Eating a vegetarian diet rich in nuts, vegetables, soy linked to lower stroke risk

People who eat a vegetarian diet rich in nuts, vegetables and soy may have a lower risk of stroke than people who eat a diet that includes meat and fish, according to a study published in the February 26, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"Stroke is the second most common cause of death worldwide and a leading cause of disability," said study author Chin-Lon Lin, M.D., of Tzu Chi University in Hualien, Taiwan. "Stroke can also contribute to dementia. If we could reduce the number of strokes by people making changes to their diets, that would have a major impact on overall public health."

The study involved two groups of people from Buddhist communities in Taiwan where a vegetarian diet is encouraged, and smoking and drinking alcohol are discouraged. Approximately 30% of participants in both groups were vegetarians. Of the vegetarians, 25% were men. Researchers defined vegetarians as people who did not eat any meat or fish.

At the start of the study, the average age of all participants was 50 and none had experienced stroke. The first group of 5,050 people was followed for an average of six years. The second group of 8,302 people was followed for an average of nine years. Participants were given medical exams at the start of the study and asked about their diet.

Vegetarians ate more nuts, vegetables and soy than non-vegetarians and consumed less dairy. Both groups consumed the same amount of eggs and fruit. Vegetarians ate more fiber and plant protein. They also ate less animal protein and fat.

Researchers then looked at a national database to determine the numbers of strokes participants had during the course of the study.

In the first group of 5,050 people, there were 54 strokes. For ischemic strokes, which are strokes when blood flow to part of the brain is blocked, there were three strokes among 1,424 vegetarians, or 0.21%, compared to 28 strokes among 3,626 non-vegetarians, or 0.77%. After adjusting for age, sex, smoking and health conditions like high blood pressure and diabetes, researchers found vegetarians in this group had a 74% lower risk of ischemic stroke than non-vegetarians.

In the second group of 8,302 people, there were 121 strokes. For both ischemic and hemorrhagic strokes, also called bleeding strokes, there were 24 strokes among 2,719 vegetarians, or 0.88%, compared to 97 strokes among 5,583 non-vegetarians, or 1.73%. After adjusting for other factors, researchers found vegetarians in this group had a 48% lower risk of overall stroke than non-vegetarians, a 60% lower risk of ischemic stroke and a 65% lower risk of hemorrhagic stroke.

"Overall, our study found that a vegetarian diet was beneficial and reduced the risk of ischemic stroke even after adjusting for known risk factors like blood pressure, blood glucose levels and fats in the blood," said Lin. "This could mean that perhaps there is some other protective mechanism that may protecting those who eat a vegetarian diet from stroke."

One limitation of the study was that the diet of participants was only assessed at the start of the study, so it is not known if participants' diets changed over time. Another limitation was that study participants did not drink or smoke, so results may not reflect the general population. Also, results from the study population in Taiwan may not be generalizable worldwide. Finally, there could be other factors, not accounted for, that might affect stroke risk.

Kids eat more calories in post-game snacks than they burn during the game

IMAGE: A YOUNG SOCCER PLAYER RUNS AFTER THE BALL IN A CITY LEAGUE GAME. view more 

CREDIT: NATE EDWARDS/BYU PHOTO

Almost every parent knows the drill: When it's your turn, you bring Capri Suns and Rice Krispies Treats to your child's soccer game as a post-game snack. Whether you're a parent that loves the tradition or despises it, new research shows just how detrimental post-game treats are to a child's health.

A new study led by Brigham Young University public health researchers finds the number of calories kids consume from post-game snacks far exceeds the number of calories they actually burn playing in the game.

"Kids are getting inundated with snack culture all the time -- celebrations at school, at birthday parties and youth sports games," said senior study author and BYU professor Lori Spruance. "We don't need to load children up with sugar after a game too."

For the study, Spruance and her students observed 3rd and 4th graders over 189 games of soccer, flag football, baseball and softball, tracking both their physical activity and the treats they consumed. They found parents brought post-game snacks 80% of the time, with almost 90% of the post-game drinks being sugar sweetened. Physical activity was tracked using the SOFIT method, wherein a child's activity was tracked on a scale of 1 to 5 (1 = nothing; 5 = running) every 10 seconds.

The researchers found the average energy expenditure for children observed was 170 calories per game while the average caloric intake from post-game snacks was 213 calories. The average amount of sugar consumed post game was a staggering 26.4 grams -- the total daily recommendation for kids is just 25 grams -- with sugary drinks being the biggest culprits. (Capri Sun drinks and Kool-Aid Jammers were the most common drinks and baked goods were the most common snacks.)

The study, publishing in the American Journal of Health Behavior, also found children averaged just 27 minutes of activity per game, with soccer players being the most active and softball players being the least active. Research shows children should have 60 minutes of physical activity per day starting around age 5.

Study authors said the 43 extra calories the children are gaining may not sound like much, but if kids are playing a game or two a week, it could mean thousands of extra sugary calories a year.

"So many kids are at games just to get their treat afterwards, which really isn't helping to develop healthy habits long term," Spruance said. "The reward should be, 'I got to have fun, I got to run around with my friend or score a goal.'"

How to change snack culture

Spruance and coauthors said youth sports programs would benefit from an intervention aimed at the food environment -- and they're happy to help with that intervention. To that end, the team is already working on their next study by providing fact sheets about the troubles with current post-game snacks to municipal Parks and Recreation departments. Those departments are then, in turn, sharing the information with parents.

Initial efforts in one city have already shown marked decreases in the number of unhealthy snacks being provided at youth games: 16% of snacks in a new season of tracking included water instead of a sugary beverage, and parents who brought fruits and vegetables increased from 3% to 15% overall.

"Little changes can make a big difference in promoting healthy body weights in our children," wrote study co-author Jay Maddock, a professor of public health at Texas A&M University. "So when your children are playing sports, we recommend making the healthy choice an choosing water, fruits an vegetables and a healthy protein source too, like nuts."

A daily fast between the evening meal and breakfast will optimize weight management

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CAPTION

(D and E) Cumulative oxidation rates over the 24-h cycle derived from the curves in panels A and B and the experimental data of Fig 3. Panel D shows cumulative CO, while panel E shows cumulative LO. The horizontal dashed lines indicate the daily total intake of carbohydrates (D) and lipids (E) for comparison with the cumulative respective oxidations. (F) Approximate net relative daily storage of carbohydrates and lipids inferred from the data of Fig 3 and the analyses depicted in the other panels of this figure (arbitrary units). Positive values indicate the extent of substrate accumulation/storage, and negative values indicate the extent of substrate oxidation ("burning"). CO, carbohydrate oxidation; LO, lipid oxidation.

CREDIT

Kelly et al, 2020

he balance between weight gain and weight gain loss is predominantly determined by what you eat, how much you eat, and by how much exercise you get. But another important factor is often neglected... Published February 27 in the open-access journal PLOS Biology, research conducted by Kevin Kelly, Owen McGuinness, Carl Johnson and colleagues of Vanderbilt University, USA shows that it's not just how many calories you eat, but WHEN you eat them that will determine how well you burn those calories.

Your daily biological clock and sleep regulate how the food you eat is metabolized; thus the choice of burning fats or carbohydrates changes depending on the time of day or night. Your body's circadian rhythm has programmed your body to burn fat when you sleep, so when you skip breakfast and then snack at night you delay burning the fat.

The researchers monitored the metabolism of mid-aged and older subjects in a whole-room respiratory chamber over two separate 56-hour sessions, using a "random crossover" experimental design. In each session, lunch and dinner were presented at the same times (12:30 and 17:45, respectively), but the timing of the third meal differed between the two halves of the study. Thus in one of the 56-hour bouts, the additional daily meal was presented as breakfast (8:00) whereas in the other session, a nutritionally equivalent meal was presented to the same subjects as a late-evening snack (22:00). The duration of the overnight fast was the same for both sessions.

Whereas the two sessions did not differ in the amount or type of food eaten or in the subjects' activity levels, the daily timing of nutrient availability, coupled with clock/sleep control of metabolism, flipped a switch in the subjects' fat/carbohydrate preference such that the late-evening snack session resulted in less fat burned when compared to the breakfast session. The timing of meals during the day/night cycle therefore affects the extent to which ingested food is used versus stored.

This study has important implications for eating habits, suggesting that a daily fast between the evening meal and breakfast will optimize weight management.

###

The freely available article in PLOS Biology: https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3000622

Antioxidant supplements do not improve male fertility

Antioxidant supplements do not improve semen quality among men with infertility, according to a new 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 found that antioxidant supplements likely do not improve pregnancy and live birth rates. The study appears in Fertility and Sterility.

Antioxidant supplements are commercially available to help treat male infertility, but research on its effects on semen quality and rates of pregnancy and live birth are limited. The new study reports on results from the Males, Antioxidants, and Infertility Trial (MOXI), a double-blind, randomized, placebo-controlled clinical study conducted at nine sites across the United States. The study enrolled 171 couples where the male partner had at least one abnormal reading on an analysis evaluating sperm concentration, mobility, shape and DNA quality; the female partners had normal fertility test results. Men received a placebo or an antioxidant supplement containing vitamins C, E and D, selenium, l-carnitine, zinc, folic acid and lycopene for at least three months and up to six months. MOXI was supported by NICHD’s Reproductive Medicine Network.

The study team found no statistically significant differences in sperm concentration, mobility, shape and DNA quality between the placebo and antioxidant groups after three months. Furthermore, live birth rates did not seem to differ at six months between the antioxidant (15%) and placebo (24%) groups. However, the authors note that per the study design, recruitment was stopped before it reached the desired number of participants because no benefits were seen in the antioxidant group. Therefore, the authors only had enough participants to evaluate statistical differences in semen quality but not in pregnancy and live birth rates.

According to the authors, MOXI is the largest randomized, placebo-controlled trial to examine the effects of antioxidants, without additional assisted reproductive technology, on male infertility.

Electrolyte supplements can't be relied on to keep essential sodium levels in balance

Electrolyte supplements popular with endurance runners can't be relied on to keep essential sodium levels in balance, according to researchers at the Stanford University School of Medicine and their collaborators.

Rather, longer training distances, lower body mass and avoidance of overhydration were shown to be more important factors in preventing illness caused by electrolyte imbalances, the researchers found. Their study also showed that hot weather increased the rates of these types of illnesses.

"Electrolyte supplements are promoted as preventing nausea and cramping caused by low salt levels, but this is a false paradigm," said Grant Lipman, MD, professor of emergency medicine at Stanford and director of Stanford Wilderness Medicine. "They've never been shown to prevent illness or even improve performance -- and if diluted with too much water can be dangerous."

Lipman is the lead author of the study, which will be published online Feb. 25 in the Clinical Journal of Sports Medicine. Brian Krabak, MD, a sports and rehabilitation medicine specialist at the University of Washington-Seattle, is the senior author.

Providing care for ultramarathoners

Lipman and several of his co-authors are experienced at providing medical care for ultramarathoners and compete in ultramarathons themselves, so they are familiar with the challenges the athletes face. Ultramarathons are any foot race longer than a marathon. The idea for this study grew out of seeing firsthand how often endurance athletes use electrolyte supplements -- whether taken in pill, powder or liquid form -- and wanting to know if they prevented illness.

"In the past, athletes were told to make sure they're taking electrolyte supplements and drinking as much water as they can," Lipman said. "It was generally thought that that would prevent things like muscle cramping, electrolyte imbalances and dizziness. But there is currently no evidence to show this is true."

Sodium levels that are too high or too low during exercise can harm athletes. This study focused on two conditions: hypernatremia, which occurs when sodium levels are too high and is associated with dehydration, and exercise-associated hyponatremia, or EAH, which is caused by a drop in sodium levels. EAH can lead to altered mental status, seizures, pulmonary edema and even death. There have been 14 such documented fatalities since 1985, according to previous studies.

"Most athletes worry about dehydration, but that won't kill you," Lipman said. "There have been multiple deaths from EAH, not only among endurance athletes but among military, football players and half-marathoners, as well."

'The perfect outdoor lab'

To conduct the study, researchers recruited 266 ultramarathoners from RacingThePlanet's weeklong athletic events, which involve running 155 miles over seven days across rough terrain in extreme weather conditions at different deserts around the world.

"It's the perfect outdoor lab for easily generalizable results," said Lipman, who is on the medical advisory board and is research director for the events. Each of the study participants ran in one of five different races held in 2017 and 2018 in South America, Namibia and Mongolia. Data was collected on the fifth day of the event, when the athletes ran 50 miles. Ninety-eight of the runners competed in temperatures that averaged over 93 F.

"It's a bit crazy," said co-author Patrick Burns, MD, assistant professor of emergency medicine at Stanford and a participant in the trial, who completed one of the colder races -- held in the Patagonia region of Chile. "The race started at 8 a.m. and I finished at 8 p.m. We ran trails through the woods with thousand-foot climbs and multiple river crossings up to your waist. It was cold and overcast and raining. I was soaked. My Achilles tendons were on fire."

Data was collected from athletes at the beginning and end of the 50-mile race, when the exhausted, thirsty participants finally crossed the finish line. Prior to the race, the participants had been asked what electrolyte supplements they planned to use, how often they planned to take them and what their drinking strategy was -- whether they planned to drink at regular intervals or just when they got thirsty. They reported their previous training programs and were weighed in. At the finish line, before hydrating or resting, researchers once again weighed them and asked how closely they followed their plans for drinking and taking supplements. A blood sample was also taken to measure sodium levels.

"People have different strategies in these races," Lipman said. "Some people take a salt tablet every hour. Some prefer to put the supplements in one water bottle, then alternate with a bottle with just water. Some like a diluted mixture with powder or tablets. There are multiple different methods. However, most electrolyte strategies end up with a drink that has a lower sodium concentration than what is found in the body. This is why drinking too much electrolyte solutions can result in EAH. "

Sodium's essential roles

Sodium plays several essential roles in the body, such as maintaining blood pressure and regulating the function of muscles and nerves. Keeping sodium levels in balance while exercising is particularly important to prevent a variety of problems, including nausea, muscle cramping, dizziness and fatigue. Both high and low levels can cause these symptoms.

Past evidence has shown that electrolyte supplements don't protect against EAH. Usually, the disorder is caused by drinking too much while exercising, which dilutes salt levels. "The reality is dehydration is not as dangerous as overhydrating," Lipman said. "Dehydration and hypernatremia can cause similar symptoms to EAH, which can be easily confused, especially in the heat, but it's rarely fatal."

Analysis of the data showed that 41 of the athletes had sodium imbalances by the end of the race: 11 were found to have EAH due to too little sodium, and 30 were dehydrated, with too much sodium in their blood. Also, 88% of the sodium imbalances recorded occurred during the hot races, indicating that heat and hydration levels were far more predictive of sodium imbalances than either the manner or type of electrolyte supplements taken. Each of the participants took supplements, although the type, amount and manner of ingestion showed little to no effect on sodium levels.

"Overhydrating can reduce electrolyte levels, and electrolyte supplements aren't going to protect you," said Lipman. "You have to be smart while exercising, especially in the heat when you are sweating more and have greater hydration requirements."

Further analysis of the data also showed that participants with EAH had, on average, shorter training programs, weighed more and took five to six hours longer to complete the race. Researchers concluded that running in hot temperatures was an independent risk factor for illnesses from sodium imbalances, avoidance of overhydration was the most important factor in preventing EAH, and avoidance of dehydration prevented hypernatremia.

Burns said that this study raises questions about what exactly are the benefits of electrolyte supplements, but he still plans to keep using them during athletic competitions until more research is done.

And, as Lipman said, "Listen to your body. Stop drinking if you feel bloated or nauseous." Drink to thirst, not at regularly scheduled intervals, he said.

Low fruit and vegetable intakes and higher body fat linked to anxiety disorders

New research from the Canadian Longitudinal Study on Aging shows that adults who have low fruit and vegetable intakes have a higher likelihood of being diagnosed with an anxiety disorder.

"For those who consumed less than 3 sources of fruits and vegetables daily, there was at least at 24% higher odds of anxiety disorder diagnosis," says study lead Karen Davison, health science faculty member, nutrition informatics lab director at Kwantlen Polytechnic University, (KPU) and North American Primary Care Research Group Fellow.

"This may also partly explain the findings associated with body composition measures. As levels of total body fat increased beyond 36%, the likelihood of anxiety disorder was increased by more than 70%," states co-author Jose Mora-Almanza, a Mitacs Globalink Intern who worked with the study at KPU.

"Increased body fat may be linked to greater inflammation. Emerging research suggests that some anxiety disorders can be linked to inflammation," says Davison.

Other factors associated with anxiety disorders among mid-age and older Canadians

In addition to diet and body composition measures, the prevalence of anxiety disorders also differed by gender, marital status, income, immigrant status and several health issues.

One in nine women had an anxiety disorder compared to one in fifteen men.

"Our findings are in keeping with previous research which has also indicated that women are more vulnerable to anxiety disorders than men," says co-author Karen Kobayashi, Professor in the Department of Sociology and a Research Affiliate at the Institute on Aging & Lifelong Health at the University of Victoria.

The prevalence of anxiety disorders among those who had always been single (13.9%) was much higher than among those who were living with a partner (7.8%). Approximately one in five respondents with household incomes under $20,000 per year had anxiety disorders, more than double the prevalence of their richer peers.

"We were not surprised to find that those in poverty had such a high prevalence of anxiety disorders; struggling to afford basics such as food and housing causes relentless stress and is inherently anxiety inducing," says co-author Hongmei Tong, Assistant Professor of Social Work at MacEwan University in Edmonton.

Individuals with three or more health conditions had fivefold the prevalence of anxiety disorders in comparison to those with no chronic conditions (16.4% vs 3%). Those in chronic pain had double the prevalence of anxiety disorders in comparisons to those who were free of pain.

"Chronic pain and multiple health conditions make life very unpredictable and can be anxiety producing. One never knows whether health problems will interfere with work or family responsibilities and many activities become more challenging and time consuming," says co-author Shen (Lamson) Lin, a doctoral student at University of Toronto's Factor-Inwentash Faculty of Social Work (FIFSW).

Immigrants to Canada had a lower prevalence of anxiety disorders compared to their peers born in Canada (6.4% vs 9.3%).

"Immigrants may face a myriad of challenges associated with resettling in a new country, including language barriers, poverty, difficulties in getting qualifications recognized, and limited social support, so it seems counter-intuitive that they should have a lower likelihood of anxiety disorders than those born in Canada. It may be that potential immigrants with anxiety disorders would find the challenges of relocation too anxiety-inducing and would therefore not choose to immigrate, so there is a 'self-selection' for those with lower anxiety," says senior author, Esme Fuller-Thomson, professor at FIFSW and director of the Institute for Life Course & Aging. Fuller-Thomson is also cross-appointed to the Department of Family and Community Medicine and the Faculty of Nursing.

The study team analyzed data from the Canadian Longitudinal Study on Aging which included 26,991 men and women between the ages of 45 and 85. The article was published this week in the International Journal of Environmental Research and Public Health.

An important limitation of the study was that the assessment of anxiety disorders was based upon self-reporting of a medical diagnosis. The authors also conducted multivariate analyses taking into account the use of a family physician in the past year to address the possibility of under-reporting of anxiety disorders among those who rarely visited health professionals. This adjustment was not found to substantially change the associations discussed above.

"It is estimated that 10% of the global population will suffer from anxiety disorders which are a leading cause of disability" says Karen Davison "Our findings suggest that comprehensive approaches that target health behaviors, including diet, as well as social factors, such as economic status, may help to minimize the burden of anxiety disorders among middle-aged and older adults, including immigrants."

Extra olive virgin oil keeps healthy properties when used for cooking

Consuming extra virgin olive oil has proved to have protecting effects for the health, especially due to its antioxidant content. However, there are not many studies on whether it is the best oil to use when cooking. A study by the University of Barcelona stated this kind of oil keeps the levels of antioxidants -regarded as health- when used for cooking, a common technique in the Mediterranean cuisine. These results could be relevant for future recommendations or nutritional guidelines.

The study, published by the journal Antioxidants, counts on the participation of a team of researchers from the Faculty of Pharmacy and Food Sciences of the UB, the Physiopathology of Obesity and Nutrition Networking Biomedical Research Centre (CIBERobn) and the University of São Paulo.

Simulation of cooking conditions in a domestic kitchen

Extra virgin olive oil is the main source of fat of the Mediterranean diet and shows a unique composition of fatty acids with a higher content of antioxidants than other edible oils. Its benefits for the health are mainly linked to these compounds, named polyphenols. "The effects of cooking on these polyphenols of oil have always been studied in a laboratory or industrial situation, which is far from the reality of our homes", says Rosa M. Lamuela, director of the Institute in Research on Nutrition and Food Safety (INSA-UB).

For this study, however, researchers simulated the cooking conditions of a domestic kitchen. The aim was to see how the homemade sauté affects the polyphenols of extra virgin olive oil. Researchers studied the effects of time -during a short and a long period of time- and temperature -at 120ºC and 170ºC- in the degradation of the antioxidants.

Results show that during the cooking process, the content of polyphenols decreased by 40% to 120ºC and by 75% at 170ºC, compared to the levels of antioxidants in raw oil. Moreover, the cooking time had an effect on individual phenols, such as hydroxytyrosol, but not on the total content of the phenol. As a whole, the levels of antioxidants keep fulfilling the parameters stated as healthy by the European Union: "Despite the decrease in concentration of polyphenols during the cooking process, this oil has a polyphenol level that reaches the declaration of health in accordance to the European regulation, which means it has properties that protect oxidation of LDL cholesterol particles", notes Julián Lozano, first signer of the publication, which is also part of his doctoral thesis.

Olive oil in Mediterranean cuisine

The Mediterranean diet, known for a high use of phytochemicals from vegetables, fruits and legumes, has been correlated to improvements in cardiovascular and metabolic health. This link is based on the results of the PREDIMED study, a multicenter clinical study conducted from 2003 to 2011 with more than 7,000 people, in which Rosa M. Lamuela took part as well.

However, the effects on health in the Mediterranean diet have been hard to reproduce in non-Mediterranean populations. According to the researchers, this fact could occur due to, probably, differences in cooking practices. In this context, the results are added to previous studies by the research group which analyzed the effects of extra virgin olive oil in the sauté -with positive results. Thus, this strengthens the idea of the Mediterranean gastronomy being beneficial for our health, not only for its food but also for the ways of cooking it.

According to the authors, the current objective is to analyze the effects of cooking with extra virgin olive oil with other food elements, such as legumes, meat, etc. "Moreover, we should conduct random research studies in humans, in which we would compare the potential benefits we obtain when cooking with quality extra virgin olive oil compared to other oils", concludes the researcher.

Slow, steady increase in exercise intensity is best for heart health

For most people, the benefits of aerobic exercise far outweigh the risks, however, extreme endurance exercise - such as participation in marathons and triathlons for people who aren't accustomed to high-intensity exercise - can raise the risk of sudden cardiac arrest, atrial fibrillation (a heart rhythm disorder) or heart attacks, according to a new Scientific Statement "Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update from the American Heart Association," published today in the Association's premier journal Circulation.

Aerobic exercises are activities in which the large muscles move in a rhythmic manner for a sustained time. They can be done at low intensity or high intensity and include walking, brisk walking, running, bicycling, swimming and many others.

"Exercise is medicine, and there is no question that moderate to vigorous physical activity is beneficial to overall cardiovascular health. However, like medicine, it is possible to underdose and overdose on exercise - more is not always better and can lead to cardiac events, particularly when performed by inactive, unfit, individuals with known or undiagnosed heart disease," said Barry A. Franklin, Ph.D., chair of the writing committee for the new Scientific Statement, director of preventive cardiology and cardiac rehabilitation at Beaumont Health in Royal Oak, Michigan, professor of internal medicine at Oakland University William Beaumont School of Medicine in Rochester, Michigan.

"More people are running marathons, participating in triathlons and doing high-intensity interval training. The purpose of this statement is to put the benefits and risks of these vigorous exercise programs in perspective," said Franklin.

After reviewing more than 300 scientific studies, the writing committee found that, for the vast majority of people, the benefits of exercise and improving physical fitness outweigh the risks. Physically active people, such as regular walkers, have up to a 50% lower risk of heart attack and sudden cardiac death. However, the committee also identified potential risks with intense exercise training.

The writing group also reviewed a small study that concluded the risk of sudden cardiac death or heart attack is low among people participating in high-intensity exercise such as marathons and triathlons. However, over time, the risk of heart attack or sudden cardiac death among male marathon participants has risen, suggesting that these events are attracting higher risk participants (those who may have an underlying or undiagnosed cardiovascular condition such as heart rhythm abnormalities or a prior heart attack). For women, who comprised only 15% of the study population, the occurrence of sudden cardiac death was 3.5-fold less than in men.

Among participants in triathlons almost 40% of cardiac events occurred in first-time participants, indicating that inadequate training or underlying heart problems may be involved. The writing group also found that:

• Half of cardiac events occur in the last mile of a marathon or half-marathon, so maintaining a steady pace rather than sprinting is advised;
• The risk of cardiac events is greater at high altitudes, but can be decreased by spending at least one day acclimating to the elevation prior to strenuous activity;; and
• Risk of atrial fibrillation (AFib), a common heart arrhythmia that raises the risk of stroke, is beneficially reduced with moderate exercise volumes but is highest in people who are sedentary and almost as high in people who are engaged in very high volumes of exercise training, that is, high-intensity training (such as running 60-80 miles a week).

For people who want to become more active, the Association suggests that most people can start a light program of exercise and build up slowly to a moderate to vigorous exercise regimen without seeing a physician first, unless they have physical symptoms such as chest pain, chest pressure or severe shortness of breath while exercising. "It is important to start exercising - but go slow, even if you were an athlete in high school," said Franklin.

In addition, people with known heart disease (such as a previous heart attack, bypass surgery or angioplasty) should get their doctor's approval prior to starting an exercise program.

For currently inactive/sedentary people, the Association also suggests checking with your doctor before engaging in any strenuous activities such as shoveling snow or racquet sports, which create rapid increases in heart rate and blood pressure and greatly increase the strain on the heart.

To implement a healthy physical activity program:

• Warm up before exercise by doing the planned activity - such as walking - at a slower pace to let your heart rate rise gradually;
• Walk on a level surface for 6-8 weeks, progressing to walking up hills, jogging or taking part in more vigorous activities as long as no symptoms occur such as shortness of breath, lightheadedness, chest pain or chest pressure;
• Increase the amount of time spent on exercise incrementally from five to ten minutes at the beginning and build up slowly to the desired time;
• Lower the intensity of your exercise when environmental conditions place a greater strain on the heart, such as high humidity or high altitude to which you are not accustomed;
• Cool down after exercise by walking at a slow pace to let your heart rate return to normal; and
• Stop and seek medical evaluation if you experience any heart-related symptoms such as lightheadedness, shortness of breath, or chest pain or pressure.

Sugary drinks a sour choice for adults trying to maintain normal cholesterol levels

TUFTS UNIVERSITY, HEALTH SCIENCES CAMPUS

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IMAGE: THE IMAGE IS AN INFOGRAPHIC SHOWING A PHOTOGRAPH OF A SODA BOTTLE LYING ON ITS SIDE, WITH SODA DRIPPING OUT. THE TEXT READS, "GETTING OLDER? THINK BEFORE YOU DRINK SODA. " view more 

CREDIT: TUFTS UNIVERSITY

BOSTON (February 26, 2020, 5:00 a.m., EST)--Middle-aged and older adults who drank sugary beverages daily were at greater risk of developing abnormal cholesterol and triglyceride levels compared to those who rarely drank those beverages, according to a new epidemiological study published today in the Journal of the American Heart Association.

The study, led by scientists at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (HNRCA), found that adults who drank at least one sugary beverage daily during the most recent period of follow-up, which was roughly four years before the assessment of lipid levels, had a 98 percent higher chance of developing low HDL (good) cholesterol and a 53 percent higher chance of developing high triglycerides, when compared to the group who seldom consumed sugary drinks. The researchers observed similar results when they examined long-term intakes of sugary beverages during a follow-up time of about 12 years.

Cholesterol and triglycerides are part of what is commonly referred to as a complete cholesterol test. When some elements of the test are abnormal, the condition is called dyslipidemia, which affects roughly half of American adults. Elevated LDL (bad) cholesterol and triglycerides, along with low good cholesterol levels, indicate a higher risk for heart disease.

"The results suggest that high intake of drinks with added sugar, such as soda, lemonade or fruit punch, may influence risk for dyslipidemia as we age," said corresponding and last author Nicola McKeown, nutritional epidemiologist at the HNRCA. "One dietary strategy to help maintain healthier blood cholesterol and triglyceride levels may be to avoid drinks with added sugars."

The researchers also found that high sugary beverage intake was associated with HDL cholesterol and triglyceride levels that, measured at approximately four-year intervals, were moving in the wrong direction among daily sugary beverage drinkers when compared to those who rarely drank beverages with added sugar - even for a group of adults whose average age was in their 40s.

"With these younger participants, we did see unfavorable changes, but they were likely too young during the short follow-up period to know if they would eventually develop dyslipidemia," said first author Danielle Haslam. "Our findings contribute to the mounting evidence that sugary drinks should be avoided to help maintain long-term health." Haslam was a doctoral student at the Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University working in the nutritional epidemiology program at the HNRCA at the time of the study.

The researchers also studied 100% fruit juice and diet drinks, common replacements for sugar-sweetened beverages, but found no consistent associations with adverse changes in cholesterol and increased risk of dyslipidemia. Still, the researchers urge moderation.

"We are better off quenching our thirst with water. The emerging research on long-term consumption of diet soda on health is inconclusive, so it is prudent to say diet drinks should only be an occasional indulgence," said McKeown. "As for 100% fruit juice, best to limit consumption and consume whole fruits when possible, as recommended by the 2015-2020 Dietary Guidelines for Americans."

"Our findings show that what we put in our glass may contribute to greater risk of cardiovascular disease via worsening of lipid levels. Managing blood cholesterol and triglyceride levels is an important goal and a promising strategy for preventing heart attack and stroke," McKeown said.

As expected and consistent with previous research, sugary beverage consumption was not linked to risk for higher LDL (bad) cholesterol, the authors said.

The researchers analyzed data from more than 5,900 people, comparing changes in blood cholesterol and triglyceride concentrations between exams. Participants were categorized according to the types and frequency of beverages they consumed. The study participants were examined at intervals of four years on average and followed for about 12 years as part of the Framingham Heart Study, which has monitored multiple generations to identify contributors to cardiovascular disease. In their statistical analysis, the researchers adjusted for other factors known to influence cholesterol and triglyceride concentrations, such as obesity, overall diet quality, physical activity, alcohol intake, and the use of cholesterol-lowering drugs.

There are some limitations to the study, including the use of self-reported food data from food frequency questionnaires. The findings are also only generalizable to middle-aged or older adults of European descent. Due to its observational design, the study does not reflect a causal relationship between sugary drink consumption and abnormal cholesterol and triglyceride levels.

Regular walnut consumption linked to health and longevity in women

According to a new epidemiological study, women in their late 50s and early 60s who consumed at least two servings of walnuts per week had a greater likelihood of healthy aging compared to those who did not eat walnuts. After accounting for various factors that could impact health in older adults, such as education and physical activity, walnuts were the only nut associated with significantly better odds of healthy aging.

In this study, which was supported by the California Walnut Commission, "healthy aging" was defined as longevity with sound mental health and no major chronic diseases, cognitive issues or physical impairments following the age of 65.

By 2034, for the first time ever, older adults will outnumber children. Baby boomers (those 65 and older) are expected to make up 21% of the population, with more than half being women. The significance of this demographic turning point in our country's history is clear - research that examines the aging process, including simple, low-cost interventions like healthy food choices, will be especially crucial to healthier lifespans.

Previous research from primary investigator Dr. Francine Grodstein, formerly of Brigham and Women's Hospital, has found that eating walnuts may have a positive impact on reducing the risk for physical impairments in older adults as well as cognitive decline. Additionally, others in the same research group have found decreases in cardiovascular disease and type 2 diabetes - all conditions that become more common as we age. There is no one solution to slowing down the effects of aging, but adopting the right habits, like snacking on a handful of walnuts, can help.

In this study, Grodstein looked at data from 33,931 women in the Nurses' Health Study (NHS) to evaluate the association between nut consumption and overall health and well-being in aging. Between 1998-2002, female nurses in the NHS were asked about their diet (including total nut consumption); evaluated for chronic diseases (such as cancer, heart attack, heart failure, stroke, type 2 diabetes and Parkinson's disease); and assessed for memory concerns, mental health and physical limitations (including daily activities like walking one block, climbing a flight of stairs, bathing, dressing oneself and pushing a vacuum cleaner). Of the study participants, 16% were found to be "healthy agers," defined as having no major chronic diseases, reported memory impairment or physical disabilities as well as having intact mental health.

Although previous research has connected a healthy diet, including walnuts, to better physical function among older men and women, this study only included women. More research is needed to understand if these results hold true among men. Additionally, participants were not assigned to eat walnuts or other foods; they were simply asked about their dietary choices. It is possible that subjects misreported their dietary intake since this information was collected by questionnaires. As an observational study, this does not prove cause and effect. However, this research sheds light on simple habits that can influence health during later years in life - such as eating walnuts.

Consistently drinking as little as one cup per day may increase rate of breast cancer up to 50%

Intake of dairy milk is associated with a greater risk of breast cancer in women, according to a new study conducted by researchers at Loma Linda University Health.

Dairy, soy and risk of breast cancer: Those confounded milks, published in the International Journal of Epidemiology, found that even relatively moderate amounts of dairy milk consumption can increase women's risk of breast cancer -- up to 80% depending on the amount consumed.

First author of the paper, Gary E. Fraser, MBChB, PhD, said the observational study gives "fairly strong evidence that either dairy milk or some other factor closely related to drinking dairy milk is a cause of breast cancer in women.

"Consuming as little as 1/4 to 1/3 cup of dairy milk per day was associated with an increased risk of breast cancer of 30%," Fraser said. "By drinking up to one cup per day, the associated risk went up to 50%, and for those drinking two to three cups per day, the risk increased further to 70% to 80%."

Current U.S. Dietary guidelines recommend three cups of milk per day. "Evidence from this study suggests that people should view that recommendation with caution," Fraser said.

Dietary intakes of nearly 53,000 North American women were evaluated for the study, all of whom were initially free of cancer and were followed for nearly eight years. Dietary intakes were estimated from food frequency questionnaires (FFQ), also repeated 24 hour recalls, and a baseline questionnaire had questions about demographics, family history of breast cancer, physical activity, alcohol consumption, hormonal and other medication use, breast cancer screening, and reproductive and gynecological history.

By the end of the study period, there were 1,057 new breast cancer cases during follow-up. No clear associations were found between soy products and breast cancer, independent of dairy. But, when compared to low or no milk consumption, higher intakes of dairy calories and dairy milk were associated with greater risk of breast cancer, independent of soy intake. Fraser noted that the results had minimal variation when comparing intake of full fat versus reduced or nonfat milks; there were no important associations noted with cheese and yogurt.

"However," he said, "dairy foods, especially milk, were associated with increased risk, and the data predicted a marked reduction in risk associated with substituting soymilk for dairy milk. This raises the possibility that dairy-alternate milks may be an optimal choice."

A hazardous effect of dairy is consistent with the recent AHS-2 report suggesting that vegans but not lacto-ovo-vegetarians experienced less breast cancer than non-vegetarians.

Fraser said the possible reasons for these associations between breast cancer and dairy milk may be the sex hormone content of dairy milk, as the cows are of course lactating, and often about 75% of the dairy herd is pregnant. Breast cancer in women is a hormone-responsive cancer. Further, intake of dairy and other animal proteins in some reports is also associated with higher blood levels of a hormone, insulin-like growth factor-1 (IGF-1), which is thought to promote certain cancers.

"Dairy milk does have some positive nutritional qualities," Fraser said, "but these need to be balanced against other possible, less helpful effects. This work suggests the urgent need for further research."

The highest probability of reaching 90 years was found for those drinking 5– < 15 g alcohol/day

For men: all drinks

For women: wine, not liquor

(In the United States, a standard drink contains about 14 grams of alcohol.^[1] This corresponds to a 12-US-fluid-ounce (350 mL) glass of beer, a 5-US-fluid-ounce (150 mL) glass of 12% ABV (alcohol by volume) wine, or a 1.5-US-fluid-ounce (44 mL) so-called "shot" of spirit.^[2] Assuming that beer is 5% ABV, wine is 12% ABV, and spirits is 40% ABV (80 proof). Most wine today is higher than 12% ABV (the average ABV in Napa Valley in 1971 was 12.5% ^[3]). 80 proof is still the standard for spirits, though higher alcohol content is common.)

Source: https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afaa003/5730334#198738775

Background

whether light-to-moderate alcohol intake is related to reduced mortality remains a subject of intense research and controversy. There are very few studies available on alcohol and reaching longevity.

Methods

we investigated the relationship of alcohol drinking characteristics with the probability to reach 90 years of age. Analyses were conducted using data from the Netherlands Cohort Study. Participants born in 1916–1917 (n = 7,807) completed a questionnaire in 1986 (age 68–70 years) and were followed up for vital status until the age of 90 years (2006–07). Multivariable Cox regression analyses with fixed follow-up time were based on 5,479 participants with complete data to calculate risk ratios (RRs) of reaching longevity (age 90 years).

Results

we found statistically significant positive associations between baseline alcohol intake and the probability of reaching 90 years in both men and women. Overall, the highest probability of reaching 90 was found in those consuming 5– < 15 g/d alcohol, with RR = 1.36 (95% CI, 1.20–1.55) when compared with abstainers. 

United States[]

14 g =

1.4 standard drinks

The exposure-response relationship was significantly non-linear in women, but not in men. Wine intake was positively associated with longevity (notably in women), whereas liquor was positively associated with longevity in men and inversely in women. Binge drinking pointed towards an inverse relationship with longevity. Alcohol intake was associated with longevity in those without and with a history of selected diseases.

Conclusions

the highest probability of reaching 90 years was found for those drinking 5– < 15 g alcohol/day. Although not significant, the risk estimates also indicate to avoid binge drinking.