Health News Report: July 2019

Wednesday, July 31, 2019

One in 10 older adults currently binge drinks

Men, cannabis users more likely to engage in this risky behavior

More than a tenth of adults age 65 and older currently binge drink, putting them at risk for a range of health problems, according to a study by researchers at NYU School of Medicine and the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.
The study, published in the Journal of the American Geriatrics Society, also finds certain factors--including using cannabis and being male--are associated with an increase in binge drinking.
Binge drinking is a risky behavior, particularly for older adults due to aging-related physical changes (for instance, an increased risk of falling) and the likelihood of having chronic health issues. Despite the potential for harm, little research has focused on binge drinking among older adults.
"Binge drinking, even episodically or infrequently, may negatively affect other health conditions by exacerbating disease, interacting with prescribed medications, and complicating disease management," said Benjamin Han, MD, MPH, the study's lead author and an assistant professor in the Department of Medicine's Division of Geriatric Medicine and Palliative Care, and the Department of Population Health at NYU Langone Health.
In this study, Han and his colleagues used the most recent national data to determine the current prevalence and factors that may increase the risk of binge drinking among adults. The researchers examined data from 10,927 U.S. adults age 65 and older who participated in the National Survey on Drug Use and Health between 2015 and 2017. They looked at the prevalence of current (past-month) binge alcohol use, defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as five drinks or more on the same occasion for men and four drinks or more for women. They also compared demographic and health factors of past-month binge drinkers with people who drank within the past month, but below the binge drinking threshold.
The authors estimate that more than one in 10 (10.6 percent) older adults have binge drank in the past month--an increase compared to earlier studies. In the decade leading up to the data used in this study (2005-2014), binge drinking among adults 65 and older was between 7.7 and 9 percent.
Binge drinkers were more likely to be male, current tobacco and/or cannabis users, African American, and have less than a high school education. They were also more likely to visit the emergency room in the past year. Similar to previous studies, the study did not find associations between binge drinking and other mental health disorders.
"The association of binge drinking with cannabis use has important health implications. Using both may lead to higher impairment effects. This is particularly important as cannabis use is becoming more prevalent among older adults, and older adults may not be aware of the possible dangers of using cannabis with alcohol," said CDUHR researcher Joseph Palamar, PhD, MPH, the study's senior author and an associate professor in the Department of Population Health at NYU Langone Health.
The researchers also examined chronic disease profiles of older binge drinkers, and noted that binge drinkers had a lower prevalence of two or more chronic diseases compared to non-binge drinkers. The most common chronic disease among binge drinkers was hypertension (41.4 percent), followed by cardiovascular disease (23.1 percent) and diabetes (17.7 percent).
"Binge drinkers were less likely to have most chronic diseases compared to alcohol users who did not binge drink. This may be because some people stop or decrease their drinking when they have an illness or alcohol-related disease," said Han, who is also a CDUHR researcher. "Clinicians must be aware that some older adults with chronic disease still engage in binge drinking behaviors, which can worsen their health issues. This may explain why binge drinkers were more likely to report visits to the emergency room."
The researchers note that while the study uses the NIAAA's recommended threshold for binge drinking, the same organization also suggests lower drinking limits for adults over 65: no more than three drinks a day. Since the current analysis used the higher cutoff for binge drinking, the study may underestimate the prevalence of binge drinking among older adults.
"Our results underscore the importance of educating, screening, and intervening to prevent alcohol-related harms in older adults, who may not be aware of their heightened risk for injuries and how alcohol can exacerbate chronic diseases," said Han.

Both low and high levels of hemoglobin linked to increased risk of dementia

Having either low or high levels of hemoglobin in your blood may be linked to an increased risk of developing dementia years later, according to a study published in the July 31, 2019, online issue of Neurology®, the medical journal of the American Academy of Neurology.
Hemoglobin is the protein in red blood cells responsible for transporting oxygen. Very low hemoglobin is called anemia.
"With around 10 percent of people over age 65 having anemia in the Americas and Europe and up to 45 percent in African and southeast Asian countries, these results could have important implications for the burden of dementia, especially as the prevalence of dementia is expected to increase threefold over the next decades, with the largest increases predicted in the countries where the anemia rate is the highest," said study author M. Arfan Ikram, PhD, of Erasmus Medical Center in Rotterdam, the Netherlands.
The study involved 12,305 people with an average age of 65 who did not have dementia. Participants' hemoglobin levels were measured at the start of the study. Overall, 745, or 6 percent, of the participants had anemia.
The participants were followed for an average of 12 years. During that time, 1,520 people developed dementia. Of those, 1,194 had Alzheimer's disease.
The researchers found that the people with anemia were 41 percent more likely to develop Alzheimer's disease and 34 percent more likely to develop any type of dementia than those who did not have anemia. Of the 745 people with anemia, 128 developed dementia, compared to 1392 of the 11,560 people who did not have anemia.
People with high levels of hemoglobin were also more likely to develop dementia. High levels can also be a sign of a health problem. The study participants were divided into five groups based on their hemoglobin levels. Compared to the middle group, the group with the highest levels were 20 percent more likely to develop dementia. Those in the lowest group were 29 percent more likely to develop dementia than those in the middle group.
The results stayed the same after researchers adjusted for other factors that could affect the risk of dementia, such as smoking, high blood pressure, high cholesterol and alcohol use.
Ikram noted that the study does not prove that low or high hemoglobin levels are a factor in causing dementia; it only shows an association.
"More research is needed to determine whether hemoglobin levels play a direct role in this increased risk or whether these associations can be explained by underlying issues or other vascular or metabolic changes," he said.
A limitation of the study was that the participants were primarily of European descent, so the results may not apply to all populations. For example, Ikram noted that a genetic mutation that is common among people of African descent makes people more likely to have anemia, and that the prevalence of malaria and sickle cell disease, which can contribute to anemia, varies around the globe.

Higher vitamin A intake linked to lower skin cancer risk

People whose diets included high levels of vitamin A had a 17 percent reduction in risk for getting the second-most-common type of skin cancer, as compared to those who ate modest amounts of foods and supplements rich in vitamin A.
That's according to researchers from Brown University, who unearthed that finding after analyzing data from two long-term observational studies.
Cutaneous squamous cell carcinoma is the second-most-common type of skin cancer among people with fair skin. Vitamin A is known to be essential for the healthy growth and maturation of skin cells, but prior studies on its effectiveness in reducing skin cancer risk have been mixed, said Eunyoung Cho, an associate professor of dermatology and epidemiology at Brown.
"Our study provides another reason to eat lots of fruits and vegetables as part of a healthy diet," said Cho, who is also an associate epidemiologist at Brigham and Women's Hospital. "Skin cancer, including squamous cell carcinoma, is hard to prevent, but this study suggests that eating a healthy diet rich in vitamin A may be a way to reduce your risk, in addition to wearing sunscreen and reducing sun exposure."
The findings were published on Wednesday, July 31, in the Journal of the American Medical Association Dermatology.
The research team led by Cho looked at the diet and skin cancer results of participants in two large, long-term observational studies: the Nurses' Health Study, which followed 121,700 U.S. women from 1984 to 2012, and the Health Professionals Follow-Up Study, which followed 51,529 U.S. men from 1986 to 2012.
Between the two studies, some 123,000 participants were white (and thus had significant risk of developing skin cancer), had no prior history of cancer and completed the dietary reports multiple times. Among these individuals included in the team's subsequent analysis, a total of 3,978 cases of squamous cell carcinoma were reported and verified within the 24- or 26-year follow-up periods.
Both studies also asked the participants about hair color, the number of severe sunburns they had received in their lifetime and any family history of skin cancer, and the researchers adjusted for these and other factors. The studies did not, however, ask participants about their avoidance of mid-day sun, known to be a major risk factor for skin cancer.
After grouping the study participants into five categories by vitamin A intake levels, the researchers found that people in the category with the highest average daily total vitamin A intake were 17 percent less likely to get skin cancer than those in the category with the lowest total vitamin A intake.
Those in the highest category reported eating on average the amount of vitamin A equivalent to one medium baked sweet potato or two large carrots each day. Those in the lowest category reported eating a daily average amount of vitamin A equivalent to one-third cup of sweet potato fries or one small carrot, which is still above the U.S. Recommended Dietary Allowance of vitamin A.
The team also found that the majority of vitamin A came from the participants' diets, particularly from fruits and vegetables, rather than from animal-based foods or vitamin supplements. Plant-based sources of vitamin A include not only sweet potatoes and carrots, but leafy green vegetables and fruits like apricots and cantaloupe. Milk, some types of fish and liver are rich sources of animal-based vitamin A.
Cho cautioned that too much vitamin A, particularly from supplements and animal sources, can lead to nausea, liver toxicity, increased risk of osteoporosis and hip fracture, and even birth defects. Side effects from high levels of plant-based vitamin A are minimal, she added.
The researchers also found that eating high levels of other plant-based pigments similar to vitamin A -- such as lycopene, commonly found in tomatoes and watermelon -- was associated with decreased risk of skin cancer.
Because the analysis was based on studies surveying a large number of people about the foods they ate and observing whether or not they got skin cancer, rather than a randomized clinical trial, it cannot establish cause and effect. It's possible that another factor may have led to the differences -- such as the fact that people who consumed more vitamin A also tended to drink less alcohol.
As a next step, Cho would like to conduct a clinical trial to see if vitamin A supplements can prevent squamous cell carcinoma. However, she added, conducting a dietary clinical trial is quite challenging on a technical level, as is ensuring that participants actually stick to the diet.
"If a clinical trial cannot be done, then a large-scale prospective study like this is the best alternative for studying diet," Cho said.

###

Other authors on the paper from Brown University include Dr. Jongwoo Kim, now at Inje University Sanggye-Paik Hospital in South Korea; Min Kyung Park; Wen-Qing Li and Dr. Abrar Qureshi.
The research was supported by the National Institutes of Health (grant numbers CA186107, CA87969, CA167552 and CA198216) as well as a research career development award from the Dermatology Foundation.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Low muscle mass in arms and legs can heighten the mortality risk in older men and women

A study of individuals over 65 years old showed that all-cause mortality risk increased nearly 63-fold in women with low appendicular muscle mass. The risk of dying increased 11.4-fold in men (patient undergoing DXA body composition and bone density scan.

Fundação de Amparo à Pesquisa do Estado de São Paulo

**IMAGE:** All-cause mortality risk increased nearly 63-fold in women with low appendicular muscle mass. view more

Credit: Rosa Maria Rodrigues Pereira

Evaluating body composition, especially appendicular muscle mass, can be an effective strategy for predicting longevity in people over 65 years of age, according to a study conducted by researchers at the University of São Paulo’s Medical School (FM-USP) in Brazil. The appendicular muscles are the muscles that move the appendages or extremities – the arms and legs. They also play a key role in stabilizing the shoulders and hips.
The researchers studied a group of 839 men and women over the age of 65 for approximately four years. They observed that all-cause mortality risk increased nearly 63-fold during the follow-up period in women with low appendicular muscle mass and 11.4-fold in men.
An article with results of the study, which was supported by FAPESP, is published in the Journal of Bone and Mineral Research.
“We evaluated the body composition of this group, focusing on appendicular muscle mass, subcutaneous fat and visceral fat. We then sought to determine which of these factors could predict mortality in the ensuing years. We concluded that the key factor was the amount of appendicular lean mass,” Rosa Maria Rodrigues Pereira, Full Professor and Head of Rheumatology at FM-USP and principal investigator for the study, told Agência FAPESP.
Body composition was determined by dual energy X-ray absorptiometry (DXA), also known as bone density scanning, using a densitometer purchased with funding from FAPESP during a previous project led by Pereira to assess the prevalence of osteoporosis and fractures in older women living in Butantã, a neighborhood in western São Paulo city. The same cohort of individuals over 65 years of age was studied in both projects.
“Participants were selected on the basis of the census performed by IBGE [Brazil’s national census bureau]. The sample was representative of the older members of the country’s population,” Pereira said.
The study sample comprised 323 men (39%) and 516 women (61%). The frequency of low muscle mass was approximately 20% for both men and women.
Silent disease
The gradual loss of muscle mass and quality associated with aging is known as age-related sarcopenia. Approximately 46% of Brazilians aged 80 or older have sarcopenia, according to the Brazilian Association of Geriatrics and Gerontology.
Especially when combined with osteoporosis, sarcopenia can increase the vulnerability of older people in that they become more prone to falls, fractures and other physical injuries. Low bone mineral density, particularly in the femur, was shown to correlate with mortality in elderly individuals by research published in 2016.
Pereira and her group developed an equation to determine which individuals can be considered to have sarcopenia based on the characteristics of the community studied.
“According to the most widely used criteria [appendicular lean mass in kg divided by height squared in m], most of the individuals identified as having sarcopenia are lean. However, our sample had a higher-than-average BMI [body mass index], so we substituted muscle mass for fat mass. Subjects with muscle mass that was 20% below average were classified as having sarcopenia,” Pereira said.
The researchers discussed this topic in articles published in Osteoporosis International in 2013 and 2014.
In addition to bone density, the researchers also analyzed blood samples and responses to questionnaires to evaluate diet, physical activity, smoking, consumption of alcoholic beverages, and the presence of chronic diseases such as diabetes, high blood pressure and dyslipidemia (abnormally elevated levels of fat in the blood).
At the end of the four-year period, 15.8% (132) of the volunteers had died; 43.2% had died from cardiovascular problems. The mortality rate was 20% for the men and 13% for the women in the sample.
“We then conducted a number of statistical analyses to detect differences between the subjects who died and those who remained alive, particularly, whether it was possible to predict a person’s death on the basis of body composition measured by the DXA examination,” Pereira said.
Differences
Generally, subjects who died were older, exercised less, and suffered more from diabetes and cardiovascular problems than those who remained alive. In the case of the women who died, they also had decreased BMIs. The men who died were more likely to suffer falls. All these variables were fed into the statistical model and adjusted for the end-result to show which body composition factor correlated best with mortality risk.
Only low muscle mass was found to be significant in the women, considering the adjustment variables, while visceral fat was also significant among the men. The mortality risk doubled with each 6 cm² increase in abdominal fat. Curiously, a higher proportion of subcutaneous fat had a protective effect in the men.
“We found that other parameters also negatively influenced mortality in the men, statistically reducing the significance of appendicular muscle mass. In the women, however, muscle mass stood out as a key factor and hence had more influence,” Pereira said.
Menopause-related hormone changes may help explain the difference between men and women. “The rapid and significant transition from a protective estrogenic environment to a deleterious hypoestrogenic environment, which is particularly adverse for the cardiovascular system, may make the protective metabolic role of skeletal muscles, including the production of anti-inflammatory cytokines, more important in the postmenopause period. This hormone change is far less abrupt in men,” she said.
Loss of muscle mass, which occurs naturally after the age of 40, can be unnoticed owing to weight gain, which is also common in middle age. Between 1% and 2% of muscle mass is lost annually after the age of 50, according to estimates. The factors that may accelerate muscle loss include sedentary habits, a protein-poor diet, chronic diseases and hospitalization.
In addition to their obvious importance in posture, balance and movement, the skeletal muscles have other functions that are essential to the body. They help regulate blood sugar by consuming energy during contraction and maintain the body temperature by trembling when cold. They also produce messenger hormones, such as myokinase, that assist communication with different organs and influence inflammatory responses.
The good news is that sarcopenia is preventable and can even be reversed by physical exercise, especially muscle toning. Attention to protein ingestion is also recommended.

Tuesday, July 30, 2019

Doctors more likely to recommend antihistamines rather than cough & cold medicine for kids

For respiratory infections in children under 12, physicians are increasingly more likely to recommend antihistamines and less likely to recommend cough and cold medicines, a Rutgers study found.
Antihistamines are widely used over-the-counter to treat various allergic conditions. However, these medicines have little known benefit for children with colds, and some older antihistamines cause sedation and occasionally agitation in children.
The study, in JAMA Pediatrics, found a sharp decline in cough and cold medicine recommendations for children under 2 after 2008, when the Food and Drug Administration recommended against the medicines for that age group due to safety concerns and uncertain benefits. The American Academy of Pediatrics subsequently recommended avoiding cough and cold medicines in children under 6.
"Families often treat their children's respiratory infections with cough and cold medicines, some of which include opioid ingredients, such as codeine or hydrocodone. However, there is little proof that these medications effectively ease the symptoms in young children," said study lead author Daniel Horton, assistant professor of pediatrics, Rutgers Robert Wood Johnson Medical School. "Also, many cough and cold medicines have multiple ingredients, which increases the chance of serious accidental overdose when combined with another product."
The researchers looked at national surveys representing 3.1 billion pediatric ambulatory clinic and emergency department visits in the United States from 2002 to 2015. During that period, physicians ordered approximately 95.7 million cough and cold medications, 12 percent of which contained opioids.
After the FDA's 2008 public health advisory, however, physician recommendations declined by 56 percent for non-opioid cough and cold medicines in children under 2 and by 68 percent for opioid-containing medicines in children under 6. At the same time, researchers saw a 25 percent increase in doctor recommendations for antihistamines to treat respiratory infections in children under 12.
"Sedating antihistamines such as diphenhydramine [Benadryl] may have a small effect on some cold symptoms in adults," said Horton. "However, there is little evidence that antihistamines actually help children with colds feel better or recover faster. We do know that these medicines can make kids sleepy and some kids quite hyper."
"It is nice to see physicians are heeding the advice to avoid cough and cold medications for children, but switching them to antihistamines is not necessarily an improvement," said co-author Brian Strom, chancellor, Rutgers Biomedical and Health Sciences.
The American Academy of Pediatrics has various suggestions for treating children with the cold or flu, including use of over-the-counter medicines for pain or fever, honey to relieve cough in children over 1 year old, and plenty of rest and hydration. For more information and suggestions, visit healthychildren.org's Caring for Your Child's Cold or Flu information page.

Diets rich in blueberries yield diverse benefits

A collection of new studies in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences further quantifies how blueberry consumption can contribute to healthy aging.
"Since the 1990s, research on the health benefits of blueberries has grown exponentially," wrote guest editor Donald K. Ingram, PhD, FGSA, in an opening editorial. "Studies have documented that this fruit ranks highest in antioxidant activity compared to many other popular fruits. Moreover, other mechanisms for the health benefits of blueberries, such as their anti-inflammatory properties, have been identified."

Ingram's editorial is followed by four articles in a special section of the journal's Biological Sciences section. One of the studies found that consuming 200 grams of blueberries (about one cup) daily can improve blood vessel function and decrease systolic blood pressure. As the cause, the authors cited anthocyanins, which are phytochemicals that give blueberries their dark color.

Other studies document the cognitive benefits of eating blueberries. One tied the fruit's high polyphenol count to improved performance on memory tests by a group of older adults. Likewise, another journal article provides a review of several clinical studies focusing on benefits of blueberry supplementation -- with a focus on specific memory effects in children as well as older adults with mild cognitive impairment.

Latest Health Research

Aging

Resistance training is imperative for older adults

Jonathan KantrowitzatHealth News Report - 3 days ago

Slower walking speed may predict future mobility problems

Jonathan KantrowitzatHealth News Report - 6 days ago

American Geriatrics Society Being able to walk outside for several blocks at a leisurely pace plays an important role in living a vibrant, healthy life. Walking short distances allows you to get the physical activity you need, live independently, go shopping, access health care, and engage in a social life. Being able to walk at even a slow speed is essential to all these benefits--but walking too slowly may foreshadow future problems that could prevent you from being fully mobile. Until now, there has been no ideal way for healthcare providers to measure walking ability, since it in... more »

Learning multiple things simultaneously increases cognitive abilities in older adults

Jonathan KantrowitzatHealth News Report - 1 week ago

Learning several new things at once increases cognitive abilities in older adults, according to new research from UC Riverside. UCR psychologist Rachel Wu says one important way of staving off cognitive decline is learning new skills as a child would. That is, be a sponge: seek new skills to learn; maintain motivation as fuel; rely on encouraging mentors to guide you; thrive in an environment where the bar is set high. "The natural learning experience from infancy to emerging adulthood mandates learning many real-world skills simultaneously," Wu's research team writes in a paper re... more »

Association of Lifespan Cognitive Reserve Indicator With Dementia Risk in the Presence of Brain Pathologies

Jonathan KantrowitzatHealth News Report - 2 weeks ago

*Question* Is high lifespan cognitive reserve (CR) indicator associated with a reduction in dementia risk, and how strong is this association in the presence of high brain pathologies? *Findings* In this cohort study including 1602 dementia-free older adults, high lifespan CR was associated with a decreased risk of dementia. This association was present in people with high Alzheimer disease and vascular pathologies. *Meaning* Accumulative educational and mentally stimulating activities enhancing CR throughout life might be a feasible strategy to prevent dementia, even for peopl... more »

Wearing hearing aid may help protect brain in later life

Jonathan KantrowitzatHealth News Report - 2 weeks ago

A new study has concluded that people who wear a hearing aid for age-related hearing problems maintain better brain function over time than those who do not. It builds on important research in recent years pulled together by the Lancet Commission on Dementia Prevention, Intervention and Care, through which hearing loss emerged as an important risk factor for dementia. This research suggests that wearing a hearing aid may mitigate that risk. The research was conducted by the University of Exeter and King's College London and is presented at the Alzheimer's Association International ... more »

Computer use, crafts and games can slow or prevent age-related memory loss

Jonathan KantrowitzatHealth News Report - 2 weeks ago

A new study has found that mentally stimulating activities like using a computer, playing games, crafting and participating in social activities are linked to a lower risk or delay of age-related memory loss called mild cognitive impairment, and that the timing and number of these activities may also play a role. The study is published in the July 10, 2019, online issue of *Neurology*®, the medical journal of the American Academy of Neurology. Mild cognitive impairment (MCI) is a medical condition that is common with aging. While it is linked to problems with thinking ability and m... more »

Diet

Consuming more polyunsaturated fat (such as omega 3 and omega 6 fatty acids) in place of refined starch and sugars is associated with a lower risk of type 2 diabetes

Jonathan KantrowitzatHealth News Report - 4 days ago

Mediterranean diet during pregnancy reduces gestational diabetes and weight gain

Jonathan KantrowitzatHealth News Report - 6 days ago

Early introduction of peanuts in babies to reduce allergy risk

Jonathan KantrowitzatHealth News Report - 1 week ago

Worried about peanut allergies in children? A practice article in *CMAJ (Canadian Medical Association Journal)* outlines five things to know about early introduction of peanuts in infants to reduce the risk of peanut allergy. - Infants who are fed peanut protein regularly have a lower risk of peanut allergy. - To prevent peanut allergy, peanut protein (such as peanut butter or powdered puff) may be introduced at home for most babies between 4 and 6 months as one of the first foods. - Babies with severe eczema are more likely to have peanut allergy, and those ... more »

Following a healthy plant-based diet may lower type 2 diabetes risk

Jonathan KantrowitzatHealth News Report - 1 week ago

People who follow predominantly plant-based diets with greater adherence may have a lower risk of developing type 2 diabetes than those who follow these diets with lower adherence, according to a new meta-analysis from Harvard T.H. Chan School of Public Health. The researchers also found that the association was stronger for people whose diets emphasized healthy plant-based foods. The study will be published online July 22, 2019 in *JAMA Internal Medicine* . "Plant-based dietary patterns are gaining popularity in recent years, so we thought it was crucial to quantify their overall as... more »

A spicy diet could be linked to dementia

Jonathan KantrowitzatHealth News Report - 1 week ago

Think twice before adding that extra kick of chili sauce or chopped jalapeno to your meal. New research involving the University of South Australia shows a spicy diet could be linked to dementia. A 15-year study of 4582 Chinese adults aged over 55 found evidence of faster cognitive decline in those who consistently ate more than 50 grams of chili a day. Memory decline was even more significant if the chili lovers were slim. The study, led by Dr Zumin Shi from Qatar University, showed that those who consumed in excess of 50 grams of chili a day had almost double the risk of memory de... more »

Heart disease biomarker linked to paleo diet

Jonathan KantrowitzatHealth News Report - 1 week ago

People who follow the paleo diet have twice the amount of a key blood biomarker linked closely to heart disease, the world's first major study examining the impact of the diet on gut bacteria has found. Researchers from Edith Cowan University (ECU) compared 44 people on the diet with 47 following a traditional Australian diet. The research, published in the *European Journal of Nutrition*, measured the amount of trimethylamine-n-oxide (TMAO) in participants' blood. High levels of TMAO, an organic compound produced in the gut, are associated with an increased risk of heart disease, whi... more »

A relaxation of regulation of salt content in food has been linked with 9,900 additional cases of cardiovascular disease, and 1,500 cases of stomach cancer

Jonathan KantrowitzatHealth News Report - 1 week ago

A relaxation of UK industry regulation of salt content in food has been linked with 9,900 additional cases of cardiovascular disease, and 1,500 cases of stomach cancer. Researchers from Imperial College London and the University of Liverpool analysed the salt intake of the population in England over thirteen years to compare the effect of changes in regulations on how much salt manufacturers can use in their products. The team, who published their work in the *Journal of Epidemiology and Community Health*, found that since the regulations on industry had been relaxed in 2011, th... more »

Even in svelte adults, cutting about 300 calories daily protects the heart

New data from a two-year Duke Health trial suggests when it comes to cutting your risk for killer ailments such as diabetes and heart disease, there's always room for improvement. In adults already at a healthy weight or carrying just a few extra pounds, cutting around 300 calories a day significantly improved already good levels of cholesterol, blood pressure, blood sugar and other markers. The findings of the randomized, controlled trial of 218 adults under age 50 are described in a July 11 article in the journal *The Lancet Diabetes & Endocrinology*... more »

Dietary quality influences microbiome composition in human colonic mucosa

Jonathan KantrowitzatHealth News Report - 1 week ago

It is well established that diet influences health and disease, but the mechanisms underlying this effect are not fully understood. Shedding light on the diet-health connection, a team led by researchers at Baylor College of Medicine reports today in The *American Journal of Clinical Nutrition* an association between diet quality and microbiome composition in human colonic mucosa. The researchers found that a high-quality diet is linked to more potentially beneficial bacteria; while a low-quality diet is associated with an increase in potentially harmful bacteria. They propose that... more »

The risk of developing colorectal cancer for individuals that follow a pro-inflammatory diet is two times higher than usual

Jonathan KantrowitzatHealth News Report - 2 weeks ago

Researchers from the Molecular Mechanisms and Experimental Therapy in Oncology program (Oncobell) of the Bellvitge Biomedical Research Institute (IDIBELL) and the Catalan Institute of Oncology (ICO), together with the Biodonostia Health Research Institute (IIS Biodonostia), among others, have published in *Nutrients* the results of a multicenter study that unveils a correlation between inflammatory and antioxidant diets and the risk of developing colorectal and breast cancer. Dr. Mireia Obón-Santacana from IDIBELL-ICO is the first author of a research which was led by Dr. Pilar Ami... more »

Moderate calorie restriction in young and middle-aged adults significantly reduces heart and metabolic risk factors independent of weight loss

Jonathan KantrowitzatHealth News Report - 2 weeks ago

Moderately reducing caloric intake over a period of two years significantly improved cardiometabolic risk factors in young and middle-aged, non-obese adults, according to new findings from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) (link is external) trial. The study is a multicenter randomized controlled trial supported by the National Institute on Aging (NIA) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health. According to the researchers, there are no pharmacologic age... more »

Preeclampsia risk may be reduced by a healthy high-fiber diet

Jonathan KantrowitzatHealth News Report - 2 weeks ago

A healthy diet rich in fibre is generally recommended, but new research shows it could be even more important during pregnancy to promote the wellbeing of the mother and child. Plant-based fibre is broken down in the gut by bacteria into factors that influence the immune system. Researchers from the University of Sydney's Charles Perkins Centre, the Barwon Infant Study from Deakin University, Monash University, James Cook University and the Australian National University collaborated to investigate the role of these metabolic products of gut bacteria during pregnancy. Senior auth... more »

Medicine

Using antibiotics without a prescription is a prevalent public health problem

Jonathan KantrowitzatHealth News Report - 5 days ago

People using antibiotics without a prescription seems to be a prevalent public health problem. Antibiotics were obtained through various means, including saving leftover prescriptions for later use, getting them from friends and family, or obtaining them from local markets "under the counter." Findings from a scoping review are published in *Annals of Internal Medicine*. When people take antibiotics without a prescription, they often take unnecessary medication or choose an inappropriate drug or dose. This practice is associated with avoidable adverse events and may also increase ... more »

Serious falls are a health risk for adults under 65

Jonathan KantrowitzatHealth News Report - 1 week ago

Adults who take several prescription medications are more likely to experience serious falls, say Yale researchers and their co-authors in a new study. This heightened risk can affect middle-aged individuals -- a population not typically viewed as vulnerable to debilitating or fatal falls, the researchers said. To identify factors that put adults at risk for serious falls, the research team used patient data from the Veterans Aging Cohort Study (VACS), a national study of individuals who receive care through the Veterans Health Administration (VA). They identified 13,000 fall cases... more »

Metformin could lower risk of dementia in African Americans with type 2 diabetes

Jonathan KantrowitzatHealth News Report - 2 weeks ago

A large observational cohort study examining male veterans aged over 50 years with type 2 diabetes found that metformin use was associated with a significantly lower risk of dementia in African American patients. The study included data from 73,500 patients who received care through the Veteran's Health Administration from 2000-2015 and were diabetes- and dementia-free at baseline and who subsequently developed type 2 diabetes and began treatment with either metformin or sulfonylurea. Cox proportional hazards models, using propensity scores and inverse probability treatment to bal... more »

Sleep

Take a bath 90 minutes before bedtime to get better sleep

Jonathan KantrowitzatHealth News Report - 1 week ago

Biomedical engineers at The University of Texas at Austin may have found a way for people to get better shuteye. Systematic review protocols -- a method used to search for and analyze relevant data -- allowed researchers to analyze thousands of studies linking water-based passive body heating, or bathing and showering with warm/hot water, with improved sleep quality. Researchers in the Cockrell School of Engineering found that bathing 1-2 hours before bedtime in water of about 104-109 degrees Fahrenheit can significantly improve your sleep. "When we looked through all known studies,... more »

Supplements

Researchers find widespread aspirin use despite few benefits, high risks

Jonathan KantrowitzatHealth News Report - 1 week ago

Medical consensus once supported daily use of low dose aspirin to prevent heart attack and stroke in people at increased risk for cardiovascular disease (CVD). But in 2018, three major clinical trials cast doubt on that conventional wisdom, finding few benefits and consistent bleeding risks associated with daily aspirin use. Taken together, the findings led the American Heart Association and American College of Cardiology to change clinical practice guidelines earlier this year, recommending against the routine use of aspirin in people older than 70 years or people with increased b... more »

More on vast majority of dietary supplements don't improve heart health or put off death

Jonathan KantrowitzatHealth News Report - 1 week ago

Johns Hopkins Medicine [image: IMAGE] *IMAGE: *Vitamins for heart health. view more Credit: Johns Hopkins Medicine In a massive new analysis of findings from 277 clinical trials using 24 different interventions, Johns Hopkins Medicine researchers say they have found that almost all vitamin, mineral and other nutrient supplements or diets cannot be linked to longer life or protection from heart disease. Although they found that most of the supplements or diets were not associated with any harm, the analysis showed possible health benefits only from a low-salt diet, omega-3 fatty acid... more »

General Health

Diabetes increases the risk of heart failure; more so in women than men

Jonathan KantrowitzatHealth News Report - 1 week ago

Researchers from The George Institute for Global Health determined that this differential was greater in type 1 than type 2 diabetes. Type 1 diabetes is associated with a 47% excess risk of heart failure in women compared to men, whilst type 2 diabetes has a 9% higher excess risk of heart failure for women than men. The findings published in *Diabetologia* (the journal of the European Association for the Study of Diabetes [EASD]) highlights the need for further sex-specific research into diabetes and how the condition can potentially contribute to heart complications. According to ...

Higher iron levels may boost heart health -- but also increase risk of stroke

Jonathan KantrowitzatHealth News Report - 1 week ago

Scientists have helped unravel the protective -- and potentially harmful -- effect of iron in the body. In a series of early-stage studies examining genetic data from over 500,000 people, a team of international scientists, led by Imperial College London, explored the role that iron plays in over 900 diseases. The results reveal not only are naturally higher iron levels associated with a lower risk of high cholesterol levels, they also reduce the risk of arteries becoming furred with a build-up of fatty substances. However the research, funded by the Wel... more »

Osteoarthritis linked to higher risk of dying from cardiovascular disease

Jonathan KantrowitzatHealth News Report - 1 week ago

Researchers at Lund University in Sweden have investigated the link between osteoarthritis and mortality in an epidemiological study. It was shown that the risk of dying from cardiovascular disease was higher for people with osteoarthritis than for the rest of the population. Using population registers, the researchers studied approximately 469 000 people living in Skåne, Sweden, who in 2003 were between 45 and 84 years old and followed them through to 2014. The group included 16 000 patients with knee arthritis, 9 000 with hip arthritis, 4 000 with wrist arthritis and 5 500 with ot... more »

Healthy lifestyle associated with lower risk of dementia regardless of genetic risk?

Jonathan KantrowitzatHealth News Report - 2 weeks ago

This observational study looked at whether a healthy lifestyle was associated with a lower risk of dementia regardless of genetic risk. Genetic factors are associated with increased risk of dementia but to what extent these might be offset by lifestyle factors is unknown. Genetic information from the UK Biobank was available for the 196,383 adults in this study who were of European ancestry, at least 60 years old and without dementia at the study baseline. Scores reflecting genetic risk and lifestyle were compiled based on genetic variants associated with Alzheimer disease and dem... more »

Study: New cars are safer, but women most likely to suffer injury

Jonathan KantrowitzatHealth News Report - 2 weeks ago

Cars built in the last decade have been shown to be safer than older models, including in the most common types of crashes - frontal collisions. However, a new study conducted by researchers at the University of Virginia's Center for Applied Biomechanics shows that women wearing seat belts are significantly more likely to suffer injury than their male counterparts. Belted female auto occupants have 73% greater odds of being seriously injured in frontal car crashes compared to belted males (after controlling for collision severity, occupant age, stature, body mass index and vehicle ... more »

Friday, July 26, 2019

Resistance training is imperative for older adults

For many older adults, resistance training may not be part of their daily routine, but a new position statement suggests it is vital to improving their health and longevity.
"When you poll people on if they want to live to 100 years old, few will respond with a 'yes'," says Maren Fragala, Ph.D., director of scientific affairs at Quest Diagnostics and lead author of the position statement.
"The reason mainly being that many people associate advanced age with physical and cognitive decline, loss of independence and poor quality of life," adds Mark Peterson, Ph.D., M.S., FACSM, an associate professor of physical medicine and rehabilitation at Michigan Medicine and one of the senior authors of the statement.
The position statement, published in theJournal of Strength and Conditioning Research, and supported by the National Strength and Conditioning Association, highlights the benefits of strength and resistance training in older adults for healthier aging.
Fragala explains that while aging does take a toll on the body, the statement provides evidence-based recommendations for successful resistance training, or exercise focused on building muscle endurance, programs for older adults.
"Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength and function," Fragala says. "Such losses decrease physiologic resilience and increase vulnerability to catastrophic events."
She adds, "The exciting part about this position statement is that it provides evidence-based recommendations for resistance training in older adults to promote health and functional benefits, while preventing and minimizing fears."
Practical applications
The position statement provides 11 practical applications divided into four main components: program design variables, physiological adaptations, functional benefits, and considerations for frailty, sarcopenia and other chronic conditions.
The applications include suggestions on training types and amounts of repetitions and intensities, patient groups that will need adaptations in training models, and how training programs can be adapted for older adults with disabilities or those residing in assisted living and skilled nursing facilities.
"Current research has demonstrated that resistance training is a powerful care model to combat loss of muscle strength and mass in the aging population," says Peterson, a member of the University of Michigan Institute for Healthcare Policy & Innovation and Michigan Center on the Demography of Aging.
"We demonstrate in this position statement just how much resistance training can positively affect physical functioning, mobility, independence, chronic disease management, psychological wellbeing, quality of life and healthy life expectancy. We also provide recommendations for how to optimize resistance training programs to ensure safety and effectiveness."
Fragala adds that the benefits of participating in resistance training as an older adult outweigh the risks.
"The coauthors of this paper and the hundreds of other prolific researchers whose work we synthesized in this position statement have found that in most cases, the vast benefits of resistance training largely outweigh the risks when training is properly implemented," Fragala says.
Empowering healthy aging
The authors are proud to have the support of the National Strength and Condition Association for the statement.
"Too few of older Americans participate in resistance training, largely because of fear, confusion and a lack of consensus to guide implementation," Peterson says. "By having this consensus statement supported by the National Strength and Condition Association, we hope it will have a positive impact on empowering healthier aging."

Thursday, July 25, 2019

Consuming more polyunsaturated fat (such as omega 3 and omega 6 fatty acids) in place of refined starch and sugars is associated with a lower risk of type 2 diabetes

As the number of people with type 2 diabetes soared to 8.8 percent of the population by 2017, a growing public health movement has sought to know if tailoring dietary recommendations to specific genetic profiles might help reduce the risk of the disease in susceptible individuals. A team of researchers from Massachusetts General Hospital (MGH) has now found that the quality of dietary fat consumed and the genetic risk of diabetes work independently of each other, and that a diet rich in polyunsaturated fats can be safely applied across the spectrum of type 2 diabetes genetic risk.
"Our meta-analysis shows on a scale never done before that there is no apparent need to be concerned about the genetic risk to inform sound dietary recommendations for individuals with type 2 diabetes," says Jordi Merino, RD, PhD, of the MGH Diabetes Unit and Center for Genomic Medicine, and corresponding author of the study published online in the BMJ. "This means that lifestyle or dietary interventions for the prevention of type 2 diabetes can be deployed across all gradients of genetic risk since genetic burden does not seem to impede their effectiveness."
Recommendations aimed at improving dietary quality have become an integral part of the worldwide public health effort to stem the rampant growth of diabetes. The MGH investigators found that irrespective of genetic risk, consuming more polyunsaturated fat (such as omega 3 and omega 6 fatty acids) in place of refined starch and sugars is associated with a lower risk of type 2 diabetes, while consuming more monounsaturated fat in place of carbohydrates is associated with a higher risk of the metabolic disease. In North America, monounsaturated fats typically derive from animal sources of food such as red meat, dairy and full-fat dairy products.
Merino emphasizes another important finding of the study that transcends the issue of dietary fat. "The positive association between polygenic scores and type 2 diabetes we reported acknowledges the fact that people at higher genetic risk could benefit from additional strategies that have nothing to do with dietary fat intake," he says.
The MGH study included more than 102,000 participants of European descent who were free from diabetes at baseline. These individuals were culled from 15 cohort studies and followed over 12 years. In finding no appreciable interaction between dietary components and diabetes type 2 risk-increasing genes, the analysis concurs with the national Diabetes Prevention Program which demonstrated that lifestyle modification is effective regardless of the genetic burden for type 2 diabetes. The MGH findings are also consistent with recent evidence around coronary artery disease, which has led to heart-healthy lifestyle and dietary regimens being promoted across the genetic landscape.
The picture is somewhat different with obesity, however, where increasing evidence has shown that unhealthy dietary or certain lifestyle patterns like sugar, sweetened drinks, fried foods and physical inactivity might interact with genetic susceptibility to elevate body mass index (BMI). Looking to explain the dichotomy, Merino says, "The metabolic complexity of type 2 diabetes and coronary heart disease may a

Wednesday, July 24, 2019

Using antibiotics without a prescription is a prevalent public health problem

When people take antibiotics without a prescription, they often take unnecessary medication or choose an inappropriate drug or dose. This practice is associated with avoidable adverse events and may also increase the risk for inducing antibiotic resistance. It is important to understand how prevalent nonprescription antibiotic use is and the factors that contribute to the issue.
Researchers from Baylor College of Medicine and the Center for Innovations in Quality, Effectiveness, and Safety reviewed 31 published studies to determine the prevalence of nonprescription antibiotic use in the U.S. and to examine the factors that influence that use. The prevalence of nonprescription antibiotic use varied from 1 percent among people visiting a clinic to 66 percent among Latino migrant workers. Storage of antibiotics for future use varied from 14 percent to 48 percent and a quarter of the people in one study reported intention to use antibiotics without a prescription.
Factors that contribute to nonprescription use include lack of insurance or health care access, cost of a physician visit or prescription, embarrassment about seeking care for a sexually transmitted infection, not being able to get time off of work to visit a clinic or physician's office, and several other reasons. According to the researchers, more studies are needed to quantitate nonprescription antibiotic use and explore potentially modifiable factors that contribute to unsafe practices.

Tuesday, July 23, 2019

Mediterranean diet during pregnancy reduces gestational diabetes and weight gain

A simple Mediterranean-style diet in pregnancy does not reduce the overall risk of adverse maternal and offspring complications, but has the potential to reduce weight gain in pregnancy and the risk of gestational diabetes, according to a clinical trial led by Queen Mary University of London and the University of Warwick.
The results, published in the journal PLOS Medicine and funded by Barts Charity, show that having a Mediterranean-style diet (including 30g of mixed nuts per day and extra virgin olive oil) led to a 35 per cent lower risk of developing diabetes in pregnancy, and on average 1.25 Kg less weight gain in pregnancy, compared to those who received routine antenatal care.
The study suggests a Mediterranean-style diet could be an effective intervention for women who enter pregnancy with pre-existing obesity, chronic hypertension or raised lipid levels.
Professor Shakila Thangaratinam from Queen Mary University of London said: "This is the first study to show that pregnant women at high risk of complications may benefit from a Mediterranean-style diet to reduce their weight gain and risk of gestational diabetes.
"Implementing this diet seems to be effective and acceptable to women. Current national dietary guidelines do not include the key components of the Mediterranean-style diet in their recommendations. Women who are at risk of gestational diabetes should be encouraged to take action early on in pregnancy, by consuming more nuts, olive oil, fruit and unrefined grains, while reducing their intake of animal fats and sugar."
Dr Bassel Wattar from the University of Warwick and Queen Mary University of London said: "Although a Mediterranean-style diet has been shown to reduce the risk of type 2 diabetes and cardiovascular complications in the general population, until now we did not know the effect of such a diet in high-risk pregnant women, and whether it could be culturally adapted for an ethnically diverse population.
"Now we know that pregnant women from an inner city, high-risk, multi-ethnic population are able to adapt their diet to a Mediterranean-style, and that this can bring them important benefits including a reduction in weight gain and a lower risk of developing gestational diabetes."
One in four mothers enter pregnancy with pre-existing obesity, chronic hypertension or raised lipid levels. These can lead to pregnancy complications, including gestational diabetes (when high blood sugar develops during pregnancy) and pre-eclampsia - the onset of high blood pressure in pregnancy which can sometimes develop into more serious conditions affecting multiple organs. These mothers and their babies are also at long-term risk of diabetes and cardiovascular complications.
A Mediterranean-style diet, rich in unsaturated fatty acids, reduces the incidence of cardiovascular diseases in the non-pregnant population. In pregnancy, such a diet has the potential to improve maternal and offspring outcomes, but has not been widely evaluated until now.
The ESTEEM study involved 1,252 women at five UK maternity units (four in London, including hospitals at Barts Health NHS Trust and St George's University Hospitals NHS Foundation Trust, and one in Birmingham).
Multi-ethnic inner-city pregnant women with metabolic risk factors, including obesity and chronic hypertension, were randomised to either receive routine antenatal care or a Mediterranean-style diet in addition to their antenatal care. The diet included a high intake of nuts, extra virgin olive oil, fruit, vegetables, non-refined grains and legumes; moderate to high consumption of fish, small-moderate intake of poultry and dairy products; and low intake of red meat and processed meat; and avoidance of sugary drinks, fast food, and food rich in animal fat.
Despite the improvements in gestational diabetes and pregnancy weight gain, there was no improvement in other important pregnancy complications such as high blood pressure, pre-eclampsia, stillbirth, small for gestational age foetus, or admission to a neonatal care unit.
The participants in the Mediterranean-style diet group reported better overall quality of life than those in the control group and reduced bloatedness in pregnancy, but there was no effect on other symptoms such as nausea, vomiting or indigestion.
When the data from the study was combined with published data from a Spanish study involving 874 pregnant women on a Mediterranean diet, the team observed a similarly large reduction in gestational diabetes (a 33 per cent reduction), but no effect on other outcomes.
Fiona Miller Smith, Chief Executive at Barts Charity said: "With the growing problems of diabetes and obesity in pregnant women, we're so proud to support this study which looks at preventing these risks. We're happy that our funding of the Barts Research Centre for Women's Health is being used to improve the health of East London mothers, and in turn helping future generations."
To promote their intake in pregnancy, participants on the Mediterranean-style diet were provided with complementary mixed nuts (30g/day of walnuts, hazelnuts, and almonds) and extra virgin olive oil (0?5 litre/week) as the main source of cooking fat. Participants also received individualised dietary advice at 18, 20 and 28 weeks' gestation.
The diet was made culturally sensitive by providing cooking advice through a bespoke recipe book (see Notes to Editors), which incorporated elements of the Mediterranean diet into the local cuisine, developed with local community teams.
The work was carried out at Barts Research Centre for Women's Health, based at Queen Mary University of London, funded by Barts Charity.
The study has limitations including its reliance on participant feedback for measuring adherence to the intervention, without use of objective biomarkers to measure nutritional intake. The team also only obtained information on dietary intake in about 40 per cent of participants in both groups, which limits the interpretation of dietary intake data.

Slower walking speed may predict future mobility problems

American Geriatrics Society

Being able to walk outside for several blocks at a leisurely pace plays an important role in living a vibrant, healthy life. Walking short distances allows you to get the physical activity you need, live independently, go shopping, access health care, and engage in a social life.
Being able to walk at even a slow speed is essential to all these benefits--but walking too slowly may foreshadow future problems that could prevent you from being fully mobile.
Until now, there has been no ideal way for healthcare providers to measure walking ability, since it involves more than just walking speed. It also is about how you deal with your environment (such as uneven pavement) and demands on your attention (such as traffic, other pedestrians, and street crossings).
In a new study, researchers assessed ways to measure complex walking tasks to learn more about early, subtle changes in walking. Their study was published in the Journal of the American Geriatrics Society.
In their study, the researchers examined whether performance on complex walking tasks involving both physical and mental challenges predicted a higher risk for an inability to walk one-quarter mile (roughly four blocks). The researchers suspected that these complex walking tasks would be more strongly tied to the risk for mobility problems than simple walking.
The researchers studied information from the Health Aging and Body Composition (Health ABC) study, which enrolled black and white adults in Pittsburgh and Memphis from 1997 to 1998. The participants were 70 to 79 years old when they entered the study, and they had no difficulty walking a quarter mile or climbing 10 steps without resting.
In the study, participants walked on several different paths and were given several different challenges to measure their walking speed and their ability to cope with mental and physical tasks at the same time. Researchers then followed up with participants every six months to see if they had any difficulty walking one-quarter mile due to a health or physical problem.
Participants reported any mobility problems or disabilities every year at in-person visits. By the end of the eight-year follow-up, more than half of the participants had developed mobility disability, meaning they were unable to walk one-quarter mile. Almost 40 percent had developed chronic mobility disability that lasted at least two years.
Participants who reported having mobility disability were more likely to be female, have diabetes, be obese, have knee pain, and experience breathing difficulty. They also had more symptoms of depression.
The researchers concluded that slow walking speed under both usual-pace and complex conditions was associated with greater risk for developing mobility disability over the next eight years.
They also concluded that measuring your simple walking speed in the healthcare provider's office may be enough for your provider to learn whether you might be at risk for future mobility problems.

###