Wednesday, May 22, 2019

Risk reduction of cognitive decline and dementia - WHO Guidelines



SUMMARY OF RECOMMENDATIONS

Physical activity interventionsPhysical activity should be recommended to adults with normal cognition to reduce the risk of cognitive decline.Quality of evidence: moderateStrength of the recommendation: strongPhysical activity may be recommended to adults with mild cognitive impairment to reduce the risk of cognitive decline.Quality of evidence: lowStrength of the recommendation: conditional

Tobacco cessation interventionsInterventions for tobacco cessation should be offered to adults who use tobacco since they may reduce the risk of cognitive decline and dementia in addition to other health benefits. Quality of evidence: lowStrength of the recommendation: strong

Nutritional interventionsThe Mediterranean-like diet may be recommended to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia. Quality of evidence: moderateStrength of the recommendation: conditionalA healthy, balanced diet should be recommended to all adults based on WHO recommendations on healthy diet.Quality of evidence: low to high (for different dietary components)Strength of the recommendation: conditionalVitamins B and E, polyunsaturated fatty acids and multi-complex supplementation should not be recommended to reduce the risk of cognitive decline and/or dementia. Quality of evidence: moderateStrength of the recommendation: strong

Interventions for alcohol use disordersInterventions aimed at reducing or ceasing hazardous and harmful drinking should be offered to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia in addition to other health benefits. Quality of evidence: moderate (for observational evidence) Strength of the recommendation: conditional

Cognitive interventionsCognitive training may be offered to older adults with normal cognition and with mild cognitive impairment to reduce the risk of cognitive decline and/or dementia. Quality of evidence: very low to low Strength of the recommendation: conditional

Social activityThere is insufficient evidence for social activity and reduction of risk of cognitive decline/dementia.Social participation and social support are strongly connected to good health and well-being throughout life and social inclusion should be supported over the life-course.xiiiExecutive SummaryWeight managementInterventions for mid-life overweight and/or obesity may be offered to reduce the risk of cognitive decline and/or dementia.Quality of evidence: low to moderateStrength of the recommendation: conditional

Management of hypertensionManagement of hypertension should be offered to adults with hypertension according to existing WHO guidelines.Quality of evidence: low to high (for different interventions)Strength of the recommendation: strongManagement of hypertension may be offered to adults with hypertension to reduce the risk of cognitive decline and/or dementia.Quality of evidence: very low (in relation to dementia outcomes) Strength of the recommendation: conditional

Management of diabetes mellitusThe management of diabetes in the form of medications and/or lifestyle interventions should be offered to adults with diabetes according to existing WHO guidelines. Quality of evidence: very low to moderate (for different interventions) Strength of the recommendation: strongThe management of diabetes may be offered to adults with diabetes to reduce the risk of cognitive decline and/or dementia. Quality of evidence: very low Strength of the recommendation: conditional

Management of depressionThere is currently insufficient evidence to recommend the use of antidepressant medicines for reducing the risk of cognitive decline and/or dementia.The management of depression in the form of antidepressants and/or psychological interventions should be provided to adults with depression according to existing WHO mhGAP guidelines.

 Management of hearing lossThere is insufficient evidence to recommend use of hearing aids to reduce the risk of cognitive decline and/or dementia.Screening followed by provision of hearing aids should be offered to older people for timely identification and management of hearing loss as recommended in the WHO ICOPE guidelines.

Tuesday, May 21, 2019

Dawn-to-sunset fasting suggests potential new treatment for obesity-related conditions


Fasting from dawn to sunset for 30 days increased levels of proteins that play a crucial role in improving insulin resistance and protecting against the risks from a high-fat, high-sugar diet, according to research presented at Digestive Disease Week® (DDW) 2019. The study, which was based on the fasting practices of Ramadan, a spiritual practice for Muslims, offers a potential new treatment approach for obesity-related conditions, including diabetes, metabolic syndrome and non-alcoholic fatty liver disease (NAFLD).
"According to World Health Organization data, obesity affects over 650 million people worldwide, placing them at risk for any number of health conditions," said Ayse Leyla Mindikoglu, MD, MPH, lead author of the study and associate professor of medicine and surgery at Baylor College of Medicine, Texas. "Feeding and fasting can significantly impact how the body makes and uses proteins that are critical to decreasing insulin resistance and maintaining a healthy body weight. Therefore, the timing of and duration between meals could be important factors to consider for people struggling with obesity-related conditions."
The pilot study included 14 healthy individuals who fasted (no food or drink) approximately 15 hours a day from dawn to sunset for 30 days during Ramadan. Researchers collected blood samples from the individuals before beginning the religious fast, again at the fourth week of fasting, and then one-week post-fasting. Resulting blood samples showed increased levels of tropomyosin (TPM) 1, 3 and 4, proteins that have a role in maintaining healthy cells and cell repairs important to the body's response to insulin.
TPM3 plays a key role in increasing insulin sensitivity, which allows the cells of the body to use blood glucose more effectively, reducing blood sugar. Findings from the study showed a significant increase in TPM3 gene protein products between the initiation of the fast and the test one week afterwards. Similar results over that period were found for TPM1 and TPM4 gene protein products.
"We are in the process of expanding our research to include individuals with metabolic syndrome and NAFLD to determine whether results are consistent with those of the healthy individuals," said Dr. Mindikoglu. "Based on our initial research, we believe that dawn-to-sunset fasting may provide a cost-effective intervention for those struggling with obesity-related conditions."

Why lack of sleep is bad for your heart S



In recent years, numerous studies have shown that people who don't get enough sleep are at greater risk of stroke and heart attack.
A new University of Colorado Boulder study, published in the journal Experimental Physiology, helps explain why.
It found that people who sleep fewer than 7 hours per night have lower blood levels of three physiological regulators, or microRNAs, which influence gene expression and play a key role in maintaining vascular health.
The findings could potentially lead to new, non-invasive tests for sleep deprived patients concerned about their health, the authors said.
"This study proposes a new potential mechanism through which sleep influences heart health and overall physiology," said senior author Christopher DeSouza, a professor of Integrative Physiology.
Despite recommendations by the American Heart Association that people get 7 to 9 hours of sleep each night, about 40 percent of adults in the United States fall short. Overall, the average American's sleep duration has plummeted from 9 hours nightly to 6.8 hours nightly over the past century.
In another recent study, DeSouza's group found that adult men who sleep 6 hours per night have dysfunctional endothelial cells - the cells that line blood vessels - and their arteries don't dilate and constrict as well as those who get sufficient sleep.
But the underlying factors leading to this dysfunction aren't well known.
MicroRNAs are small molecules that suppress gene expression of certain proteins in cells. The exact function of circulating microRNAs in the cardiovascular system, and their impact on cardiovascular health is receiving a lot of scientific attention, and drugs are currently in development for a variety of diseases, including cancer, to correct impaired microRNA signatures.
"They are like cellular brakes, so if beneficial microRNAs are lacking that can have a big impact on the health of the cell," said DeSouza.
For the new study, which is the first to explore the impact of insufficient sleep on circulating microRNA signatures, DeSouza and his team took blood samples from 24 healthy men and women, age 44 to 62, who had filled out questionnaires about their sleep habits. Half slept 7 to 8.5 hours nightly; Half slept 5 to 6.8 hours nightly.
They measured expression of nine microRNAs previously associated with inflammation, immune function or vascular health.
They found that people with insufficient sleep had 40 to 60 percent lower circulating levels of miR-125A, miR-126, and miR-146a, (previously shown to suppress inflammatory proteins) than those who slept enough.
"Why 7 or 8 hours seems to be the magic number is unclear," said DeSouza. "However, it is plausible that people need at least 7 hours of sleep per night to maintain levels of important physiological regulators, such as microRNAs."
Research is now underway in DeSouza's lab to determine whether restoring healthy sleep habits can restore healthy levels of microRNAs.
Ultimately, he said, it's possible that microRNAs in blood could be used as a marker of cardiovascular disease in people with insufficient sleep, enabling doctors to glean important information via a blood test rather than current, more invasive tests.
For now, DeSouza says, the takeaway message for those burning the midnight oil is this:
"Don't underestimate the importance of a good night's sleep."

Latest Health Research

Key Take-aways:
  • OK: One egg a day(maybe more).
  • Good: Statin use, Word and number puzzles, Magnetic stimulation of the brain, Whole grains, Avocados, Nuts, Soy protein.
  • Bad: Red and processed meat, Ultra-processed foods, A pathological obsession with healthy eating or consuming only healthy food, Drinking six or more coffees a day, Wearing tight-fitting jeans or pants four or more times a week, or removing hair from the mons pubis.
  • Possibly bad: Grapefruit juice , Meditation, Sunscreen.
Exercise

Walking and strength training may decrease the risk of dying from liver disease

Jonathan KantrowitzatHealth News Report - 15 hours ago
- Physical activity, including walking and muscle-strengthening activities, were associated with significantly reduced risk of cirrhosis-related death, according to research presented at Digestive Disease Week® (DDW) 2019. Chronic liver disease is increasing, partly due to the obesity epidemic, and currently there are no guidelines for the optimal type of exercise for the prevention of cirrhosis-related mortality. Researchers hope these findings will help provide specific exercise recommendations for patients at risk for cirrhosis and its complications. "The benefit of exercise is n... more »

Fitness reduces risk of lung, colorectal cancer and increases survival likelihood after diagnosis

Jonathan KantrowitzatHealth News Report - 2 weeks ago
In a recent study, adults who were the most fit had the lowest risk of developing lung and colorectal cancer. Also, among individuals who developed lung or colorectal cancer, those who had high fitness levels before their cancer diagnosis were less likely to die compared with those who had low fitness levels. The findings are published early online in *CANCER*, a peer-reviewed journal of the American Cancer Society. There is limited data on the relationship between cardiorespiratory fitness and lung and colorectal cancer risk and mortality. To investigate, Catherine Handy Marshall,... more »
 
Medicine

Statin use associated with reduced risk of dementia after concussion in older adults

Jonathan KantrowitzatHealth News Report - 16 hours ago
JAMA Neurology *Bottom Line:* Concussion is a common brain injury. This observational study of nearly 29,000 adults (66 and older) diagnosed with concussion examined whether statin use was associated with risk of long-term dementia after a concussion. The analysis compared 7,058 patients who received a statin prescription in the 90 days after a concussion with 21,757 who didn't. After an average follow-up of four years, 4,727 patients developed dementia (1 in 6). The risk of dementia in older adults after concussion was substantial, and statin use was associated with modestly reduc... more »

Statins linked to lower risk of early death in patients with colorectal cancer

Jonathan KantrowitzatHealth News Report - 1 week ago
Use of statins before or after a diagnosis of colorectal cancer was linked with a lower risk of premature death, both from cancer and from other causes, in a *Cancer Medicine* analysis of published studies. The meta-analysis included 14 studies involving 130,994 patients with colorectal cancer. Pre-diagnosis statin use was linked with a 15 percent lower risk of dying early from any cause and an 18 percent lower risk of dying from cancer. Post-diagnosis statin use was linked with a 14 percent lower risk of all-cause death and a 21 percent lower risk of cancer-specific death. "Conside... more »
 

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis

Jonathan KantrowitzatHealth News Report - 2 weeks ago
Men treated with medications for symptoms of benign prostatic hyperplasia (BPH) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis, report University of California San Diego School of Medicine researchers. Men who took drugs that inhibit the enzyme 5α-reductase, known as 5-ARIs, were diagnosed with prostate cancer 3.6 years after the first signs of elevated levels of a protein called prostate-specific antigen (PSA) compared to 1.4 years for men who did not use 5-ARI. The findings are published in the Ma... more »
 
Sunscreen

Does sunscreen compromise vitamin D levels?

Jonathan KantrowitzatHealth News Report - 1 week ago
Sunscreen can reduce the sun's adverse effects, but there are concerns that it might inhibit the body's production of vitamin D. In a new *British Journal of Dermatology*study, however, investigators recorded an increase of vitamin D in participants during a week of cloudless weather, with very high UV index, even when sunscreens were used properly and prevented sunburn. Sunlight contains UVA and UVB radiation, and the latter is essential for vitamin D synthesis. Two sunscreens with the same SPF were compared. Sunscreen with a high UVA protection factor enabled significantly high... more »

Absorption of sunscreen active ingredients into bloodstream

Jonathan KantrowitzatHealth News Report - 2 weeks ago
The U.S. Food and Drug Administration recommends that active ingredients in sunscreen absorbed into the bloodstream above a certain level undergo toxicology testing. Researchers from the FDA conducted this small randomized clinical trial of 24 healthy volunteers to determine bloodstream concentrations of four active ingredients (avobenzone, oxybenzone, octocrylene and ecamsule) in four sunscreens applied four times per day for four days with blood samples collected from study participants over seven days. Researchers report that all four active ingredients were found in blood samp... more »

 

 
Diet

Dietary cholesterol or egg consumption do not increase the risk of stroke

Jonathan KantrowitzatHealth News Report - 16 hours ago
A new study from the University of Eastern Finland shows that a moderately high intake of dietary cholesterol or consumption of up to one egg per day is not associated with an elevated risk of stroke. Furthermore, no association was found in carriers of the APOE4 phenotype, which affects cholesterol metabolism and is remarkably common among the Finnish population. The findings were published in the *American Journal of Clinical Nutrition*. Findings from earlier studies addressing the association of dietary cholesterol or egg intake with the risk of stroke have been contradictory. S... more »

A substantial benefit from replacing steak with fish

Jonathan KantrowitzatHealth News Report - 4 days ago
*The average Dane will gain a health benefit from substituting part of the red and processed meat in their diet with fish, according to calculations from the National Food Institute, Technical University of Denmark. Men over 50 and women of childbearing age in particular would benefit from such a change in diet.* In a PhD study at the National Food Institute, Sofie Theresa Thomsen has developed a method to calculate the total health impact of replacing one food with another in the diet. The method has been used to assess the health impact that would be achieved by replacing red and ... more »

Heavily processed foods cause overeating and weight gain

Jonathan KantrowitzatHealth News Report - 4 days ago
People eating ultra-processed foods ate more calories and gained more weight than when they ate a minimally processed diet, according to results from a National Institutes of Health study. The difference occurred even though meals provided to the volunteers in both the ultra-processed and minimally processed diets had the same number of calories and macronutrients. The results were published in *Cell Metabolism (link is external)*. This small-scale study of 20 adult volunteers, conducted by researchers at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (N... more »

Coffee addicts really do wake up and smell the coffee

Jonathan KantrowitzatHealth News Report - 6 days ago
Regular coffee drinkers can sniff out even tiny amounts of coffee and are faster at recognising the aroma, compared to non-coffee drinkers, new research has found. Habitual coffee drinkers are not just more sensitive to the odour of coffee and faster to identify it, but the more they craved coffee, the better their ability to smell it became. It is the first time evidence has been found to prove coffee addicts are more sensitive to the smell of coffee. The results could open the door to potential new ways of using aversion therapy to treat people addicted to substances with a dist... more »

When does clean eating become an unhealthy obsession?

Jonathan KantrowitzatHealth News Report - 6 days ago
Researchers at York University's Faculty of Health say those who have a history of an eating disorder, obsessive-compulsive traits, dieting, poor body image, and a drive for thinness are more likely to develop a pathological obsession with healthy eating or consuming only healthy food, known as orthorexia nervosa (ON). Although eating healthy is an important part of a healthy lifestyle, for some people this preoccupation with healthy eating can become physically and socially impairing. In the first exhaustive review of the psychosocial risk factors associated with orthorexia nervos... more »

Whole grain can contribute to health by changing intestinal serotonin production

Jonathan KantrowitzatHealth News Report - 1 week ago
Adults consuming whole grain rye have lower plasma serotonin levels than people eating low-fibre wheat bread, according to a recent study by the University of Eastern Finland and the International Agency for Research on Cancer (IARC). In the study, the consumption of cereal fibre from rye or wheat was also found to reduce serotonin levels in the colon of mice. In light of the results, the health benefits of whole grain cereals may be linked, at least in part, to the alteration of serotonin production in the intestines, where the majority of the body's serotonin is produced. The re... more »

Drinking six or more coffees a day can be detrimental to your health, increasing your risk of heart disease by up to 22 per cent

Jonathan KantrowitzatHealth News Report - 1 week ago
Latte, cappuccino or short black, a morning coffee is an essential for many people looking to kick start their day. But while the humble coffee may be a vital feature of the daily grind, how much is too much? While the pros and cons of drinking coffee have been debated for decades, new research from the University of South Australia reveals that drinking six or more coffees a day can be detrimental to your health, increasing your risk of heart disease by up to 22 per cent. In Australia, one in six people are affected by cardiovascular disease. It is a major cause of death with one p... more »

Following DASH diet can reduce heart failure risk in people under 75

Jonathan KantrowitzatHealth News Report - 1 week ago
A diet proven to have beneficial effects on high blood pressure also may reduce the risk of heart failure in people under age 75, according to a study led by researchers at Wake Forest School of Medicine, part of Wake Forest Baptist Health. The observational study of more than 4,500 people showed that those individuals under 75 who most closely adhered to the DASH (Dietary Approaches to Stop Hypertension) diet had a significantly lower risk of developing heart failure than those whose eating habits were least in keeping with the diet. The research is published in the current onlin... more »

Avocados, as a substitution for carbohydrates, can suppress hunger without adding calories

Jonathan KantrowitzatHealth News Report - 1 week ago
A new study released by the Center for Nutrition Research at Illinois Institute of Technology suggests that meals that include fresh avocado as a substitute for refined carbohydrates can significantly suppress hunger and increase meal satisfaction in overweight and obese adults. As rates of obesity in the United States continue to rise, the findings from Illinois Tech suggest that simple dietary changes can have an important impact on managing hunger and aiding metabolic control. The new research, published in the peer-reviewed journal *Nutrients*, assessed the underlying physiologi... more »
.

Grapefruit juice may impose risk on patients with long QT syndrome and should be avoided when taking QT-prolonging drugs

Jonathan KantrowitzatHealth News Report - 1 week ago
Grapefruit juice is already listed as a substance to avoid when taking QT-prolonging medications because it increases the toxicity of many drugs. Investigators have now confirmed the QT-prolonging effects of grapefruit juice in a new study and call for a stronger warning to patients who are taking QT-prolonging drugs or who have long QT syndrome because of the potential risk. They report their findings in *Heart*Rhythm, the official journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, published by Elsevier. There are over 200 medications that prolong the QT... more »

Maternal nut consumption during pregnancy linked to improvements in neurodevelopment in children

Jonathan KantrowitzatHealth News Report - 1 week ago
Nuts are known to help reduce the risk of hypertension, oxidative stress and diabetes and they may exercise a protective effect against cognitive decline in older age. To this list of beneficial health effects, we can now add new evidence from a study led by the Barcelona Institute for Global Health (ISGlobal), an institute supported by "la Caixa". The study, published in the *European Journal of Epidemiology*, found links between a maternal diet rich in nuts during the first trimester of pregnancy and improved neurodevelopment in the child. The study was carried out in Spain and i... more »
Jonathan KantrowitzatHealth News Report - 2 weeks ago
Soy protein has the ability to lower cholesterol by a small but significant amount, suggests a new study led by St. Michael's Hospital in Toronto. With the U.S. Food and Drug Administration (FDA) planning to remove soy from its list of heart healthy foods, researchers at St. Michael's set out to provide a meta-analysis of 46 existing trials that evaluated soy and determine whether the proposed move aligns with existing literature. Of the 46 trials, 43 provided sufficient data for meta-analysis. Forty-one trials examined the protein's effects on low-density lipoprotein (LDL) choleste... more »

Aging

Regular crosswords and number puzzles linked to sharper brain in later life

Jonathan KantrowitzatHealth News Report - 4 days ago
Older adults who regularly take part in word and number puzzles have sharper brains, according to the largest online study to date. The more regularly adults aged 50 and over played puzzles such as crosswords and Sudoku, the better their brain function, according to research in more than 19,000 participants, led by the University of Exeter and King's College London. The findings emerge from two linked papers published today (May 16th) in the *International Journal of Geriatric Psychiatry*. The researchers have previously presented their findings on word puzzles at the Alzheimer's ... more »
 

Magnetic stimulation of the brain improves memory in younger and older adults

Jonathan KantrowitzatHealth News Report - 5 days ago
Magnetic stimulation of the brain improves working memory, offering a new potential avenue of therapy for individuals living with Alzheimer's disease and other forms of dementia, according to new research from the Duke University School of Medicine. Healthy younger and older adult participants who received a therapy called repetitive transcranial magnetic stimulation (rTMS) performed better on a memory task than during an rTMS-like placebo in the study, which was published here in *PLoS One*. "This study relies on highly individualized parameters, from the selection of the stimulat... more »

Good sleep quality and good mood lead to good working memory with age

Jonathan KantrowitzatHealth News Report - 1 week ago
A team of psychologists has found strong associations between working memory -- a fundamental building block of a functioning mind -- and three health-related factors: sleep, age, and depressed mood. The team also reports that each of these factors is associated with different aspects of working memory. Working memory is the part of short-term memory that temporarily stores and manages information required for cognitive tasks such as learning, reasoning, and comprehension. Working memory is critically involved in many higher cognitive functions, including intelligence, creative pro... more »
 

Physical and mental health of seniors linked to optimism, wisdom and loneliness

Jonathan KantrowitzatHealth News Report - 1 week ago
Ten thousand Baby Boomers turn 65 every day. By 2029, the entire generation born between 1946 and 1964 will be at least that old. What happens next concerns millions of Americans. Advancing age is broadly associated with declining cognitive, physical and mental health. In a new study of older adults living independently in a senior continuing care facility, researchers at University of California San Diego School of Medicine analyzed how distinctive factors, such as wisdom, loneliness, income and sleep quality, impact -- for good and bad -- the physical and mental functioning of old... more »

Older adults with obesity may have fewer years of healthy life

Jonathan KantrowitzatHealth News Report - 1 week ago
A team of researchers at Duke-NUS Medical School found that older adults with obesity could expect fewer years of remaining life, at age 60, 70 and 80, with no limitation in physical function and no limitation in activities of daily living compared to individuals of normal weight. The results of this study are published in the *International Journal of Obesity*. Obesity is becoming increasingly prevalent among adults in many countries, especially those with aging populations. While some previous studies have reported that older adults with a heavier body mass index can expect to li... more »

Anger more harmful to health of older adults than sadness

Jonathan KantrowitzatHealth News Report - 1 week ago
Anger may be more harmful to an older person's physical health than sadness, potentially increasing inflammation, which is associated with such chronic illnesses as heart disease, arthritis and cancer, according to new research published by the American Psychological Association. "As most people age, they simply cannot do the activities they once did, or they may experience the loss of a spouse or a decline in their physical mobility and they can become angry," said Meaghan A. Barlow, MA, of Concordia University, lead author of the study, which was published in *Psychology and Agin... more »
 
General Health

Feeling healthy: A good start, but not always a good indicator of heart disease risk

Jonathan KantrowitzatHealth News Report - 4 days ago
Most people feel they have a general idea of how healthy they are based on their diet and exercise regimen and how often they get sick. But a new study by Johns Hopkins Medicine researchers adds to evidence that how healthy people think they are isn't always an accurate indicator of their risk for cardiovascular disease. In a study of medical information gathered on more than 6,800 people in the United States, the researchers found that 10% of those who rated themselves in excellent health had measurable evidence of cardiovascular disease without sympt...
 
Jonathan KantrowitzatHealth News Report - 6 days ago
Ever wonder how some people seem to meet their fitness goals with ease and love eating healthy foods while others constantly struggle to do either? According to a new study from the Communication Neuroscience Lab at the Annenberg School, people with stronger life purpose are more likely to accept messages promoting health behavior change than those with a weaker sense of purpose. And this might be because they experience less decisional conflict while considering health advice. "Purpose in life has been robustly associated with health in previous studies," says postdoctoral fellow Y... more »

Healthy habits could avoid 27% of cancer cases

Jonathan KantrowitzatHealth News Report - 6 days ago
Lifestyle risk factors such as smoking, alcohol consumption, overweight and obesity, unhealthy diet and lack of physical activity are associated with a third of all deaths caused by 20 types of cancer in Brazil, according to a new epidemiological study. Published in the journal *Cancer Epidemiology*, the study shows that lifestyle risk factors account for 114,497 annual cases of cancer in Brazil, which represents 27% of all cancer cases, and 63,000 deaths, or 34% of cancer mortality. The study was conducted by researchers from the Preventive Medicine Department of the University of S... more »

Being wise is good for your health

Jonathan KantrowitzatHealth News Report - 6 days ago
*Can science measure what it means to be wise? A growing body of evidence suggests that wisdom is a complex concept that contributes to mental health and happiness, according to a review in the May/June issue of Harvard Review of Psychiatry. The journal is published in the Lippincott portfolio by Wolters Kluwer.* Different aspects of wisdom may be traced to specific areas of the brain, and might possibly be enhanced by behavioral interventions, suggests the article by Dilip V. Jeste, MD, and Ellen E. Lee, MD, of the Sam and Rose Stein Institute for Research on Aging, University of Ca... more »

The death of a close friend hits harder than we think

Jonathan KantrowitzatHealth News Report - 6 days ago
The trauma caused by the death of a close friend endures four times longer than previously believed, according to new research from The Australian National University (ANU). The researchers warn a lack of recognition about the time it takes people to mourn a close friend is leading to inadequate support being made available during the grieving process. The study shows the death of a close friend will significantly affect a person's physical, psychological and social well-being up to at least four years. Previous studies suggested the grieving period las... more »

Older fathers put health of partners, unborn children at risk

Jonathan KantrowitzatHealth News Report - 1 week ago
Men who delay starting a family have a ticking "biological clock" -- just like women -- that may affect the health of their partners and children, according to Rutgers researchers. The study, which reviewed 40 years of research on the effect of parental age on fertility, pregnancy and the health of children, was published in the journal *Maturitas*. "While it is widely accepted that physiological changes that occur in women after 35 can affect conception, pregnancy and the health of the child, most men do not realize their advanced age can have a similar impact," said study autho... mor

Cancer screening rates decline when patients see doctors later in day

Jonathan KantrowitzatHealth News Report - 1 week ago
Compared to patients who see their primary care doctor earlier in the day, cancer screening rates decline significantly as the day goes on, according to a new study from researchers in the Perelman School of Medicine and the Wharton School both of the University of Pennsylvania. The researchers, whose findings were published today in *JAMA Network Open*, believe these rates of decline may be in part due to "decision fatigue" -- which results from the cumulative burden of screening discussions earlier in the day -- and doctors falling behind in their busy schedules. "Our findings sug..

Diabetes linked to numerous cancers in large Chinese study

Jonathan KantrowitzatHealth News Report - 1 week ago
A new *Journal of Diabetes* study from China, which has the highest number of people with diabetes among all countries, found that type 2 diabetes was linked with an elevated risk of 11 types of cancer in men and 13 types of cancer in women. The possible association between diabetes and cancer risk has long been speculated, but previously reported findings have been inconsistent. In the largest study to date concerning the association between type 2 diabetes and cancer risk in mainland China, investigators examined information from the Shanghai Hospital Link database. They identifie... more »

Meditation needs more research: Study finds 25% suffer unpleasant experiences

Jonathan KantrowitzatHealth News Report - 1 week ago
More than a quarter of people who regularly meditate have had a 'particularly unpleasant' psychological experience related to the practice, including feelings of fear and distorted emotions, a UCL-led study has found. The research, published in *PLOS ONE*, also found those who had attended a meditation retreat, those who only practiced deconstructive types of meditation, such as Vipassana (insight) and Koan practice (used in Zen Buddhism), and those with higher levels of repetitive negative thinking, were more likely to report a 'particularly unpleasant' meditation-related experi... more »

Tight pants and pubic-hair removal increase risk of vulvodynia

Jonathan KantrowitzatHealth News Report - 1 week ago
Risk of chronic vulva discomfort and pain nearly doubled by removing hair from mons pubis, or wearing tight-fitting jeans or pants four or more times a week. Vulvodynia is chronic, unexplained, and debilitating vulva pain, affecting an estimated 16 percent of women over their lifetimes. A new Boston University School of Public Health (BUSPH) study finds that the risk of vulvodynia is nearly doubled by wearing tight-fitting jeans or pants four or more times a week, or removing hair from the mons pubis. Published in the *Journal of Lower Genital Tract Disease*, it is the first study t... more »

Monday, May 20, 2019

Walking and strength training may decrease the risk of dying from liver disease

- Physical activity, including walking and muscle-strengthening activities, were associated with significantly reduced risk of cirrhosis-related death, according to research presented at Digestive Disease Week® (DDW) 2019. Chronic liver disease is increasing, partly due to the obesity epidemic, and currently there are no guidelines for the optimal type of exercise for the prevention of cirrhosis-related mortality. Researchers hope these findings will help provide specific exercise recommendations for patients at risk for cirrhosis and its complications.

"The benefit of exercise is not a new concept, but the impact of exercise on mortality from cirrhosis and from liver cancer has not yet been explored on this scale," said Tracey Simon, MD, lead researcher on the study and instructor of medicine at Harvard Medical School and Massachusetts General Hospital, Boston. "Our findings show that both walking and strength training contribute to substantial reductions in risk of cirrhosis-related death, which is significant because we know very little about modifiable risk factors."
Dr. Simon and her team prospectively followed 68,449 women from the Nurses' Health Study and 48,748 men from the Health Professionals Follow-up Study, without known liver disease at baseline. Participants provided highly accurate data on physical activity, including type and intensity, every two years from 1986 through 2012, which allowed researchers to prospectively examine the association between physical activity and cirrhosis-related death.
Researchers observed that adults in the highest quintile of weekly walking activity had 73 percent lower risk for cirrhosis-related death than those in the lowest quintile. Further risk reduction was observed with combined walking and muscle-strengthening exercises.
Previous research has been limited to studies that assessed physical activity at just one point in time, or studies with very short-term follow-up. This was the first prospective study in a large U.S. population to include detailed and updated measurements of physical activity over such a prolonged period, which allowed researchers to more precisely estimate the relationship between physical activity and liver-related outcomes.
"In the U.S., mortality due to cirrhosis is increasing dramatically, with rates expected to triple by the year 2030. In the face of this alarming trend, information on modifiable risk factors that might prevent liver disease is needed," said Dr. Simon. "Our findings support further research to define the optimal type and intensity of physical activity to prevent adverse outcomes in patients at risk for cirrhosis."

Statin use associated with reduced risk of dementia after concussion in older adults


JAMA Neurology
Bottom Line: Concussion is a common brain injury. This observational study of nearly 29,000 adults (66 and older) diagnosed with concussion examined whether statin use was associated with risk of long-term dementia after a concussion. The analysis compared 7,058 patients who received a statin prescription in the 90 days after a concussion with 21,757 who didn't. After an average follow-up of four years, 4,727 patients developed dementia (1 in 6). The risk of dementia in older adults after concussion was substantial, and statin use was associated with modestly reduced risk compared to patients who didn't receive a statin. Limitations of the study include missing information on other factors that could influence the risk of dementia.

Dietary cholesterol or egg consumption do not increase the risk of stroke


A new study from the University of Eastern Finland shows that a moderately high intake of dietary cholesterol or consumption of up to one egg per day is not associated with an elevated risk of stroke. Furthermore, no association was found in carriers of the APOE4 phenotype, which affects cholesterol metabolism and is remarkably common among the Finnish population. The findings were published in the American Journal of Clinical Nutrition.
Findings from earlier studies addressing the association of dietary cholesterol or egg intake with the risk of stroke have been contradictory. Some studies have found an association between high dietary cholesterol intake and an increased risk of stroke, while others have associated the consumption of eggs, which are high in cholesterol, with a reduced risk of stroke. For most people, dietary cholesterol plays a very small role in affecting their serum cholesterol levels. However, in carriers of the apolipoprotein E phenotype 4 - which significantly impacts cholesterol metabolism - the effect of dietary cholesterol on serum cholesterol levels is greater. In Finland, the prevalence of APOE4, which is a hereditary variant, is exceptionally high, with approximately one third of the population presenting as carriers. Yet, research data on the association between a high intake of dietary cholesterol and the risk of stroke in this population group has not been available until now.
The dietary habits of 1,950 men aged between 42 and 60 years with no baseline diagnosis of a cardiovascular disease were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. APOE phenotype data were available for 1,015 of the men participating in the study. Of those, 32% were known carriers of APOE4.
During a follow-up of 21 years, 217 men were diagnosed with stroke. The study found that neither dietary cholesterol nor egg consumption was associated with the risk of stroke - not even in carriers of APOE4.
The findings suggest that moderate cholesterol intake or daily egg consumption are not associated with the risk of stroke, even in persons who are genetically predisposed to a greater effect of dietary cholesterol on serum cholesterol levels. In the highest control group, the study participants had an average daily dietary cholesterol intake of 520 mg and they consumed an average of one egg per day, which means that the findings cannot be generalised beyond these levels. One egg contains approximately 200 mg of cholesterol. In this study, about a fourth of the total dietary cholesterol consumed came from eggs. Furthermore, the generalisability of this study is also weakened by the fact that the study population did not have a pre-existing cardiovascular disease at baseline and the size of the study population was relatively small. Therefore, the findings of the study should be verified in a larger cohort as well as in people with a pre-existing cardiovascular disease, who are currently advised to limit their intake of cholesterol and eggs.

Thursday, May 16, 2019

Regular crosswords and number puzzles linked to sharper brain in later life


Older adults who regularly take part in word and number puzzles have sharper brains, according to the largest online study to date.
The more regularly adults aged 50 and over played puzzles such as crosswords and Sudoku, the better their brain function, according to research in more than 19,000 participants, led by the University of Exeter and King's College London.
The findings emerge from two linked papers published today (May 16th) in the International Journal of Geriatric Psychiatry. The researchers have previously presented their findings on word puzzles at the Alzheimer's Association International Conference in 2018. The new research builds on these findings and also reports the same effect in people who regularly complete number puzzles.
Researchers asked participants in the PROTECT study, the largest online cohort in older adults, to report how frequently they engage In word and number puzzles and undertake a series of cognitive tests sensitive to measuring changes in brain function. They found that the more regularly participants engaged with the puzzles, the better they performed on tasks assessing attention, reasoning and memory.
From their results, researchers calculate that people who engage in word puzzles have brain function equivalent to ten years younger than their age, on tests assessing grammatical reasoning and eight years younger than their age on tests measuring short term memory.
Dr Anne Corbett, of the University of Exeter Medical School, who led the research, said: "We've found that the more regularly people engage with puzzles such as crosswords and Sudoku, the sharper their performance is across a range of tasks assessing memory, attention and reasoning. The improvements are particularly clear in the speed and accuracy of their performance. In some areas the improvement was quite dramatic - on measures of problem-solving, people who regularly do these puzzles performed equivalent to an average of eight years younger compared to those who don't. We can't say that playing these puzzles necessarily reduces the risk of dementia in later life but this research supports previous findings that indicate regular use of word and number puzzles helps keep our brains working better for longer."
The study used participants in the PROTECT online platform, run by the University of Exeter and Kings College London. Currently, more than 22,000 healthy people aged between 50 and 96 are registered in the study, and the study is expanding into other countries including Hong Kong and the US. The online platform enables researchers to conduct and manage large-scale studies without the need for laboratory visits. PROTECT is a 25 year study with participants being followed up annually to explore how the brain ages and what might influence the risk of dementia later in life. PROTECT is funded by the National Institute for Health Research (NIHR) Bioresource, including through its NIHR Clinical Research Network (CRN). In addition to taking part in vital research, participants in the PROTECT study have access to a brain training programme that has already been shown to benefit brain function, as well as having the opportunity to take part in exciting new research studies into brain health and dementia prevention.
Clive Ballard, Professor of Age-Related Diseases at the University of Exeter Medical School, said: "PROTECT is proving to be one of the most exciting research initiatives of this decade, allowing us to understand more about how the brain ages and to conduct cutting-edge new studies into how we can reduce the risk of dementia in people across the UK. If you're aged 50 or over, you could sign up to take part in research that will help us all maintain healthy brains as we age."

A substantial benefit from replacing steak with fish


The average Dane will gain a health benefit from substituting part of the red and processed meat in their diet with fish, according to calculations from the National Food Institute, Technical University of Denmark. Men over 50 and women of childbearing age in particular would benefit from such a change in diet.
In a PhD study at the National Food Institute, Sofie Theresa Thomsen has developed a method to calculate the total health impact of replacing one food with another in the diet. The method has been used to assess the health impact that would be achieved by replacing red and processed meat with fish, so the intake reaches the recommended weekly intake of 350 grams of fish.
Fish is an important source of healthy fatty acids and vitamin D, but may also contain potentially harmful substances such as methylmercury. Red and processed meat contributes to the intake of saturated fat in the Danish diet and is associated with the development of different types of cancer, but red meat is also an important source of e.g. dietary iron. Replacing red and processed meat with fish in the Danish diet can therefore have a health impact on human health.
Seven thousand healthy years of life to be gained annually
Risk-benefit assessments weigh up the beneficial and adverse health effects by estimating how many healthy years of life a population gains because of health improvements, or lose due to reduced quality of life or by dying earlier than expected.
This is exactly what Sofie Theresa Thomsen has done in her calculations.
"They show that the Danish population as a whole can gain up to 7,000 healthy years of life annually, if all adult Danes eat fish in the recommended quantities while at the same time reducing their meat intake. This estimate covers among others the prevention of approximately 170 deaths from coronary heart disease per year," she says.
However, the health benefit depends on the type of fish people put on their plates, as well as the age and sex of the persons whose diet is being altered.
Go easy on the tuna
The greatest health benefit comes from eating only fatty fish (such as herring and mackerel) or a mixture of fatty and lean fish (such as plaice and pollock), while a smaller health gain is achieved by eating only lean fish. This is because fatty fish contain larger amounts of beneficial fatty acids.
On the other hand, the calculations show a significant health loss if tuna is the only type of fish in the diet, because tuna is both low in beneficial fatty acids and can have high concentrations of methylmercury. The health loss is calculated as particularly high among women of childbearing age, as intake of fish with a high concentration of methylmercury can damage unborn children's brain development.
Furthermore, the study shows that it is possible to reduce the proportion of Danes who have an insufficient intake of vitamin D significantly by replacing some of the red and processed meat with a mixture of fatty and lean fish. The study also points out that the proportion of Danes with an insufficient intake of dietary iron will not increase despite the lowered meat intake.
Greatest effect among men over 50 and childbearing women
The study shows large variations in the overall health impact when the red and processed meat gives way to fish. Everyone over the age of 50--but the men in particular--as well as women of childbearing age will reap the greatest health benefits from eating 350 grams of fish weekly, of which 200 grams are fatty fish.
For men, this is because the group as a whole is at higher risk than other population groups of developing cardiovascular disease. The risk is reduced by replacing part of the red meat with fish that contain fatty acids, which can prevent cardiovascular disease.
"In women of childbearing age the health benefit is particularly large because the intake of fish containing healthy fish oils will not only benefit the women themselves. The health-promoting properties of fish will also have a beneficial effect in the development of their unborn children, which is taken into account in the overall calculations," Sofie Theresa Thomsen explains.
Useful when developed intervention strategies and dietary advice
The methods developed in the PhD study are useful e.g. when examining the health effects of various interventions designed to promote healthy eating habits or when developing official dietary guidelines.

Heavily processed foods cause overeating and weight gain


People eating ultra-processed foods ate more calories and gained more weight than when they ate a minimally processed diet, according to results from a National Institutes of Health study. The difference occurred even though meals provided to the volunteers in both the ultra-processed and minimally processed diets had the same number of calories and macronutrients. The results were published in Cell Metabolism (link is external).
This small-scale study of 20 adult volunteers, conducted by researchers at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), is the first randomized controlled trial examining the effects of ultra-processed foods as defined by the NOVA classification system. This system considers foods “ultra-processed” if they have ingredients predominantly found in industrial food manufacturing, such as hydrogenated oils, high-fructose corn syrup, flavoring agents, and emulsifiers.
Previous observational studies looking at large groups of people had shown associations between diets high in processed foods and health problems. But, because none of the past studies randomly assigned people to eat specific foods and then measured the results, scientists could not say for sure whether the processed foods were a problem on their own, or whether people eating them had health problems for other reasons, such as a lack of access to fresh foods.
“Though we examined a small group, results from this tightly controlled experiment showed a clear and consistent difference between the two diets,” said Kevin D. Hall, Ph.D., an NIDDK senior investigator and the study’s lead author. “This is the first study to demonstrate causality — that ultra-processed foods cause people to eat too many calories and gain weight.”
For the study, researchers admitted 20 healthy adult volunteers, 10 male and 10 female, to the NIH Clinical Center for one continuous month and, in random order for two weeks on each diet, provided them with meals made up of ultra-processed foods or meals of minimally processed foods. For example, an ultra-processed breakfast might consist of a bagel with cream cheese and turkey bacon, while the unprocessed breakfast was oatmeal with bananas, walnuts, and skim milk.
The ultra-processed and unprocessed meals had the same amounts of calories, sugars, fiber, fat, and carbohydrates, and participants could eat as much or as little as they wanted.
Dietitians at the Clinical Center of the National Institutes of Health designed recipes to test the effects of ultra-processed and unprocessed diets on study participants.Jennifer Rymaruk, NIDDK
“We need to figure out what specific aspect of the ultra-processed foods affected people’s eating behavior and led them to gain weight,” Hall said. “The next step is to design similar studies with a reformulated ultra-processed diet to see if the changes can make the diet effect on calorie intake and body weight disappear.”
For example, slight differences in protein levels between the ultra-processed and unprocessed diets in this study could potentially explain as much as half the difference in calorie intake.
“Over time, extra calories add up, and that extra weight can lead to serious health conditions,” said NIDDK Director Griffin P. Rodgers, M.D. “Research like this is an important part of understanding the role of nutrition in health and may also help people identify foods that are both nutritious and accessible — helping people stay healthy for the long term.”
While the study reinforces the benefits of unprocessed foods, researchers note that ultra-processed foods can be difficult to restrict. “We have to be mindful that it takes more time and more money to prepare less-processed foods,” Hall said. “Just telling people to eat healthier may not be effective for some people without improved access to healthy foods.”

Feeling healthy: A good start, but not always a good indicator of heart disease risk



Most people feel they have a general idea of how healthy they are based on their diet and exercise regimen and how often they get sick. But a new study by Johns Hopkins Medicine researchers adds to evidence that how healthy people think they are isn't always an accurate indicator of their risk for cardiovascular disease.
In a study of medical information gathered on more than 6,800 people in the United States, the researchers found that 10% of those who rated themselves in excellent health had measurable evidence of cardiovascular disease without symptoms, putting them at higher risk for a heart attack or stroke.
The better news from their analysis, the researchers say, is that when combined with definitive risk tools, such as coronary artery calcium scans to determine plaque buildup in the heart's arteries, self-reported perceptions of health do have value and can complement these tools to indicate cardiovascular disease risk.
The researchers note that this study wasn't designed to determine cause-and-effect but to identify findings that related to one another.
"Our study suggests an important public health message: that even when people perceive themselves to be healthy they may still have significant cardiovascular disease," says Olusola Orimoloye, M.D., M.P.H., postdoctoral fellow at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease. "This means that all adults would benefit from seeing a health care provider to get a more definitive assessment for their risk of disease, even if they think they're healthy and feel they don't need to visit the doctor."
In a report on the study published in JAMA Network Open on Feb. 15, the researchers say the goal was to assess the value of self-reported health status among adults in the context of more established measures of cardiovascular disease risk.
The team used data gathered from 6,814 people enrolled in the federally funded Multi-Ethnic Study of Atherosclerosis (MESA), which recruited participants from Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles County, California; Manhattan, New York and St. Paul, Minnesota. Participants were enrolled between 2000 and 2002, and were followed through December 2018. At the start of the study, they were an average of 62 years old. About 53% were women, some 39% were white, 28 percent were African American, 22 percent were Hispanic and 12 percent were Chinese.
During the study, each participant was asked to rate his or her health at the beginning of enrollment as excellent, very good, good or poor/fair. Men were more likely to report being in very good or excellent health (52%), whereas about 41% of African American and Hispanic participants were more likely to report poor/fair health (about 41%).
Additionally, each participant had a coronary artery calcium scan, a computed tomography (CT) scan that detects plaque buildup in the arteries of the heart. Having an artery calcium score of 0 aligns statistically with the lowest cardiovascular disease risk because no buildup of plaque is detected in the arteries, whereas those with scores of more than 100 are considered at the highest risk for cardiovascular disease using this test.
The authors found that while participants' health ratings tracked with health factors such as physical activity, healthy diet and known cardiovascular risk factors such as diabetes, high blood pressure and high triglycerides, there wasn't any correlation between their self-rated health and their coronary artery calcium scores.
After an average follow-up of 13 years, there were 1,161 participant deaths and 637 heart attacks, strokes or deaths due to cardiovascular disease.
Accounting for calcium scores, age, sex and race/ethnicity, the 1,073 participants who self-reported excellent health had at least a 45 percent lower risk of having a cardiovascular disease event compared to the 633 people who self-reported fair/poor health.
The authors also reported that participants with higher calcium artery scores were at increased risk regardless of their self-reported health assessment. Among those who self-reported their health as excellent, participants who had a score more than 0 on their calcium artery scan were more than five times as likely to have a cardiovascular disease event like a heart attack or stroke than those who had a coronary artery calcium score of 0.
Among the 543 people with a 0 coronary artery calcium score, those who reported excellent health were 80% less likely to have a cardiovascular disease event than those who reported fair/poor health.
Heart disease risk was calculated for each patient using the Atherosclerotic Cardiovascular Disease Risk Calculator from the American Heart Association (AHA). The calculator is routinely used to predict cardiovascular disease risk in clinical settings, and it incorporates factors such as age, sex, race, total cholesterol, "good" cholesterol, blood pressure and whether the person has diabetes, is a smoker or is being treated for high blood pressure.
The authors found that on its own, self-reported health didn't improve the predictive ability of the AHA's risk calculator. However, when the researchers compared the predictive ability of a combination of the coronary artery calcium scan results and self-reported health rating to that of the AHA's risk calculator, they found that the risk prediction was similar.
"Because self-reported health and coronary artery calcium scores only slightly overlap among those in each risk group, by using both of these measures together with traditional risk calculators, we may be able to more accurately capture who is most or least at risk for cardiovascular disease," says senior author Michael Blaha, M.D., M.P.H., professor of medicine at the Johns Hopkins University School of Medicine. "It would be fairly cheap and easy to add a question on health screenings to have someone self-rate their perceived health as a way to more precisely refine disease risk if their coronary artery calcium score is known."
According to the AHA, cardiovascular disease is the leading cause of death in the U.S., killing more than 800,000 people per year.
"Further refining existing tools to predict cardiovascular disease and to guide preventive therapy is of utmost importance," says Orimoloye.