vitamin D levels are normal to high. You can do this with diet, supplements, and a sensible amount of sun exposure."

It is well established that vitamin D is important for healthy bones, but there is increasing evidence that it plays a role in other areas of the body including the heart and muscles.

Cardiorespiratory fitness, a reliable surrogate for physical fitness, is the ability of the heart and lungs to supply oxygen to the muscles during exercise. It is best measured as the maximal oxygen consumption during exercise, referred to as VO2 max. People with higher cardiorespiratory fitness are healthier and live longer.

This study investigated whether people with higher levels of vitamin D in the blood have improved cardiorespiratory fitness. The study was conducted in a representative sample of the US population aged 20-49 years using the National Health and Nutrition Survey (NHANES) in 2001-2004. Data was collected on serum vitamin D and VO2 max. Participants were divided into quartiles of vitamin D levels.
Of 1,995 participants, 45% were women, 49% were white, 13% had hypertension, and 4% had diabetes. Participants in the top quartile of vitamin D had a 4.3-fold higher cardiorespiratory fitness than those in the bottom quartile. The link remained significant, with a 2.9-fold strength, after adjusting for factors that could influence the association such as age, sex, race, body mass index, smoking, hypertension, and diabetes.
Dr Marawan said: "The relationship between higher vitamin D levels and better exercise capacity holds in men and women, across the young and middle age groups, across ethnicities, regardless of body mass index or smoking status, and whether or not participants have hypertension or diabetes."
Each 10 nmol/L increase in vitamin D was associated with a statistically significant 0.78 mL/kg/min increase in VO2 max. "This suggests that there is a dose response relationship, with each rise in vitamin D associated with a rise in exercise capacity," said Dr Marawan.
Dr Marawan noted that this was an observational study and it cannot be concluded that vitamin D improves exercise capacity. But he added: "The association was strong, incremental, and consistent across groups. This suggests that there is a robust connection and provides further impetus for having adequate vitamin D levels, which is particularly challenging in cold, cloudy places where people are less exposed to the sun."
On the other hand, Vitamin D toxicity can lead to excess calcium in the blood, which can cause nausea, vomiting, and weakness. "It is not the case that the more vitamin D, the better," said Dr Marawan. "Toxicity is caused by megadoses of supplements rather than diet or sun exposure, so caution is needed when taking tablets."
Regarding further research, Dr Marawan said: "We know the optimum vitamin D levels for healthy bones but studies are required to determine how much the heart needs to function at its best. Randomised controlled trials should be conducted to examine the impact of differing amounts of vitamin D supplements on cardiorespiratory fitness. From a public health perspective, research should look into whether supplementing food products with vitamin D provides additional benefits beyond bone health."

Bigger brains associated with greater cancer risk

The more brain cells you have, the higher your risk of brain cancer

It may simply be that having a big brain is itself the cause.

That's what doctor and PhD candidate Even Hovig Fyllingen at the Norwegian University of Science and Technology (NTNU) has determined with his research colleagues.

"Aggressive brain cancer is a rare type of cancer, but once you have it, the chance of survival is relatively low," he says.

Lifestyle matters less
 
For some types of cancer, lifestyle makes a big difference. People who smoke have a greater risk of lung cancer than non-smokers, for example. A person's lifestyle matters less for brain tumor development.

A large brain means more brain cells. And the more cells you have, the more cell divisions that can go wrong and create mutations that lead to cancer.

Big organs, bigger risk
 
"Several studies have shown that the size of different organs is an important factor in cancer development. For example, women with larger breasts have a greater risk of breast cancer. We wanted to check if this was also the case for brain tumors," says Fyllingen.
To tackle the question, he relied on material from the Nord-Trøndelag Health Study (HUNT). It comprises health data and blood samples that have been collected in multiple waves of data gathering from thousands of Norwegians in the Nord-Trøndelag county region. The purpose of the study is to find out why some individuals become ill while others stay healthy, what affects our health and how our health affects our lives.
Fyllingen used the third version of the survey, called HUNT3, and compared it to St. Olavs Hospital's neurosurgery database. He extracted data on everyone who had been operated on for high-grade gliomas (brain tumors) between 2007 and 2015 and compared their data with healthy controls from the HUNT study.
The researchers used MRI scans to measure the size of the brain. Then 3D models were made from them so that the intracranial brain volume could be measured in millilitres.
Mostly men who get brain tumors
The study also shows that more men than women develop brain tumours.
"Men have a larger brain than women because men's bodies are generally larger. It doesn't mean that men are smarter, but you need to have more brain cells to control a large body. This is also the case with animals. In bigger bodies, organs like the heart, lungs and brain are also bigger," says Fyllingen.
Yet it turns out that women with big brains have a greater risk of developing brain tumors compared to men with big brains.
"Seventy per cent more men than women develop brain tumors, but when we correct for head size, it's no longer beneficial to be female. Women with large brains are particularly susceptible. Why that is I have no idea," says Fyllingen.

Fermented dairy products may protect against heart attack

Men who eat plenty of fermented dairy products have a smaller risk of incident coronary heart disease than men who eat less of these products, according to a new study from the University of Eastern Finland. A very high consumption of non-fermented dairy products, on the other hand, was associated with an increased risk of incident coronary heart disease. The findings were published in the British Journal of Nutrition.

Earlier studies have shown that fermented dairy products have more positive effects on blood lipid profiles and on the risk of heart disease than other dairy products. Examples of fermented dairy products include cheese, yoghurt, quark, kefir and sour milk. However, research into the topic remains scarce.

The Kuopio Ischaemic Heart Disease Risk Factor Study ongoing at the University of Eastern Finland explored the associations of fermented and non-fermented dairy products with the risk of incident coronary heart disease. Approximately 2,000 men participated in the study. Their dietary habits were assessed at the beginning of the study in 1984-1989, and they were followed up for an average of 20 years. During this follow-up, 472 men experienced an incident coronary heart disease event.
The study participants were divided into groups on the basis of how much they ate different dairy products, and the researchers compared the groups with the highest and lowest consumption, while also taking various lifestyle and nutrition factors into consideration.

When the study participants were divided into four groups on the basis of their consumption of fermented dairy products with less than 3.5% fat, the risk of incident coronary heart disease was 26% lower in the highest consumption group compared to the lowest consumption group. Sour milk was the most commonly used low-fat fermented dairy product. The consumption of high-fat fermented dairy products, such as cheese, was not associated with the risk of incident coronary heart disease.
However, the researchers found that a very high consumption on non-fermented dairy products was associated with an increased risk of incident coronary heart disease. Milk was the most commonly used product in this category, and a very high consumption was defined as an average daily milk intake of 0.9 litres. Lower consumption levels were not associated with the risk.
"Here in Finland, people's habits of consuming different dairy products have changed over the past decades. For instance, the consumption of milk and sour milk have declined, while many fermented dairy products, such as yoghurt, quark and cheeses, have gained in popularity," Adjunct Professor Jyrki Virtanen from the University of Eastern Finland says.
The new study provides further evidence on the health benefits that fermented dairy products may have over non-fermented ones. All the mechanisms are not understood yet, but they may be linked to compounds forming during the fermentation process.

Becoming more sensitive to pain increases the risk of knee pain not going away

Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis, according to a new study by researchers at Université de Montréal and its affiliated Maisonneuve Rosemont Hospital Research Centre (CRHMR), in collaboration with researchers at Boston University. Their findings were published Oct. 11 in the journal Arthritis & Rheumatology.
Osteoarthritis (OA) is a common cause of pain and altered joint function, affecting 302 million adults worldwide. It can lead to chronic disability, frequently in the knee joint. Past research suggests that a number of factors outside of structural pathology may contribute to pain in patients with OA.
"Understanding the factors that contribute to the development of persistent pain is critical to improving our ability to prevent its onset and the transition to more persistent pain," said lead author Lisa Carlesso, an assistant professor at UdeM's School of Rehabilitation and a scientist at CRHMR, part of the CIUSSS de l'Est-de-l'Île-de-Montréal.
She and her team analyzed data from a multicentre OA study that followed 852 adults (ages 50-79) with or at risk of knee OA but who were free of persistent knee pain at the beginning of the study. Sociodemographic data, pain sensitization measurements, as well as risk factors traditionally associated with knee pain such as psychological factors, widespread pain and poor sleep were collected on the participants, who then were followed for development of persistent knee pain over two years.
The researchers used the risk factors and pain sensitization data to identify four distinct subgroups called pain susceptibility phenotypes (PSPs). They found these PSPs were primarily characterized by varying degrees of pain sensitization. The PSP with the highest degree of sensitization had the highest risk of developing persistent knee pain. Female gender, non-Caucasian race and age 65+ were significant sociodemographic predictors of being a member of the PSP with the highest degree of sensitization.
The researchers believe identifying these PSPs is an important step in understanding the complex pathology of knee osteoarthritis. "Our findings suggest that therapy aimed at prevention or improvement of pain sensitization may be a novel approach to preventing persistent knee pain," said co-author Tuhina Neogi, a professor of medicine and epidemiology at Boston University's School of Medicine and School of Public Health. "Preventing pain is crucial to improving quality of life and function in patients who suffer from OA."

Few women told by doctor that breastfeeding can reduce cancer risk

A new survey shows that although nearly 60 percent of breastfeeding mothers knew about the link between breastfeeding and breast cancer risk reduction, just 16 percent say they learned this from a medical professional.
This is concerning, says study principal investigator Bhuvana Ramaswamy, MD, because women should be informed that breastfeeding can reduce breast cancer risk and improve mother's health. Epidemiological studies show strong correlation between prolonged breastfeeding and reduced risk of developing triple negative breast cancer, an aggressive form of breast cancer. This knowledge is especially relevant for African American women considering whether to breastfeed, who are two times more likely to develop triple negative breast cancer when compared with women of other ethnicities.
"We have a duty as a medical community to ensure our patients have reliable knowledge," said Ramaswamy, breast medical oncology division director at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James). "When it comes from a professional, medical information is much more likely to affect people's choices. When it comes to breast cancer specifically, prevention is the best outcome."
For this study, OSUCCC - James researchers conducted a survey of 724 women who had at least one live birth. Survey respondents were recruited through the Ohio State University Wexner Medical Center primary care practices and a national clinical research registry.
While a majority of respondents - 92 percent - reported that they had chosen to breastfeed, only 56 percent of all respondents noted that they were aware of the link between prolonged breastfeeding and breast cancer risk reduction prior to making the decision. Among those that did not breastfeed, 59 percent say that knowledge of this risk reduction would have impacted their decision to breastfeed.
The data was published in the medical journal Breastfeeding Medicine.

'Microdoses' of psychedelics may enhance a person's creative problem solving abilities

The use of minute doses of magic mushrooms and truffles containing psychedelic substances could induce a state of unconstrained thought that may produce more new, creative ideas. "Microdosing" in this way may allow people to experience the creative benefits of psychedelic drugs without the risk of the so-called "bad trips" that often come with high doses of such substances. This is according to a new study in the Springer-branded journal Psychopharmacology which is the official journal of the European Behavioural Pharmacology Society (EBPS). The research was led by Luisa Prochazkova of Leiden University in The Netherlands and is the first study of its kind to experimentally investigate the cognitive-enhancing effects of microdosing on a person's brain function within a natural setting.
Taking a tiny fraction of a normal dose of psychedelic substances is becoming a trend in some professional circles because this is thought to stimulate brain function and enhance mental flexibility and creativity. However, experimental research that moves away from anecdotal evidence is still rare.
In this study, Prochazkova and her colleagues investigated how a microdose of a psychedelic substance affected the cognitive brain function of 36 people who were present at an event organized by the Psychedelic Society of The Netherlands. During the experimental phase, participants were set three tasks before and after they consumed on average 0.37 grams of dried truffles. The tests assessed their convergent thinking (the identification of a single solution to a problem), their fluid intelligence (the capacity to reason and solve new problems) and their divergent thinking (the ability to recognize many possible solutions). Afterwards, the researchers analyzed the active substances present in the truffles consumed by participants.
After taking the microdose of truffles, the researchers found that participants' convergent thinking abilities were improved. Participants also had more ideas about how to solve a presented task, and were more fluent, flexible and original in the possibilities they came up with. Microdosing with psychedelic substances therefore improved both the divergent and convergent thinking of participants.
These findings are in line with earlier studies that found high doses of psychedelics can enhance creative performance. The fact that participants' intelligence scores and general analytical abilities did not change suggests that the effect of the truffles is rather selective, and more to the benefit of a person's creative domain.
"Taken together, our results suggest that consuming a microdose of truffles allowed participants to create more out-of-the-box alternative solutions for a problem, thus providing preliminary support for the assumption that microdosing improves divergent thinking," explains Prochazkova. "Moreover, we also observed an improvement in convergent thinking, that is, increased performance on a task that requires the convergence on one single correct or best solution."
Prochazkova hopes that these findings will stimulate further research into the beneficial effects of microdosing psychedelics. "Apart from its benefits as a potential cognitive enhancement technique, microdosing could be further investigated for its therapeutic efficacy to help individuals who suffer from rigid thought patterns or behavior such as individuals with depression or obsessive-compulsive disorder," she explains.

Trust in others predicts mortality in the United States

Do you trust other people? It may prolong your life. According to a study by researchers from Lund University and Stockholm University, people who trust others live longer - Those who do not increase their risk of a shortened life. The study is published in the Journal of Epidemiology and Community Health.
Trust in other people is sometimes described as the 'glue' that keeps societies together. A new scientific study based on nationally representative survey data from the United States shows that this important resource does even more - it literally keeps you alive.
"Whether or not you trust other people, including strangers, makes a difference of about 10 months in terms of life expectancy", says Alexander Miething, researcher at Stockholm University and one of the co-authors of the study.
It also makes a difference whether you live in a place where relatively large shares of the population are distrusters. "In those contexts", continues Miething, "your risk of dying is higher than in places with more community trust."
The study is based on data material from the US General Social Survey (GSS) that allowed the researchers to assess US Americans' attitudes, their levels of trust and socioeconomic conditions. The data consisted of pooled cross sections, which means that respondents were interviewed only once. Since the survey data can be linked to the national mortality database (NDI), it was possible to estimate whether respondents' perceived trust predicts their risk of dying. The study sample included 25 270 respondents who were surveyed between 1978 and 2010.
The results are in line with earlier research that proposed trust as a lubricant when engaging with others. As compared to distrusters, trusters may be better able to mobilize social support from network contacts and their wider communities. Trust is supposed to reduce friction in social interactions, and diminish psychosocial stress that contributes to health problems and shortened lives.
The advantages from high levels of trust were similar between men and women and persisted even when accounting for socioeconomic conditions such as education and income. Given the protective effects of trust for mortality, a decline in trust (as seen across the US over past decades) may pose an underestimated public health concern.

Probiotics are not always 'good bacteria'

The first study investigating the mechanism of how a disease develops using human organ-on-a-chip technology has been successfully completed by engineers at The University of Texas at Austin.
Researchers from the Cockrell School of Engineering were able to shed light on a part of the human body - the digestive system -- where many questions remain unanswered. Using their "gut inflammation-on-a-chip" microphysiological system, the research team confirmed that intestinal barrier disruption is the onset initiator of gut inflammation.

The study also includes evidence that casts doubt on the conventional wisdom of taking probiotics - live bacteria that are considered good for gut health and found in supplements and foods such as yogurt - on a regular basis. According to the findings, the benefits of probiotics depend on the vitality of one's intestinal epithelium, or the gut barrier, a delicate single-cell layer that protects the rest of the body from other potentially harmful bacteria found in the human gut.

"By making it possible to customize specific conditions in the gut, we could establish the original catalyst, or onset initiator, for the disease," said Hyun Jung Kim, assistant professor in the department of biomedical engineering who led the study. "If we can determine the root cause, we can more accurately determine the most appropriate treatment."

The findings are published this week in Proceedings of the National Academy of Sciences.
Until now, organs-on-chips, which are microchips lined by living human cells to model various organs from the heart and lungs to the kidneys and bone marrow, solely served as accurate models of organ functionality in a controlled environment. This is the first time that a diseased organ-on-a-chip has been developed and used to show how a disease develops in the human body -- in this case, the researchers examined gut inflammation.
"Once the gut barrier has been damaged, probiotics can be harmful just like any other bacteria that escapes into the human body through a damaged intestinal barrier," said Woojung Shin, a biomedical engineering Ph.D. candidate who worked with Kim on the study. "When the gut barrier is healthy, probiotics are beneficial. When it is compromised, however, they can cause more harm than good. Essentially, 'good fences make good neighbors.' "
Shin plans to develop more customized human intestinal disease models such as for inflammatory bowel disease or colorectal cancer in order to identify how the gut microbiome controls inflammation, cancer metastasis and the efficacy of cancer immunotherapy.
Kim is a leading researcher in the development of human organs-on-chips. He developed the first human gut-on-a-chip in 2012 at Harvard University's Wyss Institute for Biologically Inspired Engineering.

Late night snacker? Make it cottage cheese

Eager to eat a snack before bedtime? A protein-filled snack like cottage cheese is the way to go, say Florida State University researchers.

Associate Professor of Nutrition, Food and Exercise Sciences Michael Ormsbee and former FSU graduate student Samantha Leyh found that consuming 30 grams of protein about 30 minutes before bed appears to have a positive effect on muscle quality, metabolism and overall health. And for those who have sworn off eating at night, there is no gain in body fat.

Their findings are published in the British Journal of Nutrition.

Study participants -- active young women in their early 20s -- ate samples of cottage cheese 30 to 60 minutes before bedtime. Researchers specifically wanted to see if this food may have an impact on metabolic rate and muscle recovery.

This is one of the first nutrition studies where participants consumed a whole food as opposed to a protein shake or some form of supplement.

"Until now, we presumed that whole foods would act similarly to the data on supplemental protein, but we had no real evidence," Ormsbee said. "This is important because it adds to the body of literature that indicates that whole foods work just as well as protein supplementation, and it gives people options for presleep nutrition that go beyond powders and shaker bottles."

Leyh, who is now a research dietitian with the Air Force, said the results serve as a foundation for future research on precise metabolic responses to whole food consumption.
"While protein supplements absolutely have their place, it is important to begin pooling data for foods and understanding the role they can play in these situations," Leyh said. "Like the additive and synergistic effects of vitamins and minerals when consumed in whole food form such as fruits or veggies, perhaps whole food sources may follow suit. While we can't generalize for all whole foods as we have only utilized cottage cheese, this research will hopefully open the door to future studies doing just that."
Ormsbee said that his research team will start examining more presleep food options and longer-term studies to learn more about the optimal food choices that can aid individuals in recovery from exercise, repair and regeneration of muscle and overall health.

Tooth loss can indicate malnutrition

Older adults are at risk for both impaired oral health and malnutrition, according to a study by Rutgers University researchers.
The study, recently published in the Journal of Aging Research and Clinical Practice, analyzed the health records of 107 community-dwelling senior citizens treated at the Rutgers School of Dental Medicine clinic between 2015 to 2016.
The results showed that more than 25 percent of the patients had malnutrition or were at risk for malnutrition. The researchers saw a trend in which patients with 10 to 19 teeth were more likely to be at risk for malnutrition. Those patients classified as having malnutrition had higher rates of weight loss, ate less and more frequently reported that they suffered with dementia and/or depression and severe illnesses than those who had a normal nutrition status.
"The mouth is the entry way for food and fluid intake," said lead author Rena Zelig, director of the Master of Science in Clinical Nutrition Program at Rutgers School of Health Professions. "If its integrity is impaired, the functional ability of an individual to consume an adequate diet may be adversely impacted."
Although further studies need to examine the relationships between tooth loss and malnutrition risk, Zelig said the findings show that dental clinics are ideal locations to perform nutritional status screenings as they can identify patients who may not regularly visit a primary care provider and who may be at risk for malnutrition. "Clinicians also can provide patients with referrals to Registered Dietitians and community assistance programs such as Meals on Wheels to prevent further decline in nutritional status," she said.
This was the first part of a mixed-methods grant to research the associations between tooth loss and nutritional status in older adults. The second part of the grant built on these results and qualitatively studied the eating experience and eating-related quality of life of community-dwelling older adults using qualitative interviews.
The study sets the stage for further research to examine the relationships between tooth loss and malnutrition risk and the impact of tooth loss on the eating experience and eating-related quality of life.

Older adults with strong grip, good memory may avoid or delay disability

As we age, we may develop certain disabilities that make it difficult to walk, climb, balance, or maintain our fine motor skills. In turn, these changes can affect our ability to perform routine, daily tasks, which can lead to a loss of independence and reduced quality of life. However, experts say that it is often possible to treat these difficulties before they lead to disability.
For example, having good muscle strength helps us maintain the ability to function well. Research suggests that a minimum level of strength is needed for good physical function. The stronger older adults are, the better able they may be to prevent future disability.
To learn more about how and whether being strong can ward off disability, a team of researchers examined information from a study called SHARE. It involved a survey of people aged 50 and older across most European Union countries and Israel every two years. This survey collected information about health, social and economic status, and participants' social and family networks. A total of 30,434 people participated in this survey. The research team who studied the information from SHARE published their findings in the Journal of the American Geriatrics Society.
The researchers looked at the survey participants' answers to ten questions about their ability to:

• Walk 100 meters (328 feet)
• Sit for approximately 2 hours
• Get up from a chair after sitting for long periods
• Climb several flights of stairs without resting
• Climb one flight of stairs without resting, stooping, kneeling, or crouching
• Reach or extend their arms above shoulder level
• Pull or push large objects such as a living room chair
• Lift or carry weights over 10 pounds
• Pick up a small coin from a table

Answers to all ten questions were collected five different times. The researchers examined the effects of grip strength and cognition--the ability to remember, think, and make decisions--and how those affected the participants over time. The researchers learned that maintaining grip strength and protecting mental ability might prevent or delay disability.
The researchers suggested that older adults who perform physical and mental training may be able to slow down their physical decline and potentially prevent future problems such as the loss of independence, reduced quality of life, the likelihood of developing depression and dementia, and even death.

Association between physical exercise and mental health: group sports best

Exercise is known to be associated with reduced risk of all-cause mortality, cardiovascular disease, stroke, and diabetes, but its association with mental health remains unclear.

This cross-sectional study analysed data from 1 237 194 people aged 18 years or older in the USA from the 2011, 2013, and 2015 Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System survey. The researchers compared the number of days of bad self-reported mental health between individuals who exercised and those who did not, using an exact non-parametric matching procedure to balance the two groups in terms of age, race, gender, marital status, income, education level, body-mass index category, self-reported physical health, and previous diagnosis of depression. They examined the effects of exercise type, duration, frequency, and intensity using regression methods adjusted for potential confounders, and did multiple sensitivity analyses.

Findings

Individuals who exercised had 1·49 (43·2%) fewer days of poor mental health in the past month than individuals who did not exercise but were otherwise matched for several physical and sociodemographic characteristics ( W=7·42 × 10 ¹⁰, p<2 10="" sup="">−16

). All exercise types were associated with a lower mental health burden (minimum reduction of 11·8% and maximum reduction of 22·3%) than not exercising (p<2 10="" sup="">−16 for all exercise types). The largest associations were seen for popular team sports (22·3% lower), cycling (21·6% lower), and aerobic and gym activities (20·1% lower), as well as durations of 45 min and frequencies of three to five times per week.

Interpretation

In a large US sample, physical exercise was significantly and meaningfully associated with self-reported mental health burden in the past month. More exercise was not always better. Differences as a function of exercise were large relative to other demographic variables such as education and income. Specific types, durations, and frequencies of exercise might be more effective clinical targets than others for reducing mental health burden, and merit interventional study. 

 

Related article

Nutrition Facts Label Reboot: A Tale of Two Labels

The Nutrition Facts label that you may read when buying packaged foods or preparing a meal has undergone a makeover. It’s been updated by the U.S. Food and Drug Administration (FDA) to reflect updated scientific findings. These changes can help you make better-informed choices about the foods you and your family eat and help you maintain a healthy diet.
Manufacturers with $10 million or more in annual food sales have until 2020 before the new label is required, and manufacturers with less than $10 million in annual food sales will have until 2021. Some manufacturers have already started using the new label. In fact, at least 10 percent of packages being sold already carry the new label.
So until the deadlines, you may see one of two different versions on packages: either the original label you’ve grown accustomed to using, or the new label.

What’s the Difference Between the Two Labels?

While both versions provide useful information, the new label reflects updated scientific information, including our greater understanding of the links between diet and chronic disease. It is also more realistic about how people eat today. Here are some of the changes:
1. The new label makes it easier if you or a member of your family is counting calories by putting the calories, the number of servings, and the serving size in larger, bolder type. We thought it was important to better highlight these numbers because nearly 40 percent of American adults are obese, and obesity is associated with heart disease, stroke, certain cancers, and diabetes.
2. FDA is required to base serving sizes on what people actually eat and drink, so serving size requirements have been adjusted to reflect more recent consumption data.  This way, the nutrition information provided for each serving is more realistic. For certain packages that contain more than one serving, you will see nutrition information per serving as well as per package. That means for a pint of ice cream, calories and nutrients are listed for one serving and the whole container.
3. Added sugars are now listed to help you know how much you are consuming. The 2015-2020 Dietary Guidelines for Americans recommends you consume less than 10 percent of calories per day from added sugars. That is because it is difficult to get the nutrients you need for good health while staying within calorie limits if you consume more than 10 percent of your total daily calories from added sugar.
4. Good nutrition means that you are getting the right amount of nutrients for your body to function correctly and to fight chronic diseases like obesity, heart disease, certain cancers, and type II diabetes. The FDA has updated the list of nutrients required on the label to include Vitamin D and Potassium because Americans today do not always get the recommended amounts of these nutrients. Conversely, Vitamins A and C are no longer required, because deficiencies in these vitamins are rare today, but they can be listed by manufacturers voluntarily.
5. The old label lists calories from fats, but the new label does not. The FDA made this change because research shows the type of fat consumed is more important than total fats. For example, monounsaturated and polyunsaturated fats, such as those found in most vegetable oils and nuts, can reduce the risk of developing heart disease when eaten in place of saturated and trans fat.
6. Daily values for nutrients like sodium, dietary fiber, and Vitamin D have been updated and are used to calculate the % Daily Value (DV) that you see on the label. The % DV helps you understand the nutrition information in the context of a daily diet. The footnote at the bottom of the label has changed to better explain the meaning of the % DV.
During this transition, no matter which label shows up on your food package, they both provide useful information to help you and your family make informed nutrition choices and maintain healthy eating patterns.

• 
  
• 
  
• 
  
• 
  
• 
  
• 
  
• 
  

Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)

IMAGE: Percentage of US adults who report (i) no muscle-strengthening exercise (weight machines, free weights, sit-ups, push-ups); and (ii) no aerobic exercise (walking, cycling, running). view more 

Credit: American Journal of Preventive Medicine

Ann Arbor, October 24, 2018 - According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all. Using the data from a nationally representative sample of US adults, the investigators also linked low-to-moderately frequent MSE with fewer reported health conditions such as diabetes, obesity, and cancer.

"This study is among the first to show that most US adults do not engage in MSE. We also demonstrate that as few as one or two MSE sessions a week result in fewer reported health conditions such as diabetes, obesity, and cancer, even after accounting for aerobic exercise levels," explained lead investigator Jason A. Bennie, PhD, Physically Active Lifestyles Research Group (USQ PALs), Institute for Resilient Regions, University of Southern Queensland, Springfield, QLD, Australia.

To assess the weekly frequency of MSE among US adults, the investigators analyzed data on more than 397,000 participants (18-80 years old) in the 2015 Behavioral Risk Factor Surveillance System (BRFSS). Over 30 percent met the MSE recommendations (two or more times per week), while approximately 58 percent reported no MSE activity at all, which was more than twice as many respondents who reported no aerobic exercise (24.6 percent).

BRFSS was initiated in 1984 to collect state-specific data on preventive health practices and risk behaviors that are relevant to public health in the US adult population. As a result, the investigators were able to segment the findings by sociodemographic and lifestyle factors. They found that black and multi-racial respondents were more likely than others to meet or exceed the minimum MSE recommendations. People who did not adhere tended to be older, female, overweight/obese, did less aerobic activity, had lower income and education, and rated their own health as poor.
While MSE is an important component of physical activity-related health, it has been largely ignored in public health approaches for the prevention and management of chronic diseases. When performed regularly, MSE increases skeletal muscle strength, power, endurance, and mass. Previous research has shown that MSE has multiple health benefits including improved glucose and lipid metabolism, blood pressure, bone density, balance/physical function, and self-esteem and reduces anxiety.
The investigators caution that the study design did not allow them to infer causality or reverse causality. For example, the reduced odds of adverse health conditions may be due to the fact that individuals with such conditions may be more likely to avoid MSE.
Public health action is warranted to support MSE uptake/adherence. However, contrasted with moderate-to-vigorous intensity aerobic physical activity, MSE has unique health promotion challenges. MSE requires a rudimentary understanding of specific nomenclature (e.g., sets, repetitions, large muscle groups) and access to some basic equipment (e.g., resistance bands, dumbbells). Also, negative social norms associated with MSE might be impeding its uptake, as this activity might be associated with excessive muscle gain, risk of injury, and hyper-masculine settings.
The investigators hope that this study will provide a stimulus for future public health approaches to get greater proportions of the population engaged in MSE. "We hope that these findings put MSE front and center on the agenda as a key health behavior in the prevention and management of chronic diseases," Dr. Bennie added, noting that the World Health Organization's 2010 Global Recommendations on Physical Activity for Health states that adults (aged 18-64) should participate in MSE involving large muscle groups at least two days a week, in addition to 150 minutes or more of vigorous aerobic exercise.

Complementary approaches such as meditation help patients manage chronic pain

Complementary practices such as meditation and mindful breathing helped patients manage chronic pain and in some cases reduced the need for medication such as opioids, according to a study at Hospital for Special Surgery (HSS) in New York City.
The research, "Complementary Practices as Alternatives to Pain: Effectiveness of a Pain Management Program for Patients in an Orthopedic Clinic," was presented at the American College of Rheumatology/Association of Rheumatology Health Professionals annual meeting on October 24 in Chicago.
"Opioid misuse and addiction are a major public health issue in the United States, and approximately 70 percent of individuals who use opioids on a long-term basis have a musculoskeletal disorder, such as low back pain or arthritis," said Maggie Wimmer, coordinator of Programs and Outcomes, Public and Patient Education at HSS. "To address this epidemic, Hospital for Special Surgery implemented a Pain and Stress Management program in its orthopedic clinic to enhance patient knowledge and encourage complementary practices as alternatives to medication."
HSS launched the pilot program in March 2017 for patients at the hospital's Ambulatory Care Center, which serves a low income, diverse community living with chronic musculoskeletal conditions. Reaching 122 participants, the program included a monthly workshop led by a meditation instructor and a social worker, as well as a weekly meditation conference call. Participants engaged in mindful breathing techniques and meditation to manage chronic pain and stress.
To evaluate the program, researchers surveyed participants after each monthly meeting. Data was collected to assess program effectiveness, participants' knowledge of complementary practices, how often they used the techniques, and how the practices helped them cope with pain and stress.
Researchers reported the following;

• 98 percent strongly agreed/agreed that they were satisfied with the program.
• 95 percent said the program increased their understanding of complementary treatments and the ability to apply the techniques to manage pain and stress.
• 93 percent indicated that they would recommend the program to others.
• One out of three participants reported using the alternative techniques five or more times in the previous week in place of medication, and 11 percent used the techniques three to four times in place of medication.
• More than half of the participants indicated that mindful breathing helped them manage their chronic pain and stress.

The debriefings conducted by the social worker during the monthly sessions also revealed that in addition to reduced pain and stress, many participants experienced improved daily function, calmness and improved state of mind after using the techniques.
Comments from participants recorded by the social worker include:
"It's not just pills that help with pain; you can do it with your mind."
"I learned how to breathe; it relieved my pain."
"It was very calming, and it helped."
"The stillness gives the body time to rebalance itself."
"I feel less anxious, and it was very relaxing. The mind is a powerful tool".
"The results indicate that alternative approaches are effective in reducing pain and stress, and in improving self-management and general well-being," said Robyn Wiesel, associate director, Public and Patient Education at HSS. "Based on the success of the Pain and Stress Management program in the orthopedic clinic, it has been expanded to include patients in the HSS Rheumatology Clinic, many of whom rely on opioid medication to manage chronic pain."

Air pollution and noise increase risk for heart attacks

Where air pollution is high, the level of transportation noise is usually also elevated. Not only air pollution negatively impacts on health, but also car, train and aircraft noise increases the risk for cardiovascular diseases and diabetes, as previous research has demonstrated. Studies investigating the effect of air pollution without sufficiently taking into account the impact that noise exhibits on health, might overestimate the effect of air pollution. These are the results of a comprehensive study conducted by the Swiss Tropical and Public Health Institute (Swiss TPH), which was published today in the peer-reviewed European Heart Journal.
The study looked at the combined effects of air pollution and transportation noise for heart attack mortality, by considering all deaths that occurred in Switzerland between 2000 and 2008. Analyses that only included fine particulates (PM2.5) suggest that the risk for a heart attack rises by 5.2% per 10 μg/m³ increase in the long-term concentration at home. Studies which also account for road, railway and aircraft noise reveal that the risk for a heart attack attributable to fine particulates in fact increases considerably less; 1.9% per 10 μg/m³ increase. These findings indicate that the negative effects of air pollution may have been overestimated in studies which fail to concurrently consider noise exposure.
"Our study showed that transportation noise increases the risk for a heart attack by 2.0 to 3.4% per 10 decibels increase in the average sound pressure level at home." said Martin Röösli, Head of the Environmental Exposures and Health Unit at Swiss TPH, and lead author of the published research. "Strikingly, the effects of noise were independent from air pollution exposure."
Effect of noise and air pollution are additive
The study also found that people exposed to both air pollution and noise are at highest risk of heart attack. Hence, the effects of air pollution and noise are additive. "Public discussions often focus on the negative health effects of either air pollution or noise but do not consider the combined impact." said Röösli. "Our research suggests that both exposures must be considered at the same time." This has implications for both policy as well as future research. Hence, Röösli and co-researchers recommend including transportation noise exposure in any further research related to air pollution and health to avoid overestimating the negative effects of air pollution on the cardiovascular system.
Data from across Switzerland
The study included all deaths (19,261) reported across Switzerland from the period 2000 to 2008. The air pollution (PM2.5) was modelled using satellite and geographic data, calibrated with air pollution measurements from 99 measurement sites throughout Switzerland. Nitrogen dioxides (NO2) were also modelled using 9,469 biweekly passive sampling measurements collected between 2000 and 2008 at 1,834 locations in Switzerland. Transportation noise was modelled by well-established noise propagation models (sonRoad, sonRAIL and FLULA 2) by Empa and n-sphere. The air pollution and the transportation noise models were applied for each address of the 4.4 million Swiss adult citizen (aged 30 years and above).

Stress can impair memory, reduce brain size in middle age

Adults in their 40s and 50s with higher levels of cortisol--a hormone linked to stress--performed worse on memory and other cognitive tasks than peers of the same age with average cortisol levels, research found. Higher cortisol in the blood also was associated with smaller brain volumes, according to the study, published Oct. 24 in Neurology, the medical journal of the American Academy of Neurology.

"In our quest to understand cognitive aging, one of the factors attracting significant interest and concern is the increasing stress of modern life," said study senior author Sudha Seshadri, M.D., professor of neurology at UT Health San Antonio and founding director of the university's Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases. "One of the things we know in animals is that stress can lead to cognitive decline. In this study, higher morning cortisol levels in a large sample of people were associated with worse brain structure and cognition."

The cognitive data are from 2,231 participants in the Framingham Heart Study, for which Dr. Seshadri is a senior investigator; 2,018 participants also underwent magnetic resonance imaging (MRI) to measure brain volume. The team included Framingham collaborators at Harvard Medical School; the National Heart, Lung, and Blood Institute; Boston University School of Medicine; the University of California, Davis, at Sacramento; and UT Health San Antonio.

Blood serum cortisol, which varies in level throughout the day, was measured in early morning (between 7:30 and 9 a.m.) in each fasting participant. The study featured a relatively young sample of male and female participants (mean age 48.5).

"Cortisol affects many different functions, so it is important to fully investigate how high levels of the hormone may affect the brain," said study lead author Justin B. Echouffo-Tcheugui, M.D., Ph.D., of Harvard Medical School. "While other studies have examined cortisol and memory, we believe our large, community-based study is the first to explore, in middle-aged people, fasting blood cortisol levels and brain volume, as well as memory and thinking skills."

Memory loss and brain shrinkage were found in the study's middle-age participants before the onset of any symptoms, Dr. Echouffo-Tcheugui noted. He said it is important for physicians to counsel people with higher cortisol levels on ways to reduce stress, such as getting enough sleep and engaging in moderate exercise.

"The faster pace of life today probably means more stress, and when we are stressed, cortisol levels increase because that is our fight-or-flight response," Dr. Seshadri said. "When we are afraid, when we are threatened in any way, our cortisol levels go up. This study adds to the prevailing wisdom that it's never too early to be mindful of reducing stress."

Findings were adjusted for factors including age, sex, smoking and body mass index. The team asked whether having APOE4, a genetic risk factor for cardiovascular disease and Alzheimer's disease, might be associated with higher cortisol level. This did not prove to be the case.

Poor oral health linked to higher blood pressure, worse blood pressure control

People with high blood pressure taking medication for their condition are more likely to benefit from the therapy if they have good oral health, according to new research in the American Heart Association's journal Hypertension. 

Findings of the analysis, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure, reveal that those with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications, compared with individuals who have gum disease, a condition known as periodontitis. Specifically, people with periodontal disease were 20 percent less likely to reach healthy blood pressure ranges, compared with patients in good oral health.

Considering the findings, the researchers say patients with periodontal disease may warrant closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist.

"Physicians should pay close attention to patients' oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care," Pietropaoli said. "Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status," said study lead investigator Davide Pietropaoli, D.D.S., Ph.D., of the University of L'Aquila in Italy.

The target blood pressure range for people with hypertension is less than 130/80 mmHg according to the latest recommendations from the American Heart Association/American College of Cardiology. In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. Systolic pressure, the upper number in a blood pressure reading, indicates the pressure of blood against the walls of the arteries. 

While seemingly small, the 3mmHg difference is similar to the reduction in blood pressure that can be achieved by reducing salt intake by 6 grams per day (equal to a teaspoon of salt, or 2.4 grams of sodium), the researchers said.

The presence of periodontal disease widened the gap even farther, up to 7 mmHg, among people with untreated hypertension, the study found. Blood-pressure medication narrowed the gap, down to 3 mmHg, but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.

"Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control," Pietropaoli said.
While the study was not designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research that links low-grade oral inflammation with blood vessel damage and cardiovascular risk.

Hypertension is estimated to affect up to 40 percent of people over age 25 worldwide.
Untreated or poorly controlled hypertension can lead to heart attacks, strokes and heart failure, as well as kidney disease. Hypertension is estimated to claim 7.5 million lives worldwide.
Red, swollen, tender gums or gums that bleed with brushing and flossing are tell-tale signs of inflammation and periodontal disease. So are teeth that look longer than before, a sign of receding gums, and teeth that are loose or separating from the gum line.

Home-based biofeedback therapy is effective option for tough-to-treat constipation

Biofeedback therapy used at home is about 70 percent effective at helping patients learn how to coordinate and relax bowel muscles and relieve one of the most difficult-to-treat types of constipation, investigators report.

Standard treatments like more fiber in the diet, stool softeners, even laxatives, tend to be ineffective in patients with this type of constipation called dyssynergic defecation, says Dr. Satish S.C. Rao, director of neurogastroenterology/motility and the Digestive Health Clinical Research Center at the Medical College of Georgia at Augusta University.

About 15 percent of the United States population have chronic constipation, and about one-third of those individuals have dyssynergic defecation.

Familiar remedies don't address these patients' underlying issue of regaining the natural rhythm of contracting muscles at the top of the rectum to move stool out while relaxing muscles at the anal opening so stool can exit, says Rao, J. Harold Harrison MD Distinguished University Chair in Gastroenterology.

Rao led development of an office-based biofeedback therapy proven to help these patients better recognize the uncoordinated muscle movement and improve it. The American Gastroenterology Association, the American Neurogastroenterology and Motility Society and the European Society of Neurogastroenterology and Motility have all given the treatment a thumbs up.
However, limited training sites and the fact that many patients must travel long distances multiple times to get to those sites, had Rao and his team also wanting to make the effective approach more widely available and hopefully more cost-effective.
The at-home system they developed appears to be equally effective, safe and less expensive, they report in the journal The Lancet.
"When healthy individuals attempt to poop, we increase the intra-abdominal and intra-rectal pressures and at the same time we relax the anal opening. We typically learn this when we are potty trained then we never think about it anymore. Unfortunately, patients with dyssynergia don't have that pattern. When these patients are attempting to stool, unbeknownst to them, they are pushing it back or just retaining it," says Rao, the study's corresponding author.
He notes some have had problems since childhood, others developed problems in adulthood from a variety of factors like back or hemorrhoid surgery, even pregnancy or hysterectomy.
"They started straining and gradually they changed their normal behavior to this abnormal behavior. The essence of biofeedback is built on converting patients with these patterns back to a natural, efficient pattern."
The National Institutes of Health-funded study looked at a total of 100 patients, half randomly assigned to each group, from January 2005 to January 2010. Looking at all 50 patients who started in each arm, correction of the problem was seen in 72 percent of the home-based therapy group and 80 percent of the office-based group.
A total of 83 patients completed the study, 76 percent in the home-based group and 90 percent in the office-based group. Based on those who completed the study, at-home success rates were actually higher: 92 percent versus 84 percent, respectively.
Participants in both arms reported similar rates of improvement with key parameters like the number of complete, spontaneous bowel movements weekly, the investigators report. All participants also were better able to control their bowel movement, with both groups decreasing the time it took to expel a balloon - which gave them a surrogate sensation of pooping - and decreasing the number of times the balloons unexpectedly discharged.
"In every parameter we measured, the two approaches essentially matched head-to-head," says Rao, other than costs.
Total costs, including travel time and transportation costs, were about twice as much for office-based therapy: $1,082 versus $1,942.
For the office-based therapy, patients had a training session with a nurse specialist followed by up to six, one-hour sessions over three months. A manometer helped determine whether they were contracting at the top of the foot-long rectum and simultaneously relaxing the bottom, or anus. Patients also learned a variety of breathing and other techniques to enable proper coordination. They received visual and verbal commands to improve coordination while seated on the commode.
Those selected for the home therapy arm also attended a single office training session to learn to use a reusable sensor probe connected to a handheld pressure monitor that let them know whether they were pushing appropriately in the two target regions. They were asked to sit on the commode twice daily and attempt 10-15 push maneuvers while looking at the pressure responses. Lights increased when the anus was being properly relaxed and decreased when they didn't relax those muscles. A separate panel of lights would similarly respond to reflect the contraction of muscles at the top of the rectum.
At the start and conclusion of the training, participants were assessed with pressure monitoring at both key points in the rectum, a balloon expulsion test and a study of how rapidly waste, which is leftovers from digestion, passes through the colon using radiopaque markers. The six-foot long, continuously contracting colon moves waste from the small intestines to the rectum. "The colon is never inactive or still," Rao says, but is a bit of a natural braking point in the gastrointestinal tract where fluids and other digestible residue get reabsorbed before we defecate. However when movement slows too much, as it does in about 60 percent of patients with dyssnergic defecation, it also contributes to constipation. While both study arms saw restoration of a more-healthy colon speed, the home-based group saw more significant improvement.
Both groups kept a stool diary over the course of the study and answered follow up questions about the tolerability and their acceptance of biofeedback therapy. While the home group said it was a little messy, they tolerated it well. Most study participants said they would recommend biofeedback.
The fact that both approaches produced similar results and home- based care is less expensive, should make it the preferred choice for these patients, the investigators write.
Now that they have the information, the investigators need a biotech firm to develop a home biofeedback system that can be widely distributed, Rao says. For the purposes of the study, Rao used a device made by a friend.