Diet and exercise program eased knee pain and triggered weight loss

Participants report no longer needing medication or surgery with one man shedding 39kgs

New research investigating the benefits of telehealth-delivered exercise and diet programs has found 80 per cent of participants experienced improvement in pain and an average of 10 per cent in loss of body weight, with one man shedding 39 kilograms. 

More than 400 individuals with knee osteoarthritis participated in the Better Knee, Better Me trial, developed by the University of Melbourne in partnership with Medibank and Austin Health.

Published in the Annals of Internal Medicinetoday, the study shows researchers evaluated two six-month telehealth-delivered exercise programs, one with and one without a weight-loss dietary program, compared with an information-only control group.

During the trial, participants in the intervention groups were provided support from physiotherapists and dietitians via Zoom and a suite of resources. Those in the exercise plus diet group also received meal replacements so they could undertake a ketogenic low energy diet.

Compared to the group that only received information, both intervention programs resulted in benefits for pain, function and quality of life. Compared to the exercise-only program, the combined exercise and diet program led to additional benefits – including a greater reduction in pain, greater improvements in physical function, lower use of pain medications, and significant weight loss. After both programs, participants were also less willing to undergo knee joint replacement surgery.

Lead researcher and Director of the Centre for Health, Exercise and Sports Medicine at the University of Melbourne Professor Kim Bennell, said participants lost on average 10.2 kilograms over a six-month period with four out of five participants achieving significant improvement in pain. She said 30 per cent of participants lived in regional and rural Australia.

“We are proud to have developed a program that has a strong regional and rural representation and is based on a trial which made a real difference in the lives of participants. Particularly during these times of pandemic-related travel restrictions, it is crucial Australians are able to access home-based treatments to manage their osteoarthritis symptoms, no matter where they live or what COVID restrictions are in place.”

Participant Matthew Boyd, from Toowoomba in Queensland, said his knee pain had become unbearable and was struggling to do the things he enjoyed, leading to a decline in physical activity and an increase in his weight.

“Since taking part in Better Knee, Better Me, I feel amazing. I have lost 16kg which has decreased the weight load on my knees, and my pain. I no longer take any pain relief for my knee pain, which has meant I have been able to return to all the physical activities I wasn’t able to do over the past five years. The pain in my knees no longer dictates my daily routine and I am back moving in a way I haven’t done in years,” Mr Boyd said.

Around 2.1 million Australians are currently living with osteoarthritis. The prevalence of osteoarthritis is expected to increase by 58 per cent by 2032 due to an ageing population and rising obesity rates.

Medibank Head of Member Health Service and Design Catherine Keating said Medibank wants to provide its customers with healthcare that gives them more choice and control in how they receive their care. 

“It’s part of our focus on taking the lead on driving preventative health because we know our customers want personalised support to improve their health and wellbeing.”

Ultra-processed foods increase the risk of a second heart attack or stroke

 

A high consumption of industrially processed foods significantly increases the risk of a second heart attack or a fatal stroke in people who already suffer from cardiovascular diseases, even if they follow the Mediterranean diet

Ultra-processed foods are a major public health concern for their potential adverse effects on health. Now a study by the Department of Epidemiology and Prevention of the I.R.C.C.S. Neuromed in Pozzilli (Italy) explores the health effects of a large dietary share of ultra-processed food on people already suffering from cardiovascular diseases. The findings indicate a higher risk of a second heart attack (or stroke), this time fatal. Moreover, another observation emerges from this study: even in people generally following the Mediterranean diet, but consuming too many ultra-processed foods, health risks are higher.

The study, published in the European Heart Journal, the European Society of Cardiology journal, followed 1,171 people participating in the Moli-sani epidemiological project for over ten years. All of them already had cardiovascular disease at the time of inclusion in the study. Regarding the diet followed by participants, the researchers focused on the consumption of ultra-processed foods, made in part or entirely with substances not routinely used in cooking (hydrolysed proteins, maltodextrins, hydrogenated fats, for example) and which generally contain various additives, such as dyes, preservatives, antioxidants, anticaking agents, flavour enhancers and sweeteners. This category includes sugary and carbonated drinks, pre-packaged meals, spreads and some apparently “unsuspected” products, such as rusks, breakfast cereals, crackers and fruit yoghurt. These foods were classified using the NOVA system, which rates foods according to the degree of processing rather than on their nutritional value.  

"We saw - explains Marialaura Bonaccio, researcher at the Department of Epidemiology and Prevention and first author of the study - that people with a higher consumption of ultra-processed foods have a two-thirds increased risk of a second heart attack or stroke, this time fatal, compared to participants eating these foods less frequently. The probability of dying from any cause is also 40% higher. It is important to underline that the definition of ultra-processed food is not linked to the nutritional content, but rather to the process used for its preparation and storage. In other words, even if a food is nutritionally balanced, it might still be considered ultra-processed. Clearly, it is not the single food consumed occasionally that makes the difference, rather a diet that, as a whole, contains too many products coming from supermarket shelves. A diet based on the consumption of fresh, minimally processed products should be always preferred, as the Mediterranean tradition has been teaching us for centuries".

“This study - says Licia Iacoviello - Director of the Department of Epidemiology and Prevention at Neuromed – conveys an important message: it is time to overcome the distinction between healthy and unhealthy food solely on the basis of the nutrient value. In other words, a person could follow a Mediterranean diet, perhaps rich in legumes or vegetables, a healthy diet we would say. But the simple definition of 'Mediterranean' does not tell us 'how' those foods were prepared. Fresh vegetables are not the same as pre-cooked and seasoned vegetables, and the same goes for many other foods. It is a factor to be increasingly considered when advising citizens about proper nutrition. Our proposal is that the level of industrial processing of foods should be added to the front-of-pack labels, which until now only provide nutritional information".

 

Prunes have promising effect on men’s bone health

New research from San Diego State University’s School of Exercise and Nutritional Sciences reports that eating prunes daily has a protective effect on bone health in men over 50. This study is the first of its kind to examine the beneficial prune effect on bones in men. It is estimated that 2 million men are battling osteoporosis and another 16.1 million men have low bone mass, or osteopenia (Wright et al., 2014). Despite these statistics, bone disease in men is often overlooked.

“We’ve already seen significant evidence that prunes have a positive effect on bone health in women, so it’s particularly exciting to find that prunes can also play a beneficial role in men’s bone health. We look forward to continuing to study the ‘prune effect’ on bone and other health outcomes in men,” said lead researcher Professor Shirin Hooshmand, PhD, RD, School of Exercise and Nutritional Sciences, San Diego State University.

In this randomized-controlled clinical study, 57 healthy men aged 50-79 years old were assigned to either consume 100 grams of prunes every day or no prunes for twelve months. At the conclusion of 1-year, the prune consumers showed significant decreases in biomarkers of bone breakdown, while no changes were observed in the control group (Hooshmand et al., 2021). The study authors also reported the men who ate prunes showed improvements in bone geometry indicating greater bone strength.

Historically, research has focused on osteoporosis and bone health in women, already indicating a favorable bone response to prunes specifically among postmenopausal women. Several studies have suggested that eating 50 to 100 grams of prunes everyday could lead to increased bone mass and decreased bone breakdown (Arjmandi et al., 2001; Hooshmand et al., 2011, 2014, 2016). Moreover, a recent case study published in the Bone Reports earlier this year reported that total bone mineral density increased in a postmenopausal woman with osteopenia after she consumed 50 grams of prunes daily for 16 months (Strock et al., 2021).

“Bone health is not just a concern for women. Men need to think about how to protect their bones as well,” said Leslie Bonci, MPH, RDN and consultant with the California Prune Board. “Prunes are a shelf-stable and nutrient-packed food that provide a preventive, proactive, palatable option for men to optimize their bone health.”

While San Diego State University’s newest research is an exciting addition to existing prune-focused literature, more investigations into the effect of prunes on human bone health are currently underway. An upcoming study from Pennsylvania State University examines how consuming different amounts of prunes affects health outcomes in postmenopausal women over a one-year period. The study not only explores the impact of prunes on bone health, but it will also look at the prune-effect on inflammation and gut health.

The men’s bone study by Hooshmand et al. (2021) can be found here.

Prunes may help rein in holiday cravings, according to new research

 

With the holiday season in full swing, consumers are met with countless opportunities to indulge in decadent, calorie-dense foods, which can make their health goals and choices more challenging to manage. New research from the University of Liverpool, England reports that consuming prunes can help control appetite and reduce overall caloric consumption, serving as a perfect snack to keep holiday cravings at bay.

“These studies demonstrate that dried fruit can both produce satiety and be incorporated into the diet during weight management,” said Professor Jason C G Halford, University of Leeds and President of the European Association for the Study of Obesity (EASO), who was part of the research team.

The study was conducted in two phases. In the first phase, researchers compared satiety, appetite, and caloric intake among participants who consumed a snack of either prunes, raisins, or jelly-bean-like candy, all comparable in calories. Researchers found that those who ate prunes consumed the fewest calories overall at subsequent meals. The prune snackers also reported reduced hunger levels, improved satiety, and a greater perceived ability to eat less food at subsequent meals.

In the second phase of the study, researchers focused specifically on weight loss. Participants were divided into two groups – those who followed a 12-week weight loss program with prunes as their snack and those who followed the same program but were only provided with guidance on healthy snacking. While there were no statistically significant differences between the two groups in terms of pounds lost, the prune group experienced greater weight loss on average than the group who only received healthy snacking guidelines (-4.4 lbs. versus -3.4 lbs.). Additionally, those who consumed prunes also reported higher levels of satisfaction and greater ease of following the weight-loss program. 

“This study reveals that nutrient dense prunes can provide an advantage over other snack choices due to their favorable effects on satiety and appetite control,” said Andrea N. Giancoli, MPH, RD Nutrition Advisor for the California Prune Board.

While consumers may be concerned about troublesome side effects for their digestive system, Halford states “These are the first data to demonstrate both weight loss and no negative side effects when consuming prunes as part of a weight management diet.”

As consumers continue their merry way through this festive season, they may want to consider reaching for a handful of prunes to keep their health goals on track into the new year. The study can be accessed here.

Low to moderate seafood consumption not associated with risk of all-cause or CVD-related mortality

 

Key Points

Question  Are seafood consumption and mercury exposure with the current seafood consumption level associated with all-cause and cardiovascular disease (CVD)–related mortality among US adults?

Findings  In this cohort study of 17 294 US adults, no association was found between an increase in seafood consumption of 1 oz equivalent per day and all-cause and CVD-related mortality. In addition, blood mercury level was not associated with all-cause or CVD-related mortality.

Meaning  In this cohort study, environmental mercury exposure at the currently low to moderate level and seafood consumption were not associated with risk of all-cause or CVD-related mortality.

Abstract

Importance  Although seafood is known to contain heart-healthy omega-3 fatty acids, many people choose to limit their seafood consumption because of fear of mercury exposure from seafood. It is imperative to clarify the potential health effects of current mercury exposure in contemporary populations.

Objective  To examine the association of seafood consumption and mercury exposure with all-cause and cardiovascular disease (CVD)–related mortality in the US general population.

Design, Setting, and Participants  This prospective cohort study included adults 20 years or older who participated in the 2003 to 2012 cycles of the National Health and Nutrition Examination Survey; data were linked to mortality records through December 31, 2015. Data analysis was performed from January to March 10, 2021.

Exposures  Seafood consumption was assessed through two 24-hour dietary recalls, and mercury exposure was assessed by blood mercury levels.

Main Outcomes and Measures  All-cause and CVD-related mortality. Multivariable Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs of mortality associated with usual seafood consumption and blood mercury concentration quartiles.

Results  This study included 17 294 participants (mean [SD] age, 45.9 [17.1] years; 9217 [53.3%] female) with a mean (SD) blood mercury concentration of 1.62 (2.46) μg/L. During 131 276 person-years of follow-up, 1076 deaths occurred, including 181 deaths from CVD. The multivariable-adjusted HR for an increase in seafood consumption of 1 oz equivalent per day and all-cause mortality was 0.84 (95% CI, 0.66-1.07) and for CVD-related mortality was 0.89 (95% CI, 0.54-1.47). Blood mercury level was not associated with all-cause or CVD-related mortality. Comparing the highest with the lowest quartile of blood mercury concentration, the multivariable-adjusted HRs were 0.82 (95% CI, 0.66-1.05) for all-cause mortality and 0.90 (95% CI, 0.53-1.52) for CVD-related mortality.

Conclusions and Relevance  In this cohort study of US adults, seafood consumption and mercury exposure with the current seafood consumption level were not significantly associated with the risk of all-cause or CVD-related mortality. These findings may inform future public health guidelines regarding mercury exposure, seafood consumption, and cardiovascular health promotion.

Moderna COVID-19 vaccine effective 5 months after 2nd dose

 

Kaiser Permanente study shows Moderna COVID-19 vaccine is 87% effective in preventing COVID-19 infection, and more than 95% effective in preventing severe COVID-19.

— Kaiser Permanente research in Southern California published Nov. 25, 2021, in The Lancet Regional Health – Americas confirmed high Moderna COVID-19 vaccine effectiveness up to 5 months after the second dose. Effectiveness was 87% against COVID-19 infection, 96% against COVID-19 hospitalization, and 98% against COVID-19 death.

“This research provides reassuring evidence of the high effectiveness of the Moderna COVID-19 vaccine in preventing infection, hospitalization, and death from COVID-19,” said Katia Bruxvoort, PhD, an adjunct investigator with the Kaiser Permanente Southern California Department of Research & Evaluation. “One of the important aspects of this study was that it included more than 700,000 adults who were racially and ethnically diverse and had a broad range of underlying conditions including chronic diseases, immunocompromising conditions, and autoimmune conditions.”

This study evaluated the 5-month effectiveness of the Moderna COVID-19 mRNA vaccine as part of a 5-year observational study within Kaiser Permanente, an integrated health care organization with 4.7 million members in Southern California.

The study included 352,878 recipients of 2 doses of Moderna COVID-19 vaccine matched to 352,878 unvaccinated individuals by age, sex, race, and ethnicity. Vaccinated individuals received 2 doses of Moderna COVID-19 vaccine from December 18, 2020, to March 31, 2021. Individuals in both groups were followed until June 30, 2021.

• During follow-up, COVID-19 infections occurred among 289 vaccinated patients and 1,144 unvaccinated patients. Vaccine effectiveness against COVID-19 infection was 87%.
• COVID-19 hospitalization occurred among 13 vaccinated and 182 unvaccinated patients, and COVID-19 in-hospital deaths occurred among 1 vaccinated and 25 unvaccinated patients. Vaccine effectiveness against COVID-19 hospitalization was 96%, and vaccine effectiveness against COVID-19 in-hospital deaths was 98%.
• Vaccine effectiveness against COVID-19 infection remained high across age, sex, racial, and ethnic subgroups, with results ranging from 83% to 92%.
• Vaccine effectiveness was higher against symptomatic COVID-19 (88%) than asymptomatic COVID-19 (73%).
• From March to June 2021, there were 5,619 SARS-CoV-2 positive specimens that were successfully sequenced. The most prevalent variants were alpha (42%), epsilon (18%), delta (12%), and gamma (9%), with delta increasing to 54% of variants by June 2021.

“This study adds evidence of real-world Moderna COVID-19 vaccine effectiveness, particularly among the general population,” said Hung Fu Tseng, PhD, a researcher with the Kaiser Permanente Southern California Department of Research & Evaluation and the senior author of the study. “Additionally, our follow-up on these fully vaccinated patients occurred through June 2021, a period that overlapped with the emergence of the delta variant in the United States. Long-term follow-up is ongoing to further evaluate the durability of protection.”

The study was funded by Moderna, Inc.

Adverse changes in metabolic health during menopausal transition may be mitigated with a physically active lifestyle

 

A study conducted at the University of Jyväskylä in the Faculty of Sport and Health Sciences shows that menopausal transition is associated with unfavourable changes in metabolic health that may be mitigated with a physically active lifestyle. Especially, physical activity alleviated the increase in systolic blood pressure.

Menopausal transition has been associated with an increase in abdominal fat mass, blood pressure, and blood glucose levels as well as the deterioration in cholesterol levels. These changes increase the risk of, for example, cardiovascular disease and type II diabetes in postmenopausal women. Physical activity is known to be beneficial for promoting metabolic health and reduce the risk of cardiovascular and metabolic disease. Little is known, however, about the associations between physical activity and changes in metabolic health indicators during menopause.

– Metabolic health deteriorates in both men and women due to aging, but in women these changes seem to accelerate in midlife at the time of menopause, says doctoral researcher Hanna-Kaarina Juppi.

– Since women can live for several decades after menopause, understanding the factors behind metabolic health deterioration is important. By following women with a similar age but differing menopausal status, we were able to separate the changes caused by the menopausal hormonal changes from the aging-related deterioration in metabolic health.

In the study, the women were divided into three groups based on the change in their menopausal status during the follow-up period and the groups were compared to each other. Body composition, waist circumference, blood pressure, blood lipids and glucose and physical activity were measured twice during the four-year follow-up time. In all groups, the levels of several metabolic health indicators deteriorated. For example, mid-region obesity, LDL cholesterol and blood glucose increased during the study, and the most significant changes were observed in the group that experienced menopause during the follow-up period.

– Based on the results, menopause is associated with the deterioration of metabolic health, adds doctoral researcher Matti Hyvärinen.

– But a physically active lifestyle may prevent the accumulation of metabolic risk factors in menopausal women. We observed that more active participants had a healthier metabolic risk factor profile. For example, more active participants had lower LDL and higher HDL cholesterol levels as well as smaller fat mass and waist circumference. Additionally, the results implied that physically active lifestyle is effective for mitigating the increase in systolic blood pressure during the menopausal transition.

Drinking coffee could lower the risk of Alzheimer’s disease

A long-term study has revealed drinking higher amounts of coffee may make you less likely to develop Alzheimer's disease.

As part of the Australian Imaging, Biomarkers and Lifestyle Study of ageing, researchers from Edith Cowan University (ECU) investigated whether coffee intake affected the rate of cognitive decline of more than 200 Australians over a decade.

Lead investigator Dr Samantha Gardener said results showed an association between coffee and several important markers related to Alzheimer's disease.

"We found participants with no memory impairments and with higher coffee consumption at the start of the study had lower risk of transitioning to mild cognitive impairment -- which often precedes Alzheimer's disease -- or developing Alzheimer's disease over the course of the study," she said.

Drinking more coffee gave positive results in relation to certain domains of cognitive function, specifically executive function which includes planning, self-control, and attention.

Higher coffee intake also seemed to be linked to slowing the accumulation of the amyloid protein in the brain, a key factor in the development of Alzheimer's disease.

Dr Gardener said although further research was needed, the study was encouraging as it indicated drinking coffee could be an easy way to help delay the onset of Alzheimer's disease.

"It's a simple thing that people can change," she said.

"It could be particularly useful for people who are at risk of cognitive decline but haven't developed any symptoms.

"We might be able to develop some clear guidelines people can follow in middle age and hopefully it could then have a lasting effect."

Make it a double

If you only allow yourself one cup of coffee a day, the study indicates you might be better off treating yourself to an extra cup, although a maximum number of cups per day that provided a beneficial effect was not able to be established from the current study.

"If the average cup of coffee made at home is 240g, increasing to two cups a day could potentially lower cognitive decline by eight per cent after 18 months," Dr Gardener said.

"It could also see a five per cent decrease in amyloid accumulation in the brain over the same time period."

In Alzheimer's disease, the amyloid clumps together forming plaques which are toxic to the brain.

The study was unable to differentiate between caffeinated and de-caffeinated coffee, nor the benefits or consequences of how it was prepared (brewing method, the presence of milk and/or sugar etc).

Dr Gardener said the relationship between coffee and brain function was worth pursuing.

"We need to evaluate whether coffee intake could one day be recommended as a lifestyle factor aimed at delaying the onset of Alzheimer's disease," she said.

More than just caffeine

Researchers are yet to determine precisely which constituents of coffee are behind its seemingly positive effects on brain health.

Though caffeine has been linked to the results, preliminary research shows it may not be the sole contributor to potentially delaying Alzheimer's disease.

"Crude caffeine" is the by-product of de-caffeinating coffee and has been shown to be as effective in partially preventing memory impairment in mice, while other coffee components such as cafestol, kahweol and Eicosanoyl-5-hydroxytryptamide have also been seen to affect cognitive impairment in animals in various studies.

'Higher Coffee Consumption Is Associated With Slower Cognitive Decline and Less Cerebral A?-Amyloid Accumulation Over 126 Months: Data From the Australian Imaging, Biomarkers, and Lifestyle Study' was published in Frontiers of Ageing Neuroscience.

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Treating insomnia with cognitive behavioral therapy can prevent major depression in older adults

 

Cognitive behavioral therapy to treat insomnia was more effective in preventing major depression as compared to sleep education therapy in adults over the age of 60 with insomnia

 A new study led by researchers at UCLA Health has found that cognitive behavioral therapy (CBT-I) prevented major depression, decreasing the likelihood of depression by over 50% as compared to sleep education therapy in adults over the age of 60 with insomnia.

Their findings, reported today in JAMA Psychiatry, could advance public health efforts to effectively treat insomnia and prevent major depression disorder (MDD) in older adults – a growing population that is projected to rise from about 54 million Americans aged 65 and older today to about 86 million in 2050. 

More than 10% of community dwelling adults older than 60 years will experience a major depression later in life in any given year. Late-life depression increases the risk of health conditions such as heart disease and high blood pressure, cognitive decline, and suicide particularly in men. Despite its prevalence in older adults, depression often goes undiagnosed and untreated. And, even among those who receive treatment, only about one-third get better or achieve remission.

“Given that older adults account for nearly 20% of the U.S. population and are the most vulnerable for health risks associated with depression, effective depression prevention is urgently needed,” said Dr. Michael Irwin, lead author of the study and the director of the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience, and a Professor of Psychiatry and Biobehavioral Sciences at the David Geffen School of Medicine at UCLA. “Insomnia more than doubles the risk for major depression. By targeting insomnia and effectively treating it with CBT-I, depression can be effectively prevented by over 50% in community dwelling older adults with insomnia.” 

Insomnia, a condition where people have difficulty falling and staying asleep, occurs in nearly 50% of adults 60 years of age or older and when it occurs, the risk of depression is more than doubled. Although various types of sleep medications are often used to treat insomnia, they provide only temporary relief and pose a risk for daytime side effects such as prolonged drowsiness or headache, and dependency. 

Accordingly, CBT-I is recommended as the first line of treatment for people with insomnia and has been highly effective in its treatment. This type of therapy typically centers around working with a therapist to help identify and change inaccurate or distorted thinking patterns, emotional responses, and behaviors.

But how well CBT-I works to prevent major depression from occurring in older adults with insomnia has been uncertain. Prior studies showed CBT-I has benefit in treating insomnia and depressive symptoms, but it was not known whether selectively targeting insomnia, a known risk for depression, would prevent it in older adults with insomnia but without depression.

To find out, the researchers enrolled 291 adults 60 years and older with insomnia but who had not experienced any depression for 12 months or longer, randomly assigning half the group to receive CBT-I by a trained psychologist, with the other half to receive sleep education therapy (SET) from a public health educator. SET includes education about sleep, healthy sleep habits and the impact of stress on sleep. Both groups received weekly 120-minute group sessions for two months and then underwent follow-up for three years.

Over the course of 36 months of follow up, participants completed monthly questionnaires to screen for symptoms of depression and/or from insomnia and were diagnostically interviewed every six months to determine whether an episode of clinical depression had occurred. 

Key findings showed that depression occurred in 25.9% of the older adults in the SET control group during follow-up, whereas depression occurred in only 12.2% in the CBT-I group, a 51% reduction in the risk of depression with CBT-I treatment.

Second, remission of insomnia that was continuously sustained during follow-up was more likely in the CBT-I group as compared to SET. Among those who received CBT-I and had sustained remission of insomnia, the likelihood of depression was reduced by 83%. Depression occurred in over 27% of the older adults in the SET group who did not have insomnia remission, whereas depression occurred in less than 5% of those in the CBT group who achieved insomnia remission.

These findings suggest that treatment with CBT-I provided significant benefit to prevent incident and recurrent major depressive disorder in older adults with insomnia and that it did so by treating insomnia, a known risk factor for depression.

“Our study was one of the largest selective prevention trials with the longest follow up to show that treatment of insomnia, a modifiable risk factor for depression, can robustly prevent the onset of a clinical episode of depression in older adults with insomnia who were not depressed at entry,” said Dr. Irwin. “We also showed that CBT-I produced sustained remission of insomnia. Treatment of insomnia, along with prevention of depression, taken together, could have huge public health implications in reducing health risks, suicide and cognitive decline in older adults.”

Exercising at the start of fast can help people reach ketosis 3.5 hours faster

 With Thanksgiving just a day away — and the most anticipated meal of the year already in the works — the last thing on most people's minds right now is fasting. (Of course, maybe by Thursday evening, a few of us will be feeling like fasting for a day.)

But even with a short Thanksgiving pause, many people are turning to fasting for weight loss and improved metabolic health, whether that be a regimen of time-restricted eating, periodic fasting or the “monk” fast. Now a new Brigham Young University study published in the journal Medicine & Science in Sports & Exercise finds that exercising intensely at the start of a fast may help maximize health benefits of temporarily foregoing food.

“We really wanted to see if we could change the metabolism during the fast through exercise, especially how quickly the body enters ketosis and makes ketones,” said BYU Ph.D. student Landon Deru, who helped design the study for his thesis.

Ketosis occurs when the body runs out of glucose — its first, preferred fuel — and begins breaking down stored fat for energy, producing chemicals called ketones as a byproduct. In addition to being a healthy energy source for the brain and heart, ketones combat diseases like diabetes, cancer, Parkinson’s and Alzheimer’s.

For the study, the researchers asked 20 healthy adults to complete two 36-hour fasts while staying hydrated. Each fast began after a standardized meal, the first fast starting without exercise and the other with a challenging treadmill workout. Every two hours while awake, the subjects completed hunger and mood assessments and recorded their levels of B-hydroxybutyrate (BHB), a ketone-like chemical.

Exercise made a big difference: when participants exercised, they reached ketosis on average three and a half hours earlier in the fast and produced 43% more BHB. The theory is that the initial exercise burns through a substantial amount of the body’s glucose, prompting a quicker transition to ketosis. Without exercise, the participants hit ketosis about 20 to 24 hours into the fast.

“For me, the toughest time for fasting is that period between 20 and 24 hours, so if I can do something to stop fasting before 24 hours and get the same health outcomes, that’s beneficial,” said study coauthor Bruce Bailey, a BYU exercise science professor. “Or if I do fast for my usual 24 hours but start with exercise, I’ll get even more benefits.”

There are a few caveats to the proposed strategy, however.

“If you carb load or eat a huge meal before you fast, you may not reach ketosis for days, even if you do exercise, so you should eat moderately before fasting,” Bailey said. “We also don’t know the ideal frequency for fasting. There are definitely certain people who shouldn’t fast, such as those with Type 1 diabetes, and obviously it’s detrimental to fast 24/7. But for most people it’s perfectly safe and healthy to fast once or even twice a week for 24 or more hours.”

The study, which required participants to run on a treadmill for an average of 45 to 50 minutes, also didn’t establish an ideal amount or type of exercise for every person. Overall, though, the researchers believe the more energy a person can burn, the better.

“You can get a pretty good estimation of how many calories you’re burning in most exercises, and the more carbohydrates you burn off (without overdoing it or injuring yourself), the better you set the stage for starting ketosis early in your fast,” Deru said.

Also important to note is that, according to the participants’ reports, exercise didn’t seem to aggravate hunger or affect moods during the fast.

“Everyone’s going to be a little grumpier when they fast, but we found that you aren’t going to feel worse with the intervention of exercise — with exercise, you can get these extra benefits and be the exact same amount of grumpy as you would be if you didn’t exercise,” said Deru.

Only alcohol -- not caffeine, diet or lack of sleep -- might trigger heart rhythm condition

 

Lifestyle factors may play role in managing the malady, latest study shows

New research from UC San Francisco that tested possible triggers of a common heart condition, including caffeine, sleep deprivation and sleeping on the left side, found that only alcohol use was consistently associated with more episodes of the heart arrhythmia. 

The authors conclude that people might be able to reduce their risk of atrial fibrillation (AF) by avoiding certain triggers. 

The study is published in JAMA Cardiology https://jamanetwork.com/journals/jamacardiology/fullarticle/2786196 and was presented November 14, 2021, at the annual Scientific Sessions of the American Heart Association.   

Researchers were surprised to find that although most of the things that participants thought would be related to their AF were not, those in the intervention group still experienced less arrhythmia than the people in a comparison group that was not self-monitoring.

“This suggests that those personalized assessments revealed actionable results,” said lead author Gregory Marcus, MD, professor of medicine in the Division of Cardiology at UCSF. “Although caffeine was the most commonly selected trigger for testing, we found no evidence of a near-term relationship between caffeine consumption and atrial fibrillation. In contrast, alcohol consumption most consistently exhibited heightened risks of atrial fibrillation.” 

Atrial fibrillation contributes to more than 150,000 deaths in the United States each year, reports the federal Centers for Disease Control and Prevention, with the death rate on the rise for more than 20 years. 

To learn more about what patients felt was especially important to study about the disease, researchers held a brainstorming session in 2014. Patients said researching individual triggers for AF was their top priority, giving rise to the I-STOP-AFib study, which enabled individuals to  test any presumed AF trigger. About 450 people participated, more than half of whom (58 percent) were men, and the overwhelming majority of whom were white (92 percent). 

Participants in the randomized clinical trial utilized a mobile electrocardiogram recording device along with a phone app to log potential triggers like drinking alcohol and caffeine, sleeping on the left side or not getting enough sleep, eating a large meal, a cold drink, or sticking to a particular diet, engaging in exercise, or anything else they thought was relevant to their AF. Although participants were most likely to select caffeine as a trigger, there was no association with AF. Recent research from UCSF has similarly failed to demonstrate a relationship between caffeine and arrhythmias -- on the contrary, investigators found it may have a protective effect. 

The new study demonstrated that consumption of alcohol was the only trigger that consistently resulted in significantly more self-reported AF episodes. 

The individualized testing method, known as n-of-1, did not validate participant-selected triggers for AF. But trial participants did report fewer AF episodes than  those in the control group, and the data suggest that behaviors like avoiding alcohol could lessen the chances of having an AF episode. 

“This completely remote, siteless, mobile-app based study will hopefully pave the way for many investigators and patients to conduct similar personalized “n-of-1” experiments that can provide clinically relevant information specific to the individual,” said Marcus. 

Co-authors: From UCSF, co-authors are Gregory Nah, MA; Sean Joyce; Kelsey Ogomori; Vivian Yang; Xochitl Butcher; Jeffrey E. Olgin, MD; Madelaine Faulkner Modrow; Shiffen Gettabecha; and Mark J. Pletcher, MD, MPH. 

Funding and disclosures: The study was funded by a Patient Powered Research Network Demonstration Project Award from the Patient-Centered Outcomes Research Institute and the National Institutes of Health/National Institute of Biomedical Imaging and Bioengineering (grant IU2CEB021881-01). Disclosures can be found in the paper. 

About UCSF Health: UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies and pioneering research. It includes the flagship UCSF Medical Center, which is ranked among the top 10 hospitals nationwide, as well as UCSF Benioff Children’s Hospitals, with campuses in San Francisco and Oakland, Langley Porter Psychiatric Hospital and Clinics, UCSF Benioff Children’s Physicians and the UCSF Faculty Practice. These hospitals serve as the academic medical center of the University of California, San Francisco, which is world-renowned for its graduate-level health sciences education and biomedical research. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. Visit http://www.ucsfhealth.org/. Follow UCSF Health on Facebook or on Twitter.

Aspirin use is associated with a 26% raised risk of heart failure in people with at least one predisposing factor for the condition

 

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Aspirin use is associated with a 26% raised risk of heart failure in people with at least one predisposing factor for the condition. That's the finding of a study published today in ESC Heart Failure, a journal of the European Society of Cardiology (ESC).1 Predisposing factors included smoking, obesity, high blood pressure, high cholesterol, diabetes, and cardiovascular disease.

"This is the first study to report that among individuals with a least one risk factor for heart failure, those taking aspirin were more likely to subsequently develop the condition than those not using the medication," said study author Dr. Blerim Mujaj of the University of Freiburg, Germany. "While the findings require confirmation, they do indicate that the potential link between aspirin and heart failure needs to be clarified."

The influence of aspirin on heart failure is controversial. This study aimed to evaluate its relationship with heart failure incidence in people with and without heart disease and assess whether using the drug is related to a new heart failure diagnosis in those at risk.The analysis included 30,827 individuals at risk for developing heart failure who were enrolled from Western Europe and the US into the HOMAGE study. "At risk" was defined as one or more of the following: smoking, obesity, high blood pressure, high cholesterol, diabetes and cardiovascular disease. Participants were aged 40 years and above and free of heart failure at baseline. Aspirin use was recorded at enrolment and participants were classified as users or non-users. Participants were followed-up for the first incidence of fatal or non-fatal heart failure requiring hospitalisation.

The average age of participants was 67 years and 34% were women. At baseline, a total of 7,698 participants (25%) were taking aspirin. During the 5.3-year follow-up, 1,330 participants developed heart failure.

The investigators assessed the association between aspirin use and incident heart failure after adjusting for sex, age, body mass index, smoking, alcohol use, blood pressure, heart rate, blood cholesterol, creatinine, hypertension, diabetes, cardiovascular disease, and treatment with renin-angiotensin-aldosterone-system inhibitors, calcium channel blockers, diuretics, beta-blockers and lipid-lowering drugs. Taking aspirin was independently associated with a 26% raised risk of a new heart failure diagnosis.

To check the consistency of the results, the researchers repeated the analysis after matching aspirin users and non-users for heart failure risk factors. In this matched analysis, aspirin was associated with a 26% raised risk of a new heart failure diagnosis. To check the results further, the analysis was repeated after excluding patients with a history of cardiovascular disease. In 22,690 participants (74%) free of cardiovascular disease, aspirin use was associated with a 27% increased risk of incident heart failure.

Dr. Mujaj said: "This was the first large study to investigate the relationship between aspirin use and incident heart failure in individuals with and without heart disease and at least one risk factor. Aspirin is commonly used -- in our study one in four participants were taking the medication. In this population, aspirin use was associated with incident heart failure, independent of other risk factors."

He concluded: "Large multinational randomised trials in adults at risk for heart failure are needed to verify these results. Until then, our observations suggest that aspirin should be prescribed with caution in those with heart failure or with risk factors for the condition."

Poor sleep linked to feeling older and worse outlook on aging, which can impact health

 Poor sleep in the over 50s is linked to more negative perceptions of ageing, which in turn can impact physical, mental and cognitive health, new research has revealed.

A study led by the University of Exeter and found that people who rated their sleep the worst also felt older, and perceived their own physical and mental ageing more negatively.

Lead author Serena Sabatini, of the University of Exeter, said: “As we age, we all experience both positive and negative changes in many areas of our lives. However, some people perceive more negative changes than others. As we know that having a negative perception of ageing can be detrimental to future physical health, mental health, and cognitive health, an open question in ageing research is to understand what makes people more negative about ageing. Our research suggests that poor sleepers feel older, and have a more negative perception of their ageing. We need to study this further – one explanation could be that a more negative outlook influences both. However, it could be a sign that addressing sleep difficulties could promote a better perception of ageing, which could have other health benefits.”

Researchers surveyed 4,482 people aged 50 and over who are part of the PROTECT study. Run by the University of Exeter and the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, and funded by the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, PROTECT is an innovative online study in which participants take regular cognitive tests and complete lifestyle questionnaires. The study aims to understand what helps people stay cognitively healthy in later life.

The research team noticed that many PROTECT participants were commenting on their relationship with sleep as part of standard questionnaires within the study. Comments included: “How I feel fluctuates widely depending on my sleep. I feel great if I get six hours so about half the time I feel younger and half the time I feel older!”

Another comment read: “I have chronic pain problems and get very little sleep which impacts on my life quite a lot.”

As a result of such comments, the team decided to conduct a questionnaire looking specifically at sleep. In the research, published in Behavioral Sleep Medicine, participants were asked whether they had experienced a list of negative age-related changes, such as poorer memory, less energy, increased dependence on the help of others, decreased motivation, and having to limit their activities. They also rated their quality of sleep. The participants completed both questionnaires twice, one year apart.

Professor Clive Ballard, of the University of Exeter, said: “This research is an important part of the growing body of evidence about the crucial role of sleep in healthy ageing. We now need more people to sign up to PROTECT, to help us understand this further. We’ve got some exciting trials ahead on how to optimise sleep in some particularly vulnerable groups, such as people with dementia in care homes.”

May be worth adopting plant based diet to ease chronic migraine severity, say doctors

Prescribed meds, elimination diet, yoga and meditation provided no or little symptom relief
Boosting dark green leafy veg intake may be key

It may be worth adopting a plant based diet, rich in dark green leafy vegetables, to ease the symptoms of chronic migraine, suggest doctors in the online journal BMJ Case Reports.

The recommendation comes after they treated a man who had endured severe migraine headaches without aura for more than 12 years. 

He had tried prescribed meds (Zolmitriptan and Topiramate); cutting out potential ‘trigger’ foods, including chocolate, cheese, nuts, caffeine, and dried fruit; and yoga and meditation in a bid to blunt the severity and frequency of his headaches. Nothing had worked.

Over 1 billion people worldwide have migraines, characterised as one-sided, pulsating headaches lasting 4–72 hours, and often accompanied by sensitivity to noise and light and sometimes prodromal auras. 

Migraines are either episodic (fewer than 15 days a month) or chronic (15 or more migraine days a month plus migraine features on at least 8 days of the month).

Successful migraine treatment is defined as a halving in the frequency and length of attacks, or as an improvement in symptoms.

While drugs can help prevent and treat the condition, a growing body of evidence suggests that diet may also offer an effective alternative without any of the side effects associated with some meds, say the report authors. 

Six months before his clinic referral, the man’s migraines had become chronic, occurring on 18–24 days of every month.

He described the pain as starting suddenly and intensely in the forehead and temple on the left side of his head. The pain was throbbing in nature, and usually lasted 72 hours. 

His headaches were accompanied by sensitivity to light and sound, and nausea and vomiting. On a scale of 0–10, he scored the pain severity as 10–12 out of 10. 

Blood tests revealed that he didn’t have high levels of systemic inflammation and that he had a normal level of beta-carotene (53 µg/dl). 

This was likely derived from his daily consumption of sweet potatoes, which, although high in beta-carotene, are relatively low in the nutrients responsible for the anti-inflammatory and antioxidant properties of carotenoids, point out the report authors.

These are instead found in dark green leafy vegetables, such as spinach, kale, and watercress. Systemic inflammation and oxidative stress are implicated in migraine.

The report authors advised the man to adopt the Low Inflammatory Foods Everyday (LIFE) diet, a nutrient dense, whole food, plant-based diet.

The LIFE diet includes eating at least five ounces by weight of raw or cooked dark green leafy vegetables every day, drinking one 32-ounce daily green LIFE smoothie, and limiting intake of whole grains, starchy vegetables, oils, and animal protein, particularly dairy and red meat.

After 2 months on the LIFE diet, the man said that the frequency of his migraine attacks had fallen to just 1 day a month; the length and severity of the attacks had also lessened. Blood tests showed a substantial rise in beta-carotene levels, from 53 µg/dl to 92 µg/dl.

He stopped taking all his migraine meds. Even when he tried certain ‘challenge’ foods, such as egg whites, salmon, or iced tea, which triggered headache attacks, these were much less painful and much shorter in duration than before.

After 3 months his migraines stopped completely, and they haven't returned in 7.5 years. 

The man was allergic, and previously published research suggests that better control of allergies may lead to fewer migraine headaches. In this case, the man’s allergy symptoms improved to the point that he no longer needed to use seasonal medication.

He was also HIV positive, and HIV has been linked to a heightened risk of migraines, so it is certainly possible that the man’s HIV status and antiretroviral drugs had contributed to his symptoms, say the report authors. 

But it wasn’t possible to study this further without stopping the antiretroviral treatment, which is a limitation of the study, they acknowledge. 

But they conclude: “This report suggests that a whole food plant-based diet may offer a safe, effective and permanent treatment for reversing chronic migraine. 

“While this report describes one very adherent patient who had a remarkable response, the LIFE diet has reduced migraine frequency within 3 months in several additional patients (personal communication).”

Low cal. diets are the most effective methods for weight management and remission in adults with type 2 diabetes

A new study published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) finds that low energy diets with formula meal replacements are the most effective methods of weight management and remission in adults with type 2 diabetes (T2D), while the macronutrient content is not important to outcomes.

The research was conducted by Professor Mike Lean, Dr Chaitong Churuangsuk and colleagues at the Universities of Glasgow, (with Dr Churuangsuk also affiliated to Prince of Songkla University, Hat Yai, Thailand) and others from Cambridge (UK) and Otago (New Zealand) Universities. The group analysed published meta-analyses of which type of diet is best for achieving and then maintaining weight loss in adults with T2D.

While T2D is influenced by both genetic and environmental factors, it is rising levels of overweight and obesity which have driven the current global epidemic of diabetes. The authors note: “Without strategic commitment internationally on effective prevention strategies, type 2 diabetes will affect an estimated 629 million people worldwide by 2045.”

The onset of T2D is primarily driven by weight gain to the point that it becomes unhealthy. The amount of weight-gain needed varies widely between individuals. The development of the disease involves a complex interaction of gut hormones, low-grade inflammation and possibly metabolites from the gut microbiota. It develops in susceptible individuals and families who tend to have large waists and who accumulate fat in their liver, pancreas and muscles.  This impairs organ functions, resulting in hyperglycaemia (abnormally high blood sugar), commonly associated with hypertension (high blood pressure) and abnormal blood fats.

T2D requires lifelong management, but even with treatment it can cause disabling, painful and life-shortening complications. However, sufficient weight loss can remove the abnormal body fat from liver and pancreas and reverse diabetes.

Weight loss is critical to management and remission of T2D and has been shown to improve all the related cardiometabolic risk factors and reduce the patient’s need for medication.

In the UK DiRECT study, funded by Diabetes UK, almost 80% of people with T2D for up to 6 years who lost over 10kg, and maintained the weight loss of over 10 kg, remained in remission from diabetes for at least 2 years.

While there is widespread awareness of the benefits of weight loss for people withT2D, there is a lack of authoritative guidance over dietary advice, to inform both patients and healthcare providers. Ill-informed controversy over diet types has contributed to inaction and delays in providing effective treatment. Current guidelines stress the importance of personalised weight management and state that various diet strategies may be effective, but do not provide information about diet composition. This can lead to patients following diets based on distorted evidence and misleading claims.

Adherence to any energy-reduced diet will lead to sustained weight loss, provided that energy (calorie) use exceeds intake. However, in practice, adherence rates and weight losses vary widely, even within the same diet programme, and some comparisons between diets appear to show conflicting results.

The researchers wanted to help resolve these uncertainties and to inform clinical decision making and guideline development, as part of a programme of work to update the recommendations of the European Association for the Study of Diabetes (EASD).

For this new study, the researchers collected and systematically reviewed all the relevant world publications of diet trial meta-analyses for weight management of people with T2D, and all studies which have reported remissions of T2D.

Their analysis found that the greatest weight loss was achieved with very low energy formula diets, used as ‘Total Diet Replacement’ at 1.7-2.1 MJ/day [400-500 kcal/day] for 8-12 weeks, which led to an average 6.6kg more weight lost compared to food-based low-energy diets (4.2-6.3 MJ/day [1000-1500 kcal/day]). Formula meal replacements were also found to be superior to food-based low-energy diets alone, achieving 2.4kg greater weight loss over 12-52 weeks.

The published evidence showed that low-carbohydrate diets were no better than higher carbohydrate (low-fat) diets for weight loss.

For remission of T2D, there are no direct comparisons between diet types, but published studies showed the best remission rates of 46-61% at 12 months with programmes that include a formula ‘Total Diet Replacement’ of 830 kcal/day for 12 weeks, followed by a relatively low-fat high carbohydrate diet and meal replacements for long-term maintenance. With low carbohydrate diets, reported remission rates are much lower at 4%-19% of those who tried the diet.

They add: “Mediterranean, high-monounsaturated-fatty-acid, vegetarian and low-glycaemic-index diets all achieved minimal (0.3-2 kg) or no difference from conventional relatively low fat/high carb control diets…The evidence, albeit of variable quality, is rather consistent showing that no one diet type is superior over others for weight management in type 2 diabetes.” 

The researchers conclude: “Published meta-analyses of diets for weight management in people with type 2 diabetes do not support recommending any particular macronutrient profile or style over others. Very low energy diets and formula meal replacement appear the most effective approaches, generally providing less energy than self-administered food-based diets.”

A limitation of the trials examined by this study is that the benefits from weight management depend largely on long-term control of body weight, while most of the currently available evidence relates only to short-term outcomes. Successful long-term maintenance of weight may require different behavioural strategies to those effective for the weight-loss phase.  Few trials have reported data beyond 12 months. The team suggest: “Well-conducted research is needed to assess longer-term impacts on weight, blood sugar control, clinical outcomes and diabetes complications.”

 

Latest evidence review shows mask wearing and physical distancing are effective alongside COVID-19 vaccination

 

Several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence covid-19 and should be continued alongside vaccination, suggest experts after reviewing the latest evidence in The BMJ today.

However, they say more stringent measures, such as lockdowns and closures of borders, schools, and workplaces need further assessment to weigh their potential negative effects on general populations.

Public health (or non-pharmaceutical) interventions are known to be beneficial in fighting respiratory infections like influenza, and countries around the world are implementing various public health measures to curb the spread of SARS-CoV-2. 

Yet, previous reviews have not been robust enough to allow researchers to make firm conclusions about the effectiveness of such measures in reducing covid-19 incidence rates.

To plug this knowledge gap, the researchers trawled databases for studies that assessed the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality.

In all, 72 studies met their inclusion criteria, of which 35 evaluated individual public health measures and 37 assessed multiple public health measures.

Of the 35 studies of individual measures, 34 were observational and one was a randomised controlled trial. They were carried out in Asia (11), the United States (9), Europe (7), the Middle East (3), Africa (3), South America (1), and Australia (1).

Results from 8 of these 35 studies were analysed in detail, which indicated a statistically significant 53% reduction in the incidence of covid-19 with mask wearing and a 25% reduction with physical distancing. 

Handwashing also indicated a substantial 53% reduction in covid-19 incidence, although this was not statistically significant after adjusting for the small number of studies included.

Detailed analysis was not possible for other measures, including quarantine and isolation, universal lockdowns, and closures of borders, schools, and workplaces, due to differences in study design, outcome measures and quality.

The researchers point out that high quality evidence on the effectiveness of public health measures is still limited. However, their comprehensive search strategy to identify and select studies for review minimised bias and suggests the results are robust.

As such, they conclude that personal and social measures, including handwashing, mask wearing, and physical distancing are effective at reducing the incidence of covid-19, while more stringent measures, such as lockdowns and closures of borders, schools, and workplaces “need to be carefully assessed by weighing the potential negative effects of these measures on general populations.”

Further research is also needed to assess the effectiveness of public health measures after adequate vaccination coverage, states lead author Dr Stella Talic at Monash University, Australia.

The lack of good research on public health measures for covid-19 is a pandemic tragedy, argue researchers led by Professor Paul Glasziou at Bond University, Australia in a linked editorial.

Considering the central importance of public health and social measures for initial pandemic control, the uncertainties and controversies around their effects, and the immense research effort being put into vaccine and drug development, this lack of investment in research on public health measures is puzzling - at just 4% of global research funding for covid-19, they explain.

They point to a recent initiative by the World Health Organization, backed by the Norwegian government, to strengthen “the global evidence base to provide actionable and evidence-informed guidance on such measures for decision-makers” as a positive development. 

But they warn that this is only achievable if the global community of public health researchers, practitioners, and decision makers are ready and have the capacity to conduct the much needed trials, and funders are ready to fund them.

Separating fact from fiction for “anti-aging” diets

Peer-Reviewed Publication

AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE (AAAS)

In a Review, Mitchell Lee and colleagues attempt to separate fact from fiction for so-called “anti-aging” dietary interventions. They also explore these diets’ potential shared mechanisms of action. For almost a century, caloric restriction and other dietary interventions have been known to extend life span and delay age-associated disease – at least in laboratory animals – but just how these interventions work remains unclear. What’s more, despite the recent popularization of some of these diets, such as ketogenic diets and intermittent fasting, the efficacy and safety of these diets for humans has yet to be established outside of a laboratory setting. Here, Lee et al. summarize the current literature concerning the most studied anti-aging dietary interventions – those that appear to delay or reverse the hallmark molecular mechanisms of aging. While these interventions are well studied in model organisms, like mice, flies and yeast, it is not currently possible to know whether similar diets affect biological aging in people, according to the authors. Research to date shows that the physiological consequences of these dietary interventions are complex, even in the simplest model organisms; it has also revealed intriguing similarities across anti-aging diets. According to Lee et al., a common mechanism for anti-aging diets may be related to the inhibition of the protein kinase mTOR. This evolutionarily conserved signaling pathway may provide a molecular target for drugs that could prove useful for increasing health longevity in humans. “Future research should focus on both better understanding the cellular and molecular mediators of anti-aging diets under highly controlled laboratory conditions as well as the impact of genetic and environmental variation on health outcomes associated with these diets,” write Lee et al.

Coffee and tea drinking may be associated with reduced rates of stroke and dementia

 Drinking coffee or tea may be associated with a lower risk of stroke and dementia, according to a study of healthy individuals aged 50-74 publishing November 16th in the open-access journal PLOS Medicine. Drinking coffee was also associated with a lower risk of post-stroke dementia.

Strokes are life-threatening events which cause 10 percent of deaths globally. Dementia is a general term for symptoms related to decline in brain function and is a global health concern with a high economic and social burden. Post-stroke dementia is a condition where symptoms of dementia occur after a stroke.

Yuan Zhang and colleagues from Tianjin Medical University, Tianjin, China studied 365,682 participants from the UK Biobank, who were recruited between 2006 and 2010 and followed them until 2020. At the outset participants self-reported their coffee and tea intake. Over the study period, 5,079 participants developed dementia and 10,053 experienced at least one stroke.

People who drank 2-3 cups of coffee or 3-5 cups of tea per day, or a combination of 4–6 cups of coffee and tea had the lowest incidence of stroke or dementia. Individuals who drank 2-3 cups of coffee and 2-3 cups of tea daily had a 32% lower risk of stroke (HR, 0.68, 95% CI, 0.59-0.79; P <0.001) and a 28% lower risk of dementia (HR, 0.72, 95% CI, 0.59-0.89; P =0.002) compared with those who drank neither coffee nor tea. Intake of coffee alone or in combination with tea was also associated with lower risk of post-stroke dementia.

The UK Biobank reflects a relatively healthy sample relative to the general population which could restrict the ability to generalize these associations. Also, relatively few people developed dementia or stroke which can make it difficult to extrapolate rates accurately to larger populations. Finally, while it’s possible that coffee and tea consumption might be protective against stroke, dementia and post-stroke dementia, this causality cannot be inferred from the associations.

The authors add, “Our findings suggested that moderate consumption of coffee and tea separately or in combination were associated with lower risk of stroke and dementia.”

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Freely available paper in PLOS Medicine: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003830