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Wednesday, September 28, 2022
FDA Proposes Updated Definition of ‘Healthy’ Claim on Food Packages to Help Improve Diet, Reduce Chronic Disease
Tuesday, September 27, 2022
Coffee drinking is associated with increased longevity
Drinking two to three cups of coffee a day is linked with a longer lifespan and lower risk of cardiovascular disease compared with avoiding coffee, according to research published today in the European Journal of Preventive Cardiology, a journal of the ESC.1 The findings applied to ground, instant and decaffeinated varieties.
“In this large, observational study, ground, instant and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and death from cardiovascular disease or any cause,” said study author Professor Peter Kistler of the Baker Heart and Diabetes Research Institute, Melbourne, Australia. “The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle.”
There is little information on the impact of different coffee preparations on heart health and survival. This study examined the associations between types of coffee and incident arrhythmias, cardiovascular disease and death using data from the UK Biobank, which recruited adults between 40 and 69 years of age. Cardiovascular disease was comprised of coronary heart disease, congestive heart failure and ischaemic stroke.
The study included 449,563 participants free of arrhythmias or other cardiovascular disease at baseline. The median age was 58 years and 55.3% were women. Participants completed a questionnaire asking how many cups of coffee they drank each day and whether they usually drank instant, ground (such as cappuccino or filtered coffee), or decaffeinated coffee. They were then grouped into six daily intake categories, consisting of none, less than one, one, two to three, four to five, and more than five cups per day. The usual coffee type was instant in 198,062 (44.1%) participants, ground in 82,575 (18.4%), and decaffeinated in 68,416 (15.2%). There were 100,510 (22.4%) non-coffee drinkers who served as the comparator group.
Coffee drinkers were compared to non-drinkers for the incidence of arrhythmias, cardiovascular disease and death, after adjusting for age, sex, ethnicity, obesity, high blood pressure, diabetes, obstructive sleep apnoea, smoking status, and tea and alcohol consumption. Outcome information was obtained from medical records and death records. The median follow up was 12.5 years.
A total of 27,809 (6.2%) participants died during follow up. All types of coffee were linked with a reduction in death from any cause. The greatest risk reduction seen with two to three cups per day, which compared to no coffee drinking was associated with a 14%, 27% and 11% lower likelihood of death for decaffeinated, ground, and instant preparations, respectively.
Cardiovascular disease was diagnosed in 43,173 (9.6%) participants during follow up. All coffee subtypes were associated with a reduction in incident cardiovascular disease. Again, the lowest risk was observed with two to three cups a day, which compared to abstinence from coffee was associated with a 6%, 20%, and 9% reduced likelihood of cardiovascular disease for decaffeinated, ground, instant coffee, respectively.
An arrhythmia was diagnosed in 30,100 (6.7%) participants during follow up. Ground and instant coffee, but not decaffeinated, was associated with a reduction in arrhythmias including atrial fibrillation. Compared with non-drinkers, the lowest risks were observed with four to five cups a day for ground coffee and two to three cups a day for instant coffee, with 17% and 12% reduced risks, respectively.
Professor Kistler said: “Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components. It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival. Our findings indicate that drinking modest amounts of coffee of all types should not be discouraged but can be enjoyed as a heart healthy behaviour.”
Being lonely and unhappy accelerates aging more than smoking
Molecular damage accumulates and contributes to the development of aging-related frailty and serious diseases. In some people these molecular processes are more intense than in others, a condition commonly referred to as accelerated aging.
Fortunately, the increased pace of aging may be detected before its disastrous consequences manifest by using digital models of aging (aging clocks). Such models can also be used to derive anti-aging therapies on individual and population levels.
According to the latest article published in Aging-US, any anti-aging therapy needs to focus on one’s mental health as much as on one’s physical health. An international collaboration led by Deep Longevity with US and Chinese scientists have measured the effects of being lonely, having restless sleep, or feeling unhappy on the pace of aging and found it to be significant.
The article features a new aging clock trained and verified with blood and biometric data of 11,914 Chinese adults. This is the first aging clock to be trained exclusively on a Chinese cohort of such volume.
Aging acceleration was detected in people with a history of stroke, liver and lung diseases, smokers, and most interestingly, people in a vulnerable mental state. In fact, feeling hopeless, unhappy, and lonely was shown to increase one’s biological age more than smoking. Other factors linked to aging acceleration include being single and living in a rural area (due to the low availability of medical services).
The authors of the article conclude that the psychological aspect of aging should not be neglected either in research or in practical anti-aging applications. According to Manuel Faria from Stanford University:
“Mental and psychosocial states are some of the most robust predictors of health outcomes — and quality of life — yet they have largely been omitted from modern healthcare”.
Alex Zhavoronkov, the CEO of Insilico Medicine, points out that the study provides a course of action to
“slow down or even reverse psychological aging on a national scale.
Earlier this year, Deep Longevity released an AI-guided mental health web service FuturSelf.AI that is based on a preceding publication in Aging-US. The service offers a free psychological assessment that is processed by an AI and provides a comprehensive report on a user’s psychological age as well as current and future mental well-being. Deepankar Nayak, the CEO of Deep longevity affirms,
"FuturSelf.AI, in combination with the study of older Chinese adults, positions Deep Longevity at the forefront of biogerontological research".
About Deep Longevity
Deep Longevity developed the Longevity as a Service (LaaS)© solution to integrate multiple deep biomarkers of aging dubbed “deep aging clocks” to provide a universal multifactorial measure of human biological age. Deep Longevity is owned by Hong Kong Stock Exchange listed Endurance Longevity (SEHK:0575.HK).
Low-carb vegan diet shows similar health benefits to vegetarian diet
A low-carb vegan diet has the same health effects as a vegetarian diet, but at a much lower cost to the environment, according to new research from St. Michael’s Hospital.
The study, published in The American Journal of Clinical Nutrition, found that a low-carbohydrate vegan diet had a significantly lower potential carbon emission value than its high-carbohydrate vegetarian counterpart. Furthermore, the researchers found that the lower the potential carbon emission value of the diet, the larger the reduction in blood cholesterol.
At a time when people across the world are feeling the varying effects of climate change, the study shows the role of diet in both lowering carbon emissions and improving health outcomes.
“We showed that you actually reduce greenhouse gas emissions, with a diet, that is effective, and that the reduction in greenhouse gas emissions is related to the fall in LDL cholesterol – often called the ‘bad’ cholesterol,” says principal author Dr. David Jenkins, director of the Clinical Nutrition and Risk Factor Modification Centre, and a scientist in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and a professor of Nutritional Sciences at the University of Toronto. “So as you reduce the impact of your diet on the environment, you also benefit by lowering your cholesterol.”
The researchers put people on two different types of plant-based diets: one was a low-carbohydrate vegan diet with no meat, dairy or eggs, supplemented with canola-oil enriched bread and high-protein vegan meat alternatives. This diet tried to reproduce the popular low carb diets that are traditionally high in meat and animal fats - but using plant ingredients.
The second diet was a vegetarian version of the clinical standard diet for lowering blood pressure, known as the Dietary Approaches to Stopping Hypertension diet or “DASH” diet, which included egg whites and low-fat dairy, but no meat. The diet is prescribed for the treatment of high blood pressure, diabetes, and other cardiovascular diseases. The diet participants of this study followed differed from the one that is normally prescribed as it cut out cholesterol sources.
The researchers then compared the effects of the diets on their subjects’ health as well as the carbon emission potential of each diet. They did so by using multiple different greenhouse gas emission databases, obtaining mean values for each food.
At the end of the three-month study period, they found that the two diets were similar in their effects on weight loss, reducing blood pressure, and blood cholesterol. Study participants on the vegan diet lost 5.9 kilos and those on the vegetarian diet lost 5.2 kilos.
Both groups also saw a reduction in hemoglobin A1c, a marker of glycemic control.
Jenkins says the study participants reduced their hemoglobin A1c by about one per cent, which is the type of reduction most drugs will produce. This means that the diets had a drug-like effect.
While the study was only over a three-month period, previous studies featuring participants with high cholesterol have shown that the participants have been able to maintain their weight loss after three months. This means that three months is a sufficient amount of time for metabolism to adapt to what the body is consuming.
Study participants were already healthy when the study began, which would have meant that further reductions in risk factors like blood cholesterol and blood pressure would be difficult. However, the study’s participants did see reductions in the risk factors on both the vegan and vegetarian diets.
“We have got to start changing the way we’re doing things in life,” says Dr. Jenkins. “This is just a small example that you can do it, it can be healthy. It is palatable. And you can reduce at least one risk factor, too.”
JOURNAL
American Journal of Clinical Nutrition
Friday, September 23, 2022
More older adults should be checking blood pressure at home
Only 48% of people age 50 to 80 who take blood pressure medications or have a health condition that’s affected by hypertension regularly check their blood pressure at home or other places, a new study finds.
A somewhat higher number – but still only 62% -- say a health care provider encouraged them to perform such checks. Poll respondents whose providers had recommended they check their blood pressure at home were three and a half times more likely to do so than those who didn’t recall getting such a recommendation.
The findings underscore the importance of exploring the reasons why at-risk patients aren’t checking their blood pressure, and why providers aren’t recommending they check -- as well as finding ways to prompt more people with these health conditions to check their blood pressure regularly. This could play an important role in helping patients live longer and maintain heart and brain health, the study’s authors say.
Past research has shown that regular home monitoring can help with blood pressure control, and that better control can mean reduced risk of death; of cardiovascular events including strokes and heart attacks; and of cognitive impairment and dementia.
The findings are published in JAMA Network Open by a team from Michigan Medicine, the University of Michigan’s academic medical center. The data come from the National Poll on Healthy Aging and build on a report issued last year.
The poll, based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine and AARP, asked adults aged 50 to 80 about their chronic health conditions, blood pressure monitoring outside of clinic settings, and interactions with health providers about blood pressure. Study authors Mellanie V. Springer, M.D., M.S., of the Michigan Medicine Department of Neurology, and Deborah Levine, M.D., M.P.H., of the Department of Internal Medicine, worked with the NPHA team to develop the poll questions and analyze the findings.
The data in the new paper come from the 1,247 respondents who said they were either taking a medication to control their blood pressure or had a chronic health condition that requires blood pressure control – specifically, a history of stroke, coronary heart disease, congestive heart failure, diabetes, chronic kidney disease or hypertension.
Of them, 55% said they own a blood pressure monitor, though some said they don’t ever use it. Among those who do use it, there was wide variation in how often they checked their pressure – and only about half said they share their readings with a health provider. But those who own a monitor were more than 10 times more likely to check their blood pressure outside of health care settings than those who don’t own one.
The authors note that blood pressure monitoring is associated with lower blood pressure and is cost-effective. They say that the results suggest that protocols should be developed to educate patients about the importance of self blood pressure monitoring and sharing readings with clinicians.
Thursday, September 22, 2022
Healthy lifestyle linked to 90% lower risk of diabetes in susceptible women
Women with a history of diabetes in pregnancy can still reduce their chances of developing type 2 diabetes by adopting a healthy lifestyle, such as eating healthy, stopping smoking, exercising regularly, and not being overweight, finds a study in The BMJ today.
The results show that women who adhered to five key lifestyle factors - healthy weight, high-quality diet, regular physical activity, moderate alcohol consumption, and not smoking - had a 90% lower risk of the disorder compared with women who did not adhere to any, even among those who were overweight or obese, or were at greater genetic risk of type 2 diabetes.
It’s widely known that a healthy lifestyle is associated with a lower risk of developing type 2 diabetes in generally healthy middle-aged populations.
But less is known about whether this also applies to high-risk women with a history of diabetes in pregnancy (gestational diabetes), and if obesity status or genetic risk of type 2 diabetes influence this association.
To fill in these research gaps, researchers evaluated the associations of adherence to optimal levels of five modifiable risk factors - healthy body mass index, high-quality diet, regular physical activity, moderate alcohol consumption, and not smoking, with the risk of developing type 2 diabetes among these women at high risk.
Their findings are based on data for 4,275 women with a history of gestational diabetes mellitus from the Nurses’ Health Study II with repeated measurements of weight and lifestyle factors over 28 years of follow-up.
The researchers also assessed whether these associations changed according to obesity status or underlying genetic susceptibility for type 2 diabetes.
Over an average 28 years of follow-up, 924 women developed type 2 diabetes.
After taking account of other major diabetes risk factors, the researchers found that participants who had optimal levels of all five modifiable factors after the index pregnancy had a more than 90% lower risk for developing type 2 diabetes compared with those who did not have any.
Each additional optimal modifiable factor was associated with an incrementally lower risk of type 2 diabetes. For example, women with one, two, three, four, and five optimal levels of modifiable factors compared with none had a 6%, 39%, 68%, 85%, and 92% lower risk, respectively.
And these beneficial associations were consistently seen, even among women who were overweight or obese or who had higher genetic susceptibility to type 2 diabetes.
This is an observational study, so it can’t establish cause, and the researchers acknowledge that the data relied on personal reports, which may have affected accuracy. What’s more, the study included predominantly healthcare professionals of European ancestry, so the results may not apply to individuals of other racial or ethnic groups or socioeconomic groups.
However, strengths include use of data from a large study with repeated measurements of health related and behavioural risk factors, which helps to better capture long term lifestyle habits and reduce measurement error and misclassification.
As such, the researchers say their study “highlights the important public health opportunity for the prevention of type 2 diabetes in this high-risk population.”
JOURNAL
The BMJ
Researcher calls for tailoring colorectal cancer screening for 45-to-49-year-olds
It’s been a year since national recommendations issued by the American Cancer Society and the U.S. Multi-Society Task Force called for colorectal cancer (CRC) screening to be lowered to include individuals ages 45 to 49 at average risk for the disease. In an editorial in the journal Clinical Gastroenterology and Hepatology, Regenstrief Institute Research Scientist Thomas Imperiale, M.D., issues a clarion call for individuals, clinicians and healthcare systems to be good stewards of available colonoscopy resources and encourages average risk members of this age group to consider non-invasive screening alternatives.
“The importance of colorectal cancer screening cannot be overstated," said Dr. Imperiale, a highly respected researcher and practicing gastroenterologist. "But we should tailor screening to the individual -- not every 45-to-49-year-old requires colonoscopy for screening. At home, annual FIT [fecal immunochemical test] testing, which looks for blood in the stool and is inexpensive, or stool multi-target DNA and blood testing every three years, are efficient ways to screen those at the low-risk end of the average risk population, which is where most 45-to-49-year-olds fall. Using FIT and stool DNA tests doesn’t simply benefit the individual, it benefits others who need more invasive screening resources. There are only so many colonoscopies that can be performed well in this country every year.”
Roughly seven or eight out of 10 individuals who fall within the range of those for whom colorectal cancer screening is recommended by national guidelines are considered to be at average risk of the disease.
“It’s still too early to know who, in this younger age range, is getting screened. Is it the lower-risk end of average risk individuals who exercise regularly, have a healthful diet -- by eating fruits, vegetables and grains and limiting consumption of red meat -- and see screening as another personal health responsibility, or is it those at higher risk who smoke or have diabetes or are overweight?,” queries Dr. Imperiale. “It could well be that a larger number of younger individuals will get screened if we encourage non-invasive, easy-to-use home screening tests rather than colonoscopy for “average-risk” asymptomatic individuals until they get to age 50 or perhaps age 55.”
The editorial, “Uptake of Colorectal Cancer Screening Colonoscopy in 45-to-49-year-olds: An Early-Inning View from the Endoscopy Suite,” notes that lowering the age at which to commence average-risk colorectal cancer screening by five years (from 50 to 45) has increased the number of people in the U.S. requiring screening by approximately 20 million. Dr. Imperiale supports a “hybrid” strategy of non-invasive screening for younger individuals at average risk followed by colonoscopy screening for older individuals at average risk.
A healthy lifestyle may help former smokers lower their risk of death from all causes
Former smokers who stick to a healthy lifestyle have a lower risk of dying from all causes than those who don’t engage in healthy habits, according to a new study by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). The reduced risk of dying was observed for specific causes, including cancer and heart and lung diseases. Lifestyle interventions have not been robustly studied in former smokers, and these new findings could have important implications for the 52 million former smokers in the United States.
Maintaining a healthy lifestyle—defined as doing things such as being physically active and having a healthy diet—was associated with a 27% reduction in the risk of death over the 19-year follow-up period, compared with not maintaining a healthy lifestyle.
The findings, which appeared Sept. 22, 2022, in JAMA Network Open, come from an analysis of a large group of former smokers who participated in the NIH-AARP Diet and Health Study.
“I was surprised to see the robust associations [with lifestyle],” said Maki Inoue-Choi, Ph.D., of the Division of Cancer Epidemiology and Genetics at NCI, lead author of the paper. “Former smokers who adhered to evidence-based recommendations for body weight, diet, physical activity, and alcohol intake had a lower risk of mortality than former smokers who didn't adhere to these recommendations.”
Quitting smoking is well known to have many health benefits, but former smokers still have a higher risk of disease and premature death than people who have never smoked.
Past studies have suggested that people who follow healthy lifestyle recommendations, such as maintaining a healthy body weight, being physically active, eating a healthy diet, and limiting alcohol consumption, may have a lower risk of disease and death. However, few studies have looked at the benefit of such adherence among former smokers.
The current analysis included 159,937 former smokers who had completed questionnaires asking about lifestyle, demographics, and other health-related information between 1995 and 1996 when they joined the NIH-AARP Diet and Health Study. The participants, whose average age at study entry was 62.6 years, were followed for approximately 19 years. During the follow-up period, which extended through 2019, 86,127 participants died. Death information, including cause of death, came from the National Death Index.
For each participant, the researchers calculated a total adherence score ranging from no adherence to full adherence. The total adherence score incorporated individual scores for body mass index, based on guidelines from the World Health Organization; for dietary quality, based on the Dietary Guidelines for Americans, 2010-2015; for physical activity, based on the second edition of the Physical Activity Guidelines for Americans; and for alcohol use, based on the Dietary Guidelines for Americans, 2020-2025.
Former smokers who had the highest total adherence scores had a 27% lower risk of death from any cause than those with the lowest scores. In addition, participants with the highest scores had a 24% reduction in risk of death from cancer, 28% reduction in risk of death from cardiovascular disease, and 30% reduction in risk of death from respiratory disease. The reductions in risk of death were observed regardless of health status, other health conditions, how many cigarettes participants used to smoke per day, years since they quit, and age they began smoking.
The researchers also evaluated the benefit from adherence for individual lifestyle recommendations. In each case, people with the highest score had a lower risk of death than those with the lowest score: 17% lower for physical activity, 14% lower for body weight, 9% lower for diet quality, and 4% lower for alcohol intake.
“To have the greatest benefit, it is better to adhere to many lifestyle recommendations,” Dr. Inoue-Choi noted. “But even those who adopted just a single lifestyle recommendation experienced benefits.”
The researchers cautioned that studies based on self-reported data can only show associations, not establish cause and effect. Although the researchers controlled for many factors that could have confounded the associations, they said they cannot rule out the possibility that other factors may have affected the associations they observed.
The researchers also noted that more studies are needed to explore the associations between adhering to lifestyle recommendations and risk of death among former smokers in more diverse populations.
“The NIH-AARP study is a predominantly White population with relatively high socioeconomic status,” Dr. Inoue-Choi said. “These research questions need to be extended to other populations.”
Wearing a pedometer — even if you don't look at it — may boost step counts
IMAGE: PEOPLE WEARING STEP TRACKERS WALK MORE, EVEN IF THEY DON'T LOOK AT THEIR DEVICE. view more
CREDIT: JAREN WILKEY/BYU PHOTO
Almost half of American adults don’t meet recommended weekly physical activity levels, but new research from Brigham Young University suggests a surprisingly simple way to help increase exercise time: just strap on an activity monitor.
The study found that those wearing a pedometer walked an average of 318 more steps per day than those without a tracker, even if the walkers had no specific fitness goals or incentives, and even when they couldn’t see the step count the pedometer kept.
“Humans are hardwired to respond to what is being measured because if it’s being measured, it feels like it matters,” said BYU Marriott School of Business professor Bill Tayler, an author of the paper. “When people go get an Apple Watch or a Fitbit, of course it’s going to affect their behavior; they obtained the device with the goal of walking more. But it’s helpful for individuals to know that even without trying, just being aware that something is tracking your steps increases your activity.”
Since modest increases in physical activity have cumulative benefits, the study’s findings may also be useful to those in healthcare or businesses that have a vested interest in public health.
“If I were an insurance executive, I’d be interested to know that you can hand out basic fitness trackers to people, and as long as they put them on, they’re going to walk more,” Tayler said.
To determine how being monitored affected people’s step counts, the research team came up with an ingenious experiment design.
“We wanted to find out, absent goals and incentives, does simply tracking fitness change behavior? Until this study, no one had convincingly shown what we’ve shown — from an academic point of view, it turns out this is a super hard question to answer,” Tayler said.
That’s because to prove that people walk more with a pedometer, researchers need to know either 1) how much people walk before they put on the pedometer or 2) how much they walk compared to another group of randomly selected people who are not wearing a pedometer — baseline measurements that both require a pedometer.
The team’s workaround was to use the iPhone’s default step tracking feature, which few people were aware existed when the researchers began gathering data. “It was a bit of a sneaky way to get the data we needed,” Tayler said.
At the start of the study, the team asked all 90 participants’ permission to pull information generally from their phones, without telling them that their step counts from the weeks prior were being recorded. This provided the elusive baseline measure of how much participants walked when they weren’t being actively monitored.
The team then gave some of the participants a pedometer without a display, while keeping the rest of the participants in the dark about the study’s purpose. After another two weeks, the researchers again accessed step count data from the subjects’ iPhones and saw that wearing a pedometer was associated with higher step counts.
“Measurement and tracking precede improvement,” said BYU graduate Christian Tadje, who spearheaded the research as a student working with the Healthcare Industry Research Collaborative. “If you want something to improve — for example, a key performance indicator in the workplace or a personal health goal — our study shows that you should consider tracking your progress.”
The paper was published in the American Journal of Health Behavior and additionally coauthored by BYU professors James LeCheminant and Joe Price.
Clinical trial shows implantable shock absorber Knee pain is commonly caused by osteoarthritis, a chronic condition that affects approximately 14 million Americans of all ages.
Results from a multi-center clinical trial, presented today at an orthopedic symposium in Boston, show a new implantable shock absorber can relieve pain and improve function. Dr. David Flanigan, an orthopedic surgeon at The Ohio State University Wexner Medical Center, enrolled patients in the trial at the medical center and was first in the U.S. to implant the MISHA Knee System made by Moximed.
“There really hasn’t been much to offer for knee arthritis between the more basic options like medications, therapy and injections all the way to joint replacement,” said Flanigan, who is also a professor of orthopedics at the Ohio State College of Medicine “This shock absorber could be an in between step patients need.”
The device involves a piston that anchors to the inner side of the femur and tibia bones with a small plate. Trial data showed significant reduction in pain scores and improvement in function scores for more than 90% of the 81 trial participants. The shock absorber had a success rate of 86% compared to the most common procedure, high tibial osteotomy, which has a success rate of 66% and is typically used to treat symptomatic osteoarthritis of the medial compartment of the knee.
“When you're walking, doing activities, it's going to take away about 30% of that shock or stress on the knee every time you put weight on your leg,” said Flanigan. “You see patients who are struggling just to walk and have pain on a daily basis. They have this device, go through rehabilitation and then they’re walking and getting back to activities that are really important to them.”
Chuck Stenger of New Albany, Ohio was the first person to receive the shock absorber device three years ago. Today, the retired firefighter says he’s doing exceptionally well and is grateful he had the opportunity to try the device.
“Before participating in the clinical trial, I was told I was probably a candidate for a knee replacement, and I didn't think I was quite ready for that yet,” Stenger said. “Three days after the implant procedure I was walking around, and with a little therapy I’m back to golfing, taking long walks and just living life without constant pain in my knees.”
The two-year collective clinical trial data has been submitted to the U.S. Food and Drug Administration and is under regulatory review.
Wednesday, September 21, 2022
Do sleep timing and duration affect dementia risk?
New research published in the Journal of the American Geriatrics Society suggests that the time people go to bed and the amount of time they sleep may affect their risk of developing dementia.
In the study of 1,982 older adults in China who were free of dementia at the start of the study, 97 participants were diagnosed with dementia during an average follow-up of 3.7 years.
Risk of dementia was 69% higher in those who slept for more than 8 hours (versus 7-8 hours) and 2-times higher for those who went to bed before 9 PM (versus 10 PM or later).
“This suggests that cognitive function should be monitored in older adults who report prolonged 102time in bed and advanced sleep timing,” the authors wrote.
A consistent lack of sleep negatively impacts immune stem cells, increasing risk of inflammatory disorders and heart disease
IMAGE: INSUFFICIENT SLEEP AND THE IMPACT ON IMMUNE STEM CELLS. THE LEFT SIDE OF THE FIGURE SHOWS THE SLEEP TIME OF THE HUMANS IN THE STUDY. PARTICIPANTS IN THE SLEEP RESTRICTION GROUP (THE RED DOTS) SLEPT LESS OVER THE SIX WEEKS. THE RIGHT SIDE OF THE FIGURE THE STEM CELL ANALYSIS. THE FIRST GRAPH SHOWS THAT PEOPLE IN THE SLEEP RESTRICTION GROUP (AGAIN RED DOTS) HAD MORE STEM CELLS. THE REMAINDER OF THE FIGURE REPRESENTS THE ‘DNA STRUCTURE AND RE-PROGRAMMING. THE RED AND BLUE COLORS SHOW LOCATIONS IN THE GENOME THAT WERE RE-WIRED. THE BOTTOM ‘PEAKS’ ARE SPECIFIC GENES THAT RESEARCHERS LOOKED AT AND SHOWS THE RE-WIRING AT THESE LOCATIONS. view more
CREDIT: MOUNT SINAI HEALTH SYSTEM
Chronic, insufficient sleep can negatively affect immune cells, which may lead to inflammatory disorders and cardiovascular disease, according to a new study from the Icahn School of Medicine at Mount Sinai. More specifically, consistently losing an hour and a half of sleep a night potentially increases the risk.
The research, published September 21 in the Journal of Experimental Medicine, is the first to show that sleep alters the structure of DNA inside the immune stem cells that produce white blood cells—also known as immune cells—and this can have a long-lasting impact on inflammation and contribute to inflammatory diseases. Immune cells fight infection, but if the number of these cells gets too high, they overreact and cause inflammation. The study is also the first to show that catching up on sleep doesn’t reverse the effects of sleep disruption.
“This study begins to identify the biological mechanisms that link sleep and immunological health over the long-term. It shows that in humans and mice, disrupted sleep has a profound influence on the programming of immune cells and rate of their production, causing them to lose their protective effects and actually make infections worse—and these changes are long-lasting. This is important because it is yet another key observation that sleep reduces inflammation and, conversely, that sleep interruption increases inflammation,” says lead author Filip Swirski, PhD, Director of the Cardiovascular Research Institute at Icahn Mount Sinai. “This work emphasizes the importance of adults consistently sleeping seven to eight hours a day to help prevent inflammation and disease, especially for those with underlying medical conditions."
A team of investigators analyzed 14 healthy adults who regularly sleep eight hours a night. First, researchers monitored them sleeping at least eight hours a night for six weeks. They drew their blood and analyzed their immune cells. Then, the same group of adults reduced their sleep time by 90 minutes every night for six weeks, and had their blood and immune cells reanalyzed. At the end of the study researchers compared the blood and cell samples from the full night’s sleep and restricted sleep periods. All participants had significant changes in their immune cells (also known as hematopoietic cells) due to a lack of sleep—there were more of them, and the DNA structure was altered. After six weeks of sleep restriction, they had an increased number of immune cells.
Researchers also analyzed sleep in mouse models. Groups of mice were either allowed to sleep undisturbed, or had sleep fragmentation, where they were awakened throughout the night for 16 weeks. Then, mice with sleep fragmentation went through uninterrupted sleep recovery for ten weeks. Investigators took immune stem cells and immune cells from mice during these undisturbed, fragmented, and sleep recovery phases, analyzed them and compared them at the end of the experiment. Results in mice were consistent with results in humans. They showed that all mice with fragmented sleep had significant changes to their immune stem cells, producing an increased number of immune cells, and also showed evidence of rewiring and reprogramming. A notable finding from the mouse group was that even after sleep recovery, the immune stem cells retained this rewiring structure, and they continued to produce additional white blood cells, making the mice susceptible to inflammation and disease.
“Our findings suggest that sleep recovery is not able to fully reverse the effects of poor-quality sleep. We can detect a molecular imprint of insufficient sleep in immune stem cells, even after weeks of recovery sleep. This molecular imprint can cause the cells to respond in inappropriate ways leading to inflammation and disease,” says co-lead investigator Cameron McAlpine, PhD, Assistant Professor of Medicine (Cardiology) at Icahn Mount Sinai. “It was surprising to find that not all clusters of stem cells responded to insufficient sleep in the same way. There were some stem cell clusters that proliferated and grew in number, while other clusters became smaller. This reduction in overall diversity and aging of the immune stem cell population is an important contributor to inflammatory diseases and cardiovascular disease.”
Simple 20-20-20 screen rule really does help with eye strain, research shows
It’s long been recommended as a way of easing eye strain while working at a computer screen. Now the 20-20-20 rule – taking a break of at least 20 seconds, every 20 minutes, to look at least 20 feet away - has been confirmed by scientists at Aston University to help ease some of the symptoms of prolonged computer use.
It’s estimated that at least half of people using computers in their regular work have some form of digital eye strain, resulting in eye surface problems including irritation and dryness, or vision issues such as headaches or blurred vision. Humans normally blink around 15 times each minute. When staring at screens, this number decreases generally to half that rate or less. That can lead to dry, irritated, and tired eyes, but twenty seconds focusing elsewhere is long enough for the eyes to relax enough to reduce the strain.
This is the first time that the 20-20-20 guidance rule has been properly validated.
Researchers at Aston University’s College of Health and Life Sciences set up their study with the help of 29 participants who suffer from symptoms of eye strain. Special software downloaded onto the participants’ own laptop computers used the built-in laptop camera both to check if a user was sitting at the screen and to monitor their gaze direction every few seconds. After 20 minutes of continuous screen viewing, the programme flashed up a message, asking users to rest for 20 seconds while looking at any distant target around 20 feet away, such as out of the window or across a room. The message couldn’t be removed until the task was performed correctly, as measured by the app.
Participants’ digital eye strain symptoms were measured before and after two weeks of using the reminders, and one week after completing the study. Results showed a marked decrease in symptoms including dryness, sensitivity and discomfort.
Professor James Wolffsohn, Professor of Optometry at Aston University, who led the research in collaboration with the University of Valencia, Spain, said: “The one previous study merely asked people to carry out the suggestions; but here the access control on the software meant we could be sure that participants really had looked away every 20 minutes. We saw a consequent improvement in the symptoms of the group as a whole.”
Researchers noted that after the study, the participants’ eye symptoms returned to what they had been before the intervention. Professor Wolffsohn says: “We are planning to conduct longer term studies to see whether we can teach eyelid muscle memory impulses to blink more often during digital viewing, to help mitigate this chronic issue without long term use of reminders.”
The findings confirm that people should try and take breaks from their screens. He added: “Although we used sophisticated software, it’s easy for others to replicate the effect by setting a timer on their phone, or downloading a reminder app. It’s a simple way of reminding yourself to take regular breaks for the good of your eyes.”
Stain-resistant school uniforms could expose children to harmful chemicals
Children who wear stain-resistant school uniforms may be exposed to potentially harmful levels of chemicals, according to a new study by researchers in the Paul H. O'Neill School of Public and Environmental Affairs at Indiana University and colleagues from the University of Toronto, the University of Notre Dame and the Green Science Policy Institute.
About a quarter of U.S. children wear school uniforms, according to a survey from Statista. One-fifth of U.S. public schools require uniforms, with the greatest prevalence in elementary and low-income schools. They are even more common in Catholic and other private schools in the United States and Canada.
The study, published in Environmental Science & Technology, found that millions of schoolchildren in the U.S. and Canada are exposed to potentially harmful levels of per- and polyfluoroalkyl substances, or PFAS, through their uniforms. The researchers detected PFAS in all of the stain-resistant school uniforms they tested from nine popular brands. Most products had concentrations as high as those in outdoor clothing.
"PFAS don't belong in any clothing, but their use in school uniforms is particularly concerning," said Marta Venier, senior author and professor at Indiana University. "School uniforms are worn directly on the skin for up to eight hours per day by children, who are particularly vulnerable to harm."
Some PFAS have been associated with a wide variety of serious health issues, such as cancer, obesity and more severe COVID-19 outcomes. They've also been found to contaminate the drinking water for millions of citizens. Only a small fraction of the thousands of PFAS have been tested for toxicity, and all PFAS are either extremely persistent in the environment or break down into extremely persistent PFAS. Additionally, some newer PFAS first claimed to be safe have later been determined to be harmful to human health.
PFAS in treated uniforms may end up harming children through skin absorption, as well as from eating with unwashed hands, other hand-to-mouth behaviors and mouthing of clothing by younger children. The fluorotelomer alcohols, which were the primary type of PFAS found in the uniforms, also pose an inhalation risk. Further, PFAS-treated uniforms are a source of PFAS contamination in the environment when they are worn, laundered, and discarded or recycled.
"I don't know any parent who values stain repellency over their child's health," said Miriam Diamond, co-author and professor at the University of Toronto.
The findings come as legislation to phase out PFAS in textiles, which would include school uniforms, moves forward in New York and California. New York's Senate Bill S6291A and California's Assembly Bill 1817, known as the Safer Clothes and Textiles Act, have both passed their legislatures and are expected to be signed by their respective governors soon.
"To protect our children and future generations, the whole class of PFAS should be eliminated from school uniforms and all other products where they are not essential," said Arlene Blum, co-author and executive director of the Green Science Policy Institute. "Manufacturers can prevent harm by moving away from PFAS as soon as possible."
The researchers recommend that parents check labels to see if their children's' uniforms are marketed as stain resistant. If so, they say there is some evidence to suggest that multiple washes can reduce PFAS concentration. They also say that used clothes or hand-me-down clothes are better options, because the levels of PFAS might decline with laundering.
Other authors of the study include Chunjie Xia of the O'Neill School at IU; Graham Peaslee, Heather Whitehead and Megan Green from the University of Notre Dame; Zhanyun Wang of the Swiss Federal Laboratories for Materials Science and Technology; and Hui Peng, Anna Shalin, Heather Schwartz-Narbonne and Diwen Yang of the University of Toronto.
JOURNAL
Environmental Science & Technology
Tuesday, September 20, 2022
People who are ‘night owls’ could have greater risk of type 2 diabetes and heart disease than those who are ‘early birds’
Are you an early bird or a night owl? Our activity patterns and sleep cycles could influence our risk of diseases, such as type 2 diabetes and heart disease. New research published in Experimental Physiology found wake/sleep cycles cause metabolic differences and alter our body’s preference for energy sources. The researchers found that those who stay up later have a reduced ability to use fat for energy, meaning fats may build-up in the body and increase risk for type 2 diabetes and cardiovascular disease.
The metabolic differences relate to how well each group can use insulin to promote glucose uptake by the cells for storage and energy use. People who are ‘early birds’ (individuals who prefer to be active in the morning) rely more on fat as an energy source and are more active during the day with higher levels of aerobic fitness than ‘night owls’. On the other hand, ‘night owls’ (people who prefer to be active later in the day and night) use less fat for energy at rest and during exercise.
Researchers from Rutgers University, New Jersey, USA classified participants (n=51) into two groups (early and late) based on their ‘chronotype’ – our natural propensity to seek activity and sleep at different times. They used advanced imaging to assess body mass and body composition, as well as insulin sensitivity and breath samples to measure fat and carbohydrate metabolism.
Participants were monitored for a week to assess their activity patterns across the day. They ate a calorie and nutrition-controlled diet and had to fast overnight to minimise dietary impact on the results. To study fuel preference, they were tested while at rest before completing two 15-minute bouts of exercise: one moderate and one high intensity session on a treadmill. Aerobic fitness levels were tested through an incline challenge where the incline was raised 2.5% every two minutes until the participant reached a point of exhaustion.
Researchers found that early birds use more fat for energy at both rest and during exercise than night owls. Early birds were also more insulin sensitive. Night owls, on the other hand, are insulin resistant, meaning their bodies require more insulin to lower blood glucose levels, and their bodies favoured carbohydrates as an energy source over fats. This group’s impaired ability to respond to insulin to promote fuel use can be harmful as it indicates a greater risk of type 2 diabetes and/or heart disease. The cause for this shift in metabolic preference between early birds and night owls is yet unknown and needs further investigation.
Senior author Professor Steven Malin, Rutgers University, New Jersey, USA said:
“The differences in fat metabolism between ‘early birds’ and ‘night owls’ shows that our body’s circadian rhythm (wake/sleep cycle) could affect how our bodies use insulin. A sensitive or impaired ability to respond to the insulin hormone has major implications for our health. This observation advances our understanding of how our body’s circadian rhythms impact our health. Because chronotype appears to impact our metabolism and hormone action, we suggest that chronotype could be used as a factor to predict an individual’s disease risk.”
“We also found that early birds are more physically active and have higher fitness levels than night owls who are more sedentary throughout the day. Further research is needed to examine the link between chronotype, exercise and metabolic adaptation to identify whether exercising earlier in the day has greater health benefits.”
JOURNAL
Experimental Physiology
Many heart-related emergencies are due to uncontrolled blood pressure
The researchers found that 13% of all heart-related emergency department diagnoses, representing more than 2.7 million people, were for “essential” hypertension, which is high blood pressure not caused by other diseases. Most cases of high blood pressure are essential hypertension.
“These visits resulted in hospital admission less than 3% of the time and with very few deaths - less than 0.1%. This suggests that these visits were mostly related to the management of hypertension,” said lead author Mamas A. Mamas, M.D., a professor of cardiology at Keele University in Stoke-on-Trent, and a consultant cardiologist at University Hospitals of North Midlands NHS Trust, both in the UK.
For the 15 CVD conditions detailed in the study, about 30% were hypertension-related diagnoses.
The study analyzed cardiovascular diagnoses made during emergency department visits that were part of the Nationwide Emergency Department Sample from 2016-2018. The sample was 48.7% women, and the average age was 67 years. The majority were Medicare or Medicaid participants. Men in the sample were more likely to have other diseases in addition to cardiovascular disease, such as diabetes, while women had higher rates of obesity, high blood pressure and medical conditions that affect blood vessels in the brain.
The most common heart- or stroke-related diagnoses for women seen in the emergency department were high blood pressure (16% of visits), high blood pressure-related heart or kidney disease (14.1%) and atrial fibrillation (10.2%). The most common diagnoses for men were high blood pressure-related heart or kidney disease (14.7%), high blood pressure (10.8%) and heart attack (10.7%).
“Previous studies have shown sex differences in patterns of CVD among hospitalized patients,” Mamas said. “However, examining CVD encounters in the emergency department provides a more complete picture of the cardiovascular health care needs of men and women, as it captures encounters prior to hospitalization.” He also points out that previous studies of CVD emergency visits are limited to suspected heart attack visits. “Therefore, this analysis of 15 CVD conditions helps to better understand the full spectrum of acute CVD needs, including sex disparities in hospitalization and risk of death.”
The study found that outcomes from the emergency CVD visits were slightly different for men and women. Overall, women were less likely to die (3.3% of women vs 4.3% of men) or be hospitalized (49.1% of women vs 52.3% of men) after an emergency department visit for CVD. The difference may be due to women’s generally lower risk diagnoses, said Mamas, but there could be an underestimation of deaths in women.
“We did not track deaths outside of the hospital setting,” said Mamas. “Given past evidence that women are more likely to be inappropriately discharged from the emergency department, and strong evidence for the systemic undertreatment of women, further study is warranted to track outcomes beyond the emergency department visit.”
An additional limitation of the data includes potential misdiagnosis errors in cases where the final diagnosis did not match the emergency diagnosis, particularly after a hospitalization and additional bloodwork and other health information could be obtained. Furthermore, the data is limited in that it does not capture information related to severity of disease, which may make comparisons around mortality differences between different patient groups challenging.
“Our work with this large, nationally representative sample of cardiovascular emergency visits highlights differences in health care needs of men and women, which may be useful to inform planning and provision of health care services,” said Mamas. “We also encourage further research into understanding the underlying factors driving the differences in CVD patterns and outcomes between men and women.”
Studies published in the American Heart Association’s scientific journals are peer-reviewed. The statements and conclusions in each manuscript are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers and the Association’s overall financial information are available here.
Additional Resources:
- Available multimedia is on right column of release link https://newsroom.heart.org/news/many-heart-related-emergencies-are-due-to-uncontrolled-blood-pressure
- View the manuscript online.
- AHA news release: Women and Black adults waited longer in ER for chest pain evaluation (May 2022)
- AHA news release: Investment, action urged to improve access, quality and equity in women’s heart health (May 2022)
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- Follow news from the Journal of the American Heart Association @JAHA_AHA