It doesn’t matter much which fiber you choose – just get more fiber!

-- That huge array of dietary fiber supplements in the drugstore or grocery aisle can be overwhelming to a consumer. They make all sorts of health claims too, not being subject to FDA review and approval. So how do you know which supplement works and would be best for you?

A rigorous examination of the gut microbes of study participants who were fed three different kinds of supplements in different sequences concludes that people who had been eating the least amount of fiber before the study showed the greatest benefit from supplements, regardless of which ones they consumed.

“The people who responded the best had been eating the least fiber to start with,” said study leader Lawrence David, an associate professor of molecular genetics and microbiology at Duke University.

The benefit of dietary fiber isn’t just the easier pooping that advertisers tout. Fermentable fiber -- dietary carbohydrates that the human gut cannot process on its own but some bacteria can digest -- is also an essential source of nutrients that your gut microbes need to stay healthy.

“We’ve evolved to depend on nutrients that our microbiomes produce for us,” said Zack Holmes, former PhD student in the David lab and co-author on two new papers about fiber. “But with recent shifts in diet away from fiber-rich foods, we’ve stopped feeding our microbes what they need.”

When your gut bugs are happily munching on a high-fiber diet, they produce more of the short-chain fatty acids that protect you from diseases of the gut, colorectal cancers and even obesity. And in particular, they produce more of a fatty acid called butyrate, which is fuel for your intestinal cells themselves. Butyrate has been shown to improve the gut’s resistance to pathogens, lower inflammation and create happier, healthier cells lining the host’s intestines.

Given the variety of supplements available, David’s research team wanted to know whether it may be necessary to ‘personalize’ fiber supplements to different people, since different fermentable fibers have been shown to have different effects on short-chain fatty acid production from one individual to the next.

“We didn’t see a lot of difference between the fiber supplements we tested. Rather, they looked interchangeable,” David said during a tour of his sparkling new lab in the MSRB III building, which includes a special “science toilet” for collecting samples and an array of eight “artificial gut” fermenters for growing happy gut microbes outside a body.

“Regardless of which of the test supplements you pick, it seems your microbiome will thank you with more butyrate,” David said.

The average American adult only consumes 20 to 40 percent of the daily recommended amount of fiber, which is believed to be a root cause behind a lot of our common health maladies, including obesity, cardiovascular disease, digestive disorders and colon cancer. Instead of having to go totally vegetarian or consume pounds of kale daily, convenient fiber supplements have been created that can increase the production of short-chain fatty acids.

The Duke experiments tested three main kinds of fermentable fiber supplements: inulin, dextrin (Benefiber), and galactooligosaccharides (GOS) marketed as Bimuno. The 28 participants were separated into groups and given each of the three supplements for one week in different orders, with a week off between supplements to allow participants’ guts to return to a baseline state. 

Participants who had been consuming the most fiber beforehand showed the least change in their microbiomes, and the type of supplement really didn’t matter, probably because they were already hosting a more optimal population of gut bugs, David said.

Conversely, participants who had been consuming the least fiber saw the greatest increase in butyrate with the supplements, regardless of which one was being consumed.

In a second study the David lab performed with support from the U.S. Office of Naval Research, they found that gut microbes responded to a new addition of fiber within a day, dramatically altering the populations of bugs present in the gut and changing which of their genes they were using to digest food.

Using their artificial gut fermenters, the researchers found the gut microbes were primed by the first dose to consume fiber, and digested it quickly on the second dose.

"These findings are encouraging,” said graduate student Jeffrey Letourneau, lead author of the second study. “If you’re a low fiber consumer, it’s probably not worth it to stress so much about which kind of fiber to add. It’s just important that you find something that works for you in a sustainable way.”

“It doesn’t need to be a supplement either,” Holmes added. “It can just be a fiber-rich food. Folks who were already eating a lot of fiber, which comes from plants like beans, leafy greens, and citrus, already had very healthy microbiomes.”

Daily prune consumption preserves hip BMD in postmenopausal women

A study recently published in the American Journal of Clinical Nutrition revealed that daily prune consumption preserved bone mineral density (BMD) at the hip and protected against increased fracture risk in postmenopausal women.

Researchers from Pennsylvania State University conducted a 12-month randomized controlled trial to test the effects of daily consumption of 50 grams (5-6 prunes) and 100 grams (10-12 prunes) of prunes on BMD in over 200 postmenopausal women. Results indicated that women who consumed 50 grams of prunes a day for one year maintained hip BMD while those in the control group who ate no prunes lost significant bone mass at the hip. Further, hip fracture risk increased in the control group while those who consumed both 50 grams and 100 grams of prunes experienced no increase in hip fracture risk.1

“Our data supports the use of prunes to protect the hip from bone loss post menopause. Indeed, these data may be especially valuable for postmenopausal women who cannot take pharmacological therapy to combat bone loss and need an alternative strategy”, said Principal Investigator Mary Jane De Souza, PhD, FACSM, Distinguished Professor, Pennsylvania State University.

After menopause, women tend to lose bone density rapidly and they are more likely to have osteoporosis than men.2 Women also experience three-quarters of all hip fractures typically from falling, and women fall more often than men3. Hip fractures are difficult to recover from and can lead to decreased quality of life, financial stress, and increased risk of early mortality.4 This new research demonstrates a favorable effect of prune consumption on BMD at the hip and suggests that prunes may serve as a food-based option to support bone health in aging women.

Previous clinical trials in postmenopausal women have shown the promising effects that daily prune consumption can have on preventing bone loss.4 This new study represents a milestone in prune research as it is the largest clinical trial to date with a sample size of 235 postmenopausal women.

“While this latest research showed a significant benefit for postmenopausal women, prunes can make a significant nutritional contribution to any eating plan at any stage of life”, according to Andrea N. Giancoli, MPH, RD, Nutrition Advisor, California Prune Board. “Prunes are a delicious and convenient snack as travel picks back up and everyone is getting back into routines. Plus, this whole fruit is surprisingly versatile as an ingredient in both sweet and savory recipes.”

To learn more about the nutritional benefits of prunes and how they fit into a variety of recipes, visit CaliforniaPrunes.org.

Most high blood pressure in children and teenagers is linked with unhealthy lifestyle

:  Inactivity, diets high in sugar and salt, and excess weight account for nine in ten cases of high blood pressure in children and adolescents, according to a consensus paper by heart health experts published today in European Heart Journal, a journal of the European Society of Cardiology (ESC).1 The document, which focuses on hypertension in 6 to 16 year-olds, recommends that families get healthy together.

“Parents are significant agents of change in the promotion of children's health behaviours,” said first author Professor Giovanni de Simone of the University of Naples Federico II, Italy. “Very often, high blood pressure and/or obesity coexist in the same family. But even when this is not the case, it is desirable that lifestyle modifications involve all family members.”

Dietary recommendations for treating high blood pressure in children include emphasising fresh vegetables, fruits, and other high fibre foods, limiting salt intake, and avoiding sugar-sweetened drinks and saturated fat. Children and adolescents should do at least one hour of moderate-to-vigorous physical activity every day, such as jogging, cycling or swimming, and spend no more than two hours a day on sedentary activities. “Parents should monitor the amount of time their children spend watching TV or using smartphones and suggest active alternatives,” said Professor de Simone.

Realistic goals should be set for weight, diet, and physical activity that focus on the aspects needing the most improvement. “Recording weight, eating habits and exercise over time – but without becoming obsessive – can help young people and their families to track progress towards their goals,” said Professor de Simone.

A “health-promoting reward system” is recommended. Professor de Simone said: “Ideal incentives are those that increase social support and reinforce the value of targeted behaviours, such as a family bike ride or a walk with friends.”

The document refers to childhood obesity and hypertension as “insidious siblings” which gradually become a serious health hazard. Studies have shown that childhood hypertension is becoming more common2,3 and that part of the increase can be explained by obesity, particularly abdominal obesity.3 It is estimated that less than 2% of normal weight children are hypertensive, compared to 5% of overweight and 15% of obese children.2 Professor de Simone said: “The rise in childhood hypertension is of great concern as it is associated with persistence of hypertension and other cardiovascular problems during adulthood.”

Early diagnosis of elevated blood pressure is crucial so that it can be managed with lifestyle and, if needed, medications. Even one blood pressure measurement by a doctor or nurse can identify children with high blood pressure, but a second visit is recommended for confirmation. Professor de Simone said: “Screening should be performed in the primary care setting at least yearly, regardless of symptoms. This is because hypertension in children, as in adults, is usually asymptomatic.”

When blood pressure measurements point to hypertension, a medical history and physical examination are needed to determine potential causes and identify behaviours that can be modified. Information includes family history of hypertension and cardiovascular disease, birth weight and gestational age; details on lifestyle such as smoking, salt intake, alcohol consumption, physical exercise and leisure time activities; and possible symptoms including headache, nosebleeds, vertigo, visual impairment, low school performance, attention difficulties, shortness of breath, chest pain, palpitations and fainting.

In the early stages, treatment of childhood hypertension should focus on education and behaviour change. If blood pressure goals are not achieved, a single low-dose drug should be introduced. If one drug is ineffective, small doses of two drugs may be needed.

The authors call for public health agencies to prioritise prevention and management of hypertension in children and adolescents. For example, campaigns to increase awareness of the risks of high blood pressure in young people and the positive impact of a healthy lifestyle including physical activity, a nutritious diet low in salt and sugar, and not smoking. Other recommended actions include protected time for children on TV and social media without promotion of junk food or potentially deleterious lifestyle habits.

Diets high in N-3 polyunsaturated fats may help decrease risk of breast cancer

Diet has long been reported to potentially affect breast cancer risk. Growing evidence suggests that n-3 polyunsaturated fatty acids (PUFAs) may play a role in the pathogenesis of breast cancer. A new study documents an inverse association between breast cancer risk and n-3 PUFA consumption, especially in premenopausal women who are obese. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Breast cancer is by far the most common malignant tumor in women worldwide, so it’s little wonder that so many studies focus on ways to limit the risk of this highly prevalent disease. Previous studies have been conducted to investigate the association of n-3 PUFAs with breast cancer risk but have shown mixed results. Many of these studies were performed only in postmenopausal women because the peak age for breast cancer is 60 to 70 years in western countries, whereas it is age 40 to 50 years in Asian countries.

In this latest hospital-based, case-control study including nearly 1,600 cases, researchers not only examined the association between the intake of n-3 PUFAs in general with breast cancer, but they also looked at the effect of individual n-3 PUFAs. Good sources of n-3 PUFAs include fish, vegetable oil, nuts (especially walnuts), flax seeds and flaxseed oil, and leafy vegetables. Because the human body does not produce n-3 fatty acids naturally, these food sources are essential. In addition, researchers also examined whether the association was modified by menopause status, hormone-receptor status, or linoleic acid intake.

The study concluded that a higher intake of marine n-3 PUFAs and total n-3 PUFAs was associated with a lower risk of breast cancer. Dietary a-linolenic acid, eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid also were inversely associated with breast cancer risk. Such inverse associations were more evident in premenopausal women and women with certain types of breast tumors. In addition, a decreased risk of breast cancer was significantly associated with increasing n-3 PUFA intake in women who were overweight or obese but not in women of normal weight. There was a significant interaction between linoleic acid and marine n-3 PUFAs.

Study results are published in the article “Association of dietary intake of n-3 polyunsaturated fatty acids with breast cancer risk in pre- and postmenopausal Chinese women.”

“This study highlights the effect of lifestyle habits and, specifically, dietary intake of polyunsaturated fatty acids on breast cancer risk. Lifestyle (or diet) is known to contribute to up to one-third of the risk for breast cancer. Women can affect their risk of developing breast cancer by making dietary changes to include fruits and vegetables, fiber, and whole grains and avoiding high-fat animal and dairy products,” says Dr. Chrisandra Shufelt, NAMS president.

JOURNAL

Menopause

DOI

10.1097/GME.00000000000019901 

Eating more ultra-processed foods associated with increased risk of dementia

 People who eat the highest amounts of ultra-processed foods like soft drinks, chips and cookies may have a higher risk of developing dementia than those who eat the lowest amounts, according to a new study published in the July 27, 2022, online issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers also found that replacing ultra-processed foods in a person’s diet with unprocessed or minimally processed foods was associated with a lower risk. The study does not prove that ultra-processed foods cause dementia. It only shows an association.

Ultra-processed foods are high in added sugar, fat and salt, and low in protein and fiber. They include soft drinks, salty and sugary snacks, ice cream, sausage, deep-fried chicken, yogurt, canned baked beans and tomatoes, ketchup, mayonnaise, packaged guacamole and hummus, packaged breads and flavored cereals.

“Ultra-processed foods are meant to be convenient and tasty, but they diminish the quality of a person’s diet,” said study author Huiping Li, PhD, of Tianjin Medical University in China. “These foods may also contain food additives or molecules from packaging or produced during heating, all of which have been shown in other studies to have negative effects on thinking and memory skills. Our research not only found that ultra-processed foods are associated with an increased risk of dementia, it found replacing them with healthy options may decrease dementia risk.”

For the study, researchers identified 72,083 people from the UK Biobank, a large database containing the health information of half a million people living in the United Kingdom. Participants were age 55 and older and did not have dementia at the start of the study. They were followed for an average of 10 years. By the end of the study, 518 people were diagnosed with dementia.

During the study, participants filled out at least two questionnaires about what they ate and drank the previous day. Researchers determined how much ultra-processed food people ate by calculating the grams per day and comparing it to the grams per day of other foods to create a percentage of their daily diet. They then divided participants into four equal groups from lowest percentage consumption of ultra-processed foods to highest.

On average, ultra-processed foods made up 9% of the daily diet of people in the lowest group, an average of 225 grams per day, compared to 28% for people in the highest group, or an average of 814 grams per day. One serving of items like pizza or fish sticks was equivalent to 150 grams. The main food group contributing to high ultra-processed food intake was beverages, followed by sugary products and ultra-processed dairy.

In the lowest group, 105 of the 18,021 people developed dementia, compared to 150 of the 18,021 people in the highest group.

After adjusting for age, gender, family history of dementia and heart disease and other factors that could affect risk of dementia, researchers found that for every 10% increase in daily intake of ultra-processed foods, people had a 25% higher risk of dementia.

Researchers also used study data to estimate what would happen if a person substituted 10% of ultra-processed foods with unprocessed or minimally processed foods, like fresh fruit, vegetables, legumes, milk and meat. They found that such a substitution was associated with a 19% lower risk of dementia.

“Our results also show increasing unprocessed or minimally processed foods by only 50 grams a day, which is equivalent to half an apple, a serving of corn, or a bowl of bran cereal, and simultaneously decreasing ultra-processed foods by 50 grams a day, equivalent to a chocolate bar or a serving of fish sticks, is associated with 3% decreased risk of dementia,” said Li. “It’s encouraging to know that small and manageable changes in diet may make a difference in a person’s risk of dementia.”

Li noted that further research is needed to confirm the findings.  

Maura E. Walker, PhD, of Boston University in Massachusetts, who wrote an editorial accompanying the study, said, “While nutrition research has started to focus on food processing, the challenge is categorizing such foods as unprocessed, minimally processed, processed and ultra-processed. For example, foods like soup would be classified differently if canned versus homemade. Plus, the level of processing is not always aligned with diet quality. Plant-based burgers that qualify as high quality may also be ultra-processed. As we aim to understand better the complexities of dietary intake, we must also consider that more high-quality dietary assessments may be required.”

A limitation of the study was that cases of dementia were determined by looking at hospital records and death registries rather than primary care data, so milder cases may have been overlooked.  .

Chores, exercise, and social visits linked to lower risk of dementia

 

Study on time restricted eating reveals limiting food intake to daytime shows promising beneficial metabolic effects 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 following a time-restricted eating (TRE) protocol which limits food intake to a max 10-hour time window shows promising beneficial metabolic effects in adults with type 2 diabetes (T2D). The research was conducted by Prof Patrick Schrauwen, Charlotte Andriessen and colleagues at NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, the Netherlands.

Our modern 24-hour society is characterised by endless food availability and disrupted day-night rhythm brought on by irregular sleep-activity patterns and frequent exposure to artificial light sources. In Western nations, people also tend to spread their daily food intake over a minimum of 14 hours, which is likely to result in the absence of a true, nocturnal fasted state. These factors all contribute to the development of T2D which has become one of the most common metabolic diseases globally, estimated by the World Health Organization to cause more than 1.5 million deaths per year.

TRE is a novel strategy for improving metabolic health and is intended to counteract the detrimental effects of eating throughout the day by limiting the duration of food intake (typically 12 h or less) and restore the cycle of daytime eating and prolonged fasting during the evening and night.

Previous studies show that TRE leads to promising metabolic changes in people with overweight or obesity, including increased fat burning, decreased blood sugar levels and improved insulin sensitivity; but these effects have not been studied in detail. Moreover, while these results are promising, these studies used extremely short eating time windows (6-8 h) and highly controlled study settings, making such protocols difficult to implement in daily life. TRE is sometimes accompanied by unintended weight loss which would be expected to increase metabolic health, but such improvements have also been reported in the absence of weight loss, indicating that additional mechanisms are involved in how restricted eating influences metabolism.

Individuals with impaired metabolic health experience alterations in the rhythms of metabolic processes compared to healthy, lean individuals and the authors hypothesise that a disturbed fed-fasting cycle contributes to these impairments in metabolic rhythms. They suggest that by restricting food intake to daytime only and extending the length of the nocturnal fast may have beneficial effects on metabolic health.

The researchers recruited 14 individuals with T2D for the study, aged between 50 and 75 years (7 male, 7 female, average age 67.5 years) and body mass index (BMI) ≥25 kg/m2. The study consisted of two 3-week intervention periods: TRE and control (CON), separated by a wash-out period of at least 4 weeks. At the start of each intervention, participants had their body weight measured and were fitted with a continuous glucose monitoring (CGM) device which measured their blood sugar level every 15 minutes. They were instructed to keep to their normal sleep patterns and physical activity, and to maintain a stable weight. A food and sleep diary completed during the first intervention was used to ensure that diet during the second period was similar in both quantity and quality.

During TRE participants were instructed to consume their normal diet within a 10-hour window during the daytime, and to complete their food intake no later than 1800H. Outside this time window they were permitted to drink water, plain tea, or black coffee, and zero-calorie soft drinks were also allowed during the evening if consumed in moderation. During CON volunteers were only required to spread their normal food intake over at least 14 hours, with no other restrictions.

The eating window for TRE averaged 9.1 h compared to 13.4 h in CON, while sleep-wake patterns were similar in each case with mean sleep durations of 8.1 h and 8.0 h, respectively. Mean body mass was comparable at the start of both TRE and CON and although volunteers were instructed to remain weight stable, a small but statistically significant weight loss occurred in response to TRE but not CON.

TRE was found to decrease 24-hour glucose levels, primarily as a result of lower nocturnal blood sugar, and the average time spent with blood glucose in the normal range increased to 15.1 hours versus 12.2 hours during the CON phase. Morning fasting glucose was consistently lower among the TRE group than those on the control diet, which may be the result of lasting changes in nocturnal glucose control. Time spent in hypoglycaemia (low blood sugar) was not significantly increased by TRE and no serious adverse effects were reported resulting from the protocol, demonstrating that an eating window of approximately 10 h is a safe and effective lifestyle intervention for adults with T2D.

Approximately half-way through each intervention, liver glycogen levels were assessed in the morning following the 10 h or 14 h night-time fast period, and were measured again at the end of each study period after an 11 h fast for both TRE and CON. In both cases, liver glycogen did not differ significantly between TRE and CON and an analysis of liver fats showed no difference in their quantity or composition between interventions.

Unlike a previous study into TRE, this one did not show that the protocol had any effect on insulin sensitivity, however the earlier research had used a much shorter 6 h food intake window with the last meal being consumed at 15:00 h. This resulted in a longer fasting period which may have been more effective but was felt to be unrealistic to incorporate into the lifestyle of most adults with T2D. The team advise: “Future studies will be needed to reveal whether the duration of the fasting period is indeed crucial in determining positive effects on insulin sensitivity.”

The authors say: “Mechanisms underlying the improvement in glucose regulation upon TRE remain unclear. Our results show that TRE did not improve peripheral and liver insulin sensitivity, skeletal muscle mitochondrial function, energy metabolism or liver fat content, all of which are known to be affected in T2D.” They propose that the mechanisms involved in the effects and their implications should be investigated further, with particular focus on studying nocturnal glucose metabolism in more detail.

Limitations of this research include its relatively short duration and that some but not all participants were on glucose-lowering medication which may have caused TRE to have less effect. Despite this, a 3-week intervention period has been found to be long enough to affect the variables being analysed, and the authors highlight that only recruiting volunteers who were not on medication would reduce the study’s relevance to the general T2D population.

The authors conclude: “A daytime 10 h TRE regimen for 3 weeks decreases glucose levels and prolongs the time spent in the normal blood sugar range in adults with T2D as compared with spreading daily food intake over at least 14 h. These data highlight the potential benefit of TRE in T2D”

They also suggest: “Since our TRE protocol was feasible and safe, and resulted in improved 24 h glucose levels, it would be interesting to examine the impact of 10 h TRE on glucose regulation and insulin sensitivity in type 2 diabetes in the long term to address the clinical relevance of TRE.”

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JOURNAL

Diabetologia

First trial to prove a diet supplement can prevent hereditary cancer

 

A trial in people with high hereditary risk of a wide range of cancers has shown a major preventive effect from resistant starch, found in a wide range of foods such as oats, breakfast cereal, cooked and cooled pasta or rice, peas and beans and slightly green bananas.

An international trial - known as CAPP2 – involved almost 1000 patients with Lynch syndrome from around the world and revealed that a regular dose of resistant starch, also known as fermentable fibre, taken for an average of two years, did not affect cancers in the bowel but did reduce cancers in other parts of the body by more than half. This effect was particularly pronounced for upper gastrointestinal cancers including oesophageal, gastric, biliary tract, pancreatic and duodenum cancers. 

The astonishing effect was seen to last for 10 years after stopping taking the supplement.

The study, led by experts at the Universities of Newcastle and Leeds, published today in Cancer Prevention Research, a journal of the American Association for Cancer Research, is a planned double blind 10 year follow–up, supplemented with comprehensive national cancer registry data for up to 20 years in 369 of the participants.

Previous research published as part of the same trial, revealed that aspirin reduced cancer of the large bowel by 50%.

“We found that resistant starch reduces a range of cancers by over 60%. The effect was most obvious in the upper part of the gut,” explained Professor John Mathers, professor of Human Nutrition at Newcastle University. “This is important as cancers of the upper GI tract are difficult to diagnose and often are not caught early on.

“Resistant starch can be taken as a powder supplement and is found naturally in peas, beans, oats and other starchy foods.  The dose used in the trial is equivalent to eating a daily banana; before they become too ripe and soft, the starch in bananas resists breakdown and reaches the bowel where it can change the type of bacteria that live there.

“Resistant starch is a type of carbohydrate that isn’t digested in your small intestine, instead it ferments in your large intestine, feeding beneficial gut bacteria – it acts in effect, like dietary fibre in your digestive system. This type of starch has several health benefits and fewer calories than regular starch. We think that resistant starch may reduce cancer development by changing the bacterial metabolism of bile acids and to reduce those types of bile acids that can damage our DNA and eventually cause cancer. However, this needs further research.”

Professor Sir John Burn, from Newcastle University and Newcastle Hospitals NHS Foundation Trust who ran the trial with Professor Mathers, said: “When we started the studies over 20 years ago, we thought that people with a genetic predisposition to colon cancer could help us to test whether we could reduce the risk of cancer with either aspirin or resistant starch.

“Patients with Lynch syndrome are high risk as they are more likely to develop cancers so finding that aspirin can reduce the risk of large bowel cancers and resistant starch other cancers by half is vitally important.

“Based on our trial, NICE now recommend Aspirin for people at high genetic risk of cancer, the benefits are clear – aspirin and resistant starch work.”

Long term study

Between 1999 and 2005, nearly 1000 participants began either taking resistant starch in a powder form every day for two years or aspirin or a placebo.

At the end of the treatment stage, there was no overall difference between those who had taken resistant starch or aspirin and those who had not. However, the research team anticipated a longer-term effect and designed the study for further follow-up.

In the period of follow-up, there were just 5 new cases of upper GI cancers among the 463 participants who had taken the resistant starch compared with 21 among the 455 who were on the placebo.

The team are now leading the international trial, CaPP3, with more than 1,800 people with Lynch syndrome enrolled to look at whether smaller, safer doses of aspirin can be used to help reduce the cancer risk.

The research is funded by Cancer Research UK, the European Commission, Medical Research Council and the National Institute for Health Research.

Reference: Cancer Prevention with Resistant Starch in Lynch syndrome patients in the CAPP2 Randomised Placebo Controlled Trial: planned 10 year follow-up. Cancer Prevention Research.

 

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JOURNAL

Cancer Prevention Research

Green tea extract promotes gut health, lowers blood sugar

 New research in people with a cluster of heart disease risk factors has shown that consuming green tea extract for four weeks can reduce blood sugar levels and improve gut health by lowering inflammation and decreasing “leaky gut.”

Researchers said this is the first study assessing whether the health risks linked to the condition known as metabolic syndrome, which affects about one-third of Americans, may be diminished by green tea’s anti-inflammatory benefits in the gut.

“There is much evidence that greater consumption of green tea is associated with good levels of cholesterol, glucose and triglycerides, but no studies have linked its benefits at the gut to those health factors,” said Richard Bruno, senior study author and professor of human nutrition at The Ohio State University.

The team conducted the clinical trial in 40 individuals as a follow-up to a 2019 study that associated lower obesity and fewer health risks in mice that consumed green tea supplements with improvements to gut health.

In the new study, green tea extract also lowered blood sugar, or glucose, and decreased gut inflammation and permeability in healthy people – an unexpected finding.

“What this tells us is that within one month we’re able to lower blood glucose in both people with metabolic syndrome and healthy people, and the lowering of blood glucose appears to be related to decreasing leaky gut and decreasing gut inflammation – regardless of health status,” Bruno said.

Articles on the glucose results and lowered gut permeability and inflammation were published recently in Current Developments in Nutrition.

People with metabolic syndrome are diagnosed with at least three of five factors that increase the risk for heart disease, diabetes and other health problems – excess belly fat, high blood pressure, low HDL (good) cholesterol, and high levels of fasting blood glucose and triglycerides, a type of fat in the blood.

The tricky thing about these risk factors that constitute metabolic syndrome is that they are often only slightly altered and do not yet require drug management, but still impose great risk to health, Bruno said.

“Most physicians will initially recommend weight loss and exercise. Unfortunately, we know most persons can’t comply with lifestyle modifications for various reasons,” he said. “Our work is aiming to give people a new food-based tool to help manage their risk for metabolic syndrome or to reverse metabolic syndrome.”

Forty participants – 21 with metabolic syndrome and 19 healthy adults – consumed gummy confections containing green tea extract rich in anti-inflammatory compounds called catechins for 28 days. The daily dose equaled five cups of green tea. In the randomized double-blind crossover trial, all participants spent another 28 days taking a placebo, with a month off of any supplement between the treatments.

Researchers confirmed that participants, as advised, followed a diet low in polyphenols – naturally occurring antioxidants in fruits, vegetables, teas and spices – during the placebo and green tea extract confection phases of the study so any results could be attributed to the effects of green tea alone.

Results showed that fasting blood glucose levels for all participants were significantly lower after taking green tea extract compared to levels after taking the placebo. Decreased gut inflammation due to the green tea treatment in all participants was established through an analysis that showed a reduction in pro-inflammatory proteins in fecal samples. Using a technique to assess sugar ratios in urine samples, researchers also found that with green tea, participants’ small intestine permeability favorably decreased.

Gut permeability, or leaky gut, enables intestinal bacteria and related toxic compounds to enter the bloodstream, stimulating low-grade chronic inflammation.

“That absorption of gut-derived products is thought to be an initiating factor for obesity and insulin resistance, which are central to all cardiometabolic disorders,” Bruno said. “If we can improve gut integrity and reduce leaky gut, the thought is we’ll be able to not only alleviate low-grade inflammation that initiates cardiometabolic disorders, but potentially reverse them.

“We did not attempt to cure metabolic syndrome with a one-month study,” he said. “But based on what we know about the causal factors behind metabolic syndrome, there is potential for green tea to be acting at least in part at the gut level to alleviate the risk for either developing it or reversing it if you already have metabolic syndrome.”

Cocoa shown to reduce blood pressure and arterial stiffness in first real-life study

Cocoa only reduces blood pressure and arterial stiffness when elevated, a new study from the University of Surrey finds.

Cocoa flavanols have previously been found to lower blood pressure and arterial stiffness as much as some blood pressure medication. However, how effective flavanols are in everyday life in reducing blood pressure has remained unknown, as previous studies in this area have been performed in tightly controlled experimental settings.

Surrey’s new research reduces concerns that cocoa as a treatment for raised blood pressure could pose health risks by decreasing blood pressure when it is not raised, paving the way for it to be potentially used in clinical practice.

In the first study of its kind study, researchers set out to investigate the use of flavanols, a compound found in cocoa, in lowering blood pressure and arterial stiffness in individuals outside of clinical settings.

Christian Heiss, Professor of Cardiovascular Medicine at the University of Surrey, said:

“High blood pressure and arterial stiffness increases a person’s risk of heart disease and strokes, so it is crucial that we investigate innovative ways to treat such conditions.

“Before we even consider introducing cocoa into clinical practices, we need to test if the results previously reported in laboratory settings safely translate into real-world settings, with people going about their everyday lives.”

For several days, eleven healthy participants consumed, on alternating days, either six cocoa flavanol capsules or six placebo capsules containing brown sugar. Participants were provided with an upper arm blood pressure monitor and a finger clip measuring pulse wave velocity (PWV) which gauges levels of arterial stiffness.

Measurements of blood pressure and PWV were taken prior to consumption of the capsules and every 30 minutes after ingestion for the first three hours, and then hourly for the remaining nine hours. Researchers found that blood pressure and arterial stiffness were only lowered in participants if it was high, and there was no effect when the blood pressure was low in the morning.

Significantly, effects were also, for the first time, identified at eight hours after cocoa was consumed. Researchers believe that this second peak may be due to how bacteria in the gut metabolise cocoa flavanols.

Professor Heiss added:

“The positive impact cocoa flavanols have on our cardiovascular system, in particular, blood vessel function and blood pressure, is undeniable. Doctors often fear that some blood pressure tablets can decrease the blood pressure too much on some days.

“What we have found indicates that cocoa flavanols only decrease blood pressure if it is elevated. Working with participants’ personal health technologies showed us how variable blood pressure and arterial stiffness can be from day to day and shows the role of personal health monitors in developing and implementing effective personalised care.”

The research was published in Frontiers in Nutrition. 

Some antivirals used in nonsevere COVID-19 may reduce hospitalizations and deaths

 

The antiviral drugs molnupiravir and nirmatrelvir–ritonavir (Paxlovid), when used to treat nonsevere COVID-19, most likely reduce the risk of subsequent progression to hospitalization and death, according to new research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.220471.

As most trials have focused on patients with severe or critical COVID-19, researchers conducted a systematic review and meta-analysis to understand the effectiveness of these drugs in treating nonsevere COVID-19.

"Because antiviral drugs may be most useful in nonsevere disease, this review addresses an important gap in evidence," says Dr. Tyler Pitre, Division of Internal Medicine, McMaster University, Hamilton, Ontario, with coauthors.

The researchers identified 41 trials involving 18 568 patients with nonsevere COVID-19, most of whom were aged 36.5 to 65.5 years. Compared with standard care or placebo, nirmatrelvir–ritonavir likely reduced the risk of hospital admission (46.2 fewer admissions per 1000), and molnupiravir probably reduced the risk (16.3 fewer admissions per 1000).

These findings have implications for health care systems and clinical guidelines.

"Our findings suggest that nirmatrelvir–ritonavir may be superior to molnupiravir for some outcomes, which has implications for organizations, such as the [World Health Organization] WHO, that are in the process of developing recommendations addressing molnupiravir and nirmatrelvir–ritonavir," write the authors. "Health care systems deciding on drug procurement and cost issues need to consider the relative efficacy of nirmatrelvir–ritonavir over molnupiravir."

In a related commentary https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221012, authors point out challenges in applying these findings to current patients with COVID-19. Several of the trials on which the study is based were conducted among unvaccinated patients who had been infected with the Delta variant. As a significant portion of Canada's population is now vaccinated and many have been infected with the Omicron variant, the medications may be less effective in a real-world setting.

Study shows link between frequent naps and high blood pressure

 Napping on a regular basis is associated with higher risks for high blood pressure and stroke, according to new research published today in Hypertension, an American Heart Association journal.

Researchers in China examined whether frequent naps could be a potential causal risk factor for high blood pressure and/or stroke. This is the first study to use both observational analysis of participants over a long period of time and Mendelian randomization – a genetic risk validation to investigate whether frequent napping was associated with high blood pressure and ischemic stroke.

“These results are especially interesting since millions of people might enjoy a regular, or even daily nap,” says E Wang, Ph.D., M.D., a professor and chair of the Department of Anesthesiology at Xiangya Hospital Central South University, and the study’s corresponding author.

Researchers used information from UK Biobank, a large biomedical database and research resource containing anonymized genetic, lifestyle and health information from half a million UK participants. UK Biobank recruited more than 500,000 participants between the ages of 40 and 69 who lived in the United Kingdom between 2006 and 2010. They regularly provided blood, urine and saliva samples, as well as detailed information about their lifestyle. The daytime napping frequency survey occurred 4 times from 2006 – 2019 in a small proportion of UK Biobank participants.

Wang’s group excluded records of people who had already had a stroke or had high blood pressure before the start of the study. This left about 360,000 participants to analyze the association between napping and first-time reports of stroke or high blood pressure, with an average follow-up of about 11 years. Participants were divided into groups based on self-reported napping frequency: “never/rarely,” “sometimes,” or “usually.”

The study found:

• A higher percentage of usual-nappers were men, had lower education and income levels, and reported cigarette smoking, daily drinking, insomnia, snoring and being an evening person compared to never- or sometimes-nappers;
• When compared to people who reported never taking a nap, people who usually nap had a 12% higher likelihood of developing high blood pressure and 24% higher likelihood of having a stroke;
• Participants younger than age 60 who usually napped had a 20% higher risk of developing high blood pressure compared to people the same age who never napped. After age 60, usual napping was associated with 10% higher risk of high blood pressure compared to those who reported never napping;
• About three-fourths of participants remained in the same napping category throughout the study;
• The Mendelian randomization result showed that If napping frequency increased by one category (from never to sometimes or sometimes to usually) high blood pressure risk increased 40%. Higher napping frequency was related to the genetic propensity for high blood pressure risk.

“This may be because, although taking a nap itself is not harmful, many people who take naps may do so because of poor sleep at night. Poor sleep at night is associated with poorer health, and naps are not enough to make up for that," said Michael A. Grandner, Ph.D., MTR, a sleep expert and co-author of the American Heart Association’s new Life’s Essential 8 cardiovascular health score, which added sleep duration in June 2022 as the 8th metric for measuring optimal heart and brain health. "This study echoes other findings that generally show that taking more naps seems to reflect increased risk for problems with heart health and other issues.” Grander is director of the Sleep Health Research Program and the Behavioral Sleep Medicine Clinic and associate professor of psychiatry at the University of Arizona in Tucson.

The authors recommend further examination of the associations between a healthy sleep pattern, including daytime napping, and heart health.

The study has several important limitations to consider. Researchers only collected daytime napping frequency, not duration, so there is no information how or whether the length of nap affects blood pressure or stroke risks. Additionally, nap frequency was self-reported without any objective measurements, making estimates nonquantifiable. The study’s participants were mostly middle-aged and elderly with European ancestry, so the results may not be generalizable. Finally, researchers have not yet discovered the biological mechanism for the effect of daytime napping on blood pressure regulation or stroke.

New study finds lowest risk of death was among adults who exercised 150-600 minutes/week

 An analysis of more than 100,000 participants over a 30-year follow-up period found that adults who perform two to four times the currently recommended amount of moderate  or vigorous  physical activity per week have a significantly reduced risk of mortality, according to new research published today in the American Heart Association’s flagship, peer-reviewed journal Circulation. The reduction was 21-23% for people who engaged in two to four times the recommended amount of vigorous physical activity, and 26-31% for people who engaged in two to four times the recommended amount of moderate physical activity each week.

It is well documented that regular physical activity is associated with reduced risk of cardiovascular disease  and premature death.  In 2018, the United States Department of Health and Human Services’ Physical Activity Guidelines for Americans recommended that adults engage in at least 150-300 minutes/week of moderate physical activity or 75-150 minutes/week of vigorous physical activity, or an equivalent combination of both intensities. The American Heart Association’s current recommendations, which are based on HHS’s Physical Activity Guidelines, are for at least 150 minutes per week of moderate-intensity aerobic exercise or 75 minutes per week or vigorous aerobic exercise, or a combination of both.

“The potential impact of physical activity on health is great,  yet it remains unclear whether engaging in high levels of prolonged, vigorous or moderate intensity physical activity above the recommended levels provides any additional benefits or harmful effects on cardiovascular health,”  said Dong Hoon Lee, Sc.D., M.S., a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.  ”Our study leveraged repeated measures of self-reported physical activity over decades to examine the association between long-term physical activity during middle and late adulthood and mortality.”

Researchers analyzed mortality data and medical records for more than 100,000 adults gathered from two large prospective studies: the all-female Nurses’ Health Study and the all-male Health Professionals Follow-up Study from 1988-2018.  Participants whose data were examined were 63% female, and more than 96% were white adults. They had an average age of 66 years and an average body mass index (BMI) of 26 kg/m2 over the 30-year follow-up period.

Participants self-reported their leisure-time physical activity by completing a validated questionnaire for either the Nurses’ Health Study or Health Professionals Follow-Up Study every two years. The publicly available questionnaires, which were updated and expanded every two years, included questions about health information, physician-diagnosed illnesses, family medical histories and personal habits such as cigarette and alcohol consumption and frequency of exercise.  Exercise data was reported as the average time spent per week on various physical activities over the past year. Moderate activity was defined as walking, lower-intensity exercise, weightlifting and calisthenics.  Vigorous activity included jogging, running, swimming, bicycling and other aerobic exercises.

The analysis found that adults who performed double the currently recommended range of either moderate or vigorous physical activity each week had the lowest long-term risk of mortality.  

The analysis also found:

• Participants who met the guidelines for vigorous physical activity had an observed 31% lower risk of CVD mortality and 15% lower risk of non-CVD mortality, for an overall 19% lower risk of death from all causes.
• Participants who met the guidelines for moderate physical activity had an observed 22-25% lower risk of CVD mortality and 19-20% lower risk of non-CVD mortality, for an overall 20-21% lower risk of death from all causes.
• Participants who performed two to four times above the recommended amount of long-term vigorous physical activity (150-300 min/week) had an observed 27-33% lower risk of CVD mortality and 19% non-CVD mortality, for an overall 21-23% lower risk of death from all causes.
• Participants who performed two to four times above the recommended amount of moderate physical activity (300-600 min/week) had an observed 28-38% lower risk of CVD mortality and 25-27% non-CVD mortality, for an overall 26-31% lower risk of mortality from all causes.

In addition, no harmful cardiovascular health effects  were found among the adults who reported engaging in more than four times the recommended minimum activity levels.  Previous studies have found evidence that long-term, high-intensity, endurance exercise, such as marathons, triathlons and long-distance bicycle races, may increase the risk of adverse cardiovascular events, including myocardial fibrosis, coronary artery calcification, atrial fibrillation and sudden cardiac death.

“This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” Lee noted.

However, engaging in long-term, high intensity physical activity (≥300 minutes/week) or moderate intensity physical activity (≥600 minutes/week)  at levels more than four times the recommended weekly minimum did not provide any additional reduction in risk of death.

“Our study provides evidence to guide individuals to choose the right amount and intensity of physical activity over their lifetime to maintain their overall health,” Lee said.  “Our findings support the current national physical activity guidelines and further suggest that the maximum benefits may be achieved by performing medium to high levels of either moderate or vigorous activity  or a combination.”

He also noted that people who perform less than 75 minutes of vigorous activity or less than 150 minutes of moderate activity per week may have greater benefits on mortality reduction by consistently performing approximately 75-150 minutes of vigorous activity or 150-300 minutes of moderate exercise per week,  or an equivalent combination of both, over the long term.

“We have known for a long time that moderate and intense levels of physical exercise can reduce a person’s risk of both atherosclerotic cardiovascular disease and mortality,” said Donna K. Arnett, M.S.P.H., Ph.D., B.S.N., a past president of the American Heart Association (2012-2013) and the dean and a professor in the department of epidemiology at the University of Kentucky College of Public Health in Lexington, Kentucky. Arnett served as co-chair of the writing committee for the American Heart Association’s 2019 Guideline on the Primary Prevention of Cardiovascular Disease, however, she was not involved in the study. “We have also seen that getting more than 300 minutes of moderate-intensity aerobic physical activity or more than 150 minutes of vigorous-intensity aerobic physical exercise each week may reduce a person’s risk of atherosclerotic cardiovascular disease even further, so it makes sense that getting those extra minutes of exercise may also decrease mortality.”

Additional Resources:

• Multimedia is available on right column of release link https://newsroom.heart.org/news/new-study-finds-lowest-risk-of-death-was-among-adults-who-exercised-150-600-minutesweek?preview=1420ac77e02e661a2338295d3aabc36a
• After July 25, 2022, view the manuscript online.
• AHA Guideline: 2019 Guideline on the Primary Prevention of Cardiovascular Disease
• AHA news release: Walk this way – or any way – to better health | American Heart Association (April 2022)
• AHA news release: Exercise, healthy diet in midlife may prevent serious health conditions in senior years | American Heart Association (March 2021)
• Follow AHA/ASA news on Twitter @HeartNews
• Follow news from the AHA’s flagship journal Circulation @CircAHA

Women urged to eat potassium-rich foods to improve their heart health

 

Women who eat bananas, avocados and salmon could reduce the negative effects of salt in the diet, according to a study published today in European Heart Journal, a journal of the European Society of Cardiology (ESC).1 The study found that potassium-rich diets were associated with lower blood pressure, particularly in women with high salt intake.

“It is well known that high salt consumption is associated with elevated blood pressure and a raised risk of heart attacks and strokes,” said study author Professor Liffert Vogt of Amsterdam University Medical Centers, the Netherlands. “Health advice has focused on limiting salt intake but this is difficult to achieve when our diets include processed foods. Potassium helps the body excrete more sodium in the urine. In our study, dietary potassium was linked with the greatest health gains in women.”

The study included 24,963 participants (11,267 men and 13,696 women) of the EPIC-Norfolk study, which recruited 40 to 79 year olds from general practices in Norfolk, UK, between 1993 and 1997. The average age was 59 years for men and 58 years for women. Participants completed a questionnaire on lifestyle habits, blood pressure was measured, and a urine sample was collected. Urinary sodium and potassium were used to estimate dietary intake. Participants were divided into tertiles according to sodium intake (low/medium/high) and potassium intake (low/medium/high).

The researchers analysed the association between potassium intake and blood pressure after adjusting for age, sex and sodium intake. Potassium consumption (in grams per day) was associated with blood pressure in women – as intake went up, blood pressure went down. When the association was analysed according to sodium intake (low/medium/high), the relationship between potassium and blood pressure was only observed in women with high sodium intake, where every 1 gram increase in daily potassium was associated with a 2.4 mmHg lower systolic blood pressure. In men, there was no association between potassium and blood pressure.

During a median follow-up of 19.5 years, 13,596 (55%) participants were hospitalised or died due to cardiovascular disease. The researchers analysed the association between potassium intake and cardiovascular events after adjusting for age, sex, body mass index, sodium intake, use of lipid lowering drugs, smoking, alcohol intake, diabetes and prior heart attack or stroke. In the overall cohort, people in the highest tertile of potassium intake had a 13% lower risk of cardiovascular events compared to those in the lowest tertile. When men and women were analysed separately, the corresponding risk reductions were 7% and 11%, respectively. The amount of salt in the diet did not influence the relationship between potassium and cardiovascular events in men or women.

Professor Vogt said: “The results suggest that potassium helps preserve heart health, but that women benefit more than men. The relationship between potassium and cardiovascular events was the same regardless of salt intake, suggesting that potassium has other ways of protecting the heart on top of increasing sodium excretion.”

The World Health Organization recommends that adults consume at least 3.5 grams of potassium and less than 2 grams of sodium (5 grams of salt) per day.2 High potassium foods include vegetables, fruit, nuts, beans, dairy products and fish. For example, a 115 gram banana has 375 mg of potassium, 154 grams of cooked salmon has 780 mg, a 136 gram potato has 500 mg, and 1 cup of milk has 375 mg.

Professor Vogt concluded: “Our findings indicate that a heart healthy diet goes beyond limiting salt to boosting potassium content. Food companies can help by swapping standard sodium-based salt for a potassium salt alternative in processed foods. On top of that, we should all prioritise fresh, unprocessed foods since they are both rich in potassium and low in salt.”

 

Finding the right memory strategy to slow cognitive decline

A new study compares two popular forms of cognitive training that people often use to improve learning and memory

What’s the best way to improve your memory as you age? Turns out, it depends, a new study suggests. But your fourth-grade  math teacher may have been onto something with that phrase to help you remember how to work out a complicated problem: Please Excuse My Dear Aunt Sally.

 

A new study led by researchers from the University of Michigan and Penn State College of Medicine compared two approaches for people with an early form of memory loss.

 

The two are mnemonic strategy training, which aims to  connect what someone is trying to remember to something else like a word, phrase or song (such as the Dear Aunt Sally mnemonic),  and  spaced retrieval training, which gradually increases the amount of time between tests of remembering something.

People with mild cognitive impairment, which can but does not always lead to a later Alzheimer’s disease diagnosis, were better able to remember information when using one of these cognitive training approaches. However, the data, and brain scans that revealed which areas of the brain were more active, showed each activity works differently.

“Our research shows that we can help people with mild cognitive impairment improve the amount of information they learn and remember; however, different cognitive training approaches engage the brain in distinct ways,” said lead and corresponding author Benjamin Hampstead, Ph.D. Hampstead is a professor of psychiatry at Michigan Medicine and the VA Ann Arbor Healthcare System. He directs the Research Program on Cognition and Neuromodulation Based Interventions and leads the Clinical Core and co-leads the Neuroimaging Core at the federally funded Michigan Alzheimer’s Disease Research Center.

“Mnemonic strategy training increased activity in brain areas often affected by Alzheimer’s disease, which likely explains why this training approach helped participants remember more information and for longer,” Hampstead said “In contrast, those completing rehearsal-based training showed reduced brain activity, which suggests they were processing the information more efficiently.”

Hampstead and his team worked with Krish Sathian, MBBS, Ph.D., professor and chair of Penn State’s Department of Neurology and director of Penn State Neuroscience Institute. Sathian noted that cognitive training approaches are likely to become increasingly important in synergy with the new pharmacological treatments on the horizon for those with neurodegenerative disorders.

Moving forward, Hampstead said researchers and clinicians can use this type of information to help identify the best-fit non-pharmacologic treatments for their patients with memory impairment.

Wearable activity trackers encourage us to walk up to 40 minutes more each day

 New findings from Australian researchers have endorsed what millions of people around the world believe: fitness trackers, pedometers and smart watches motivate us to exercise more and lose weight.

Wearable activity trackers encourage us to walk up to 40 minutes more each day (approximately 1800 more steps), resulting in an average 1kg weight loss over five months.

Researchers from the University of South Australia reviewed almost 400 studies involving 164,000 people across the world using wearable activity trackers (WATs) to monitor their physical activity.

Their findings, published in Lancet Digital Health today, underline the value of low-cost interventions to tackle a growing epidemic of health conditions partially caused by a lack of exercise, including cardiovascular disease, stroke, type 2 diabetes, cancers, and mental illness.

Lead researcher UniSA PhD candidate Ty Ferguson says despite the popularity of WATs, there is widespread scepticism about their effectiveness, accuracy, and whether they fuel obsessive behaviours and eating disorders, but the evidence is overwhelmingly positive.

"The overall results from the studies we reviewed shows that wearable activity trackers are effective across all age groups and for long periods of time," Ferguson says. "They encourage people to exercise on a regular basis, to make it part of their routine and to set goals to lose weight."

The 1kg weight loss may not seem a lot, but researchers say from a public health perspective it is meaningful.

"Bearing in mind these were not weight loss studies, but lifestyle physical activity studies, so we wouldn't expect dramatic weight loss," says UniSA Professor Carol Maher, co-author of the review.

"The average person gains about 0.5 kg a year in weight creep so losing 1kg over five months is significant, especially when you consider that two thirds of Australians are overweight or obese."

Between 2014 and 2020, the number of wearable activity trackers shipped worldwide increased by almost 1500 per cent, translating to a global spend of $2.8 billion in 2020.

Apart from the extra physical activity and weight loss attributed to WATs, there is some evidence that fitness trackers also help lower blood pressure and cholesterol in people with type 2 diabetes and other health conditions.

"The other reported benefit is that WATs improved depression and anxiety through an increase in physical activity," Ferguson says.

Journal Reference:

1. Ty Ferguson, Timothy Olds, Rachel Curtis, Henry Blake, Alyson J Crozier, Kylie Dankiw, Dorothea Dumuid, Daiki Kasai, Edward O'Connor, Rosa Virgara, Carol Maher. Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. The Lancet Digital Health, 2022; 4 (8): e615 DOI: 10.1016/S2589-7500(22)00111-X