Low fiber intake during pregnancy may delay development in infants’ brains

 

Undernutrition during pregnancy is one of the factors linked to an increased risk of diseases in children as they grow older. Yet, maternal malnutrition remains a problem for women worldwide.

Animal studies have shown that a low-fiber diet during pregnancy impairs brain nerve function in offspring. Now, in the first human cohort study on the relation of maternal nutritional imbalance and infants’ brain development, researchers in Japan have investigated if the same effects can be found in humans.

“Most pregnant women in Japan consume far less dietary fiber than what is the recommended intake,” said Dr Kunio Miyake, a researcher at the University of Yamanashi and first author of the study published in Frontiers in Nutrition. “Our results provided reinforcing evidence that undernutrition during pregnancy is associated with an increased risk of neurodevelopmental delay in children.”

Fiber for brain development

Miyake et al. compared the development of children whose mothers had the highest intake of dietary fiber to groups of mothers who consumed successively less fiber during pregnancy.

In comparison to the highest-intake group, the children of mothers in the low-intake groups were more likely to show neurodevelopmental delays. The effect of maternal fiber undersupply was noticeable in several domains related to brain function. Affected were communication skills, problem solving skills, and personal-social skills. The researchers also found delays in the development of large body part movement and coordination, as well as in the coordination of smaller muscles.

The researchers’ results are based on the analysis of more than 76,000 mother-infant pairs from the Japan Environment and Children’s Study. It is an ongoing project aiming to elucidate how the environment affects children’s health.

To collect dietary information about the participants, the scientists used a food frequency questionnaire, which asked respondents about their dietary status during the second and third trimester of pregnancy. Developmental delays were assessed in another questionnaire that was sent to parents once their children were three years old. Based on parents’ answers, the researchers showed the correlation of maternal fiber intake and child brain development.

Nutritional guidance is crucial

The researchers also found that the median dietary fiber intake in Japan is just over 10 grams a day. Only 8.4% of Japanese pregnant women consumed enough fiber. They also pointed out that the recommended fiber intake for pregnant women varies: While in Japan the recommended daily dietary fiber intake is 18 grams each day, it is 28 grams in the US and Canada. “Our results show that nutritional guidance for pregnant mothers is crucial to reduce the risk of future health problems for their children,” said Miyake.

The researchers also pointed to certain limitations of their study. “Human studies cannot assess the effects of dietary fiber alone. Although this study considered the impact of folic acid intake during pregnancy, the possibility of other nutrients having an impact cannot be completely ruled out,” Miyake pointed out. “In addition, dietary fiber intake from supplements could not be investigated.”

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JOURNAL

Frontiers in Nutrition

DOI

10.3389/fnut.2023.1203669 

Mangos contribute a variety of nutrients, phytochemicals and bioactive compounds to the diet

 Mangos are one of the most popular fruits1 in the world, grown in more than 100 countries2 globally and consumed by an extremely diverse population. Now, two new studies funded by the National Mango Board and presented as posters during the American Society for Nutrition’s Annual Conference (Nutrition 2023) show mangos may play a role in risk reductions for vascular issues while helping to improve antioxidant levels among relatively healthy adult men and women who are overweight or obese.

“Mangos contribute a variety of nutrients, phytochemicals and bioactive compounds to the diet—including 50 percent of the daily value (DV) for vitamin C, 15 percent of the DV for folate and 15 percent of the DV for copper, and mangoes are also a predominant source of the bioactive compound mangiferin,” says Mee Young Hong, Ph.D., the primary investigator for both studies and professor at the School of Exercise and Nutritional Sciences in the College of Health and Human Services at San Diego State University. “It’s likely the unique matrix of vitamins and bioactive compounds synergistically working together that resulted in our findings,” says Young Hong.

Both crossover interventions followed the same 27 overweight or obese participants (16 males, 11 females; BMI 31.8 +/- 4.1 kg/m2) that were between the ages of 18-55 for 28 weeks. The participants were separated into two groups and instructed to eat either a 100-calorie snack of mangos (1 cup) or a 100-calorie snack of low-fat cookies for 12 weeks, as part of their normal lifestyle and eating patterns. Following the first 12 weeks, participants took a 4-week washout break then switched groups and consumed the alternate snack for another 12 weeks. During each 12-week period, participants provided fasting blood samples three times: at baseline, week 4 and week 12.

When the mango snack was eaten versus the low-fat cookie snack, following the12-week intervention, findings from the first study show significant health-positive changes to two markers of oxidative stress, reduced vascular cell adhesion molecule-1 (VCAM-1) and increased superoxide dismutase (SOD). Findings from the second study show a significant increase of glutathione peroxidase (GPX), a powerful antioxidant enzyme. Other biomarker and biochemical analyses performed across the two studies, which tested additional vascular, inflammatory, and immune risk factors and mediators, did not yield significant results.

“SOD and VCAM-1 play opposite roles as risk factors for vascular issues,” says Young Hong. “While the SOD enzyme reduces risk by breaking down charged oxygen molecules called superoxide radicals,3 which are toxic, the VCAM-1 gene causes cells to stick together along the vascular lining, leading to increased risk for issues.4 To achieve good vascular health, we want to see these two compounds move in opposite directions—SOD up and VCAM-1 down—which is what happened in the study. Additionally, GPX acts by converting hydrogen peroxide to water in the body, thus reducing the harmful oxidative effects of hydrogen peroxide,”5 says Young Hong.

“The totality of findings across both studies continues to add to a growing body of fresh mango research and can help to further advance the scientific understanding of the role mangos can play in helping all Americans achieve their health and wellness goals,” says Leonardo Ortega, Director of Research, National Mango Board.

“Vascular diseases include strokes, which are the third leading cause of death in the United States. Helping Americans find food-first solutions for reducing risks, like including more fruits, such as mangos, in the diet, is critical to reverse these trends and improve public health,” says Young Hong.

With only 70 calories and over 20 different vitamins and minerals, a 3/4-cup serving of mango is nutrient-dense, making it a superfood. Because mangos are widely consumed in cultures around the world including the United States, research into their health benefits contributes to a better understanding of their place in a healthy diet.

For more information, please visit www.mango.org. Click here for mango photography.

 

1. National Mango Board (2023) Mango Facts. Available at: https://www.mango.org/mango-facts/  
2. Mitra, S.K. (2016). Mango production in the world – present situation and future prospect. Acta Hortic. 1111, 287-296 DOI: 10.17660/ActaHortic.2016.1111.41 https://doi.org/10.17660/ActaHortic.2016.1111.41
3. MedlinePlus, Bethesda (MD): National Library of Medicine (US); [updated 2020 Jun 24]. SOD1 gene. Available at: https://medlineplus.gov/genetics/condition/noonan-syndrome/.
4. National Library of Medicine (2023) VCAM1 vascular cell adhesion molecule 1 [Homo sapiens (human)]. Available at: https://www.ncbi.nlm.nih.gov/gene/7412#bibliography
5. Lubos E, Loscalzo J, Handy DE. Glutathione peroxidase-1 in health and disease: from molecular mechanisms to therapeutic opportunities. Antioxid Redox Signal. 2011 Oct 1;15(7):1957-97. doi: 10.1089/ars.2010.3586. Epub 2011 Apr 10. PMID: 21087145; PMCID: PMC3159114.

Short bursts of daily activity linked to reduced cancer risk

Promising new research suggests a total of just 4.5 minutes of vigorous activity that makes you huff and puff during daily tasks could reduce the risk of some cancers by up to 32 percent. 

Published in JAMA Oncology and led by the University of Sydney, Australia, the study used data from wearable devices to track the daily activity of over 22,000 ‘non-exercisers’. Researchers then followed the group’s clinical health records for close to seven years to monitor for cancer.

As few as four to five minutes of vigorous intermittent lifestyle physical activity or ‘VILPA’ was associated with a substantially lower cancer risk compared to those who undertook no VILPA.

Vigorous Intermittent Lifestyle Physical Activity, or VILPA for short, was coined by researchers at the University of Sydney’s Charles Perkins Centre to describe the very short bursts of activity—around one minute each—we do with gusto each day. This includes activities like vigorous housework, carrying heavy shopping around the grocery store, bursts of power walking or playing high-energy games with the kids.

“VILPA is a bit like applying the principles of High-Intensity Interval Training (HIIT) to your everyday life,” said lead author Professor Emmanuel Stamatakis of the Charles Perkins Centre.

He said adults who don’t exercise are at increased risk of developing certain cancers like breast, endometrial or colon, but until recently the impact of less structured forms of vigorous physical activity was unable to be measured.

“We know the majority of middle-aged people don’t regularly exercise which puts them at increased cancer risk but it’s only through the advent of wearable technology like activity trackers that we are able to look at the impact of short bursts of incidental physical activity done as part of daily living,” said first author Professor Stamatakis.

“It’s quite remarkable to see that upping the intensity of daily tasks for as little as four to five minutes a day, done in short bursts of around one minute each, is linked to an overall reduction in cancer risk by up to 18 percent, and up to 32 percent for cancer types linked to physical activity.”

The study is observational, meaning it isn’t designed to directly explore cause and effect. However, the researchers say they are seeing a strong link and refer to previous early-stage trials showing that intermittent vigorous physical activity leads to rapid improvements in cardio-respiratory fitness, which may provide a possible biological explanation for reduced cancer risk. Other likely contributors include physical activity’s role in improving insulin sensitivity and chronic inflammation.

“We need to further investigate this link through robust trials, but it appears that VILPA may be a promising cost-free recommendation for lowering cancer risk in people who find structured exercise difficult or unappealing,” says Professor Stamatakis.

The international research team includes investigators from the University of Sydney (Australia), University College London (UK), Harvard Medical School (US), University of Calgary (Canada), Maastricht University (The Netherlands), National Research Centre for the Working Environment (Denmark), The University of East Anglia (UK), Norwegian University of Science and Technology (Norway), Loughborough University (UK), and University of Adger (Norway).

What did the researchers find?

In a study sample of 22,398 people with an average age of 62 who didn’t exercise in their leisure time, the researchers found;

• 2356 new cancer events (1084 in physical activity related cancer) over an average follow-up of 6.7 years
• a minimum of around 3.5mins of daily VILPA was associated with up to 18 percent reduction in cancer incidence (compared with no VILPA)
• 4.5 mins of daily VILPA was associated with up to 32 percent reduction in physical activity-related cancer incidence
• the steepest gains in cancer risk reduction were seen in people who did small amounts of VILPA compared to those who did none, however, benefits continued with higher levels of daily VILPA -  particularly for physical activity-related cancers
• most VILPA (92 percent) occurred in bouts of up to 1min.

Study design

The current study analysed the impact of VILPA on overall cancer incidence, as well as for 13 cancer sites associated with physical activity; these include liver, lung, kidney, gastric cardia (a type of stomach cancer), endometrial, myeloid leukaemia, myeloma, colorectal, head and neck, bladder, breast and esophageal adenocarcinoma (cancer of the oesophagus).

The researchers used data from the UK Biobank Accelerometry Sub Study and only included those who identified as ‘non-exercisers’ – meaning they self-reported no leisure time exercise and no regular recreational walks.

They excluded study participants that could skew the results including due to previous cancer diagnosis or diagnosis within a year of enrolment. Other influences such as age, smoking status, BMI, cardiovascular disease, sleep, diet and hereditary cancer risk were also taken into account.

VILPA was assessed based on the participant’s activity levels as measured by wrist accelerometers worn over 7 days at study onset. This is consistent with other wearable studies as physical activity levels remain relatively stable at the population level over adulthood.

New cancer events were recorded via cancer registries, and hospitalisations or deaths attributable to cancer.

Next steps

“We are just starting to glimpse the potential of wearable technology to track physical activity and understand how unexplored aspects of our lives affect our long-term health – the potential impact on cancer prevention and a host of other health outcomes is enormous,” said Professor Stamatakis.

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MIND diet study shows 'short-term' impact on cognition

 

New research shows the importance of long-term commitment to the MIND diet for reaping the greatest benefit to brain health.

“The benefits within the new study’s three-year clinical trial weren’t as impressive as we’ve seen with the MIND diet observational studies in the past, but there were improvements in cognition in the short-term, consistent with the longer-term observational data,” said lead study author Lisa Barnes, PhD, associate director of the Alzheimer’s Disease Research Center at RUSH.

Results from the study, published in The New England Journal of Medicine, showed that within a three-year period, there was no significant statistical difference in change in cognition for participants in the MIND diet group compared to the usual diet control group; both groups were coached to reduce calories by 250 kilocalories per day. But there was a significant improvement during the first two years of the study.

“What we saw was improvement in cognition in both groups, but the MIND diet intervention group had a slightly better improvement in cognition, although not significantly better,” Barnes said. “Both groups lost approximately 5 kilograms over three years, suggesting that it could have been weight loss that benefited cognition in this trial.”

'Exciting' improvement

This is the first randomized clinical trial designed to test the effects of a diet thought to be protective for brain health, on the decline of cognitive abilities among a large group of individuals 65 years or older who did not have cognitive impairment. The MIND diet has been ranked among the top five diets by U.S. News & World Report annually for the last six years.

“There is established research that shows that a person’s diet affects health,” Barnes said. “The participants in this study had to have sub-optimal diets as determined by a score of 8 or less on a diet screening instrument before the study even began. It is reasonable to think that either they were going to maintain their cognition or decrease the rate of cognitive decline in the future.”

“It was exciting to see that there was improvement in cognition over the first year or so, but it could have been due to practice effects on the cognitive tests, and we saw it for the control diet as well, which focused on just caloric restriction.”

Previous research by the late Martha Clare Morris, ScD, showed that there was a slower rate of decline among those who ate specific foods. Morris was a nutritional epidemiologist at RUSH and the original principal investigator of the MIND diet study that was funded by a $14.5 million National Institutes of Health grant and involved two clinical sites, RUSH in Chicago and Harvard School of Public Health in Boston.

In 2015, Morris and her colleagues at RUSH and Harvard University developed the MIND diet — which is short for Mediterranean-DASH Intervention for Neurodegenerative Delay — in preparation for the trial. The diet is based on the most compelling research on the foods and nutrients that affect brain health. As the name suggests, the MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both diets have been found to reduce the risk of cardiovascular conditions, such as hypertension, diabetes, heart attack and stroke. In two studies published in 2015, Morris and colleagues found that the MIND diet could slow cognitive decline and lower a person’s risk of developing Alzheimer’s disease significantly, even if the diet was not followed meticulously.

Study tracked 604 participants over three years

The latest trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons, was a randomized, Phase III trial that enrolled 604 people who were overweight and had a suboptimal diet and a family history of Alzheimer’s disease. The trial compared two different diet interventions, both of which included dietary counseling with mild calorie restriction of 250 calories per day for weight loss.

Participants of both groups had individualized diet guidelines developed by dietitians, and they received regular phone and in-person consultations, as well as occasional group sessions over the three-year life of the study. Participants were seen five times during the three years to evaluate their mental abilities, blood pressure, diet, physical activity, health conditions and medication use.

“Both groups of participants got a lot of support and accountability by trained registered dietitians,” said Jennifer Ventrelle, assistant professor in the Departments of Preventive Medicine and Clinical Nutrition and lead dietitian on the MIND diet trial at RUSH.

“The good news is that this helped all participants improve on average, but unfortunately hindered the ability to detect significant differences between the two groups in this relatively short period of time. Current and future research plans to look at people coached to follow the diet in this format compared to individuals following a usual diet in a format closer to usual care such as brief clinical encounters or a self-guided program with less support.”

“By the end of the study, the average weight loss was approximately 5.5% of initial body weight for all participants, exceeding the study target of 3%, the amount recognized as clinically significant to prevent or improve adverse health outcomes,” Ventrelle said.

“The average MIND score at the end of three years for the MIND group was 11.0 and 8.3 for the control group, placing both groups in a therapeutic range to slow cognitive decline and lower a risk for Alzheimer’s disease, according to previous studies. The significant weight loss and improved MIND scores suggest that the control group also improved their diet and may suggest that following the MIND diet at a score of at least 8.3, coupled with at least a 250 calorie reduction to produce weight loss, may improve cognition. More research is needed to confirm this.”

Fish, chicken, berries, nuts and leafy greens

The MIND diet has 14 dietary components, including nine “brain-healthy food groups” – such as chicken and fish, green leafy vegetables and berries, and nuts – and five unhealthy groups: red meat, butter and stick margarine, full fat cheese, pastries and sweets, and fried foods.

“Randomized trials are gold standards for establishing a cause-and-effect relationship between diet and incidence of Alzheimer’s disease,” Barnes said.

“These individuals were healthy at the start of the trial and had no cognitive impairment, and their cognition got slightly better over time,” Barnes said. “Why there was no difference between the two diet groups at the end of the trial could be a result of many factors including that the control group had a relatively healthy diet. Moving forward, we will look at specific food groups and their associations with biomarkers that were measured in the blood to see if certain nutrients and food groups are more important than others since the two groups were pretty healthy from a dietary perspective at the start.”

Mediterranean diet and physical activity could prevent hospitalization-associated disability in older people

 Hospitalized older people who do not follow a Mediterranean diet could benefit from a physical exercise program to prevent hospitalization-associated disability, that is, loss of skills in daily-life activities. Therefore, if the factor of following a Mediterranean diet is included among the variables assessed on the hospital admission of elderly patients, more precise and personalized strategies could be designed to prevent hospitalization-associated disability, which is only frequent in the elderly.

 

This is one of the conclusions of an article published in the Journal of Nutrition and Healthy Aging and led by experts Mireia Urpi-Sarda, from the Faculty of Pharmacy and Health Sciences, the Institute for Research in Nutrition and Food Safety (INSA-UB) and the Torribera Food Campus of the University of Barcelona, and José Antonio Serra-Rexach, from the Biopathology of Aging Research Group of the Gregorio Marañón Health Research Institute (IISGM), both members of the CIBER on Frailty and Healthy Aging (CIBERFES).

The study notes that hospitalized older adults who eat similarly to a Mediterranean diet also improve their overall condition with exercise and health education guidelines. Notably, in an editorial the journal has highlighted the fact that patients with poorer physical condition show more significant improvements in response to a physical exercise program. Also, it encourages further studies on the influence of dietary patterns on the effects of exercise to prevent hospitalisation-associated disability.

A basic exercise program for older patients

Hospitalization-associated disability is a phenomenon that affects even older patients who have been successfully treated for their condition while in the medical center. In addition, it can also lead to higher economic costs, readmissions, and even a higher mortality in some cases. In this context, physical exercise interventions during hospitalization have been shown to be safe and effective strategies to prevent this functional deterioration in hospitalized older people.

The new study is based on the AGECAR-PLUS project, a randomized clinical study of 260 patients aged 75 years or older at the Gregorio Marañón University Hospital. As part of the study, a group of 109 volunteers — 46% women aged around 87 — were evaluated for adherence to a Mediterranean dietary pattern, urinary polyphenol levels, functional status, and other health parameters at the time of admission and discharge.

José Antonio Serra-Rexach says: "We observed that patients who underwent the physical exercise and health education intervention during hospitalization significantly increased their functional status at discharge, compared to their admission and to patients who did not undergo the intervention. However, to date, there was no evidence of the effect of a healthy diet on functional status in hospitalized older people".

"A healthy diet pattern, such as the Mediterranean diet, is associated with a lower risk of physical deterioration and weakness in elderly people. Considering that the Mediterranean diet is rich in polyphenols, we have evaluated the monitoring of this dietary pattern through a validated questionnaire, as well as by analyzing the level of polyphenols in urine", says Professor Mireia Urpi-Sarda, from the UB's Biomarkers and Nutritional & Food Metabolomics Research Group.

Researcher Alba Tor-Roca, from the Department of Nutrition, Food Sciences and Gastronomy of the UB, notes that "in the study, we observed that in individuals who had a low adherence to the Mediterranean diet when hospitalized, the intervention with physical exercise had a greater and clinically relevant effect on their functional capacities".

"These results suggest that adherence to the Mediterranean diet may represent an indicator of those older patients with an apparently better response to exercise interventions", the researchers conclude.

Increased cardiovascular risks for people with obstructive sleep apnea

Reduction in blood oxygen levels, largely attributed to blocked airways, emerges as a leading factor

Researchers have found that people with obstructive sleep apnea have an increased cardiovascular risk due to reduced blood oxygen levels, largely explained by interrupted breathing. Obstructive sleep apnea has long been associated with increased risk of cardiovascular issues, including heart attack, stroke, and death, but the findings from this study, partially supported by the National Institutes of Health and published in the American Journal of Respiratory and Critical Care Medicine, show the mechanism mostly responsible for the link.

 

“These findings will help better characterize high-risk versions of obstructive sleep apnea,” said Ali Azarbarzin, Ph.D., a study author and director of the Sleep Apnea Health Outcomes Research Group at Brigham and Women’s Hospital and Harvard Medical School, Boston. “We think that including a higher-risk version of obstructive sleep apnea in a randomized clinical trial would hopefully show that treating sleep apnea could help prevent future cardiovascular outcomes.”

 

Researchers reviewed data from more than 4,500 middle-aged and older adults who participated in the Osteoporotic Fractures in Men Study (MrOS) and the Multi-Ethnic Study of Atherosclerosis (MESA), and sought to identify features of obstructive sleep apnea that could explain why some people were more likely than others to develop cardiovascular disease or related death. 

 

Physiological features of obstructive sleep apnea assessed included hypoxic burden, which is a reduction in blood oxygen levels during sleep; ventilatory burden, which are interruptions in breathing due to airway obstruction; and nighttime arousals, which are when a person suddenly wakes up from sleep due to interrupted breathing and that can cause their blood pressure or heart rate to rise.

 

While sleep apnea severity is defined as how many times the airways become blocked during an hour of sleep, this study sought to better characterize underlying mechanisms of obstructive sleep apnea and identify those that strongly predict increased cardiovascular risks.

 

Through MrOS, 2,627 men, with an average age of 76, were followed for about nine to 12 years. MESA included data from 1,973 men and women, with an average age of 67, who were followed for about seven years. During this time, participants completed medical check-ins and sleep assessments and shared information about their health. Approximately 110 participants in MESA and 382 in MrOS experienced a primary cardiovascular event.

 

For every measure of observed reduction in blood oxygen levels, or hypoxic burden, a person in MESA had a 45% increased associated risk for having a primary cardiovascular event. In MrOS, the observed increased risk was 13%. Airway obstruction, measured by a full or partial closing of the airways, accounted for 38% of observed risks in MESA and for 12% in MrOS. Similar findings for predicting premature death based on hypoxic and ventilatory burden were also observed. Sudden awakenings weren’t associated with cardiovascular outcomes in MESA, but were linked with cardiovascular-related deaths in MrOS. Additionally, the researchers found that a high hypoxic burden was mostly due to severe obstruction of the airway and not other factors, such as abdominal obesity or reduced lung function.

 

“That’s something that makes this metric specific to sleep apnea,” said Gonzalo Labarca, M.D., a study author and an instructor in medicine at Brigham and Women's Hospital and Harvard Medical School. “The connections are less explained by obesity or another factor.”

 

The authors noted the findings have the potential to change how sleep apnea is assessed but need to be validated through future studies.

 

“Understanding these mechanisms could change the way that sleep apnea clinical trials are designed and what is measured in clinical practice,” said Marishka K. Brown, Ph.D., director of the National Center for Sleep Disorders Research at the National Heart, Lung, and Blood Institute (NHLBI), part of NIH.

 

Previous studies have estimated that nearly up to 425 million adults worldwide, and about 54 million in the United States have obstructive sleep apnea and are therefore at higher risk of cardiovascular disease, the leading cause of death in the world. 

Healthy eating is not enough if the diet is rich in ultra-processed foods

 

The very first rule for people diagnosed with type 2 diabetes is to eat a healthy nutritious diet. Attention to ingested calories, as well as nutrients contained in various foods, become integral parts of a diabetic person's life. However, this might not be enough: an important role in determining the future health status of people with this condition could be played by the degree of processing of foods that end up on the dish. These products are described as "ultra-processed" and are associated with adverse health outcomes, as reported in general population studies.

A study conducted by the Department of Epidemiology and Prevention at the I.R.C.C.S. Neuromed in Pozzilli, Italy, published in the American Journal of Clinical Nutrition, has now analyzed whether consumption of ultra-processed foods could be a risk factor also for more vulnerable people, such as those suffering from type 2 diabetes. Results show that a high consumption of ultra-processed foods is associated with a substantial increase in the risk of mortality, especially from cardiovascular diseases, regardless of the nutritional quality of the diet, as reflected by adherence to the Mediterranean Diet.

Ultra-processed foods are products that have undergone often intense processing, made, in part or entirely, with substances that are not usually used in the kitchen (e.g., hydrolyzed proteins, maltodextrins, hydrogenated fats) and generally contain several food additives, such as colorings, preservatives, antioxidants, flavor enhancers and sweeteners. Their main purpose is not to improve the nutritional properties of food but rather to enhance its taste, appearance and shelf life. Packaged snacks, fizzy and sugary drinks, ready-to-eat meals and fast-food come immediately to the mind. It's true, but they don't represent the whole situation: the level of processing, as well as the use of additives, are features that can also be found in foods that we might consider healthful, such as fruit yogurt, breakfast cereals, crackers, and a large part of meat substitutes.

The Italian researchers analyzed data from the large Moli-sani Study and specifically examined 1,066 participants who were affected by type 2 diabetes at study entry in 2005-2010.

"Over an average follow-up of 12 years - says Marialaura Bonaccio, epidemiologist of the Department of Epidemiology and Prevention of the IRCCS Neuromed of Pozzilli and first author of the study - we observed that a diet rich in ultra-processed foods exposed people with diabetes to a greater risk of death. Participants reporting a higher consumption of ultra-processed foods had 60% increased risk of dying from any cause, compared to people consuming less of these products. The risk of mortality from cardiovascular diseases, which is a leading cause of death for people with diabetes, was more than doubled."

"One of the most interesting results of this study - says Licia Iacoviello, Director of the Department and full professor of Hygiene at the University of Insubria of Varese and Como - is that the increased risk linked to ultra-processed foods was observed even when participants reported a good adherence to the Mediterranean Diet. These findings suggest that if the dietary share of ultra-processed foods is high, the potential advantages of a healthful Mediterranean Diet risk to be overlooked”.

"These results - comments Giovanni de Gaetano, President of the IRCCS Neuromed of Pozzilli - may have important implications for future dietary guidelines to manage type 2 diabetes. In addition to the adoption of a diet based on well-known nutritional requirements, dietary recommendations should also suggest limiting the consumption of ultra-processed foods as much as possible. In this context, and not only for people with diabetes, the front-of-pack nutrition labels should also include information on the degree of food processing".

Link between Vitamin D and psoriasis severity

 

More than eight million people in the U.S. experience psoriasis, a condition in which skin cells build up and form itchy dry patches. A person’s vitamin D levels could play an important role in psoriasis severity, according to one of the largest studies to date.

 

The analysis, which included almost 500 psoriasis cases from the National Health and Nutrition Examination Survey (NHANES), showed a linear relationship between increasing psoriasis severity and decreasing vitamin D levels measured through blood tests.

 

“Topical synthetic vitamin D creams are emerging as new therapies for psoriasis, but these usually require a doctor’s prescription,” said Rachel K. Lim, an MD candidate at the Warren Alpert Medical School of Brown University. “Our results suggest that a vitamin D-rich diet or oral vitamin D supplementation may also provide some benefit to psoriasis patients.”

 

Lim will present the findings at NUTRITION 2023, the annual flagship meeting of the American Society for Nutrition held July 22-25 in Boston.

 

The research team was led by Eunyoung Cho, ScD, an associate professor in the Department of Dermatology at the Warren Alpert Medical School of Brown University who studies the role of nutrition and environmental factors in skin cancer and inflammatory skin diseases such as psoriasis. Vitamin D is thought to influence the development of skin diseases by affecting the body’s immune response and through direct effects on the cells involved in skin repair.

 

“With growing public interest in vitamin supplementation, we wanted to further examine the connection between vitamin D levels and psoriasis severity,” said Cho. “Few studies have looked for this association in groups of people, especially in large U.S. populations, or examined this relationship through a clinical nutrition lens.”

 

For the new study, the researchers identified 491 psoriasis cases from more than 40,000 NHANES participants, with 162 cases from 2003-2006 and 329 from 2011-2014. They also extracted data on vitamin D levels, self-reported psoriasis-affected body surface area and other factors including age, gender, race, body mass index, and smoking status.

 

After adjusting for lifestyle factors such as smoking, the analysis showed that lower vitamin D levels and vitamin D deficiency were significantly associated with greater psoriasis severity. The researchers also found that patients with the least amount of body surface affected by psoriasis had the highest average vitamin D levels while those with the greatest affected area had the lowest average levels of vitamin D. 

 

“Only one previous study, published in 2013, has used NHANES data to analyze the relationship between vitamin D and psoriasis,” said Lim. “We were able to add more recent data, which more than tripled the number of psoriasis cases analyzed, making our results more up-to-date and statistically powerful than previously available data.”

 

Vegetarian dietary patterns and cardiometabolic risk in people with or at high risk of cardiovascular disease

 The results of a study published in JAMA Network Open suggest that consuming a vegetarian diet may modestly but significantly improve cardiometabolic outcomes beyond standard pharmacological therapy in individuals at high risk of cardiovascular diseases (CVDs), highlighting the potential protective and synergistic effects of vegetarian diets for the primary prevention of CVD.

Static isometric exercise, such as wall sits, best for lowering blood pressure

 

But squats, press-ups, high intensity interval training (HIIT), and ‘cardio’ also effective.

Static isometric exercises—the sort that involve engaging muscles without movement, such as wall sits and planks—are best for lowering blood pressure, finds a pooled data analysis of the available evidence from clinical trials, published online in the British Journal of Sports Medicine.

But ‘cardio’ (aerobic exercise); dynamic resistance training, such as squats, press-ups, and weights; high intensity interval training or HIIT for short (episodic short bouts of high intensity exercise interspersed with short periods of recovery at a lower intensity) are all effective, indicate the findings.

It may be time to review the current exercise guidelines for the prevention and treatment of high blood pressure, suggest the researchers.

Previously published research shows that exercise in general is associated with significant reductions in blood pressure, with aerobic (’cardio’) exercise, such as walking, running, and cycling, the type primarily recommended for managing blood pressure.

But this recommendation is largely based on older data that exclude the newer forms of exercise, such as HIIT and isometric exercise, meaning that the current recommendations are probably outdated, suggest the researchers.

In a bid to potentially update information on the best form of exercise for controlling blood pressure, they trawled research databases looking for clinical trials reporting the effects of an exercise training intervention lasting 2 or more weeks on resting blood pressure. 

The exercise interventions were classified as aerobic (‘cardio’); dynamic resistance training; a combination of these; HIIT; and isometric exercises. 

Healthy resting blood pressure was defined as a reading below 130/85 mmHg; pre-high blood  pressure as 130–139/85–89 mmHg; and high blood pressure as 140/90 mmHg or more.

Systolic blood pressure, the first number in a reading, measures arterial pressure when the heart beats; diastolic blood pressure, the second number, measures arterial pressure between beats.

In all, 270 randomised controlled trials published between 1990 and February 2023 were included in the final analysis, with a pooled data sample size of 15,827 participants.

The pooled data analysis showed significant reductions in resting systolic and diastolic blood pressure after all the various categories of exercise, but with the largest falls in both systolic and diastolic blood pressure after isometric exercise training.

The reductions in blood pressure after aerobic exercise training amounted to 4.49/ 2.53 mmHg; 4.55/3.04 mm Hg after dynamic resistance training; 6.04/2.54 mmHg after combined training; 4.08/2.50 mmHg after HIIT; and 8.24/4 mmHg after isometric exercise training.

The rank order of effectiveness values for reducing systolic blood pressure were isometric exercise training (98%), combined training (76%), dynamic resistance training (46%), aerobic exercise training (40.5%) and HIIT (39%). 

Secondary analyses revealed wall squats (isometric) and running (aerobic) as the most effective individual exercises for reducing systolic blood pressure (90.5%) and diastolic blood pressure (91%), respectively, with isometric exercise, overall, the most effective for reducing both blood pressure elements.

The researchers acknowledge that variations in the types of participants included across the clinical trials and differences in statistical and methodological processes and exercise interventions may have influenced the findings, and so should be interpreted in light of these limitations.

But they nevertheless conclude: “Overall, isometric exercise training is the most effective mode in reducing both systolic and diastolic blood pressure. 

“These findings provide a comprehensive data driven framework to support the development of new exercise guideline recommendations for the prevention and treatment of arterial hypertension.”

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Regular olive oil consumption associated with 28% lower risk of fatal dementia

 A new study suggests that incorporating olive oil into your diet could help reduce the risk of dying from dementia. As many countries face rising rates of Alzheimer’s disease and other forms of dementia, the study offers hope that healthy lifestyle factors such as diet can help to prevent or slow the progression of these devastating conditions.

 

“Our study reinforces dietary guidelines recommending vegetable oils such as olive oil and suggests that these recommendations not only support heart health but potentially brain health, as well,” said Anne-Julie Tessier, RD, PhD, a postdoctoral fellow at the Harvard T.H. Chan School of Public Health. “Opting for olive oil, a natural product, instead of fats such as margarine and commercial mayonnaise is a safe choice and may reduce the risk of fatal dementia.”

 

Tessier will present the findings at NUTRITION 2023, the flagship annual meeting of the American Society for Nutrition held July 22–25 in Boston.

 

Dementia includes a range of conditions in which impairments in thinking or memory affect a person’s daily activities. Alzheimer’s, a progressive and fatal disease affecting an estimated 5.7 million Americans, is the most common form of dementia.

 

The study is the first to investigate the relationship between diet and dementia-related death. Scientists analyzed dietary questionnaires and death records collected from more than 90,000 Americans over three decades, during which 4,749 study participants died from dementia.

 

The results indicated that people who consumed more than half a tablespoon of olive oil per day had a 28% lower risk of dying from dementia compared with those who never or rarely consumed olive oil. In addition, replacing just one teaspoon of margarine and mayonnaise with the equivalent amount of olive oil per day was associated with an 8-14% lower risk of dying from dementia.

 

Research suggests that people who regularly use olive oil instead of processed or animal fats tend to have healthier diets overall. However, Tessier noted that the relationship between olive oil and dementia mortality risk in this study was independent of overall diet quality. This may suggest that olive oil has properties that are uniquely beneficial for brain health.

 

“Some antioxidant compounds in olive oil can cross the blood-brain barrier, potentially having a direct effect on the brain,” said Tessier. “It is also possible that olive oil has an indirect effect on brain health by benefiting cardiovascular health.”

 

Previous studies have linked higher olive oil intake with a lower risk of heart disease. Incorporating olive oil as part of a Mediterranean dietary pattern has also been shown to help protect against cognitive decline.

 

Tessier cautioned that the research is observational and does not prove that olive oil is the cause of the reduced risk of fatal dementia. Additional studies such as randomized controlled trials would be needed to confirm the effects and determine the optimal quantity of olive oil to consume in order to reap these benefits. Overall, however, the study aligns with dietary recommendations and bolsters the evidence that using olive oil in place of margarine or mayonnaise can help to support a healthy diet.

Upping your intake of omega-3s may help protect your hearing

 

Researchers report that blood levels of the omega-3 fatty acid docosahexaenoic acid (DHA) were inversely correlated with hearing difficulty in a new population-based cross-sectional study. Middle-aged and older adults with higher DHA levels were 8-20% less likely to report age-related hearing issues than those with lower DHA levels.

 

“Higher DHA levels have previously been found to be associated with a lower risk of heart disease, cognitive impairment, and death. Our study extends these findings to suggest a role for DHA in maintaining auditory function and helping reduce the risk of age-related hearing loss,” said Michael I. McBurney, PhD, a senior scientist with the Fatty Acid Research Institute and an adjunct professor in the Department of Human Health & Nutritional Sciences at the University of Guelph and the Friedman School of Nutrition Science and Policy at Tufts University.

 

McBurney, a Fellow of the American Society for Nutrition and the Canadian Nutrition Society, will present the findings at NUTRITION 2023, the flagship annual meeting of the American Society for Nutrition held July 22–25 in Boston.

 

Using data from the UK Biobank, the researchers analyzed self-reported hearing status and blood DHA levels of over 100,000 people 40-69 years of age in the United Kingdom. After accounting for potential confounding variables, the results showed that people in the highest quintile (one-fifth of participants) of blood DHA levels were 16% less likely to answer yes to the question ‘do you have difficulty hearing’ compared with those in the lowest quintile of DHA levels. Similarly, those in the highest quintile for DHA levels were 11% less likely to answer yes to the question ‘do you have difficulty following conversations when there is background noise’ compared with people in the lowest quintile for DHA levels.

 

While the results show a significant association between DHA levels and hearing, McBurney cautioned that a cross-sectional population study does not provide enough evidence to definitively conclude that DHA maintains auditory function or that inadequate DHA levels contribute to hearing loss. However, the findings add to a mounting body of evidence of the importance of omega-3 fatty acids, including DHA in particular, to maintain health and help protect against aging-related declines in a variety of body functions.

 

Omega-3s may help to protect the health of cells in the inner ear or mitigate inflammatory responses to loud noises, chemicals, or infections. Previous studies conducted in older adults and in animals have similarly suggested that higher omega-3 levels are inversely related to and may protect against age-related hearing loss.

 

Our bodies have a limited ability to produce DHA, so the amount of DHA found in our blood and tissues largely depends on our omega-3 intake. DHA levels can be increased by regularly consuming seafood or by taking dietary supplements.

 

“There is strong evidence that higher blood levels of omega-3 fatty acids are beneficial,” said McBurney. “Fatty fish and omega-3 supplements are both good dietary sources. If choosing to use a dietary supplement, compare products by reading the Supplement Facts panel for eicosapentaenoic acid (EPA)+DHA content.”

 

It is estimated that around 20% of people—over 1.5 billion people worldwide—live with hearing loss, and this number is expected to rise as the population ages in the coming decades. Hearing loss can range from mild to profound; it affects communication and social interactions, educational and job opportunities, and many other aspects of daily life. 

 

Environmental factors as well as genetic proclivities and medicines contribute to hearing loss. Proven ways to reduce the risk of hearing loss include protecting the ears from loud noises by using protective equipment and getting appropriate medical care for infections.

 

Breastfeeding is associated with a 33% reduction in first-year post-perinatal infant mortality

 

Among nearly 10 million US infants born between 2016 and 2018, breastfed babies were 33% less likely to die during the post-perinatal period (day 7−364) than infants who were not breastfed, reports a new study in the American Journal of Preventive Medicine, published by Elsevier. The findings build on previous US research with smaller datasets, which documented the association between the initiation of breastfeeding and the reduction of post-perinatal infant mortality by a range of 19% to 26%.

Lead investigator Julie L. Ware, MD, MPH, Division of General and Community Pediatrics, Department of Pediatrics, Cincinnati Children’s Center for Breastfeeding Medicine, said, “Based on these data, there is clear evidence that breastfeeding confers a protective benefit during the first year of life and is strongly associated with reduced post-perinatal infant mortality across the USA.”

Dr. Ware noted that the findings suggest there is an opportunity for breastfeeding promotion, protection, and support to be included as a key component in comprehensive infant mortality reduction initiatives in regions and states across the US.

With help from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, birth certificate data on US infants born from 2016 to 2018 were linked with infant deaths occurring up to one year after birth. An analysis was conducted to demonstrate whether the initiation of breastfeeding, as recorded on the birth certificate (a practice adopted by all states in 2016), was associated with post-perinatal infant death, taking into account factors such maternal age, education, race and ethnicity, and geographical location.

Breastfeeding is recognized by the World Health Organization, American Academy of Pediatrics, and other authorities as the preferred normative nutrition for infants, both recommending that families breastfeed their infants exclusively for 6 months, continuing with the addition of complementary foods for at least the first 2 years of life.  These organizations consider breastfeeding a public health imperative with many short- and long-term improved health outcomes for both mother and child, including significant reductions in all-cause infant mortality and specific protection against sudden infant death syndrome and necrotizing enterocolitis in preterm infants. Despite these recommendations, the rates for breastfeeding initiation, exclusivity, and continuation in the US do not meet breastfeeding goals, especially in certain racial and ethnic populations, and in some geographic regions.

Co-investigator Ardythe Morrow, PhD, University of Cincinnati College of Medicine stated that, "Though breastfeeding is widely recommended, nevertheless, some may still consider it to be of minor importance. We hope that our findings will change the narrative. Human milk is replete with protective molecules, and breastfeeding offers significant protection."

Addressing breastfeeding disparities may improve the health of mothers and their babies and help reduce adverse outcomes. Although most states advocate breastfeeding promotion, protection, and support activities, analysis of the association between breastfeeding and infant mortality had not previously been conducted at the state and regional levels. To this end, the investigators conducted a regional and state-by-state analysis.

Co-investigator Aimin Chen, PhD, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, explained, “We found that the effect was evident across the US, but with regional variations, ranging from 44% in the Northeast and Mid-Atlantic, where breastfeeding initiation is the highest, and 21% in the Southeast, where breastfeeding initiation is the lowest. Although regional and state variation in the magnitude of the association between breastfeeding and infant mortality exists, there was a remarkable consistency of reduced risk. Together with existing literature, our data suggest that breastfeeding promotion and support may be an effective strategy to help reduce infant mortality in the US.”

Dr. Ware summarized, “Breastfeeding saves lives. August is National Breastfeeding Month. Let’s do all we can to support breastfeeding families and improve the health of our nation.”

 

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JOURNAL

American Journal of Preventive Medicine

DOI

10.1016/j.amepre.2023.05.015