Friday, December 29, 2023
Thursday, December 28, 2023
Low-carbohydrate diet macronutrient quality and weight change
JAMA Network Open
: In this study using data from three large prospective cohort studies among 123,000 individuals, low-carbohydrate diets that emphasized high-quality proteins, fats and carbohydrates from whole grains and other healthy plant-based foods were significantly associated with slower weight gain in the long term. In contrast, low-carbohydrate diets emphasizing animal-sourced proteins and fats or refined carbohydrates were associated with faster weight gain.
Wednesday, December 27, 2023
Risk of young-onset dementia could be reduced through targeting health and lifestyle factors
Researchers have identified a wide range of risk factors for young-onset dementia. The findings challenge the notion that genetics are the sole cause of the condition, laying the groundwork for new prevention strategies.
The largescale study identified 15 risk factors, which are similar to those for late-onset dementia. For the first time, they indicate that it may be possible to reduce the risk of young-onset dementia by targeting health and lifestyle factors.
Relatively little research has been done on young-onset dementia, though globally there are around 370,000 new cases of young-onset dementia each year.
Published in JAMA Neurology, the new research by the University of Exeter and Maastricht University followed more than 350,000 participants younger than 65 across the United Kingdom from the UK Biobank study. The team evaluated a broad array of risk factors ranging from genetic predispositions to lifestyle and environmental influences. The study revealed that lower formal education, lower socioeconomic status, genetic variation, lifestyle factors such as alcohol use disorder and social isolation, and health issues including vitamin D deficiency, depression, stroke, hearing impairment and heart disease significantly elevate risk of young-onset dementia
Professor David Llewellyn of the University of Exeter emphasized the importance of the findings: "This breakthrough study illustrates the crucial role of international collaboration and big data in advancing our understanding of dementia. There's still much to learn in our ongoing mission to prevent, identify, and treat dementia in all its forms in a more targeted way. This is the largest and most robust study of its kind ever conducted. Excitingly, for the first time it reveals that we may be able to take action to reduce risk of this debilitating condition, through targeting a range of different factors.
Dr Stevie Hendriks, Researcher at Maastricht University, said: “Young-onset dementia has a very serious impact, because the people affected usually still have a job, children, and a busy life. The cause is often assumed to be genetic, but for many people we don’t actually know exactly what the cause is. This is why we also wanted to investigate other risk factors in this study.”
Sebastian Köhler, Professor of Neuroepidemiology at Maastricht University, said: “We already knew from research on people who develop dementia at older age that there are a series of modifiable risk factors. In addition to physical factors, mental health also plays an important role, including avoiding chronic stress, loneliness and depression. The fact that this is also evident in young-onset dementia came as a surprise to me, and it may offer opportunities to reduce risk in this group too.”
The study's support was supported by Alzheimer’s Research UK, The Alan Turing Institute/Engineering and Physical Sciences Research Council, Alzheimer Nederland, Gieskes Strijbis Fonds, the Medical Research Council, the National Institute for Health and Care Research (NIHR) Applied Research Collaboration South West Peninsula (PenARC), the National Health and Medical Research Council, the National Institute on Aging, and Alzheimer Netherlands.
Dr Janice Ranson, Senior Research Fellow at the University of Exeter, said: “Our research breaks new ground in identifying that the risk of young-onset dementia can be reduced. We think this could herald a new era in interventions to reduce new cases of this condition.”
Dr Leah Mursaleen, Head of Clinical Research at Alzheimer’s Research UK, which co-funded the study, said: “We’re witnessing a transformation in understanding of dementia risk and, potentially, how to reduce it on both an individual and societal level. In recent years, there’s been a growing consensus that dementia is linked to 12 specific modifiable risk factors such as smoking, blood pressure and hearing loss . It’s now accepted that up to four in 10 dementia cases worldwide are linked to these factors.
“This pioneering study shines important and much-needed light on factors that can influence the risk of young-onset dementia. This starts to fill in an important gap in our knowledge. It will be important to build on these findings in broader studies.’
The full study is entitled ‘Risk factors for young-onset dementia in the UK Biobank: A prospective population-based study’, published in JAMA Neurology.
Thursday, December 21, 2023
Mediterranean diet ‘a straightforward approach’ for improving the chance of success in IVF
IMAGE:
HART - NUTRITIONAL SUPPLEMENTS AND IVF (RBMONLINE, 2023)
view moreCREDIT: REPRODUCTIVE BIOMEDICINE ONLINE, 2023
Adjuvant therapies to help infertile women conceive by IVF - especially those whose treatments have been unsuccessful in the past - are now a common feature both before and during the treatment cycle. Now, a new analysis of the evidence for many nutritional supplements and diets thought to improve outcome in IVF has concluded that adopting a Mediterranean diet during treatment would offer a single ‘straightforward approach’ with good evidence of benefit in contrast to that of a Western diet.
Evidence from studies of nine commonly used nutritional supplements was found to be inconsistent and not always of good quality. The analysis, by Professor Roger Hart, University of Western Australia and City Fertility, Perth, Australia, is published today in the peer-reviewed journal Reproductive Biomedicine Online.
He explained that the extent to which nutritional supplements are used in IVF is largely unknown. ‘Nutritional supplements are usually not prescribed,’ explained Professor Hart, ‘but bought online or over-the-counter. They’re self-medicated and solid data on usage is impossible to determine. Our information is largely anecdotal but it’s quite clear from online IVF discussion forums that they are widely used and of great public interest.’
The nutritional supplements analysed in the study were dehydroepiandrosterone (DHEA), melatonin, co-enzyme Q10 (CoQ1O), carnitine, selenium, Vitamin D, myo-inositol, Omega-3, Chinese herbs and several diets (as well as weight loss). Many were reviewed as adjuvants for poor response to previous IVF treatment, of which DHEA and COQ10 appeared in studies to have more benefit than control therapies. Similarly, there was some evidence of benefit from melatonin, but it remains unclear which patient groups might benefit, nor at which dose.
However, the evidence in favour of a Mediterranean diet is much stronger and includes several well designed randomised clinical trials, showing benefits in both embryo development and pregnancy outcome (even from a six-week intervention programme). Professor Hart explained that the common features of these favourable diets were those with high intakes of fruits and vegetables, whole grains, legumes, nuts, fish, and monounsaturated or polyunsaturated oils, but with a limited intake of highly processed foods. ‘These diets are high in B-vitamins, antioxidants, omega-3 poly-unsaturated fatty acids and fibre and are low in saturated fat, sugar and sodium,’ he said. Omega-3 fatty acids, often taken as combined preparations, are the most studied dietary fatty acids in the IVF literature, largely, said Professor Hart, because of their perceived benefits in general health and reproduction. The evidence suggests that omega-3 fatty acids ‘may be beneficial’ in improving IVF clinical outcomes and embryo quality.
Similarly, antioxidants are usually taken as combinations of supplements but evidence from one major review (of 63 antioxidant studies in reproduction) described them as of low quality and was unable to demonstrate any benefit in terms of live birth rate.
Thus, from this mass of evidence Professor Hart advised that a simple nutritional approach to assist conception via IVF would be the adoption of a Mediterranean diet. The use of COQ-10 and DHEA before starting IVF may be a useful adjunct for women who had a previously poor response to ovarian stimulation, while supplementation with omega-3 free-fatty acids may indeed improve some clinical and embryological outcomes.
Professor Hart also advised that all women attempting to conceive should be taking adequate folate supplementation and should seek the advice of their general practitioner or specialist to ensure they are in their best general health for conception.
* This press release is in support of
Hart RJ, Nutritional supplements and IVF: an evidence based approach. Reproductive Biomedicine Online 2023; doi; https://doi.org/10.1016/j.rbmo.2023.103770
* For more information on this press release, the published paper and interview opportunities, please contact:
Duncan Nicholas, RBM Online Development Editor, dev.editor@rbmonline.com
Saturday, December 16, 2023
Physical and social activities promote healthy brain aging
Physical exercise is associated with a variety of positive health aspects. Numerous studies have shown that regular physical activity has a preventive effect on cardiovascular diseases, diabetes, cancer, high blood pressure and obesity. But how do various leisure activities – physical, social and cognitive – affect brain health in old age? A team of researchers from the University Research Priority Program Dynamics of Healthy Aging and from the Healthy Longevity Center of the University of Zurich (UZH) decided to investigate this question.
To this end, they examined data from a comprehensive longitudinal study on brain development and behavior in old age. The longitudinal study was set in motion 12 years ago by Lutz Jäncke, meanwhile professor emeritus at UZH, who continues to supervise the project together with co-lead Susan Mérillat. The aim of the current research was to investigate the relationships between the thickness of the entorhinal cortex, memory performance and leisure activities in cognitively healthy adults over the age of 65, for a period of seven years.
Exercise and social activity slow down neurodegeneration
The entorhinal cortex, approximately 3.5 millimeters thick, is part of the cerebral cortex in the inner part of the temporal lobe and plays a key role in learning and memory. It is also one of the brain regions that is affected early on in the development of Alzheimer’s disease. “Our findings show that in people who were more physically and socially active at the beginning of the study, the thickness of their entorhinal cortex decreased less over the seven-year period,” says neuropsychologist Jäncke.
The researchers also found that the thickness of the entorhinal cortex is closely linked to memory performance. The less the thickness of this brain structure decreased over the course of the study, the less memory performance was reduced. “Physical exercise and an active social life with friends and family are therefore important for brain health and can prevent neurodegeneration in later life,” says Jäncke.
Brain can be trained like a muscle
It was also shown that higher memory performance at the beginning of the study was associated with a lower decline in memory performance over the course of the study. “These findings support the idea that we have a ‘cognitive reserve’, and that the brain can be trained throughout our lives like a muscle to counteract age-related decline,” says Isabel Hotz, one of the two first authors alongside Pascal Deschwanden. In other words, it pays to be physically, mentally and socially active throughout our lives, including in later life.
Fortunately, many older people in Switzerland already seem to be living by this credo: according to the Swiss Health Survey conducted by the Swiss Federal Statistical Office in 2022, around three quarters of people over 65 get the recommended amount of physical exercise in their daily lives.
Eating meals early could reduce cardiovascular risk
Cardiovascular diseases are the leading cause of death in the world according to the Global Burden of Disease study, with 18.6 million annual deaths in 2019, of which around 7.9 are attributable to diet. This means that diet plays a major role in the development and progression of these diseases. The modern lifestyle of Western societies has led to specific eating habits such as eating dinner late or skipping breakfast. In addition to light, the daily cycle of food intake (meals, snacks, etc.) alternating with periods of fasting synchronizes the peripheral clocks, or circadian rhythms, of the body’s various organs, thus influencing cardiometabolic functions such as blood pressure regulation. Chrononutrition is emerging as an important new field for understanding the relationship between the timing of food intake, circadian rhythms and health.
Scientists used data from 103,389 participants in the NutriNet-Santé cohort (79% of whom were women, with an average age of 42) to study the associations between food intake patterns and cardiovascular disease. To reduce the risk of possible bias, the researchers accounted for a large number of confounding factors, especially sociodemographic factors (age, sex, family situation, etc.), diet nutritional quality, lifestyle and sleep cycle.
The results show that having a first meal later in the day (such as when skipping breakfast), is associated with a higher risk of cardiovascular disease, with a 6% increase in risk per hour delay. For example, a person who eats for the first time at 9 a.m. is 6% more likely to develop cardiovascular disease than someone who eats at 8 a.m. When it comes to the last meal of the day, eating late (after 9 p.m.) is associated with a 28% increase in the risk of cerebrovascular disease such as stroke compared with eating before 8 p.m., particularly in women. Finally, a longer duration of night-time fasting – the time between the last meal of the day and the first meal of the following day – is associated with a reduced risk of cerebrovascular disease, supporting the idea of eating one’s first and last meals earlier in the day.
These findings, which need to be replicated in other cohorts and through additional scientific studies with different designs, highlight a potential role for meal timing in preventing cardiovascular disease. They suggest that adopting the habit of eating earlier first and last meals with a longer period of night-time fasting could help to prevent the risk of cardiovascular disease.
About NutriNet-Santé
The NutriNet-Santé study is a public health study coordinated by the Nutritional Epidemiology Research Team (EREN-CRESS, Inserm/INRAE/Cnam/Université Sorbonne Paris Nord/Université Paris Cité), which, thanks to the commitment and support of over 175,000 study participants, is advancing research into the links between nutrition (diet, physical activity, nutritional status) and health. The study was launched in 2009 and has already resulted in over 270 international scientific publications. There is still a call for new study participants living in France to continue advancing research into the relationship between nutrition and health.
By spending a few minutes a month responding via the etude-nutrinet-sante.fr secure online platform, participants help to advance knowledge of the relationship between diet and health.
JOURNAL
Nature Communications
Guidelines advise against routinely taking aspirin daily for primary prevention of heart attack
The updated Canadian Cardiovascular Society (CCS)/Canadian Association of Interventional Cardiology (CAIC) antiplatelet therapy guidelines for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) provide recommendations based on the latest randomized evidence available in the literature. Updated by a panel of national experts, these new evidence-based guidelines appear in the Canadian Journal of Cardiology, published by Elsevier.
ASCVD, also known as ischemic heart disease (coronary artery disease), is the buildup of plaque in the heart’s arteries that can lead to death from a heart attack or sudden cardiac death. It is the second leading cause of death in Canada, according to Health Canada. Antiplatelet medications prevent the formation of blood clots following a heart attack and/or following a stent procedure or open-heart bypass surgery.
Co-chair and first author of the guidelines, Kevin Bainey, MD, MSc, Mazankowski Alberta Heart Institute, University of Alberta, explains: “Historically, doctors recommended taking aspirin daily for primary prevention for individuals over 50 years old (‘An aspirin a day keeps the doctor away.’), but routine use is now no longer advised. Recent evidence shows the bleeding risk outweighs the benefits, questioning the routine use to prevent a heart attack, particularly in individuals who have never had a heart attack – called primary prevention. We now recommend against routine use of aspirin for primary prevention.”
Dr. Bainey notes, “However, daily aspirin could be used for people with high risk factors for heart attack — a family history of premature coronary artery disease, diabetes, high cholesterol, high blood pressure, and smoking. The 10% risk reduction is consistent in the literature. However, we also need to recognize that bleeding can be bad. The key is to talk to your doctor to decide what’s best for you. The guidelines include a new decision-aid tool to guide those conversations in an evidence-based format.
“We really focus on individuals and determining their cardiovascular risk, their risk of bleeding, and then tailoring their antiplatelet therapy to maximize the outcomes for them. So, it’s really taking it to a different level; we’re the first in the world to endorse a shared decision-making model, engaging the person who is at risk together with their doctor.”
Dr. Bainey had this very conversation with his own father who has not had a heart attack, but has diabetes, high cholesterol, high blood pressure, and a low risk of bleeding. His dad is now taking an antiplatelet to address those risk factors.
These updated national guidelines give people who are at risk and their healthcare providers access to the latest scientific findings, which have changed considerably since the last time the guidelines were published in 2018. While the daily aspirin question is likely the most controversial topic tackled by the new guidelines, most of the topics in the guidelines focus on secondary prevention, for people who have already developed ASCVD and want to avoid further damage to their hearts.
The guidelines focus on the following key topics:
- Potential role of aspirin therapy for primary prevention of cardiovascular disease
- Recommendations for shorter duration of dual antiplatelet therapy following percutaneous coronary intervention (PCI) recognizing bleeding risk, a minimally invasive procedure to open a blocked artery
- Standards for extending therapy as well as de-escalating therapy in appropriate patients
- Recommendations for the use of potent P2 Y12 inhibitors (super antiplatelets) in dual antiplatelet therapy
- Focus on patients with heart attacks who are medically managed without stents or open heart surgery
- Discontinuation of antiplatelet therapy prior to coronary artery bypass grafting (CABG) surgery and its use following CABG surgery for bypass graft protection
- Importance of minimizing antithrombotic therapy in those requiring other blood thinners (oral anticoagulation for atrial fibrillation) in the context of antiplatelet therapy
The guidelines include simple illustrative diagrams and algorithms to help healthcare providers navigate through clinical scenarios for antiplatelet management.
Friday, December 15, 2023
Study discovers cause of pregnancy sickness – and potential treatment
A Cambridge-led study has shown why many women experience nausea and vomiting during pregnancy – and why some women, including the Duchess of Cambridge, become so sick they need to be admitted to hospital.
The culprit is a hormone produced by the fetus – a protein known as GDF15. But how sick the mother feels depends on a combination of how much of the hormone is produced by the fetus and how much exposure the mother had to this hormone before becoming pregnant.
The discovery, published today in Nature, points to a potential way to prevent pregnancy sickness by exposing mothers to GDF15 ahead of pregnancy to build up their resilience.
As many as seven in ten pregnancies are affected by nausea and vomiting. In some women – thought to be between one and three in 100 pregnancies – it can be severe, even threatening the life of the fetus and the mother and requiring intravenous fluid replacement to prevent dangerous levels of dehydration. So-called hyperemesis gravidarum is the commonest cause of admission to hospital of women in the first three months of pregnancy.
Although some therapies exist to treat pregnancy sickness and are at least partially effective, widespread ignorance of the disorder compounded by fear of using medication in pregnancy mean that many women with this condition are inadequately treated.
Until recently, the cause of pregnancy sickness was entirely unknown. Recently, some evidence, from biochemical and genetic studies has suggested that it might relate to the production by the placenta of the hormone GDF15, which acts on the mother’s brain to cause her to feel nauseous and vomit.
Now, an international study, involving scientists at the University of Cambridge and researchers in Scotland, the USA and Sri Lanka, has made a major advance in understanding the role of GDF15 in pregnancy sickness, including hyperemesis gravidarum.
The team studied data from women recruited to a number of studies, including at the Rosie Maternity Hospital, part of Cambridge University Hospitals NHS Foundation Trust and Peterborough City Hospital, North West Anglia NHS Foundation Trust. They used a combination of approaches including human genetics, new ways of measuring hormones in pregnant women’s blood, and studies in cells and mice.
The researchers showed that the degree of nausea and vomiting that a woman experiences in pregnancy is directly related to both the amount of GDF15 made by the fetal part of placenta and sent into her bloodstream, and how sensitive she is to the nauseating effect of this hormone.
GDF15 is made at low levels in all tissues outside of pregnancy. How sensitive the mother is to the hormone during pregnancy is influenced by how much of it she was exposed to prior to pregnancy – women with normally low levels of GDF15 in blood have a higher risk of developing severe nausea and vomiting in pregnancy.
The team found that a rare genetic variant that puts women at a much greater risk of hyperemesis gravidarum was associated with lower levels of the hormone in the blood and tissues outside of pregnancy. Similarly, women with the inherited blood disorder beta thalassemia, which causes them to have naturally very high levels of GDF15 prior to pregnancy, experience little or no nausea or vomiting.
Professor Sir Stephen O’Rahilly, Co-Director of the Wellcome-Medical Research Council Institute of Metabolic Science at the University of Cambridge, who led the collaboration, said: “Most women who become pregnant will experience nausea and sickness at some point, and while this is not pleasant, for some women it can be much worse – they’ll become so sick they require treatment and even hospitalisation.
“We now know why: the baby growing in the womb is producing a hormone at levels the mother is not used to. The more sensitive she is to this hormone, the sicker she will become. Knowing this gives us a clue as to how we might prevent this from happening. It also makes us more confident that preventing GDF15 from accessing its highly specific receptor in the mother’s brain will ultimately form the basis for an effective and safe way of treating this disorder.”
Mice exposed to acute, high levels of GDF15 showed signs of loss of appetite, suggesting that they were experiencing nausea, but mice treated with a long-acting form of GDF15 did not show similar behaviour when exposed to acute levels of the hormone. The researchers believe that building up woman’s tolerance to the hormone prior to pregnancy could hold the key to preventing sickness.
Co-author Dr Marlena Fejzo from the Department of Population and Public Health Sciences at the University of Southern California whose team had previously identified the genetic association between GDF15 and hyperemesis gravidarum, has first-hand experience with the condition. “When I was pregnant, I became so ill that I could barely move without being sick. When I tried to find out why, I realized how little was known about my condition, despite pregnancy nausea being very common.
“Hopefully, now that we understand the cause of hyperemesis gravidarum, we’re a step closer to developing effective treatments to stop other mothers going through what I and many other women have experienced.”
The work involved collaboration between scientists at the University of Cambridge, University of Southern California, University of Edinburgh, University of Glasgow and Kelaniya University, Colombo, Sri Lanka. The principal UK funders of the study were the Medical Research Council and Wellcome, with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.
“I was told: ‘Oh, for God's sake, you've just got morning sickness. Pull yourself together.’”
Charlotte Howden considered herself to be in good health prior to getting pregnant in her early thirties. Her pregnancy was proceeding as normal until around week six or seven, when she began feel nauseous. Even then, she didn’t see any reason to be concerned.
“It’s just what we've been told to expect in early pregnancy,” she says.
Around a week after the onset of nausea, Charlotte’s condition got worse. Much worse. She found herself being sick as often as 30 times a day, unable to keep food down.
“Every time I tried to eat something, which is obviously what I wanted to do, not only because I felt hungry, but because I was pregnant, that would then instantly make me sick.”
Worse still, she could not keep any fluids down – not even water. Her condition – which she now knows to be hyperemesis gravidarum (HG) – became so bad that even to swallow saliva would make her sick. And a cruel irony is that a common symptom of HG is excessive saliva production.
When Charlotte finally accepted that there was something wrong, that this was not normal pregnancy sickness, she turned to her GP.
“They just said ‘There's nothing we can do for you. Have you tried ginger? Try and limit your daily activities to best get through this. Try eating a little and often.’”
Returning to the GP, she was offered a urine test for levels of ketones, a chemical produced by the liver (high levels can indicate a serious problem) – the only way, it seemed, that she would be diagnosed with dehydration and referred for treatment. And given that she had not been taking any fluids, this made taking the test incredibly difficult.
“For some reason, it’s only women with HG who are asked to give a sample, when other conditions it is obvious from the way someone looks,” she says.
Charlotte was not referred, but instead her GP prescribed her the first line medication for HG. This did little to help.
“It just makes you comatose, so you sleep the whole day. But I had a full time job, I had responsibilities, financial and otherwise. Sleeping 20 hours a day is not an effective way to live!”
A second ketone test showed that something was obviously wrong. She was told to get to the hospital immediately.
Charlotte was admitted to the early pregnancy ward, which she describes as a traumatic experience.
“You're with women who are losing their pregnancies, and you're very much still pregnant. There's a kind of dismissive behaviour around you of, ‘Oh, for God's sake, you've just got morning sickness. That woman over there has just had a miscarriage. Pull yourself together.’”
After being rehydrated, she was discharged, only to become very sick again and be re-admitted. This cycle repeated, taking its toll.
“Mentally you end up thinking to yourself there is no point in going back to hospital. The definition of insanity is doing the same thing over and over again. You feel completely broken.”
Eventually, she had had enough.
“When I went in again for my third time, I begged [the consultant] to help me because I was very close to making the decision to terminate. She said ‘Look, just give me 24 hours.’”
This time, the consultant gave her medication that finally made her “feel incredible” for 12 hours. Discharged, she would need to get a repeat prescription from her GP – something they were unwilling to do.
“There was a complete disconnect between my GP and the consultant,” she says. Fortunately, Charlotte, rehydrated and re-energised, was ready to fight. She managed to get through to the consultant, who was astounded to hear she was being refused the medication.
“She got on the phone to the GP and I won't repeat the language she used, but she was very stern, quite rightly, because what's the point of treating someone in hospital and then just sending them home to come back in a couple of days’ time?”
It took Charlotte until around week 16 of her pregnancy before she was finally on the right treatment to overcome her sickness. She continued taking the medication until around week 37 as she was “petrified to stop taking it”.
In 2016, Charlotte gave birth to a healthy son, Henry. She is determined that no woman should have to go through what she did. In 2020, she presented the world’s first documentary on HG, Sick - The Battle Against HG.
Charlotte became involved with the charity Pregnancy Sickness Support, joining an army of around 600 volunteers who offer peer support and man telephone helplines. She is now its Chief Executive and uses her position to raise awareness of the condition among women and healthcare professionals, including pushing for HG to be taught on all midwifery courses.
Charlotte is hopeful that this new study will lead to a way of treating – and even preventing – HG. She is grateful to Professor O’Rahilly and Dr Fejzo for their work – and in particularly, for taking the condition seriously.
“When you are suffering from a condition and no one can tell you why, you start to think, oh, is it me? Is it something I've done?” she says. “I’m so grateful for the dedication of the researchers, because this isn't a condition that really ever made the headlines until the now Princess of Wales suffered with it. It wasn't an area of research that people were really interested in. It was just morning sickness – why should we care?”
Reference
Fejzo, M et al. GDF15 linked to maternal risk of nausea and vomiting during pregnancy. Nature; 13 Dec 2023; DOI: 10.1038/s41586-023-06921-9
Poor diet quality during adolescence is linked to serious health risks
Research published in the Journal of Nutrition Education and Behavior closely measured cardiometabolic risk factors over two years
Peer-Reviewed Publication
AUDIO:
KATHY HU AND ALYSSA M. BUTTON, PHD, DISCUSS FINDINGS THAT SHOWED ADOLESCENTS WITH POOR ADHERENCE TO THE 2015-2020 DIETARY GUIDELINES FOR AMERICANS AND ASSOCIATED CARDIOMETABOLIC RISK FACTORS CONTINUED THESE SAME PATTERNS OVER THE TWO YEARS OF THE STUDY, SUGGESTING THAT THE ADVERSE EFFECTS OF A POOR-QUALITY DIET HAD ALREADY ESTABLISHED THE HEALTH RISKS THESE TEENAGERS WILL FACE THROUGHOUT LIFE.
view moreCREDIT: JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR
Philadelphia, December 13, 2023 – Diet quality among adolescents in the United States is among the worst across all age groups, putting young people at risk for heart attack, stroke, and diabetes, among other cardiometabolic diseases later in life. The research brief shared in the Journal of Nutrition Education and Behavior, published by Elsevier, used the Healthy Eating Index-2015 and medical testing to assess a group of youth aged 10-16 years.
This study examined data from the Translational Investigation of Growth and Everyday Routine in Kids cohort. This study measured physical activity, sleep, and overall dietary guidelines for youth living in metropolitan areas of Louisiana, which are typically medically underserved and characterized by high poverty levels, food insecurity, obesity, and related diseases. Study participants provided a baseline data set with follow-up measures two years later.
Corresponding author Amanda E. Staiano, PhD, Pennington Biomedical Research Center, Louisiana State University, explained, “Examining the data related to diet quality may help identify targets for future interventions in families, homes, and communities. Effective and timely interventions focusing on adherence to dietary guidelines are necessary for improving diet quality and reducing health risks.”
Of the 342 eligible and enrolled adolescents, the final study sample included 192 participants with complete baseline and follow-up data. At baseline and follow-up, the adolescents were asked to wear an accelerometer for at least seven days and complete two 24-hour dietary recalls for their food and beverage intake during research visits that included body composition, blood pressure, and clinical chemistry measurements and anthropometrics.
Considering overall eating patterns, the findings showed that adolescents with poor adherence to the 2015-2020 Dietary Guidelines for Americans and associated cardiometabolic risk factors continued these same patterns over the two years of the study, suggesting that the adverse effects of a poor-quality diet had already established the health risks these teenagers will face throughout life.
Dr. Staiano concluded, “This study found specific dietary quality patterns associated with adolescent cardiometabolic risk factors. Promotion of nutrition knowledge is necessary, but knowledge is not consistently linked with food consumption behavior. Identifying barriers to consuming a healthful diet and investigating effective strategies to overcome these barriers may curtail future health risks.”
Thursday, December 14, 2023
New study shows exercise can boost brain health
A fascinating link between regular exercise and better brain health has been revealed, according to an international study that included a team of clinical researchers from Pacific Neuroscience Institute’s Brain Health Center, located at Providence Saint John’s Health Center.
The research, detailed in the paper "Exercise-Related Physical Activity Relates to Brain Volumes in 10,125 Individuals," was published this week in the Journal of Alzheimer’s Disease and shows being physically active is related to increased size of brain areas important for memory and learning.
The study looked at MRI brain scans from 10,125 people done at Prenuvo imaging centers, a key collaborator in the research. It found those who regularly engaged in physical activities such as walking, running or sports had larger brain volumes in key areas. This includes the gray matter, which helps with processing information, and the white matter, which connects different brain regions, as well as the hippocampus, important for memory.
Cyrus A. Raji, M.D., the lead researcher, explains the findings in simple terms: "Our research supports earlier studies that show being physically active is good for your brain. Exercise not only lowers the risk of dementia but also helps in maintaining brain size, which is crucial as we age."
David Merrill, M.D., study co-author and director of the PBHC noted, "We found that even moderate levels of physical activity, such as taking fewer than 4,000 steps a day, can have a positive effect on brain health. This is much less than the often-suggested 10,000 steps, making it a more achievable goal for many people."
Study co-author Somayeh Meysami, M.D., assistant professor of neurosciences at Saint John’s Cancer Institute and the Pacific Brain Health Center noted, “Our research links regular physical activity to larger brain volumes, suggesting neuroprotective benefits. This large sample study furthers our understanding of lifestyle factors in brain health and dementia prevention.”
A Lancet Study in 2020 found about a dozen modifiable risk factors increase risk for Alzheimer’s disease, including physical activity. This work builds upon previous work by this group, linking caloric burn from leisure activities to improved brain structure.
"This study demonstrates the influence of exercise on brain health imaging and when added to other studies on the role of diet, stress reduction and social connection offer the proven benefits of drug-free modifiable factors in substantially reducing Alzheimer's disease," said George Perry, Editor-in-Chief of Journal of Alzheimer's Disease.
“With comprehensive imaging scans, our study underscores the interconnected synergy between the body and the brain. It echoes the knowledge of past generations, showcasing that increased physical activity is a predictor of a healthier aging brain," said Dr. Attariwala, senior author of this paper.
This research highlights an easy way to keep our brains healthy: stay active! Whether it's a daily walk or a favorite sport, regular physical activity can have lasting benefits for our brain health.
JOURNAL
Journal of Alzheimer s Disease
Breastfeeding alters infant gut in ways that boost brain development, may improve test scores
A study of the infant 'fecal metabolome' suggests that nursing, including part-time while supplementing with formula, yields significant brain-health benefits
Peer-Reviewed PublicationBreastfeeding, even partially alongside formula feeding, changes the chemical makeup—or metabolome—of an infant’s gut in ways that positively influence brain development and may boost test scores years later, suggests new CU Boulder research.
“For those who struggle with exclusively breastfeeding, this study suggests your baby can still get significant benefits if you breastfeed as much as you can,” said senior author Tanya Alderete, an assistant professor of integrative physiology at CU Boulder.
The study, published Dec. 13 in the journal npj Metabolic Health and Disease, also identifies specific metabolites that manufacturers may want to consider adding to infant formula to optimize healthy brain development and concerning compounds they should try to leave out.
“Our research suggests that even at low levels, some contaminants found in formula may have negative neurodevelopmental effects downstream,” said first author Bridget Chalifour, a postdoctoral researcher in Alderete’s lab.
A health report card for the gut
For the study, the research team examined what is known as the “fecal metabolome” — the diverse collection of metabolites found in the gut and shed in poop. Metabolites are small molecules that are churned out by gut bacteria as a byproduct of metabolizing food and make their way into the bloodstream, impacting the brain and other organs.
Breastmilk, formula and solid food also contain metabolites.
While scientists have long studied our resident bacteria, or microbiome, to better understand human health, the emerging field of “metabolomics” goes a step further.
“Looking at the gut microbiome tells us which bacteria are there, while looking at the fecal metabolome can help tell us what they are doing,” said Chalifour. “It’s like a health report card for the gut.”
The team collected fecal samples from 112 infants at 1- and 6-months-old and worked with Donghai Liang, assistant professor of environmental health at Emory University in Atlanta, and other colleagues to chemically analyze which metabolites were present. They grouped infants based on how much they were breastfed vs. formula fed. At age 2, the children took cognitive, motor and language tests.
The study found that the samples from infants in different feeding groups contained significantly different levels of metabolites.
For instance, at 1 month old, 17 metabolites were more abundant the more a baby was breastfed, and 40 were more abundant the more a baby was formula fed.
When looking more closely at specific metabolites, the researchers identified 14 that were also associated with differences in test scores at age 2.
With only one notable exception, caffeine, the more metabolites associated with breast milk a baby had in their stool, the better they did on cognitive tests as toddlers (more on caffeine later.)
The more metabolites associated with formula feeding they had, the worst they did.
“The consistency of these results is striking and supports the benefits of breastfeeding as much as possible in early life,” said Alderete.
Some metabolites associated with formula concerning
One particularly beneficial metabolite was cholesterol: At both 1 and 6 months old, the more a baby was breastfed the more cholesterol they had in their stool. And the more cholesterol babies had in their stool, the better they did on cognitive tests. This makes sense, as the fatty acid is critical for forming healthy circuits between brain cells. As the authors note, 80% to 90% of the brain’s volume grows in the first two years of life.
In contrast, the more a baby was formula fed, the higher their levels of a metabolite called cadaverine, a known contaminant formed via fermentation.
In the study, the more a child was formula fed, the higher their levels of cadaverine and the lower their test scores at age 2. While the compound is considered a toxin at higher levels, the Food and Drug Administration permits low levels in infant formula.
“It may be that formula manufacturers should be more vigilant in getting levels of this compound down to zero,” said Chalifour.
Interestingly, babies who were breastfed had higher levels of caffeine in their stool – perhaps because moms may have been breastfeeding over a cup of coffee.
Not surprisingly, higher levels of caffeine, a stimulant, were associated with poorer cognitive scores. Prenatal caffeine exposure has previously been associated with lower neurodevelopmental scores, and experts recommend no more than 12 ounces, or a cup and a half, of coffee per day for pregnant women.
Not all or nothing
The World Health Organization recommends that infants be exclusively breastfed for the first six months of life, but in the United States, only 63% of infants are exclusively breastfed immediately following birth. By six months, only a quarter of U.S. babies are exclusively breastfed.
Alderete acknowledges that for some parents, breastfeeding isn't possible. She hopes her research can ultimately help manufacturers improve formula to make it as close to breastmilk as it can be. And she stresses that just because a child was not breastfed does not mean they’ll have neurodevelopmental deficits. Early feeding patterns are just one of many factors that contribute to how a brain develops.
Her takeaway to new parents having trouble breastfeeding exclusively: Don’t give up. It doesn’t have to be all or nothing.
“Just increasing the proportion of breastmilk relative to formula may have a positive impact on your developing child,” she said.
Researcher says men should abstain from drinking at least three months prior to conceiving
In examining the effects of paternal alcohol consumption on fetal alcohol syndrome, a groundbreaking new study reveals that it can take over a month for negative alcohol effects to wear off.
Peer-Reviewed PublicationResearchers at Texas A&M University have already shown that paternal drinking habits prior to conception can have a negative effect on fetal development — with semen from men who regularly consume alcohol impacting placenta development, fetal alcohol syndrome (FAS)-associated brain and facial defects, and even IVF outcomes.
In an article published this month in Andrology, the lab of Dr. Michael Golding has now demonstrated that it takes much longer than previously believed, longer than a month, for the effects of alcohol consumption to leave the father’s sperm.
“When someone is consuming alcohol on a regular basis and then stops, their body goes through withdrawal, where it has to learn how to operate without the chemical present,” said Golding, a professor in the School of Veterinary Medicine & Biomedical Sciences’ Department of Veterinary Physiology & Pharmacology. “What we discovered is that a father’s sperm are still negatively impacted by drinking even during the withdrawal process, meaning it takes much longer than we previously thought for the sperm to return to normal.”
The Dangers Of Paternal Drinking
One of the major risks associated with alcohol consumption before and during pregnancy is FAS, which causes abnormal facial features, low birth weight and/or height, attention and hyperactivity issues, and poor coordination.
Currently, doctors are required to confirm only that the mother has consumed alcohol — not the father — to diagnose a child with FAS.
“For years, there’s really been no consideration of male alcohol use whatsoever,” Golding said. “Within the last five to eight years, we’ve started to notice that there are certain conditions where there’s a very strong paternal influence when it comes to alcohol exposure and fetal development.
“With this project, we wanted to see how long it would take for the effects of alcohol on sperm to wear off,” he said. “We thought it would be a relatively quick change back to normal, but it wasn’t. The withdrawal process took over a month.”
When drinking alcohol, an individual’s liver experiences oxidative stress, leading the body to overproduce certain chemicals, which then interrupts normal cellular activity. Golding’s team discovered that withdrawal causes the same kind of oxidative stress, effectively lengthening the duration of alcohol’s effects on the body beyond what was previously thought.
“During withdrawal, the liver experiences perpetual oxidative stress and sends a signal throughout the male body,” Golding said. “The reproductive system interprets that signal and says, ‘Oh, we are living in an environment that has a really strong oxidative stressor in it. I need to program the offspring to be able to adapt to that kind of environment.’ But Golding suspects that the adaptations to the sperm aren’t beneficial — they lead to problems like FAS.”
He also noted that it doesn’t take excessive alcohol use for a person to experience withdrawal.
“In the models we’re using, even drinking three to four beers after work several days a week can induce withdrawal when the behavior ceases,” Golding said. “You may not feel inebriated, but your body is going through chemical changes.”
Changing The Narrative
Golding’s work is vital to improving pregnancy outcomes by changing the conversation about who is responsible for alcohol-related birth defects, since society has historically placed all blame on mothers, even when they do not consume alcohol during their pregnancy.
“There’s psychological trauma associated with the question, ‘Did you drink while you were pregnant?’ It’s also difficult for physicians to have that conversation,” he said. “But if they don’t, then FAS doesn’t get diagnosed right away and the child may not get the support that they need until later in life.”
Because of this, it’s crucial that couples planning on getting pregnant know how far in advance to stop drinking in order to prevent birth defects.
While Golding and his lab will continue to research the effects of paternal drinking to help doctors advise couples, he suggests that fathers abstain from alcohol at least three months prior to conceiving, given this groundbreaking discovery.
“There’s still a lot of work to be done to get a hard answer, but we know that sperm are made over the course of 60 days, and the withdrawal process takes at least one month,” he said. “So, my estimate would be to wait at least three months.”
Wednesday, December 13, 2023
Reduce inflammation and preserve bone health with prunes
IMAGE:
FINDINGS SHOW NON-PHARMACOLOGICAL APPROACHES, LIKE PRUNES, MAY BE BENEFICIAL FOR POSTMENOPAUSAL WOMEN
view moreCREDIT: CALIFORNIA PRUNE BOARD
A new study published in The Journal of Nutrition shows daily consumption of prunes may reduce inflammation markers connected to bone signaling pathways and reduce the effects of bone loss among postmenopausal women.
“Bone loss is a significant issue impacting more than 50% of women over the age of 50, and there is no cure,” said Principal Investigator Mary Jane De Souza, PhD, Professor, Department of Kinesiology, Pennsylvania State University. “While medications and hormone therapies are available, they often require lifelong management and come with risks. It’s important to have a better understanding of how non-pharmacological approaches – like lifestyle and dietary choices—can also impact the progression and mitigation of bone loss.”
The new study’s findings show significant reductions in inflammatory cytokines, which are proteins that help control inflammation, and activated monocytes, which are a major type of immune cell that has been shown to drive the chronic inflammatory response, when 50 to 100 grams of prunes (about 5-12 prunes) are included in the diet, daily. Specifically, reductions were seen in Tumor Necrosis Factor-α following 50 grams of daily prune intake, and reductions in Interleukin-1β, Interleukin-6, Interleukin-8 secretions, as well as activated monocytes, with 100 grams of prune intake, compared to diets without prunes.
“These findings may be attributed to the abundance of bioactive compounds found in prunes, including vitamins, minerals, phenolic acids and polyphenols, which are likely acting synergistically to suppress activated monocytes and their secretion of bone-resorptive inflammatory cytokines,” said Co-author Connie Rogers, PhD, MPH, Professor and Department Head, Department of Nutritional Sciences, University of Georgia.
This is an ancillary study of a larger, single-center, parallel-arm, 12-month randomized control trial[1] (PRUNE study). The PRUNE study aimed to explore immune, inflammatory and oxidative stress markers related to the bone-protective effects of prunes in nonsmoking and not severely obese postmenopausal women, aged 55-75 years who refrained from phenolic supplements or large amounts of phenolic-containing fruit (apples and blueberries) for at least 2 months prior to the start of the study. This investigation was completed by 183 participants who were split into three groups: control/no prunes (n=70), 50 grams/day prunes (n=67) and 100 grams/day prunes (n=46). After a run-in period, participants followed the prune protocol for a total of 12-months and were instructed to record the days and number of prunes eaten in a daily log, used to monitor compliance. Participants were considered compliant if they consumed more than 80% of their prescribed treatment, and all participants consumed more 90% of their prescribed treatment.
Measurements of immune, inflammatory and oxidative stress markers were taken at baseline and at the end of the 12-month intervention. Beyond the prune intake protocols, all participants received a daily dose of calcium and vitamin D3 to meet the recommended dietary allowance of 1200 mg of calcium and 800 IU vitamin D3 daily from diet plus supplements, and they followed a free-living diet.
“These findings add to a growing body of research and interest investigating the role of ‘food as medicine’ and complement other studies I have conducted using the same data,” De Souza said. “For example, the previous study I led showed connections between hip bone integrity and daily consumption of prunes—where postmenopausal women who did not eat prunes lost 1.5% of their hip bone density compared to women who ate 5-6 prunes daily. Collectively, these findings have significant practical importance given the prevalence of bone loss among this population.”
“Our investment in the PRUNE study has led to many key publications and novel findings that can help improve public health and the understanding of the role foods may play in disease prevention and management,” said Donn Zea, executive director, California Prune Board. “We are deeply committed to the scientific rigor of our nutrition research program which provides a license to communicate how enjoying California Prunes can have an effect on health outcomes.”
For about 100 calories, a serving of 4-6 California Prunes is a nutrient-dense superfood providing more than 20 different vitamins, minerals and plant compounds to the diet. As a premium dried fruit enjoyed across cultures and ethnicities, research into California Prunes’ health benefits contributes to a better understanding of their role as a dietary tool to promote health and potentially lower chronic disease risk.
Subscribe to:
Posts (Atom)