Tuesday, February 18, 2020

Variety and consistency are essential to keep the mind healthy


For many adults, the mid-30's is a busy time. There's often career advancement, the start of a new family and associated responsibilities. It's also a critical time for how we diversify our days in order to stay up to speed. A new study from the University of South Florida (USF) finds a key piece to maintaining cognitive function throughout adulthood is to engage in diverse activities regularly.
Researchers focused on seven common daily activities: paid work, time with children, chores, leisure, physical activity, volunteering, and giving informal help. They reviewed two sets of data from 732 people ranging between the ages of 34 and 84 that was collected by the National Survey of Daily Experiences. Every day for eight consecutive days, each participant was asked if they partook in those activities and scored on an activity diversity score that captures both the breadth (variety) and evenness (consistency) of activity participation. The same group was queried ten years later. The study published in the Journal of Gerontology: Psychological Sciences found those who increased activity diversity over the decade exhibited higher levels of cognitive functioning than those who maintained lower or decreased activity diversity.
Their cognitive functioning was assessed using the Brief Test of Adult Cognition by Telephone (BTACT) battery, which measures multiple dimensions of cognition, including working memory span, verbal fluency, attention, speed of processing, reasoning and verbal memory. Previous studies have examined how activity variety and frequency impact cognition. This is the first study to prove activity consistency is also essential, regardless of age.
"Results support the adage to 'use it or lose it' and may inform future interventions targeting the promotion of active lifestyles to include a wide variety of activities for their participants," said Soomi Lee, PhD, assistant professor in the USF College of Behavioral and Community Sciences. "Findings suggest that active and engaged lifestyles with diverse and regular activities are essential for our cognitive health."
Daily engagement results in greater accumulation of intellectual and social repertoires. Life experiences, such as educational attainment or leisure activities, can help compensate for progressing Alzheimer's Disease. Conversely, a lack of activities or passive behavior, like binge watching TV, is associated with cognitive decline. While participants did keep their minds sharp, Lee says she did not find a correlation between activity diversity and episodic memory, which is known to decline with age. A previous study by Lee also shows that activity diversity is important for psychological well-being, especially for older adults. The current study shows that activity diversity matters for cognitive health across age groups and an active lifestyle is important for different domains of health.

Natural sugars in breastmilk contribute to to early childhood height and weight


Human milk oligosaccharides (HMOs) found in breastmilk may influence a child’s growth from infancy through early childhood, according to a study supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), part of the National Institutes of Health. The study also suggested that maternal obesity may affect HMO composition in breastmilk. The study was led by Lars Bode, Ph.D., at the University of California, San Diego. It appears in The American Journal of Clinical Nutrition.
HMOs are complex sugars found in breastmilk, but infants do not digest them directly. Instead, HMOs serve as prebiotics by influencing the composition of the gut microbiome. Previous studies have found that HMOs may also protect infants from disease-causing microbes. Approximately 150 types of HMOs are known, and mothers have unique combinations and concentrations of them in their breastmilk, influenced in part by genetics and the types of HMO-processing enzymes they have.
Researchers evaluated approximately 800 pairs of mothers and children in a Finnish study of child development. The researchers analyzed the content of HMOs in breastmilk samples (collected when the children were 3 months old), among them two HMOs that are now added to some commercial infant formulas: 2’-fucosyllactose (2’FL) and lacto-N-neo-tetraose (LNnT).
Breastmilk from mothers of taller and heavier infants and children tended to have less diverse HMO composition, higher concentrations of 2’FL and lower concentrations of LNnT. Breastmilk from overweight and obese mothers also tended to have less diverse HMO composition, higher concentrations of 2’FL and lower concentrations of LNnT.
According to the authors, these results confirm findings of two of their previous smaller studies. Together, the three studies found similar patterns of HMO composition and child growth among three different groups of mothers. The authors noted that, although their study linked HMO composition with early childhood growth, it couldn’t prove that variations in HMO patterns cause differences in children’s growth. If additional studies confirm their findings, specific HMOs might one day provide a treatment for early childhood growth problems and obesity. 

Friday, February 14, 2020

Cocoa could bring sweet relief to walking pain for people with peripheral artery disease


Circulation Research journal report
AMERICAN HEART ASSOCIATION
Consumption of cocoa may improve walking performance for patients with peripheral artery disease, according to the results of a small, preliminary, phase II research trial published today in the American Heart Association's journal Circulation Research.
In a small study of 44 peripheral artery disease patients over age 60, those who drank a beverage containing flavanol-rich cocoa three times a day for six months were able to walk up to 42.6 meters further in a 6-minute walking test, compared to those who drank the same number and type of beverages without cocoa. Those who drank the flavanol-rich cocoa also had improved blood flow to their calves and some improved muscle function compared to the placebo group.
Peripheral artery disease or PAD, a narrowing of the arteries that reduces blood flow from the heart to the legs, affects over 8.5 million people 40 years of age and older nationwide. The most common symptoms are pain, tightness, cramping, weakness or other discomfort in leg muscles in while walking.
"Few therapies are available for improving walking performance in people with PAD," said lead study author Mary McDermott, M.D., the Jeremiah Stamler professor of medicine and preventive medicine at the Feinberg School of Medicine at Northwestern University in Chicago. "In addition to reduced blood flow to the legs, people with peripheral artery disease have been shown to have damaged mitochondria in their calf muscles, perhaps caused by the reduced blood flow. Mitochondria are known as the powerhouse of the cell, converting food to energy. Previous research has shown that better mitochondrial health and activity are associated with better walking performance and improving the health of damaged mitochondria could lead to walking improvements."
Researchers hypothesized that epicatechin, a major flavanol component of cocoa, may increase mitochondrial activity and muscle health in the calves of patients with lower extremity peripheral artery disease, potentially improving patient walking ability. Epicatechins and flavanols also have the potential to improve blood flow.
Study participants were randomly assigned to drink milk or water mixed with the contents of a powder packet containing flavanol-rich cocoa (15 grams of cocoa and 75 mgs of epicatechin daily) or a placebo powder packet without cocoa or epicatechin three times daily over six months. Walking performance was measured at the beginning of the study and at six months, with a 6-minute walking measured test twice - 2.5 hours after drinking the beverage and at 24 hours after drinking the beverage. Participants were also given a treadmill walking test and had the blood flow to their legs measured using magnetic resonance imaging (MRI). Participants who consented had a calf muscle biopsy to evaluate muscle health.
The cocoa used in the study is commonly available natural unsweetened cocoa powder., which is rich in the flavanol epicatechin, found in larger quantities in dark chocolate (>85% cacao) than in milk chocolate. Regular chocolate would not be expected to have the same effect.
Researchers found that the patients who consumed cocoa showed significant improvement - walking an average of almost 43 meters further in the 6-minute walking test compared to their baseline results during the test performed at 2.5 hours after the final study beverage. Researchers also found increased mitochondrial activity, increased capillary density, and other improvements to muscle health in those who consumed the cocoa. Patients who drank the placebo beverage had a decline of 24.2 meters in their walking distance at 2.5 hours after the final study beverage compared to their baseline results. This is consistent with other studies, in which people with PAD without treatment have declines in their six-minute walk distance over time.
Cocoa appeared to have no effect on treadmill walking performance. However, McDermott said the treadmill walking and the 6-mile walking test are distinct measures of walking endurance and do not respond identically to the same therapy. The improvement in 6-minute distance walking better reflects the type of walking required in daily life, and therefore, these results are a more relevant outcome for patients with PAD.
"While we expected the improvements in walking, we were particularly pleased to see that cocoa treatment was also associated with increased capillary density, limb perfusion, mitochondrial activity, and an additional measure of overall skeletal muscle health," McDermott said. "If our results are confirmed in a larger trial, these findings suggest that cocoa, a relatively inexpensive, safe and accessible product, could potentially produce significant improvements in calf muscle health, blood flow, and walking performance for PAD patients."
Limits to this pilot study include: a small sample size; an imbalance between the two study groups in the number of participants of each sex, race and in body mass index; and a lack of data for overall dietary consumption.
"Patients with PAD have difficulty walking that is as bad as people with advanced heart failure. Leg muscles don't get enough blood supply in PAD leading to injury and in this study, cocoa appeared to be protecting the muscle and improving metabolism," said Naomi Hamburg, M.D., FAHA, Chair of the American Heart Association's Peripheral Vascular Disease Council and author of an editorial on the study that also appears in this issue. "We know that exercise therapy helps people with PAD walk farther, and this early study suggests that cocoa may turn out to be a new way to treat people with PAD. We will need larger studies to confirm whether cocoa is an effective treatment for PAD, but maybe, someday, if the research supports it, we may be able to write a prescription for chocolate for our patients with PAD."

Acetaminophen and forgiveness

Most everyone experiences the pain of social rejection at some point in their lives. It can be triggered by the end of a romantic relationship, losing a job or being excluded by friends.
The emotional distress that often accompanies these experiences is called social pain, and it may cause sadness, depression and loneliness, as well as actual physical pain, research has shown.
A study, published recently in the Annals of Behavioral Medicine may have found an antidote - forgiveness combined with acetaminophen, the active ingredient in Tylenol.
For the study, researchers followed a group of healthy adults for three weeks and randomly assigned them to receive daily doses of either 1,000 mg of acetaminophen, 400 mg of a placebo potassium pill, or no pill. They also measured their levels of forgiveness on a daily basis using a questionnaire. For example, participants were asked to rate how strongly they agree or disagree with statements, such as, "I hope this person gets what's coming to them for what he/she did to me."
George Slavich, PhD, director of the UCLA Laboratory for Stress Assessment and Research, a senior author on the study discussed the results.
What is the key takeaway from this study?
When combined with a tendency to forgive, taking acetaminophen substantially reduced how much social pain people felt over time. More specifically, participants taking acetaminophen who were high in forgiveness exhibited an 18.5% reduction in social pain over the 20-day study period.
What made researchers think that acetaminophen and forgiveness might ease the pain of rejection?
Research has shown that physical pain and social pain are influenced by some of the same biological processes in the brain and body. Based on this research, we thought that acetaminophen, which is commonly used to treat physical pain, might also be able to reduce social pain.
Based on the study's findings, what is it about acetaminophen and forgiveness that help alleviate social pain? Do they act synergistically?
We think they help reduce experiences of social pain in different ways. For example, acetaminophen likely reduces social pain by influencing pain signaling in the brain through its effects on specific brain pathways. On the other hand, forgiveness has been found to lessen peoples' feelings of stress and anger following experiences of social rejection and exclusion. Based on the findings from our study, it appears as though acetaminophen acts synergistically with peoples' ability to forgive to alleviate the feelings of social pain that are commonly associated with rejection and exclusion.
How does social pain affect people emotionally?
Experiencing a socially painful life event, like a relationship break-up, is one of the strongest predictors of developing depression in adolescence and adulthood. Social pain is also associated with decreased cognitive functioning and increased aggression and engagement in self-defeating behaviors, like excessive risk taking and procrastination.
Why does social rejection also cause physical pain?
We can only speculate about why social rejection causes physical pain, but one possibility is that physical pain alerts the person to the fact that an important social relationship has been threatened or lost. This may motivate the person to try to rekindle the relationship or form other relationships to help ensure continued safety and survival.
Are there further studies planned?
Looking forward, we hope to better understand the mechanisms underlying how acetaminophen and forgiveness alleviate social pain and, most importantly, how we can use this knowledge to enhance human health and wellbeing.

Thursday, February 13, 2020

Daily potato intake leads to better diet quality compared to refined grains


Potatoes are often equated with refined grains due to their carbohydrate content. Yet, potatoes contain fiber, resistant starch, and key micronutrients that Americans need more of in their diet. A randomized crossover study that included 50 generally healthy adults directly compared the nutrient quality and impact on cardiometabolic risk factors of non-fried potatoes to refined grains. The study was conducted by researchers at Penn State and was recently published in the British Journal of Nutrition. Its findings demonstrate that potatoes can support a healthy diet; daily intake of one serving of non-fried potato did not affect markers of glycemia and was associated with better diet quality compared to refined grains.
"Clinical studies are important to contextualize observational findings," say Penn State Researchers. "Some epidemiologic studies have suggested an association between potato intake and increased risk of cardiometabolic diseases. However, the context around how potatoes are eaten, such as their preparation method or other foods eaten alongside them, may be important factors in explaining why our clinical trial findings differ from those of observational studies."
Participants were randomly assigned to eat either a refined grain side dish (e.g., pasta, rice, white bread) or a steamed/baked potato side dish of equal calories each day with a main meal for four weeks. After a two-week break, the same individuals ate the opposite side dish with a main meal for another four weeks. Aside from being required to consume either a potato or refined grain side dish, no other dietary restrictions were placed on participants. Several markers of cardiometabolic risk were measured including plasma glucose, serum insulin, cholesterol and other blood lipids, blood pressure, and participants' reported diet quality.
While neither refined grains nor potatoes impacted cardiometabolic risk factors, participants' potassium and fiber intake, total vegetable and starchy vegetable intake and Healthy Index Score - a sign of how well people are following the Dietary Guidelines for Americans were higher when they ate potatoes, compared to refined grains.
"Americans eat too many refined carbohydrates and not enough whole grains or starchy vegetables, according to the 2015-2020 Dietary Guidelines for Americans. Our study findings suggest that eating 1 serving of non-fried potatoes in place of refined grains can help individuals meet more dietary recommendations."
The study had several strengths, such as the randomized crossover design and isocaloric dietary substitution. All dishes were prepared in a healthy way with limited added fat or sodium. However, the researchers noted a few limitations: the need for larger sample sizes, a longer intervention time and controlled dietary intake rather than self-reported diets. "It is important to replicate our findings in other groups, such as those at higher risk of cardiometabolic disease. These findings apply to the generally healthy population."

10,000 steps a day: Not a magical formula for preventing weight gain


Even far eclipsing 10K steps didn't prevent weight gain for college freshmen studied
BRIGHAM YOUNG UNIVERSITY
IMAGE
IMAGE: IMAGE OF A STEP-COUNTING WATCH ON A PERSON'S WRIST. view more 
CREDIT: BYU PHOTO
For years now, 10,000 steps a day has become the gold standard for people trying to improve their health -- and recent research shows some benefits can come from even just 7,500 steps. But if you're trying to prevent weight gain, a new Brigham Young University study suggests no number of steps alone will do the trick.
Researchers from BYU's Exercise Science Department, along with colleagues from the Nutrition, Dietetics & Food Science Department, studied 120 freshmen over their first six months of college as they participated in a step-counting experiment. Participants walked either 10,000, 12,500 or 15,000 steps a day, six days a week for 24 weeks, while researchers tracked their caloric intake and weight.
The goal of the study was to evaluate if progressively exceeding the recommended step count of 10,000 steps per day (in 25% increments) would minimize weight and fat gain in college freshmen students. In the end, it didn't matter if the students walked more than even 15,000 steps; they still gained weight. Students in the study gained on average about 1.5 kg (roughly 3.5 lbs.) over the study period; a 1 to 4 kg average weight gain is commonly observed during the first academic year of college, according to previous studies.
"Exercise alone is not always the most effective way to lose weight," said lead author Bruce Bailey, professor of exercise science at BYU. "If you track steps, it might have a benefit in increasing physical activity, but our study showed it won't translate into maintaining weight or preventing weight gain."
Study subjects wore pedometers 24 hours a day for the six-week study window. On average, students walked approximately 9,600 steps per day prior to the study. By the end of the study, the participants in the 10,000-step group averaged 11,066 steps, those in the 12,500-step group averaged 13,638 steps and those in the 15,000-step group averaged 14,557 steps a day.
Although weight was not affected by the increased steps, there was a positive impact on physical activity patterns, which "may have other emotional and health benefits," study authors said. One positive, if not unsurprising, outcome of the study was that sedentary time was drastically reduced in both the 12,500- and 15,000-step groups. In the 15,000-step group, sedentary time decreased by as much as 77 minutes a day.
"The biggest benefit of step recommendations is getting people out of a sedentary lifestyle," Bailey. "Even though it won't prevent weight gain on its own, more steps is always better for you."

Wednesday, February 12, 2020

Shingles vaccine may also reduce stroke risk


American Stroke Association International Stroke Conference - Poster Presentation TP493
AMERICAN HEART ASSOCIATION
DALLAS, Feb. 12, 2020 -- Shingles, a viral infection caused by the chickenpox virus, is linked to an increased risk of stroke. A new study found that Zoster Vaccine Live, one type of shingles vaccination, may prevent some older adults from having a stroke, according to preliminary research to be presented at the American Stroke Association's International Stroke Conference 2020 - Feb. 19-21 in Los Angeles, a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
More than 99% of people aged 40 or older in the United States carry the dormant chickenpox virus, also known as the varicella-zoster virus. Shingles is a reactivation of the chicken pox virus and typically occurs after age 50. The risk of developing shingles, a painful condition that causes skin blisters and can have serious complications, increases with age and other health conditions.
"One in three people who have had chickenpox develop shingles in their lifetime," said Quanhe Yang, Ph.D., lead study author and senior scientist at the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia. "The Zoster Vaccine Live helps to prevent shingles and reduces the risk for shingles by about 51%. But its effect declines with increased age, about 64% in people 60-69 years, about 41% for ages 70-79 years and about 18% in those 80 years or older."
To help determine if the shingles vaccine reduces the risk of stroke, Yang and colleagues reviewed the Medicare health records of more than one million Medicare fee-for-service beneficiaries age 66 or older who had no history of stroke and who were vaccinated with the Zoster Vaccine Live between 2008 and 2014, and followed them for an average of almost four years. That group was matched with the same number of Medicare fee-for-service beneficiaries who did not receive the shingles vaccine with the same four-year follow-up. To examine the effect of the vaccine on risk of stroke, researchers controlled for age, gender, race, medications and co-existing health conditions.
Researchers found:
  • Receiving the shingles vaccine lowered the risk of stroke by about 16%, lowered the risk of ischemic (clot-caused) stroke by about 18% and lowered the risk of hemorrhagic (bleeding) stroke by about 12%;
  • The vaccine's protection was strongest among people ages 66 to 79 years; and
  • Among those under the age of 80 years, the shingles vaccine reduced the risk of stroke by nearly 20% and in those older than 80, reduced the risk by about 10%.
"The reason for increased risk of stroke after a shingles infection may be due to inflammation caused by the virus," according to Yang.
"Approximately one million people in the United States get shingles each year, yet there is a vaccine to help prevent it," said Yang. "Our study results may encourage people ages 50 and older to follow the recommendation and get vaccinated against shingles. You are reducing the risk of shingles, and at the same time you may be reducing your risk of stroke."
This study was conducted when the only shingles vaccine was Zoster Vaccine Live (available since 2006). The newest shingles vaccine, Adjuvanted, Non-Live Recombinant Shingles Vaccine (available since 2017), confers even greater protection and is now the preferred vaccine recommended by the CDC's Advisory Committee on Immunization Practices. Two doses of Adjuvanted, Non-Live Recombinant Shingles Vaccine is more than 90% effective at preventing shingles and is recommended for adults age 50 and older.
Future studies are needed to confirm the link between Zoster Vaccine Live and stroke and to determine any association between Adjuvanted, Non-Live Recombinant Shingles Vaccine and risk for stroke.


Regularly golfing - at least once per month - was found to lower the risk of death among older adults, according to preliminary research to be presented at the American Stroke Association's International Stroke Conference 2020 - Feb. 19-21 in Los Angeles, a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.
Golf, a sport played by approximately 25 million Americans, can provide benefits such as stress reduction and regular exercise. Due to its social nature and controlled pace, people often maintain motivation and the ability to continue playing the sport even in older age and after suffering heart attack or stroke.
"Our study is perhaps the first of its kind to evaluate the long-term health benefits of golf, particularly one of the most popular sports among older people in many countries," said Adnan Qureshi, M.D., lead author and executive director of the Zeenat Qureshi Stroke Institutes and professor of neurology at the University of Missouri in Columbia, Missouri. "The U.S. Department of Health and Human Services Physical Activity Guidelines for Americans does not yet include golf in the list of recommended physical activities. Therefore, we are hopeful our research findings could help to expand the options for adults to include golf."
Researchers analyzed data from the Cardiovascular Health Study, a population-based observational study of risk factors for heart disease and stroke in adults 65 and older. Starting in 1989 and continuing through 1999, participants had extensive annual clinical exams and clinic visits every six months for the 10-year period. Once clinic visits ended, patients were contacted by phone to determine any occurrences of heart attack and stroke events. Patients who played golf at least once a month were considered regular golfers.
Out of almost 5,900 participants, average age 72, researchers identified 384 golfers (41.9% men). During follow-up, 8.1% of the golfers had suffered strokes and 9.8% of the golfers had heart attacks. When comparing death rates among golfers and non-golfers, researchers found a significantly lower rate of death among golfers compared to non-golfers, 15.1% compared to 24.6%, respectively.
"While walking and low intensity jogging may be comparable exercise, they lack the competitive excitement of golf," Qureshi said. "Regular exercise, exposure to a less polluted environment and social interactions provided by golf are all positive for health. Another positive is that older adults can continue to play golf, unlike other more strenuous sports such as football, boxing and tennis. Additional positive aspects are stress relief and relaxation, which golf appears better suited for than other sports."
While researchers were unable to determine if golfing had a direct impact on lowering the risk of heart attack or stroke, they are currently performing additional analyses to identify what other health conditions may benefit from regularly playing golf. They also did not specify whether the golfers walked or rode in a golf cart. Researchers are currently performing additional analyses to determine whether gender and race of golfers has any effect on their findings.

Prolonged use of hormone therapy may minimize muscle loss associated with aging



Skeletal muscle mass and strength are critical in helping prevent falls, fractures, and disability. Yet, they continue to decline during the menopause transition. A new study showed that the prolonged use (defined as ≥13 mo) of hormone therapy (HT) was associated with higher muscle mass and less chance of sarcopenia. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
Sarcopenia is defined as a loss of skeletal muscle mass and strength that mostly affects older people. In addition to increasing the risk of falls and fractures, it can also increase the risk of diabetes and cardiovascular disease. Although sarcopenia is highly prevalent in postmenopausal women, there is no definitive evidence supporting its link with the decline in estrogen during the menopause transition. Multiple small-scale studies have been conducted to assess the association between HT use and muscle mass, but their results have been inconsistent.
This new study, which included more than 4,200 postmenopausal women, is one of the few large-scale studies known to assess the link between use of HT and muscle loss in postmenopausal women. More specifically, it focused on the duration of HT use and its effect on muscle mass and the prevalence of sarcopenia.
On the basis of study results, which appear in the article "The association between hormone therapy and sarcopenia in postmenopausal women: the Korea National Health and Nutrition Examination Survey, 2008-2011," the researchers concluded that prolonged use of HT is associated with higher muscle mass and a lower prevalence of sarcopenia in postmenopausal women.
"Although not all studies examining an association between hormone therapy and muscle mass have shown positive results, this large cross-sectional study demonstrated a relationship between extended use of hormone therapy and both greater muscle mass and lower risk of sarcopenia in women aged younger than 65 years and with a body mass index less than 25 kg/m2," says Dr. Stephanie Faubion, NAMS medical director. "The mechanism by which estrogen protects muscle mass remains unclear, and additional study is needed."

Thyroid cancer, cell phones linked


Radiation from cell phones is associated with higher rates of thyroid cancer among people with genetic variations in specific genes, a new study led by the Yale School of Public Health finds.
The researchers examined over 900 people in Connecticut and found that those with certain single nucleotide polymorphisms (genetic variations commonly referred to as SNPs and pronounced as "snips") were significantly more likely to develop cancer in their thyroid, a gland in the throat that controls metabolism.
Cell phone users with SNPs in four of the genes studied were more than two times likely to develop cancer. The researchers examined a total of 176 genes and identified 10 SNPs that appear to increase the risk of thyroid cancer among cell phone users.
Published in the journal Environmental Research, the study is believed to be the first to examine the combined influence of genetic susceptibility and cell phone use in relation to thyroid cancer.
"Our study provides evidence that genetic susceptibility influences the relationship between cell phone use and thyroid cancer," said Yawei Zhang, M.D., Ph.D., a professor in the Department of Environmental Health Sciences at the Yale School of Public Health. "More studies are needed to identify populations who are susceptible to radiofrequency radiation (RFR) and understand exposure to RFR by different using patterns of cell phones."
The findings suggest that genetic susceptibilities play an important role in cell phone use and the risk of developing thyroid cancer and could help to identify subgroups who are potentially at risk. Further research is needed to confirm the findings and to better understand the interaction between cell phone radiation and SNPs within specific genes.
The rates of thyroid cancer have been steadily increasing in the United States and in many other parts of the world, Zhang said.
According to the American Cancer Society's most recent report, there were nearly 53,000 new cases of thyroid cancer in the United States, resulting in 2,180 deaths. Thyroid cancer is three times more common in women and is diagnosed at a younger age than most other cancers.
Zhang noted that the study relied on data collected from 2010 to 2011 when smartphones were first being introduced to the market. At the time, only a small proportion of people had smart phones. Therefore, if cell phone use increased the risk of thyroid cancer, it was possibly due to the use of earlier generation cell phones that were more commonly used when the data was collected.
Additionally, the transition to smartphones has also seen a major change in how cell phones are used (e.g., texting vs. phone calls). As a result, findings from this current study warrant a further evaluation in future studies, she said.

Diet makes a difference in fight against hospital-acquired infection


New UNLV research shows promise for role of a high-carb, low-protein, and low-fat diet in fighting off C. diff infections

Popular diets low in carbs and high in fat and protein might be good for the waistline, but a new UNLV study shows that just the opposite may help to alleviate the hospital-acquired infection Clostridioides difficile.
In a study published in mSystems, an open access journal of the American Society for Microbiology, UNLV scientists found that an interaction between antibiotic use and a high-fat/high-protein diet exacerbate C. diff infections in mice. Conversely, they found that a high-carbohydrate diet - which was correspondingly low in fat and protein - nearly eliminated symptoms.
C. diff, an intestinal infection designated as an urgent threat by the U.S. Centers for Disease Control and Prevention, is often acquired when antibiotics have wiped out the "good" bacteria in the gut. Hundreds of thousands of people are diagnosed with C. diff infections each year and more than 10,000 die.
"Every day, we are learning more about the human microbiome and its importance in human health," said Brian Hedlund, a UNLV microbiologist and study co-author. "The gut microbiome is strongly affected by diet, but the C. diff research community hasn't come to a consensus yet on the effects of diet on its risk or severity. Our study helps address this by testing several diets with very different macronutrient content. That is, the balance of dietary carbohydrate, protein, and fat were very different." 
Though studies suggest dietary protein exacerbates C. diff, there's little or no existing research exploring the interaction of a high-fat/high-protein diet with the infection. Hedlund and study co-author Ernesto Abel-Santos, a UNLV biochemist, caution that the study was conducted using an animal model, and more work is underway to begin to establish a link between these diets and infections in people.
"Extreme diets are becoming very popular but we do not know the long-term effects on human health and specifically on the health of the human gut flora," Abel-Santos said. "We have to look at humans to see if it correlates."
Recent studies suggest that because antibiotics kill bacterial species indiscriminately, the medications decimate populations of organisms that compete for amino acids, leaving C. diff free to propagate.
But Hedlund said the story is even more complex. "It's clear that it's not just a numbers game," he said. The new work suggests that diet may promote microbial groups that can be protective, even after antibiotics. For an infection to flourish, he said, "you might need this combination of wiping out C. diff competitors with antibiotics and then a diet that promotes overgrowth and disease."
The new study raised other questions as well. For example: The high-carb diet, which was protective against C. diff infection, gave rise to the least diverse community of microbes.
"Lots of papers say that a lower microbial diversity is always a bad thing, but in this case, it had the best disease outcome," said Abel-Santos. However, he cautions that a high-carb diet could lead to animals becoming asymptomatic carriers that can disseminate the infection to susceptible subjects.

Component of human breast milk enhances cognitive development in babies


Maternal factors, such as breast milk, have been shown to affect a baby's development, and previous animal studies have determined that a carbohydrate, the oligosaccharide 2'FL found in maternal milk, positively influences neurodevelopment. Now, in the first study done in humans, investigators at Children's Hospital Los Angeles in collaboration with the University of California, San Diego, have shown that 2'FL found in breast milk enhances cognitive development. Findings will be published in PLOS ONE on Feb 12.
In this cohort study of 50 mothers and their babies, investigators analyzed breast milk composition and frequency of feeding at 1 and 6 months of age. Cognitive development was measured at 24 months using the Bayley-III scale, a standardized test of infant and toddler development. The study showed that the amount of 2'FL in breast milk in the first month of feeding was related to significantly higher cognitive development scores in babies by 2 years of age. The amount of 2'FL in breast milk at 6 months of feeding was not related to cognitive outcomes, indicating that early exposure may be more beneficial.
Many studies have reported a positive effect of breastfeeding on cognitive development. "We wanted to specifically identify what was causing this effect," said Michael Goran, PhD, Director of the Diabetes and Obesity Program at The Saban Research Institute of Children's Hospital Los Angeles and senior author on the study.
"Through our high-throughput analytical platform we can quantify oligosaccharides like 2'FL and many others in hundreds of breast milk samples in a short period of time," says study collaborator and co-author Lars Bode, PhD, Professor of Pediatrics and Director of the Mother-Milk-Infant Center of Research Excellence at the University of California, San Diego. "This technology allows us to associate differences in milk composition with specific infant outcomes like cognitive development, validating existing data from preclinical models or generating entirely new hypotheses," Bode adds.
Using a statistical technique called mediation analysis, the investigators were able to independently evaluate the effects of breastfeeding in general, and the effects of the oligosaccharide 2'FL.
"This enhanced cognitive development in the first 2 years of life raises the question of possible long term impact on a child¬-in school and beyond," said Paige Berger, PhD, RD, a postdoctoral research associate at CHLA and the first author of the study.
These observations allowed the team to conclude that the increased neurodevelopment provided by breastfeeding was due primarily to mothers who were producing more 2'FL for the baby to consume.
"We know that there are many different compounds in breast milk and the composition is dynamic - it changes over time and is highly variable between mothers," Dr. Goran said. "In addition to identifying the impact of oligosaccharide 2'FL, we also wanted to determine the timing of when it is most critical to a child's development."
While the investigators observed neuroenhancement explained by higher 2'FL during the first month of a baby's life, this effect was not observed when looking at 2'FL content of breast milk at the six-month time-point. Being able to identify factors critical to early neurodevelopment offers the possibility for supplementing women's breast milk in individuals who produce lower quantities of this important substance.
"For some women, breastfeeding is a challenge. For those that are not able to breastfeed or can only do so short-term, 2'FL could potentially be offered as an add-on to the nutrition their baby is receiving to better support cognitive development," said Dr. Berger.

Tuesday, February 11, 2020

Statins: Researchers uncover how cholesterol-lowering drugs cause muscle pain


SAARLAND UNIVERSITY
IMAGE
IMAGE: LEFT: MICROSCOPE IMAGE OF CULTIVATED NORMAL MUSCLE CELLS: THE STRUCTURES STAINED IN GREEN SHOW THAT MUSCLE FIBRES HAVE DIFFERENTIATED FROM PRECURSOR CELLS; THE CELL NUCLEI ARE SHOWN IN BLUE. CENTRE: CULTIVATED... view more 
CREDIT: MICROSCOPE IMAGING: JENNY VANESSA VALBUENA PEREZ
Patients who take statins in order to lower their blood cholesterol levels often complain about muscle problems, typically muscle pain. But why this occurs is still largely unresolved. In a recent study, the pharmaceutical scientists Professor Alexandra K. Kiemer und Jessica Hoppst├Ądter from Saarland University have identified a potential causal relationship. According to the results of their work, statins cause enhanced production of a protein called 'GILZ' that impairs muscle cell function.
The study has been published in The FASEB Journal under the title 'The Glucocorticoid-Induced Leucine Zipper Mediates Statin-Induced Muscle Damage', DOI: 10.1096/fj.201902557RRR
Cholesterol-lowering drugs, which are commonly referred to as statins, are some of the most frequently prescribed drugs around the world. Generally speaking, statins are well tolerated by patients. However, it is not uncommon for patients on statins to complain of muscle pain or muscle weakness. 'According to figures from observational studies, muscle problems have been found to occur in 5% to 29% of cases. Older patients and female patients appear to be at greater risk of developing these symptoms, but so too are patients that are very physically active,' explains Alexandra K. Kiemer, Professor of Pharmaceutical Biology at Saarland University. In 2018, more than 6 million patients in Germany were treated with statins. This would suggest that muscle problems may be affecting several hundreds of thousands of patients, potentially as many as 1.8 million, in Germany alone. The precise nature of the bodily processes that induce symptoms of muscle impairment has not yet been fully characterized.
Alexandra K. Kiemer and her research group may now have identified the actual cause of the muscle pain affecting patients receiving statins. They believe that a protein known as GILZ is responsible. 'The acronym GILZ stands for glucocorticoid-induced leucine zipper,' explains Professor Kiemer. Over the years, her research group has conducted numerous experimental studies into this particular protein. 'The main function of GILZ is actually to suppress inflammatory processes in the body. Statins prevent cardiovascular disease not only by lowering blood cholesterol levels, but also by reducing vascular inflammation. That's why we thought there might be a connection between statins and GILZ. Our data indicate that the presence of GILZ in the body can have both positive and negative effects,' says Kiemer. Building on this initial conjecture that there might be a link between the protein GILZ and statins and their side effects, the pharmaceutical researchers began analysing numerous datasets drawn from research databases available around the world.
They assessed the data in terms of whether statins influenced the production of GILZ in the body. After confirming their original suspicions, the researchers were able to corroborate their hypothesis by carrying out a series of experiments on living cells. 'Statins cause an increase in the cellular production of the GILZ protein. This, however, leads to impaired muscle function, because increased GILZ production results in an increased rate of muscle cell death. In addition, the formation of muscle fibres is inhibited,' says Alexandra K. Kiemer. The research team then tried switching off the GILZ protein in living cells and observing what effect the statins then had. 'When we look at what happens when statins are administered to muscle cells or entire muscle fibres in which GILZ has been genetically deactivated, the damage that was previously observed is now almost completely absent,' says Kiemer.
There also seem to be indications that people who engage in a significant amount of physical activity suffer from muscle problems when prescribed statins. Furthermore, the statins appear to impair the success of physical training programmes. The pharmaceutical researchers led by Alexandra K. Kiemer are therefore planning a new study to be conducted in collaboration with the sports medicine physician Anne Hecksteden from the research group headed by Professor Tim Meyer at Saarland University. 'We have some evidence that there is a link between statins, physical activity and the GILZ protein, and our plan is to shed more light on how these factors interact with each other,' says Professor Kiemer.

Statin use alone or with metformin is associated with lower prostate cancer mortality from all causes, among high-risk patients


Among high-risk prostate cancer patients - those with high PSA and Gleason scores of 8 or more - many will develop a difficult-to-treat disease. Preliminary research suggests that two commonly prescribed medications, cholesterol-lowering statins and the diabetes therapy metformin may have anticancer effects. However, it is unclear which of these two medications - commonly prescribed together -- contributes the most and whether they can impact high-risk prostate cancer. New research shows that statins, alone or with metformin, increase survival in men with high-risk prostate cancer.
"Both metformin and statins have been associated with longer life in prostate cancer patients, yet because they are commonly prescribed together, no study we know of has looked at these two medications separately," says senior author Grace Lu-Yao, PhD, associate director of Population Science at the Sidney Kimmel Cancer Center--Jefferson Health, one of only eight NCI-designated cancer centers nationwide with a prostate cancer program of excellence.
The study, published in Cancer Medicine on Feb 8th, looked at a number of statin therapies, and metformin, an anti-diabetic medication, in high-risk prostate cancer populations.
Using data from the Surveillance, Epidemiology and End Results (SEER-18) database linked with Medicare files, Dr. Lu-Yao and colleagues looked at patients diagnosed with cancer from 2007 through to 2011. Based on 12,700 patients, the researchers observed that statins alone or in combination with metformin was significantly associated with reduced mortality from all causes.
Dr. Lu-Yao and colleagues saw the highest median survival of 3.9 months in men who took both metformin and statins, 3.6 with statins alone and 3.1 years with metformin alone. The median survival for those who did not use either drug was also 3.1 years.
"With respect to prostate mortality, metformin plus statin was associated with a 36% reduction in risk of death followed by statins alone," says Dr. Lu-Yao. "Those taking metformin alone were relatively rare, and there was no significant association with all-cause mortality."
Interestingly, the study revealed that men who took atorvastatin, pravastatin, or rosuvastatin - but not lovastatin - demonstrated a reduction in mortality compared with non-users, which is consistent with the findings from a recent population-based cohort study using Taiwan National Health Insurance Research Data. The Taiwanese research showed that these three statins are more effective at lowering triglycerides and low-density lipoprotein cholesterol and raising high-density lipoprotein cholesterol than other statins in patients with hypercholesterolemia.
Of the three statins studied, men on atorvastatin did have a longer median time to progression on androgen deprivation therapy compared to those who weren't treated with statins. "Although the exact mechanisms remain unknown, it is worth noting that atorvastatin exhibits a potent lipid-lowering effect per dose of any statin, and has the greatest bioavailability and one of the longest half-lives," says to Dr. Lu-Yao.
The data presented in the current study provide crucial insight for the design of future randomized clinical trials of statin for high-risk patients with prostate cancer. Based on the existing evidence, a well-designed clinical trial is warranted to investigate the roles of statins and combination statins/metformin to reduce the mortality cancer of the prostate.
"Our study showed that the effects were more pronounced in patients taking statins after the diagnosis of prostate cancer, 54% reduction in PCA mortality among patients with high-risk prostate cancer," says Lu-Yao. "This magnitude of reduction is comparable to the results of men treated with androgen signaling inhibitors." Statins are relatively inexpensive with good safety records. Further studies to understand the mechanisms of the observed association and its potential clinical utility are warranted.

Wednesday, February 5, 2020

Healthy habits still vital after starting blood pressure, cholesterol medications


Research Highlights:
  • Heart-healthy lifestyle habits are always recommended whether blood pressure or cholesterol medications are prescribed or not, yet many patients let healthy habits slip after starting the prescription drugs.
  • In a Finnish study, people who started blood pressure or cholesterol medications were more likely to gain weight and exercise less compared to those who didn't take these medications.
Heart-healthy lifestyle modifications are always recommended whether blood pressure or cholesterol medications are prescribed or not. However, a new study found that many patients let these healthy habits slip after starting the prescription medications, according to new research published today in the Journal of the American Heart Association, the open access journal of the American Heart Association.
Finnish researchers found patients at risk for heart disease and stroke who took cholesterol or blood pressure lowering medications were more likely to reduce their activity levels and gain weight.
"Medication shouldn't be viewed as a free-pass to continue or start an unhealthy lifestyle. Our research sought to determine if people who started medications were making the lifestyle changes necessary to see health benefits," said Maarit J. Korhonen, Ph.D., lead author of the study and senior researcher at the University of Turku in Finland.
Researchers studied more than 40,000 public-sector workers (average age 52, more than 80% female) in Finland who had not been previously diagnosed with heart disease or stroke. Participants were given two or more surveys in 4-year intervals from 2000?2013. The surveys included a baseline and follow up questionnaire to assess BMI, physical activity, alcohol consumption and smoking history. Pharmacy data of participants was also obtained to determine if they began taking the prescribed high blood pressure or statin medications.
Participants' medication use was categorized by those who began the preventive medications between the baseline and 4-year follow-up surveys, and those who did not start medications. The researchers found that compared to those who did not start medications, those who did:
  • Were more likely to reduce their physical activity and were 8% more likely to become physically inactive;
  • Were 82% more likely to become obese or have an increase in body mass index;
  • Were 26% more likely to quit smoking; and
  • Reduced their alcohol consumption.
While people often gain weight when they stop smoking, this did not explain the BMI increase found in the study. Participants who took their medications and stopped smoking gained more weight than those who didn't take medications and stopped smoking.
"People starting on medications should be encouraged to continue or start managing their weight, be physically active, manage alcohol consumption and quit smoking," Korhonen said.
The analysis was limited by the lack of additional details about the respondents' diets, blood pressure measurements and cholesterol levels. This study was in Finland, where a large public health effort aimed at preventing and managing diabetes was initiated during the study period and may not be generalizable to people in countries without comparable programs and resources. In addition, participants in this study were white and predominantly female public-sector workers, therefore, the results may not be generalizable to more diverse populations.

Pain medication tramadol was linked with a higher risk of hip fractures


Use of the pain medication tramadol was linked with a higher risk of hip fractures compared with the use of other pain medications in an analysis of a patient database.

The analysis, which is published in the Journal of Bone and Mineral Research, compared tramadol use with codeine, naproxen, ibuprofen, celecoxib, and etoricoxib use among adults aged 50 years or older.

During one-year follow-up, 518 hip fractures occurred among 146,956 patients taking tramadol, corresponding to approximately one additional new hip fracture per 1000 person-years relative to taking codeine (3.7 vs. 2.9, respectively). Likewise, up to 1.5 additional new fractures per 1000 person-years occurred with tramadol than with naproxen, ibuprofen, celecoxib, and etoricoxib.

"Considering the significant impact of hip fracture on morbidity, mortality, and healthcare costs, our results point to the need to consider tramadol's associated risk of fracture in clinical practice and treatment guidelines," said corresponding author Guanghua Lei, MD, PhD, of Xiangya Hospital, Central South University.

The benefits of physical activity for older adults



Physically active older adults benefit from reduced risks of early death, breast and prostate cancer, fractures, recurrent falls, functional limitations, cognitive decline, dementia, Alzheimer's disease, and depression. The findings come from a review of all published reviews of studies that assessed the relationship between physical activity and health in adults aged 60 years or older.

The review, which is published in the Scandinavian Journal of Medicine & Science in Sports, also found that physically active older adults experience healthier ageing trajectories, better quality of life, and improved cognitive functioning.

"This research highlights the benefits of physical activity to our physical and mental health in older age. For some time, we have known of the benefits of physical activity for our physical health; however, what is important about this research is that it highlights compelling emerging evidence of the positive effects of being physically active on our mental health--including depression, cognition, and dementia and Alzheimer's disease," said lead author Conor Cunningham, PhD, of the Institute of Public Health in Ireland.