2020-2025 Dietary Guidelines for Americans - Issued December 29, 2020

1 At every life stage—infancy, toddlerhood, childhood, adolescence, adulthood, pregnancy, lactation, and older adulthood—it is never too early or too late to eat healthfully. 

• For about the first 6 months of life, exclusively feed infants human milk. Continue to feed infants human milk through at least the first year of life, and longer if desired. Feed infants iron-fortified infant formula during the first year of life when human milk is unavailable. Provide infants with supplemental vitamin D beginning soon after birth. 

• At about 6 months, introduce infants to nutrient-dense complementary foods. Introduce infants to potentially allergenic foods along with other complementary foods. Encourage infants and toddlers to consume a variety of foods from all food groups. Include foods rich in iron and zinc, particularly for infants fed human milk.

• From 12 months through older adulthood, follow a healthy dietary pattern across the lifespan to meet nutrient needs, help achieve a healthy body weight, and reduce the risk of chronic disease. 

2 Follow a healthy dietary pattern at every life stage. 

Customize and enjoy nutrient-dense food and beverage choices to reflect personal preferences, cultural traditions, and budgetary considerations. A healthy dietary pattern can benefit all individuals regardless of age, race, or ethnicity, or current health status. The Dietary Guidelines provides a framework intended to be customized to individual needs and preferences, as well as the foodways of the diverse cultures in the United States.

 3 Focus on meeting food group needs with nutrient-dense foods and beverages, and stay within calorie limits. 

An underlying premise of the Dietary Guidelines is that nutritional needs should be met primarily from foods and beverages—specifically, nutrient-dense foods and beverages. Nutrient-dense foods provide vitamins, minerals, and other health-promoting components and have no or little added sugars, saturated fat, and sodium. A healthy dietary pattern consists of nutrient-dense forms of foods and beverages across all food groups, in recommended amounts, and within calorie limits. 

The core elements that make up a healthy dietary pattern include: 

• Vegetables of all types—dark green; red and orange; beans, peas, and lentils; starchy; and other vegetables 

• Fruits, especially whole fruit 

• Grains, at least half of which are whole grain 

• Dairy, including fat-free or low-fat milk, yogurt, and cheese, and/or lactose-free versions and fortified soy beverages and yogurt as alternatives 

• Protein foods, including lean meats, poultry, and eggs; seafood; beans, peas, and lentils; and nuts, seeds, and soy products 

• Oils, including vegetable oils and oils in food, such as seafood and nuts 

4 Limit foods and beverages higher in added sugars, saturated fat, and sodium, and limit alcoholic beverages. 

At every life stage, meeting food group recommendations—even with nutrient-dense choices—requires most of a person’s daily calorie needs and sodium limits. A healthy dietary pattern doesn’t have much room for extra added sugars, saturated fat, or sodium—or for alcoholic beverages. A small amount of added sugars, saturated fat, or sodium can be added to nutrient-dense foods and beverages to help meet food group recommendations, but foods and beverages high in these components should be limited. 

Limits are: 

• Added sugars—Less than 10 percent of calories per day starting at age 2. Avoid foods and beverages with added sugars for those younger than age 2. 

• Saturated fat—Less than 10 percent of calories per day starting at age 2. 

• Sodium—Less than 2,300 milligrams per day—and even less for children younger than age 14. 

• Alcoholic beverages—Adults of legal drinking age can choose not to drink, or to drink in moderation by limiting intake to 2 drinks or less in a day for men and 1 drink or less in a day for women, when alcohol is consumed. Drinking less is better for health than drinking more. There are some adults who should not drink alcohol, such as women who are pregnant.

My Diet

 

Breakfast 6-7 days a week: Alternating days:

A. Oatmeal, barley, non-fat Lactaid milk, blueberries, strawberries

B. Hard-boiled egg, avocado, red pepper, tomato, unslated nut, olive oil

Lunch - Varies

Favorites include SAFFRON ROAD Chicken Enchiladas Poblano, Enchiladas Al Chipotle With Black Beans & Rice, and Chicken Pad Thai With Rice Noodle; FRONTERA Chicken Fajita Bowl; Smoked salmon, avocado, cream cheese, tomato or red pepper on whole wheat, *Boston Market or Trader Joe's chicken pot pie; *Scott & Jon's Shrimp Jambalaya Frozen Rice Bowl

* Haven't had since lockdown.

Dinner - Almost every night

An olive oil based saute with all of the following:

 Vegetables: Onion, Broccoli, Orange or yellow pepper, Baby carrots, Mushrooms.

 Legumes: Green beans or Peas; and Black beans, Chickpeas( Garbanzo beans), or Black-eyed peas.

 Protein: Usually seafood: Most often Pollack, Shrimp, Calamari, or Clams. Also Scallops, Salmon, Mussels, Whitefish. Once in a while: Chicken.

and sometimes:

  Grain - Brown rice or Whole wheat pasta.

  Red sauce, Chili powder

Desserts -  Only after dinner most days

 Pie, Cookies (chocolate chip, fig newtons).

Snacks - 2-3 most days

 Dark chocolate - try to have every day; Salt free pretzels or Salt free corn chips often with Cheese; Pirates booty, Low carb protein bars. Peanut butter crackers. Salt free nuts. Cheez-its.

Beverages

 Every day - lots of water and white tea.

 4-5 days a week - glass of red wine (usually Cabernet).

 1-2 days a week - bottle of beer  (usually Dos Equis Amber).

 Sports days - Gatorade Zero.

Increased meat consumption associated with symptoms of childhood asthma

 

THE MOUNT SINAI HOSPITAL / MOUNT SINAI SCHOOL OF MEDICINE

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Substances present in cooked meats are associated with increased wheezing in children, Mount Sinai researchers report. Their study, published in Thorax, highlights pro-inflammatory compounds called advanced glycation end-products (AGEs) as an example of early dietary risk factors that may have broad clinical and public health implications for the prevention of inflammatory airway disease.

Asthma prevalence among children in the United States has risen over the last few decades. Researchers found that dietary habits established earlier in life may be associated with wheezing and potentially the future development of asthma.

Researchers examined 4,388 children between 2 and 17 years old from the 2003-2006 National Health and Nutrition Examination Survey (NHANES), a program of the National Center for Health Statistics, which is part of the U.S. Centers for Disease Control and Prevention. It is designed to evaluate the health and nutritional status of adults and children in the United States through interviews and physical examinations.

The researchers used NHANES survey data to evaluate associations between dietary AGE and meat consumption frequencies, and respiratory symptoms. They found that higher AGE intake was significantly associated with increased odds of wheezing, importantly including wheezing that disrupted sleep and exercise, and that required prescription medication. Similarly, higher intake of non-seafood meats was associated with wheeze-disrupted sleep and wheezing that required prescription medication.

"We found that higher consumption of dietary AGEs, which are largely derived from intake of non-seafood meats, was associated with increased risk of wheezing in children, regardless of overall diet quality or an established diagnosis of asthma," said Jing Gennie Wang, MD, lead author of the study, and a former fellow in Pulmonary, Critical Care and Sleep Medicine at the Icahn School of Medicine at Mount Sinai.

"Research identifying dietary factors that influence respiratory symptoms in children is important, as these risks are potentially modifiable and can help guide health recommendations. Our findings will hopefully inform future longitudinal studies to further investigate whether these specific dietary components play a role in childhood airways disease such as asthma," said Sonali Bose, MD, senior author, and Assistant Professor of Pulmonary, Critical Care and Sleep Medicine and Pediatrics at Icahn School of Medicine at Mount Sinai.

Exercise for low back pain beneficial but no one agrees on why

 

UNIVERSITY OF NEW SOUTH WALES

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Exercise is scientifically proven to provide relief from chronic low back pain (CLBP), but a new UNSW Sydney systematic review shows researchers are still unsure as to why it's beneficial.

The study, published in Musculoskeletal Science and Practice recently, was a collaboration between researchers from UNSW Medicine and NeuRA (Neuroscience Research Australia), led by Professor James McAuley.

Their aim was to better understand why back pain researchers think exercise helps people with CLBP.

The study's senior author Dr Matt Jones, accredited exercise physiologist, clinician and researcher, said the researchers were surprised to find there was no clear agreement between scientists about why they think exercise works for CLBP.

"Therefore, despite decades of research in the area and more than 100 studies we analysed in our review, we still do not have a good idea of why exercise might be effective for CLBP," Dr Jones said.

"Both in Australia and globally, low back pain (LBP) is the leading cause of disability and has been for the past few decades. LBP is associated with a significant burden both for the individual and society - i.e., through healthcare costs.

"A lot of treatments have stemmed from studies for people with CLBP (for example, medications, manual therapy, cognitive behavioural therapy), but the one with the most consistent evidence of benefit is exercise."

Dr Jones defined CLBP as pain felt on the back of the body between the bottom of the ribs and the bottom of the backside, lasting for three months or longer.

"It's the kind of pain that extends beyond the expected healing time of the body tissue. We also know that for many people, it is part of their daily lives and can significantly impact their quality of life," he said.

"Today's evidence suggests CLBP likely comes from the brain and nervous system being a bit over-protective and generating a pain response - despite no obvious physical damage to the body."

Exercise improves fitness, mood, confidence

The researchers conducted a systematic review of the literature in the Physiotherapy Evidence Database (PEDro) on why back pain researchers think exercise helps adults (under the age of 65) with CLBP.

They analysed 110 research papers which represent an estimated several thousand study subjects with CLBP.

The studies investigated span almost three decades and were conducted in a range of countries and regions, including Australia, the United States, China, Brazil and Europe.

Dr Jones said despite the lack of agreement in the literature as to why researchers thought exercise worked for CLBP, the systematic review did find some common ground.

"Researchers proposed common reasons as to why exercise was beneficial, including improvements in fitness - for example, core stability, aerobic fitness - and improvements in mood and confidence," he said.

"But the effects of these proposed reasons on outcomes for people with CLBP were seldom examined in the papers.

"In one-third of studies, researchers did not even propose a reason for why they thought exercise might be effective."

Dr Jones said the jury was still out on why exercise worked for people with CLBP because chronic pain was a complex condition.

"Chronic pain is tricky and there are a lot of factors that can contribute to it - so, it's not simply biological aspects of tissue damage, but there are psychosocial elements at play, as well things like a person's mood or confidence in their own abilities to do something," he said.

"There have been trends in research over time, where everyone focuses on a 'flavour of the month' - like motor control or McKenzie therapy, for example - but because the effects of exercise are broad and it impacts on many different systems in the human body, it's difficult for researchers to pinpoint exactly why they think it might be benefiting people with pain."

Findings to help future research on exercise benefits

Prof. James McAuley, who leads a group of 30 researchers focused on improving the management of chronic pain, said the evidence review formed part of a larger body of work aiming to understand why exercise works for people with CLBP.

"Future primary studies could involve randomised controlled trials designed to investigate the mechanisms of benefit identified in our review. For example, mechanisms such as improving strength, improving self-efficacy - someone's belief in their ability to perform tasks despite pain - and others," Prof. McAuley said.

"The answer could also be achieved by using a technique called 'mediation analysis' which seeks to identify mechanisms of benefit in trials that have already been conducted. If we can identify why exercise works, then we can design treatments to maximise its benefits.

"Pain is very complex - so, in all likelihood, it will be a combination of many factors that lead to the consistent improvements in pain and function after exercise for people with CLBP."

Staying physically active is key for chronic pain

Although the systematic review did not aim to establish which exercises were most effective for people with CLBP, Dr Jones recommended people engage in meaningful activities.

"Many scientists have investigated this question before and the short answer is, there are no specific exercises recommended to alleviate CLBP," he said.

"But there are literally hundreds of studies on exercise for people with chronic pain, not only CLBP, and researchers consistently find exercise is one of the most effective treatments - it might not cause huge reductions in pain and disability, but it does help.

"So, remaining physically active and being reassured it is safe to do so - it is rare that chronic pain is caused by 'issues with the tissues' - is probably the simplest, best advice for someone with chronic pain."

Dr Jones said there were many options for how someone with chronic pain could stay active. "This might be through structured exercise (for example, going for a jog, going to the gym), but it could be other activities or hobbies people enjoy doing as well, such as gardening, surfing, walking the dog or mowing the lawn," he said.

"It is important the activities are progressed slowly and if they do aggravate someone's pain slightly that is okay, because staying sedentary is no longer a recommended option.

"But if you are unsure about what activities or exercise would work for you, ask your GP who could refer you to a physiotherapist or find an accredited exercise physiologist."

'Three pillars' of good mental health for young adults

 

Getting good quality sleep, exercising, and eating more raw fruits and vegetables predicts better mental health and well-being in young adults, a University of Otago study has found.

The study, published in Frontiers in Psychology, surveyed more than 1100 young adults from New Zealand and the United States about their sleep, physical activity, diet, and mental health.

Lead author Shay-Ruby Wickham, who completed the study as part of her Master of Science, says the research team found sleep quality, rather than sleep quantity, was the strongest predictor of mental health and well-being.

"This is surprising because sleep recommendations predominantly focus on quantity rather than quality. While we did see that both too little sleep - less than eight hours - and too much sleep - more than 12 hours - were associated with higher depressive symptoms and lower well-being, sleep quality significantly outranked sleep quantity in predicting mental health and well-being.

"This suggests that sleep quality should be promoted alongside sleep quantity as tools for improving mental health and well-being within young adults," Ms Wickham says.

Along with quality sleep, exercising, and eating more raw fruits and vegetables - in that order - were three modifiable behaviours which correlated with better mental health and well-being in young adults.

Depressive symptoms were lowest for young adults who slept 9.7 hours per night, and feelings of well-being were highest for those who slept 8 hours per night.

Well-being was highest for young adults who ate 4.8 servings of raw fruit and vegetables per day; those who ate less than two servings, and also more than eight servings, reported lower feelings of well-being.

"Sleep, physical activity, and a healthy diet can be thought of as three pillars of health, which could contribute to promoting optimal well-being among young adults, a population where the prevalence of mental disorders is high and well-being is suboptimal," Ms Wickham says.

Senior author, Associate Professor Tamlin Conner, of the Department of Psychology, says most prior research examines these health behaviours in isolation of each other.

"We showed that they are all important for predicting which young adults are flourishing versus suffering."

She also stressed the study's findings were correlations only.

"We didn't manipulate sleep, activity, or diet to test their changes on mental health and well-being. Other research has done that and has found positive benefits. Our research suggests that a 'whole health' intervention prioritising sleep, exercise, and fruit and vegetable intake together, could be the next logical step in this research," she says.

What makes hard workouts so effective

 High-intensity interval training strengthens the heart even more than moderate exercise does. Now researchers have found several answers to what makes hard workouts so effective.

"Our research on rats with heart failure shows that exercise reduces the severity of the disease, improves heart function and increases work capacity. And the intensity of the training is really importance to achieve this effect," says Thomas Stølen, a researcher at the Norwegian University of Science and Technology (NTNU).

Stølen and his colleague Morten Høydal are the main authors of a comprehensive study published in the Journal of Molecular and Cellular Cardiology. The researchers went to great lengths to investigate what happens inside tiny heart muscle cells after regular exercise.

"We found that exercise improves important properties both in the way heart muscle cells handle calcium and in conducting electrical signals in the heart. These improvements enable the heart to beat more vigorously and can counteract life-threatening heart rhythm disorders," says Stølen.

For a heart to be able to beat powerfully, regularly and synchronously, a lot of functions have to work together. Each time the heart beats, the sinus node -- the heart's own pacemaker -- sends out electrical impulses to the rest of the heart. These electrical impulses are called action potentials.

All the heart muscle cells are enclosed by a membrane. At rest, the electrical voltage on the inside of the cell membrane is negative compared to the voltage on the outside. The difference between the voltage on the outside and the inside of the cell membrane is called the resting membrane potential.

When the action potentials reach the heart muscle cells, they need to overcome the resting membrane potential of each cell to depolarize the cell wall. When this happens, calcium can flow into the cell through channels in the cell membrane.

Calcium initiates the actual contraction of the heart muscle cells. When this process is complete, calcium is transported out of the cell or back to its storage site inside each heart muscle cell. From there, the calcium is ready to contribute to a new contraction the next time an action potential comes rushing by.

If the heart's electrical conduction or calcium management system fails, the risk is that fewer heart muscle cells will contract, the contraction in each cell will be weak, and the electrical signals will become chaotic so that the heart chambers begin to flutter.

"All these processes are dysfunctional when someone has heart failure. The action potentials last too long, the resting potential of the cells is too high, and the transport function of the calcium channels in the cell wall is disturbed. Calcium then constantly leaks from its storage places inside every heart muscle cell," Stølen says.

Before Stølen gives us the rest of the good news, he notes, "Our results show that intensive training can completely or partially reverse all these dysfunctions."

Normally, the sinus node causes a human heart to beat between 50 and 80 beats every minute when at rest. This is enough to supply all the organ systems and cells in the body with as much oxygen-rich blood as they need to function properly.

When we get up to take a walk, our heart automatically starts beating a little faster and pumping a little harder so that the blood supply is adapted to the increased level of activity. The higher the intensity of the activity, the harder the heart has to work.

Exercise strengthens the heart so it can pump more blood out to the rest of the body with each beat. Thus, the sinus node can take it a little easier, and well-trained people have a lower resting heart rate than people who have not done regular endurance training.

At the other end of the continuum are people with heart failure. Here the pumping capacity of the heart is so weak that the organs no longer receive enough blood to maintain good functioning. People with heart failure have a low tolerance for exercise and often get out of breath with minimal effort.

In other words, increasing the pumping power to the heart is absolutely crucial for the quality of life and health of people with heart failure.

Many of the more than 100,000 Norwegians who live with heart failure have developed the condition after suffering a major heart attack -- just like the rats in Stølen and Høydal's study.

In the healthy rats, the heart pumped 75 percent of the blood with each contraction. In rats with heart failure, this measure of pump capacity, called ejection fraction, was reduced to 20 per cent, Stølen says.

The ejection fraction increased to 35 percent after six to eight weeks with almost daily interval training sessions on a treadmill. The rats did four-minute intervals at about 90 percent of their maximum capacity, quite similar to the 4 × 4 method that has been advocated by several research groups at NTNU for many years.

"The interval training also significantly improved the rats' conditioning. After the training period, their fitness level was actually better than that of the untrained rats that hadn't had a heart attack," says Stølen.

Impaired calcium handling in a heart muscle cell not only causes the cell to contract with reduced force every time there is an action potential. It also causes the calcium to accumulate inside the fluid-filled area of the cell -- the cytosol -- where each contraction begins.

The calcium stores inside the cells are only supposed to release calcium when the heart is preparing to beat. Heart failure, however, causes a constant leakage of calcium out of these stores. After each contraction, calcium needs to be efficiently transported back into the calcium stores -- or out of the heart muscle cell -- via specialized pumps. In heart failure patients, these pumps work poorly.

When a lot of calcium builds up inside the cytosol, the heart muscle cells can initiate new contractions when they're actually supposed to be at rest. An electrical gradient develops which causes the heart to send electrical signals when it shouldn't. This can cause fibrillation in the heart chambers. This ventricular fibrillation is fatal and a common cause of cardiac arrest.

"We found that interval training improves a number of mechanisms that allow calcium to be pumped out of the cells and stored more efficiently inside the cells. The leakage from the calcium stores inside the cells also stopped in the interval-trained rats," says Stølen.

The effect was clear when the researchers tried to induce ventricular fibrillation in the diseased rat hearts: they only succeeded at this in one of nine animals that had completed interval training. By comparison, they had no problems inducing fibrillation in all the rats with heart failure who had not exercised.

So far, the research group had shown that exercise improves calcium management in diseased heart muscle cells in several ways. The training also makes the electrical wiring system of the heart more functional.

In addition, they showed that exercise counteracted processes that cause the heart to become big and stiff.

Taken together, these improvements make each heartbeat more powerful and reduce the severity of heart failure. The risk of dangerous ventricular fibrillation was also reduced.

But Stølen and team still lacked an answer to why exercise corrects slow action potentials and ensures that the heart muscle cells are able to take care of calcium in the right way.

Therefore, they investigated whether the training had altered the genetic activity inside the rat cells. Thousands of different types of micromolecules called micro-RNA probably control most of this activity through direct interaction with genes.

"It turned out that 55 of the micro-RNA variants we examined were altered in rats with heart failure compared to the healthy rats. Interval training changed 18 of these back towards healthy levels. Several of the relevant micromolecules are known to play a role in both calcium management and the electrical conduction system of the heart, but the most interesting thing is that we discovered new micro-RNAs that can play an important role in heart failure," says Stølen.

This article has mostly considered the effects of high-intensity interval training. But the study also includes a group of rats that trained more sedately.

The rats in this group ran the same distance and thus did as much total training work as the rats in the interval training group. However, they had to exercise longer each time since they trained at a lower intensity. Stolen notes that this form of training also resulted in several health improvements.

But, he emphasizes, the vast majority of improvements were greater with interval training. "For example, we were able to induce cardiac fibrillation in five of eight rats after a period of moderate exercise, and their pumping capacity had only improved half as much as in the interval training group."

Better heart health scores in midlife linked to lower risk of late-life dementia

 A long-term study of 1,449 people in Finland found that those who had better scores on standard metrics of cardiovascular health in midlife, especially for behavioral factors such as smoking, had a lower risk of dementia later in life. Yajun Liang of Karolinska Institutet in Stockholm, Sweden, and colleagues present these findings in the open-access journal PLOS Medicine.

Previous research suggests that efforts to address modifiable risk factors, such as behaviors that impact heart health, could reduce the global number of people with dementia by up to one third. However, there is a lack of evidence on potential links between risk of late-life dementia and scores on standard heart health metrics in midlife and late life.

To gain further clarity on late-life risk of dementia, Liang and colleagues analyzed data on 1,449 participants in the Finnish Cardiovascular Risk Factors, Aging and Dementia study, enrolled 1972¬-1987 and assessed in 1998, and 744 dementia-free survivors were followed further into late life (2005¬-2008). Participants' heart health was evaluated from midlife to late life according to six factors classified as three behavioral (smoking status, physical activity, and body mass index) and three biological factors (fasting plasma glucose, total cholesterol, and blood pressure). Dementia was diagnosed in 61 persons in the first follow up, and additional 47 persons in the second.

The researchers found that participants with intermediate or ideal cardiovascular health scores from midlife onwards, especially for behavioral factors, had a lower risk of dementia later in life than participants with poor scores.

The researchers found no significant overall association between heart health scores measured in late life and risk of dementia. However, when looking specifically at biological factors, ideal scores in late life were actually associated with greater risk of dementia. The authors note that this could be because some biological hallmarks of dementia might overlap with "ideal" scores on these factors, such as lower blood pressure and lower cholesterol. They also note that the major limitations of this study include the lack of data on diet and midlife plasma glucose, and high rate of attrition.

These findings suggest that maintaining lifelong cardiovascular health, particularly in the areas of smoking, exercise, and body mass index, could reduce dementia risk later in life.

Resistance training paired with peanut protein affects muscle health in older adults

THE PEANUT INSTITUTE

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IMAGE: THIS INFOGRAPHIC REVIEWS FINDINGS FROM A RECENT STUDY THAT SUGGESTS WHEN COMBINED WITH RESISTANCE TRAINING, DEFATTED PEANUT POWDER CAN BE AN EFFECTIVE PLANT-BASED PROTEIN OPTION FOR POSITIVELY AFFECTING SELECT MARKERS... view more 

CREDIT: © 2020 THE PEANUT INSTITUTE

Declines in muscle mass and strength can begin in early adulthood, unnoticeable at first, and eventually progress until functionality, endurance, and general health may be compromised. Evidence-based and cost-effective lifestyle interventions, such as resistance training (RT) and ensuring optimal dietary protein intake, aim to increase muscle mass in older individuals, and support healthy aging and longevity.

Now, as the popularity and consumer demand for plant-based protein to support exercise training grows, the full array of essential and non-essential amino acids and high protein digestibility of defatted peanut protein powder (PP) makes it an exceptional plant-based protein option. Yet, no studies to date have examined if PP combined with RT can enhance training adaptations and measures of muscle mass, function and strength, especially in an older population. For the first time, a randomized controlled clinical trial from researchers at Auburn University published in the Journal of the International Society of Sports Nutrition demonstrates that in combination with RT, intake of PP positively affects select markers of muscle growth and strength among untrained, older adults.

"Many of the previous studies in this space have looked at how animal-based or soy protein-based supplements enhance the response to resistance training," says Dr. Roberts, PhD, a co-principal investigator on the study from Auburn University in the School of Kinesiology. "This study suggests that pairing resistance training with supplemental peanut powder may be an effective plant-based protein solution to meet protein needs and perhaps slow or prevent age-related loss of muscle in older adults."

Thirty-nine older, untrained individuals completed a six-week or ten-week supervised RT program, where full-body training was implemented twice weekly. Participants were also randomly assigned to consume either a PP supplement mixed with 16 fl. oz. of water once per day (75 total grams of powder providing 30 grams protein, >9.2 grams of essential amino acids, ~315 calories) or be a "wait-list" control who did not receive any supplement (CTL). On workout days, PP supplements were provided immediately following exercise and compliance was monitored by trained study personnel. Skeletal muscle biopsies and other markers of muscle quality, body composition and strength, as well as three-day self-reported habitual food intake, were collected.

PP supplementation significantly increased knee flexion peak torque - a marker of muscle strength - in the ten-week cohort relative to the CTL group. In looking at the combined data from both the six- and ten-week groups, PP participants experienced significant increases in vastus lateralis (VL) thickness - a measure of muscle growth - compared to CTL participants. Notably, the consumption of protein and fiber significantly increased during the study in the PP group compared to CTL. This is attributed to the ~15 grams per day of fiber and 30 grams per day of protein received from the nutritional supplement. Surprisingly, PP supplementation after one bout of resistance exercise did not enhance muscle protein synthesis rates within a 24-hour period following the first training bout. Body composition was not different between the PP and CTL groups.

"There is strong evidence to suggest protein needs, specifically, the intake of more essential amino acids, increase with age due to many factors," added co-principal investigator, Drew Frugé, PhD, RD, with the Department of Nutrition, Dietetics and Hospitality Management at Auburn University. "The protein isolated from peanuts contains a full complement of essential amino acids, including the important muscle growth 'switch' leucine, that can be delivered in a nutrient-dense package with the functional benefit of being simply incorporated into many easy to consume and tasty food or beverage preparations that meet the dietary needs of older adults."

This study followed a rigorous methodology by using a randomized design in a laboratory setting and supervising participant training, as well as PP supplement compliance. However, the researchers noted a few limitations, mainly the duration of the intervention of the second cohort. As the original intent was to recruit two separate ten-week cohorts, due to the SARS-CoV-2 pandemic, the researchers voluntarily decided to end the second cohort after only six weeks of training to maintain the health and safety of the participants. The decision to compare PP supplementation to no supplementation was made to establish more "real world" relevance (i.e., people supplement their diets with protein powder, or nothing at all).

Despite such limitations, the researchers concluded that "...peanut protein powder supplementation with 6-10 weeks of resistance training enhance certain aspects of muscle hypertrophy and strength in older adults, compared to a resistance training program alone in the elderly population." Future studies that are longer in duration are needed to definitively determine if PP supplementation can enhance hypertrophic adaptations with resistance training.

Spermidine given to older adults improves their cognitive function

Spermidine, a drug that boosts the removal of cellular debris in immune cells may increase the protective effects of vaccines in older adults, a study published today in eLife shows.A small clinical trial recently tested whether giving spermidine to older adults would improve their cognitive function. As the results were positive, and spermidine did not appear to have any harmful effects, this provides some evidence that it would be safe to test whether spermidine might also be helpful for boosting the immune response of older people to vaccines.

Good dietary sources of spermidine are aged cheese, mushrooms, soy products, legumes, corn, and whole grains. Spermidine is plentiful in a Mediterranean diet.

An avocado a day keeps your gut microbes happy

IMAGE: ADDING AVOCADO TO YOUR MEAL IMPROVES GUT HEALTH, A NEW UNIVERSITY OF ILLINOIS STUDY SHOWS. view more 

CREDIT: COLLEGE OF ACES, UNIVERSITY OF ILLINOIS.

URBANA, Ill. - Eating avocado as part of your daily diet can help improve gut health, a new study from University of Illinois shows. Avocados are a healthy food that is high in dietary fiber and monounsaturated fat. However, it was not clear how avocados impact the microbes in the gastrointestinal system or "gut."

"We know eating avocados helps you feel full and reduces blood cholesterol concentration, but we did not know how it influences the gut microbes, and the metabolites the microbes produce," says Sharon Thompson, graduate student in the Division of Nutritional Sciences at U of I and lead author on the paper, published in the Journal of Nutrition.

The researchers found that people who ate avocado every day as part of a meal had a greater abundance of gut microbes that break down fiber and produce metabolites that support gut health. They also had greater microbial diversity compared to people who did not receive the avocado meals in the study.

"Microbial metabolites are compounds the microbes produce that influence health," Thompson says. "Avocado consumption reduced bile acids and increased short chain fatty acids. These changes correlate with beneficial health outcomes."

The study included 163 adults between 25 and 45 years of age with overweight or obesity - defined as a BMI of at least 25 kg/m2 - but otherwise healthy. They received one meal per day to consume as a replacement for either breakfast, lunch, or dinner. One group consumed an avocado with each meal, while the control group consumed a similar meal but without the avocado. The participants provided blood, urine, and fecal samples throughout the 12-week study. They also reported how much of the provided meals they consumed, and every four weeks recorded everything they ate.

While other research on avocado consumption has focused on weight loss, participants in this study were not advised to restrict or change what they ate. Instead they consumed their normal diets with the exception of replacing one meal per day with the meal the researchers provided.

The purpose of this study was to explore the effects of avocado consumption on the gastrointestinal microbiota, says Hannah Holscher, assistant professor of nutrition in the Department of Food Science and Human Nutrition at U of I and senior author of the study.

"Our goal was to test the hypothesis that the fats and the fiber in avocados positively affect the gut microbiota. We also wanted to explore the relationships between gut microbes and health outcomes," Holscher says.

Avocados are rich in fat; however, the researchers found that while the avocado group consumed slightly more calories than the control group, slightly more fat was excreted in their stool.

"Greater fat excretion means the research participants were absorbing less energy from the foods that they were eating. This was likely because of reductions in bile acids, which are molecules our digestion system secretes that allow us to absorb fat. We found that the amount of bile acids in stool was lower and the amount of fat in the stool was higher in the avocado group," Holscher explains.

Different types of fats have differential effects on the microbiome. The fats in avocados are monounsaturated, which are heart-healthy fats.

Soluble fiber content is also very important, Holscher notes. A medium avocado provides around 12 grams of fiber, which goes a long way toward meeting the recommended amount of 28 to 34 grams of fiber per day.

"Less than 5% of Americans eat enough fiber. Most people consume around 12 to 16 grams of fiber per day. Thus, incorporating avocados in your diet can help get you closer to meeting the fiber recommendation," she notes.

Eating fiber isn't just good for us; it's important for the microbiome, too, Holscher states. "We can't break down dietary fibers, but certain gut microbes can. When we consume dietary fiber, it's a win-win for gut microbes and for us."

Holscher's research lab specializes in dietary modulation of the microbiome and its connections to health. "Just like we think about heart-healthy meals, we need to also be thinking about gut healthy meals and how to feed the microbiota," she explains.

Avocado is an energy-dense food, but it is also nutrient dense, and it contains important micronutrients that Americans don't eat enough of, like potassium and fiber.

"It's just a really nicely packaged fruit that contains nutrients that are important for health. Our work shows we can add benefits to gut health to that list," Holscher says.

 

Everything you want to know about sunscreen

 

CANADIAN MEDICAL ASSOCIATION JOURNAL

Research News

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From safety and effectiveness to who should use sunscreen and how to apply it, Canadian dermatologists review the latest evidence and guidelines on use of sunscreen.

The review, published in CMAJ (Canadian Medical Association Journal), recommends that everyone older than six months of age should use sunscreen to protect against skin cancer 
https://www.cmaj.ca/lookup/doi/10.1503/cmaj.201085.

Most skin cancers develop because of long-term sun exposure. Sunscreen reduces the risk of developing skin cancer by blocking solar radiation through chemical or physical sunscreen filters such as titanium dioxide and zinc oxide.

"Exposure to ultraviolet radiation is directly harmful and has been associated with the development of skin cancers, which are common in Canada. High-quality evidence has shown that sunscreen reduces the risk of developing both melanoma and nonmelanoma skin cancer," writes Dr. Megan Sander, a dermatologist and clinical lecturer at the Cumming School of Medicine, University of Calgary, Calgary, Alberta, with coauthors.

Some key points:

• Prevention -- Evidence from randomized controlled trials indicates that sunscreen is effective at protecting against skin cancer as well as premature aging of the skin.
• Non-White populations -- There is a lack of evidence for the effectiveness of sunscreen in people with darker skin. Current evidence is mostly limited to White people, who have a higher rate of skin cancers.
• Babies -- Sun avoidance and protective clothing are recommended for babies. Sunscreen is not recommended for use before age 6 months because of the potential for systemic absorption of sunscreen ingredients.
• SPF -- Sunscreens with an SPF (sun protection factor) of 30 or higher are recommended in cream or lotion format. Spray-on sunscreens are not recommended as they can be dispersed, are flammable and their effects if inhaled are unknown.
• Harms -- Some people can have skin reactions such as contact dermatitis, especially to chemical sunscreens, and there is evidence these sunscreens can be systemically absorbed, although the clinical importance of the absorption is not known.
• Environmental impact -- Recent evidence indicates that chemical sunscreens can be detected in water and fish and may contribute to the bleaching of coral reefs.

"Sunscreen is only one part of a comprehensive photoprotection strategy. It is important to counsel patients regarding behaviours for avoiding ultraviolet radiation, including the use of wide-brimmed hats, eye protection (e.g., "wrap-around" sunglasses with ultraviolet radiation protection) and seeking shade when the ultraviolet index is above 3 (usually 11 am-3 pm, April to September in Canada)," write the authors.

High blood pressure at any age, no matter how long you have it, may speed cognitive decline

Hypertension journal report

AMERICAN HEART ASSOCIATION

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DALLAS, Dec. 14, 2020 -- High blood pressure appears to accelerate a decline in cognitive performance in middle-aged and older adults, according to new research published today in Hypertension, an American Heart Association journal.

Nearly half of American adults have high blood pressure or hypertension. Having high blood pressure is a risk factor for cognitive decline, which includes such things as memory, verbal fluency, attention and concentration. Blood pressure of 120 mmHg - 129 mmHg systolic (the top number in a reading) or higher is considered elevated. Systolic pressure above 130 mmHg, or diastolic pressure (the bottom number) of 80 mmHg or higher is considered hypertension.

"We initially anticipated that the negative effects of hypertension on cognitive function would be more critical when hypertension started at a younger age, however, our results show similar accelerated cognitive performance decline whether hypertension started in middle age or at older ages," said study author Sandhi M. Barreto, M.D., M.Sc., Ph.D., professor of medicine at the Universidade Federal de Minas Gerais in Belo Horizonte, Brazil. "We also found that effectively treating high blood pressure at any age in adulthood could reduce or prevent this acceleration. Collectively, the findings suggest hypertension needs to be prevented, diagnosed and effectively treated in adults of any age to preserve cognitive function."

Barreto and colleagues analyzed findings from an existing study that included blood pressure and cognitive health information for more than 7,000 adults in Brazil, whose average age was about 59 years old at the study's start. The study participants were followed for an average of nearly 4 years; testing included analysis of memory, verbal fluency and executive function, which includes attention, concentration and other factors associated with thinking and reasoning.

Their analysis found:

• Systolic blood pressure between 121 and 139 mmHg or diastolic blood pressure between 81 and 89 mmHg with no antihypertensive medication use was associated with accelerated cognitive performance decline among middle-aged and older individuals.
• The speed of decline in cognition happened regardless of hypertension duration, meaning high blood pressure for any length of time, even a short duration, might impact a person's speed of cognitive decline.
• Adults with uncontrolled hypertension tended to experience notably faster declines in memory and global cognitive function than adults who had controlled hypertension.

"In addition to other proven benefits of blood pressure control, our results highlight the importance of diagnosing and controlling hypertension in patients of any age to prevent or slow down cognitive decline," Barreto said. "Our results also reinforce the need to maintain lower blood pressure levels throughout life, since even prehypertension levels were associated with cognitive decline."

According to Barreto, some of the study's limitations are the relatively short follow-up period and that the participants self-reported the hypertension diagnosis at baseline.

"Although the participants of our study are adults from Brazil, we believe that our findings are applicable to other regions. Previous studies have shown that similar unhealthy behaviors and risk factors, including hypertension, are common in the development of cardiovascular diseases in different populations across the globe," Barreto said.