Excess thyroid hormone levels associated with higher risk of cognitive disorders among older adults

 

Thyrotoxicosis — excess thyroid hormone levels in the body — has been linked to an increased risk of cognitive disorders among older adults, according to a new study from Johns Hopkins Medicine. Exogenous thyrotoxicosis (caused by ingesting thyroid medication) and endogenous thyrotoxicosis (caused by thyroid disorders such as hyperthyroidism and Graves’ disease) were both associated with a higher likelihood of developing a cognitive disorder. The study was published online Oct. 23 by JAMA Internal Medicine.

“Some prior studies have suggested that thyrotoxicosis was associated with an increased risk of cognitive disorders,” says Roy Adams, Ph.D., M.S., first author of the study and assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “But results have been mixed, and exogenous thyrotoxicosis was mostly excluded from those studies.”

According to GoodRx, thyroid hormone is among the most common prescriptions in the United States. A previous Johns Hopkins Medicine study found that up to 20% of people prescribed thyroid hormone may be overtreated, placing them at risk for exogenous thyrotoxicosis.

“Our goal was to investigate whether aggressive treatment practices, which can cause exogenous thyrotoxicosis, can also possibly cause cognitive harm,” says Adams. “Understanding the negative effects of overtreatment is critical to help guide clinicians in how they prescribe thyroid hormone therapy.”

The research team selected participants for the study from a Johns Hopkins Medicine electronic health record database. The team identified 65,931 qualified participants age 65 and older who received primary care within the Johns Hopkins Health System between Jan. 1, 2014, and May 6, 2023. The average age during the first recorded primary care visit was 71, and all patients had at least two visits that were 30 or more days apart.

Results showed that all-cause thyrotoxicosis — endogenous and exogenous thyrotoxicosis combined — was associated with a 39% increase in the risk of cognitive disorder diagnosis across age groups. Of patients who experienced thyrotoxicosis, 11% were diagnosed with a cognitive disorder by age 75 versus 6.4% of patients who did not experience thyrotoxicosis. By age 85, 34% of patients who had thyrotoxicosis were diagnosed with a cognitive disorder, compared with 26% of patients who did not have thyrotoxicosis. The excess risk associated with thyrotoxicosis persisted with an analysis using statistical models that examined possible sources of bias and alternative reasons for the associations.

The study also found that among those prescribed thyroid hormone, the level of exposure to thyroid hormone correlated with the degree of risk for a cognitive disorder. Patients with a more severe degree of excess thyroid hormone had a 65% increased risk of cognitive disorder, while those with a more moderate degree of excess thyroid hormone had a 23% increased risk.

“Our results suggest that an increased risk of cognitive disorders is among the potential negative consequences of thyroid hormone excess, a common consequence of thyroid hormone therapy,” says Jennifer Mammen, M.D., Ph.D., the study’s senior author and assistant professor of medicine at the Johns Hopkins University School of Medicine. “Clinicians considering thyroid hormone therapy in older adults should avoid overtreatment by using age-appropriate treatment strategies.”

Following “Life’s Essential 8” checklist may slow biological aging by 6 years

  American Heart Association’s Scientific Sessions 2023 and Resuscitation Science Symposium 2023, held earlier this month in Philadelphia: here are some of the important scientific findings that could impact your heart and stroke health.

• An analysis of more than 6,500 adults found that having high cardiovascular health — as measured by the American Heart Association’s Life’s Essential 8 checklist — may slow the pace of biological aging, which may reduce the risk of developing cardiovascular and other age-related diseases while extending life,
• After accounting for a range of socioeconomic factors, adults with high cardiovascular health were about six years younger biologically than their chronological age.
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Think marijuana is heart safe? Think again.

 American Heart Association’s Scientific Sessions 2023 and Resuscitation Science Symposium 2023, held earlier this month in Philadelphia: here are some of the important scientific findings that could impact your heart and stroke health.

• As more people across the U.S. use marijuana for medical and recreational reasons, two new studies suggest its regular intake may damage heart and brain health.
• In one study, daily use of marijuana raised the risk of developing heart failure by about one-third, even after considering other factors, compared to people who reported never using marijuana.
• In a second study, older people with any combination of Type 2 diabetes, high blood pressure and high cholesterol who used marijuana, significantly increased their risk for a major acute heart or brain event while hospitalized, compared to those who reported not using marijuana.
• “The latest research about cannabis use indicates that smoking and inhaling cannabis increases concentrations of blood carboxyhemoglobin (carbon monoxide, a poisonous gas), tar (partly burned combustible matter) similar to the effects of inhaling a tobacco cigarette, both of which have been linked to heart muscle disease, chest pain, heart rhythm disturbances, heart attacks and other serious conditions,” said Robert L. Page II, Pharm.D., M.S.P.H., FAHA, chair of the volunteer writing group for the 2020 American Heart Association Scientific Statement: Medical Marijuana, Recreational Cannabis, and Cardiovascular Health. “Together with the results of these two research studies, the cardiovascular risks of cannabis use are becoming clearer and should be carefully considered and monitored by health care professionals and the public.”

Depressed? Anxious? Stressed? These could put you on the fast track to heart disease risk

 American Heart Association’s Scientific Sessions 2023 and Resuscitation Science Symposium 2023, held earlier this month in Philadelphia: here are some of the important scientific findings that could impact your heart and stroke health.

• A study found that depression and anxiety may speed development of risk factors, like high blood pressure, high cholesterol or Type 2 diabetes, that increase heart attack and stroke risk. Participants previously diagnosed with anxiety or depression developed a new risk factor on average six months earlier than those who did not have depression or anxiety. Depression and anxiety increased the risk for a major cardiovascular event, such as a heart attack or stroke, by about 35%.
• A second study found that cumulative stress increased the risk of poor heart and brain health in two ways: by directly influencing physical well-being and increasing poor lifestyle behaviors, such as smoking and being sedentary, according to two new studies.
• “There are clear associations between psychological health and cardiovascular disease risk. These studies add to a growing body of data we have on how negative psychological health can increase the risk of heart and brain disease, They illustrate that health care professionals should be aware that negative psychological health — things like depression or anxiety — not only affect patient’s mental state of being, but also can impact their physical health and the risk for heart disease. So, these are not benign conditions, these are things for which we want to aggressively refer people to mental health professionals,” said Glenn N. Levine, M.D., FAHA, writing committee chair of the American Heart Associations’ 2021 Psychological Health, Well-Being, and the Mind-Heart-Body Connection scientific statement and master clinician and professor of medicine at Baylor College of Medicine, chief of the cardiology section at the Michael E. DeBakey VA Medical Center, both in Houston.
• AHA health information: How does stress affect the body?

Alcohol consumption may have positive and negative effects on cardiovascular disease risk

 

While past research has indicated that moderate alcohol consumption can lower one’s risk of cardiovascular disease (CVD), more recent studies suggest that moderate levels of drinking may be hazardous to heart health. A new analysis led by Boston University School of Public Health and Friedman School of Nutrition Science and Policy at Tufts University (Friedman School) now sheds new insight on this complex relationship between alcohol consumption and the progression of CVD.

Published in the journal BMC Medicine, the study found that alcohol consumption may have counteractive effects on CVD risk, depending on the biological presence of certain circulating metabolites—molecules that are produced during or after a substance is metabolized and studied as biomarkers of many diseases.

The researchers observed a total of 60 alcohol consumption-related metabolites, identifying seven circulating metabolites that link long-term moderate alcohol consumption with an increased risk of CVD, and three circulating metabolites that link this same drinking pattern with a lower risk of CVD.

The findings provide a better understanding of the molecular pathway of long-term alcohol consumption and highlight the need for and direction of further research on these metabolites to inform targeted prevention and treatment of alcohol-related CVD.

“The study findings demonstrate that alcohol consumption may trigger changes of our metabolomic profiles, potentially yielding both beneficial and harmful outcomes,” says Dr. Chunyu Liu, assistant professor of biostatistics at BUSPH and co-corresponding/co-senior author of the study along with Dr. Jiantao Ma, assistant professor in the Division of Nutrition Epidemiology and Data Science at the Friedman School. “Because the majority of our study participants are moderate alcohol consumers, our findings contribute to the ongoing discussion about the relationship between moderate alcohol drinking and heart health.

“However, rather than definitively settling that debate, this study underscores the intricate effects of alcohol consumption on cardiovascular health and generates a useful hypothesis for future investigations,” Dr. Liu says.

For the study, the researchers examined blood samples to measure the association between the cumulative average consumption of beer, wine, and liquor and 211 metabolites among 2,428 Framingham Heart Study Offspring Study participants, who are the children of participants in the long-running Boston University-based Framingham Heart Study, over 20 years. Among the participants, 636 developed CVD over the study period.

Among the 60 drinking-related metabolites, 13 metabolites had a stronger association with alcohol consumption in women than in men, perhaps due to women’s generally smaller body size and likely higher blood alcohol concentration after consuming the same amount of alcohol as men.

The results also showed that consumption of different types of alcohol was linked to different metabolomic responses, with beer consumption generating a slightly weaker association overall than wine and liquor. In roughly two-thirds of the 60 metabolites, higher plasma levels were detected in participants who consumed greater amounts of alcohol.

Branched-chain amino acids (BCAAs), were among the metabolites that were not associated with alcohol consumption.

The researchers then calculated two alcohol consumption-associated metabolite scores, which had opposite associations with the development of CVD.

“While our study presents intriguing findings, validation through state-of-the-art methods and large and diverse study populations is crucial,” Dr. Ma says. “To enhance reliability, we aim to conduct larger-scale research involving a more diverse racial and ethnic background, as the current study participants are all white. In addition, we will expand our study to integrate with other molecular markers such as genetic information to illustrate the complex relationships between alcohol consumption, metabolite features, and cardiovascular risk.”

Health, lifestyle changes protect elders from Alzheimer's

 

As more medications move toward federal approval for Alzheimer’s disease, a new study led by researchers at UC San Francisco and Kaiser Permanente Washington has found that personalized health and lifestyle changes can delay or even prevent memory loss for higher-risk older adults. 

The two-year study compared cognitive scores, risk factors and quality of life among 172 participants, of whom half had received personalized coaching to improve their health and lifestyle in areas believed to raise the risk of Alzheimer’s, such as uncontrolled diabetes and physical inactivity. These participants were found to experience a modest boost in cognitive testing, amounting to a 74% improvement over the non-intervention group. 
 
Improvements were also noted between the two groups in measurements of risk factors and quality of life, translating approximately to 145% and 8%, respectively, the researchers reported. The study publishes Nov. 27, 2023, in JAMA IM. 
 
Older adults highly motivated to make changes 
 
The study, known as SMARRT, for systematic multi-domain Alzheimer’s risk reduction trial, follows previous work from other researchers that has yielded contradictory results on the effects of health and lifestyle interventions. This study differed, though, in providing personal coaching that was customized to each participant.  
 
“This is the first personalized intervention, focusing on multiple areas of cognition, in which risk factor targets are based on a participant’s risk profile, preferences and priorities, which we think may be more effective than a one-size-fits-all approach,” said first author and lead investigator Kristine Yaffe, MD, vice chair of research in psychiatry and professor in the UCSF departments of neurology, psychiatry, and epidemiology and biostatistics. “Not only did we find a significant reduction in risk factors, this is one of only a few trials that has shown a benefit in cognition that likely translates to lower dementia risk. 
 
“In an earlier survey of 600 older adults, we found that most were concerned about Alzheimer’s disease and related dementias. They wanted to know their personal risk factors and were highly motivated to make lifestyle changes to lower dementia risk,” said Yaffe, referring to her collaboration with co-lead investigator and co-author Eric B. Larson, MD, MPH, former vice president for research and health care intervention at Kaiser Permanente Washington. 
 
Participants in the current study, as well as the earlier survey, were enrolled in Kaiser Permanente Washington and were between 70 and 89 years old. They had at least two of eight risk factors for dementia: physical inactivity, uncontrolled hypertension, uncontrolled diabetes, poor sleep, use of prescription medications associated with risk of cognitive decline, high depressive symptoms, social isolation and current smoking status. 
 
The intervention participants met with a nurse and health coach and selected specific risk factors they wanted to address. They received coaching sessions every few months to review their goals, which ranged from tracking hypertension to walking a certain number of steps per day or signing up for a class. The meetings started in person and switched to phone calls during the pandemic.  
 
Non-intervention participants were similar in age, risk factors and cognitive scores and received educational material, mailed every three months, on dementia risk reduction. 
 
Pandemic did not offset study’s positive effects 
 
“We were pleasantly surprised that the positive results of the trial were not offset by the impact of the pandemic,” said Larson, who is currently professor of medicine at University of Washington. “We know that isolation from social distancing took a heavy toll on cognition, social lives, and mental and physical health in some older adults. But participants in the intervention group fared better cognitively and had fewer risk factors after the trial, during the pandemic, than they did before.” 
 
Unlike anti-amyloid medications, risk-reduction programs are not costly, nor do they have strict eligibility criteria or require extensive monitoring for side-effects, said Yaffe, who is also affiliated with the San Francisco VA Health Care System and the UCSF Weill Institute for Neurosciences.  
 
“Hopefully in the future, treatment of Alzheimer’s and related dementias will be like cardiovascular disease management, with a combination of risk-reduction and specific drugs targeted for disease mechanisms,” she said. 
 

Faster walking speed of 4 km+/hour linked to significantly lower type 2 diabetes risk

 

Walking at a speed of 4 or more km an hour is linked to a significantly lower risk of type 2 diabetes, suggests a pooled data analysis of the available evidence, published online in the British Journal of Sports Medicine.

And the faster the speed above 4 km/hour, the lower the risk seems to be, with every 1 km increase in speed associated with a 9% reduction in risk, the findings suggest. 

While regularly nipping out for a stroll is associated with a lower risk of developing type 2 diabetes, it’s not clear what the optimal speed might be to ward off the disease, say the researchers.

The global number of adults with type 2 diabetes is currently 537 million, but is expected to reach 783 million by 2045, so a simple and inexpensive physical activity that is also associated with several other social, mental, and physical health benefits, might be an easy way of helping to stave off the disease, they add.

They looked for relevant long term studies published up to May 2023 and found 10 that were eligible for inclusion. These had all been published between 1999 and 2022 and included monitoring periods ranging from 3 to 11 years for a total of 508,121 adults from the USA, Japan, and the UK.

Pooled data analysis of the results showed that compared with strolling at less than 2 miles or 3 km/hour, an average or normal walking speed of 2-3 miles or 3-5 km/hour was associated with a 15% lower risk of type 2 diabetes, irrespective of the time spent walking.

Similarly, fairly brisk walking at a speed of 3–4 miles/hour or 5–6 km/hour was associated with a 24% lower risk of type 2 diabetes compared with strolling.

Brisk walking or striding at a speed above 4 miles or 6 km/hour was associated with a reduced risk of around 39%, equal to 2.24 fewer cases of type 2 diabetes in every 100 people.

Every 1 km/hour increase in walking speed was associated with a 9% lower risk of type 2 diabetes, with the minimal threshold of 4km/hour equal to 87 steps/min for men and 100 steps/ min for women, the findings suggest.

The researchers acknowledge that 3 studies were rated as having a moderate risk of bias while the other seven were rated as having a serious risk, principally due to inadequate adjustment for potentially influential factors and the way in which walking speed had been assessed.

Another factor to consider is reverse causality whereby participants with faster walking speed might be more likely to be physically active and have better cardiorespiratory fitness, greater muscle mass, and better overall health status. 

So the findings need to be interpreted in light of these limitations, caution the researchers. But there are plausible explanations for the findings, they explain.

Walking speed is an important indicator of overall health and a key indicator of functional capacity; faster walking speed is associated with better cardiorespiratory fitness and muscle strength, both of which are linked to diabetes risk; and brisk walking is good for weight loss, which helps to improve insulin sensitivity.

They conclude: “The present meta-analysis of cohort studies suggests that fairly brisk and brisk/striding walking, independent of the total volume of physical activity or time spent walking per day, may be associated with a lower risk of type 2 diabetes in adults. 

“While current strategies to increase total walking time are beneficial, it may also be reasonable to encourage people to walk at faster speeds to further increase the health benefits of walking.”

Stem cell transplantation benefits patients with knee osteoarthritis

 

Cell therapy represents a potential regenerative treatment for osteoarthritis. A recent analysis of all relevant published studies indicates that stem cell transplantation from different sources is effective for treating knee osteoarthritis, the most prevalent chronic joint disease.

The review and meta-analysis, which is published in the Journal of Orthopaedic Research, included 16 studies involving 875 patients with knee osteoarthritis (441 in the stem cell transplantation group and 434 in the control group). Stem cell treatment was associated with significant reductions in patient-reported pain from the third month onwards. The most significant pain relief at different postoperative months came from fat-derived and umbilical cord–derived stem cells. A patient’s own fat-derived stem cells resulted in better pain alleviation compared with those from other donors. Also, a patient’s own fat-derived stem cells led to the most effective recovery of knee joint function.

“Stem cell transplantation proved safe and effective for knee osteoarthritis treatment,” the authors wrote. “Different sources stem cells have a good effect on alleviating knee joint pain, restoring knee joint function, and minimizing patient trauma.”

Adding a few servings of whole grains linked to slower memory decline in Black people

 

Peer-Reviewed Publication

AMERICAN ACADEMY OF NEUROLOGY

Black people who eat more foods with whole grains, including some breads and cereals, quinoa, and popcorn, may have a slower rate of memory decline compared to Black people who eat fewer whole grain foods, according to a study published in the November 22, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. The researchers did not see a similar trend in white participants.

The study does not prove that eating more whole grains slows memory decline; it only shows an association.

The study found that among Black people, those who ate the most whole grains had lower levels of memory decline—equivalent to being 8.5 years younger than those who ate small amounts of whole grains.

“With Alzheimer’s disease and dementia affecting millions of Americans, finding ways to prevent the disease is a high public health priority,” said study author Xiaoran Liu, PhD, MSc, of Rush University in Chicago. “It’s exciting to see that people could potentially lower their risk of dementia by increasing their diet of whole grains by a couple of servings a day.”

The study involved 3,326 people with an average age of 75 without dementia. Of all participants, 1,999 people, or 60%, were Black. They were followed for an average of six years.

They filled out a questionnaire every three years on how often they ate whole grains. They also completed cognitive and memory tests every three years, including recalling lists of words, remembering numbers and putting them in the correct order.

Participants were then divided into five groups based on the amount of whole grains they had in their diet. The lowest group consumed less than half a serving per day, and the highest group consumed 2.7 servings per day. The Dietary Guidelines for Americans recommend at least three servings of whole grain foods daily. One serving of whole grains is equivalent to an ounce of food, such as one slice of bread, a half cup of cooked pasta or rice, an ounce of crackers or a cup of dry cereal.

Researchers found that a higher proportion of Black participants had more than one serving per day of whole grains than white participants, with 67% and 38%, respectively.

To determine rates of cognitive decline, researchers used an overall global cognition score summarizing four cognitive tests and examined their change over time.

After adjusting for factors that could affect the rate of cognitive decline, such as age, sex, education and smoking, researchers found that the global cognitive score of Black people who had the highest intake of whole grains, or more than three servings a day, declined at a rate of 0.2 standard deviation units per decade more slowly than Black people who had the lowest intake, or less than one serving per day.

“These results could help medical professionals make tailored diet recommendations,” Liu added. “More large studies are needed to validate our findings and to further investigate the effect of whole grains on cognition in different racial groups.”

A limitation of the study is that the food frequency questionnaire was self-reported, so people may not accurately remember what they ate.

Swapping pulses for common proteins and grains improves American diet

 

:  A recently published study[i] in Nutrients, an open-access peer-reviewed scientific journal, demonstrates that exchanging pulses for small amounts of typical protein sources and refined grains significantly improves the nutritional profile of the American diet.  This new research adds to the extensive established body of evidence that showcases the multiple benefits of including pulses as part of a healthy diet. 

Researchers modeled the nutritional impact of substituting servings of protein foods and/or refined grains with servings of pulses (e.g., dry peas, lentils, chickpeas, dry beans) while keeping calories consistent in the Healthy U.S.-Style Dietary Pattern identified in the 2020-2025 Dietary Guidelines for Americans.  Results showed an improved nutritional profile of the diet.  Specifically, the addition of about ¼ cup of pulses per day in place of one ounce per day of common protein foods increases fiber, a nutrient of concern, and decreases cholesterol, each by more than 10%.  Additionally, they found that substituting ½ cup of pulses daily in place of one ounce of refined grains daily also while keeping calories constant increases fiber, magnesium, copper, and potassium, a nutrient of concern, by more than 10%. 

“Our results suggest that encouraging increased pulse consumption may be an effective strategy for improving nutrient intake and achieving a healthier dietary pattern,” states author Victor Fulgoni III, PhD, of Nutrition Impact, LLC.  “Pulses (dry peas, lentils, chickpeas, beans) are excellent sources of fiber, folate and potassium and good sources of plant protein.”  The study was funded by the Coalition for the Advancement of Pulses.

The findings are consistent with the body of existing peer-reviewed studies that show the inclusion of pulses as part of a plant-forward dietary strategy imparts cardiovascular, metabolic, and gut protective effects; improves weight outcomes, low-grade inflammation, and may play a role in immune-related disease risk management.[ii]  The American Heart Association and other public health organizations recommend adding more plant-based proteins and less animal protein to reduce risk of heart disease, high blood pressure and high cholesterol.[iii]

“This research underscores the fact that pulses are a nutritional powerhouse,” said Tim McGreevy, CEO, USA Dry Pea and Lentil Council and American Pulses Association.  “They are high in fiber, plant protein and several important macronutrients.  We know this and are working with our partners to increase awareness about the nutritional benefits of regular pulse consumption.”

Pulses are so nutritious that dietary guidelines globally include them in both the vegetable and/or protein food groups or as a separate food group all together. i, [iv],[v],[vi] The Dietary Guidelines for Americans 2020 – 2025 and the USDA’s Choose My Plate indicate that beans, peas, and lentils can be considered as part of the vegetable or protein groups.

Obesity may not be the only factor to link ultra-processed foods to higher risk of mouth, throat and oesophagus cancers

Eating more ultra-processed foods (UPFs) may be associated with a higher risk of developing cancers of upper aerodigestive tract (including the mouth, throat and oesophagus), according to a new study led by researchers from the University of Bristol and the International Agency for Research on Cancer (IARC).  The authors of this international study, which analysed diet and lifestyle data on 450,111 adults who were followed for approximately 14 years, say obesity associated with the consumption of UPFs may not be the only factor to blame. The study is published today [22 November] in the European Journal of Nutrition.

Several studies have identified an association between UPF consumption and cancer, including a recent study which looked at the association between UPFs and 34 different cancers in the largest cohort study in Europe, the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

As more evidence emerges about the associations between eating UPFs and adverse health outcomes, researchers from the Bristol Medical School and IARC wanted to explore this further. Since many UPFs have an unhealthy nutritional profile, the team sought to establish whether the association between UPF consumption and head and neck cancer and oesophageal adenocarcinoma (a cancer of the oesophagus) in EPIC could be explained by an increase in body fat.

Results from the team’s analyses showed that eating 10% more UPFs is associated with a 23% higher risk of head and neck cancer and a 24% higher risk of oesophageal adenocarcinoma in EPIC. Increased body fat only explained a small proportion of the statistical association between UPF consumption and the risk of these upper-aerodigestive tract cancers.

Fernanda Morales-Berstein, a Wellcome Trust PhD student at the University of Bristol and the study’s lead author, explained: “UPFs have been associated with excess weight and increased body fat in several observational studies. This makes sense, as they are generally tasty, convenient and cheap, favouring the consumption of large portions and an excessive number of calories. However, it was interesting that in our study the link between eating UPFs and upper-aerodigestive tract cancer didn’t seem to be greatly explained by body mass index and waist-to-hip ratio.”

The authors suggest that other mechanisms could explain the association. For example, additives including emulsifiers and artificial sweeteners which have been previously associated with disease risk, and contaminants from food packaging and the manufacturing process, may partly explain the link between UPF consumption and upper-aerodigestive tract cancer in this study.

However, Fernanda Morales-Berstein and colleagues did add caution regarding their findings and suggest that the associations between UPF consumption and upper-aerodigestive tract cancers found in the study could be affected by certain types of bias. This would explain why they found evidence of an association between higher UPF consumption and increased risk of accidental deaths, which is highly unlikely to be causal.

George Davey Smith, Professor of Clinical Epidemiology and Director of the MRC Integrative Epidemiology Unit at the University of Bristol, and co-author on the paper, said: “UPFs are clearly associated with many adverse health outcomes, yet whether they actually cause these, or whether underlying factors such as general health-related behaviours and socioeconomic position are responsible for the link, is still unclear, as the association with accidental deaths draws attention to.”

Inge Huybrechts, Team head of the Lifestyle exposures and interventions team at IARC, added: “Cohorts with long-term dietary follow-up intake assessments, considering also contemporary consumption habits, are needed to replicate these study’s findings, as the EPIC dietary data were collected in the 1990s, when the consumption of UPFs was still relatively low. As such associations may potentially be stronger in cohorts including recent dietary follow-up assessments.”

Further research is needed to identify other mechanisms, such as food additives and contaminants, which may explain the links observed. However, based on the finding that body fat did not greatly explain the link between UPF consumption and upper-aerodigestive tract cancer risk in this study, Fernanda Morales-Berstein, suggested: “Focussing solely on weight loss treatment, such as Semaglutide, is unlikely to greatly contribute to the prevention of upper-aerodigestive tract cancers related to eating UPFs.”

Dr Helen Croker, Assistant Director of Research and Policy at World Cancer Research Fund, added: “This study adds to a growing pool of evidence suggesting a link between UPFs and cancer risk. The association between a higher consumption of UPFs and an increased risk of developing upper-aerodigestive tract cancer supports our Cancer Prevention Recommendations to eat a healthy diet, rich in wholegrains, vegetables, fruit, and beans.” 

Why do some people get headaches from drinking red wine?

A red wine may pair nicely with the upcoming Thanksgiving meal. But for some people, drinking red wine even in small amounts causes a headache. Typically, a “red wine headache” can occur within 30 minutes to three hours after drinking as little as a small glass of wine.

What in wine causes headaches?

In a new study, scientists at the University of California, Davis, examined why this happens – even to people who don’t get headaches when drinking small amounts of other alcoholic beverages. Researchers think that a flavanol found naturally in red wines can interfere with the proper metabolism of alcohol and can lead to a headache. The study was published in the journal Scientific Reports.

The headache culprit: Quercetin, a flavanol

This flavanol is called quercetin and it is naturally present in all kinds of fruits and vegetables, including grapes. It’s considered a healthy antioxidant and is even available in supplement form. But when metabolized with alcohol, it can be problematic.

“When it gets in your bloodstream, your body converts it to a different form called quercetin glucuronide,” said wine chemist and corresponding author Andrew Waterhouse, professor emeritus with the UC Davis Department of Viticulture and Enology. “In that form, it blocks the metabolism of alcohol.”

Acetaldehyde toxin buildup leads to flushing, headache, nausea

As a result, people can end up accumulating the toxin acetaldehyde, explains lead author Apramita Devi, postdoctoral researcher with the UC Davis Department of Viticulture and Enology.

“Acetaldehyde is a well-known toxin, irritant and inflammatory substance,” said Devi. “Researchers know that high levels of acetaldehyde can cause facial flushing, headache and nausea.”

The medication disulfiram prescribed to alcoholics to prevent them from drinking causes these same symptoms. Waterhouse said that’s because the drug also causes the toxin to build up in the body when normally an enzyme in the body would break it down. About 40% of the East Asian population also has an enzyme that doesn’t work very well, allowing acetaldehyde to build up in their system.

“We postulate that when susceptible people consume wine with even modest amounts of quercetin, they develop headaches, particularly if they have a preexisting migraine or another primary headache condition,” said co-author Morris Levin, professor of neurology and director of the Headache Center at the University of California, San Francisco. “We think we are finally on the right track toward explaining this millennia-old mystery.  The next step is to test it scientifically on people who develop these headaches, so stay tuned.”

Sunlight increases headache-causing flavanol in grapes

Waterhouse said levels of this flavanol can vary dramatically in red wine.

“Quercetin is produced by the grapes in response to sunlight,” Waterhouse said. “If you grow grapes with the clusters exposed, such as they do in the Napa Valley for their cabernets, you get much higher levels of quercetin. In some cases, it can be four to five times higher.”

Levels of quercetin can also differ depending on how the wine is made, including skin contact during fermentation, fining processes and aging.

Clinical trial on wine headaches

Scientists will next compare red wines that contain a lot of quercetin with those that have very little to test their theory about red wine headaches on people. This small human clinical trial, funded by the Wine Spectator Scholarship Foundation, will be led by UCSF.

Researchers said there are still many unknowns about the causes of red wine headaches. It’s unclear why some people seem more susceptible to them than others. Researchers don’t know if the enzymes of people who suffer from red wine headaches are more easily inhibited by quercetin or if this population is just more easily affected by the buildup of the toxin acetaldehyde.

“If our hypothesis pans out, then we will have the tools to start addressing these important questions,” Waterhouse said.

Poor nutrition contributes to depression, anxiety and risk of diabetes

 

People with diabetes (Diabetes Mellitus) are two-to-three times more likely to have depression than people without, according to the Centers for Disease Control. Current treatment includes therapy, medicine, or both. However, the understanding of the multifaceted relationship between nutrition, mental health, and DM is relatively new in scientific discourse. Mason researchers sought to learn about the connection between nutrition, diabetes, and mental health. 

Two literature reviews from assistant professor Raedeh Basiri show that poor nutrition plays a dual role, contributing to both the risk of developing type 2 diabetes and impacting mental health, including anxiety and depression. According to the findings, mental disorders, such as depression and anxiety, increase the risk of developing type 2 diabetes, and diabetes is also linked with an increased risk of developing depression and anxiety. Nutrition interventions can aid in both of these health issues. 

“Our findings underscore the pivotal role of dietary choices in reducing the risks associated with both diabetes and mental health. The implications of these findings extend beyond the scientific community, as they hold promise for informing public health policies, health care practices, and dietary recommendations that can positively impact the general population, said Basiri, the lead author of the papers.  

“Ultimately, the research seeks to empower individuals to make informed and health-promoting dietary choices that can serve as a proactive strategy for the prevention and management of diabetes, as well as anxiety and depression,” Basiri said. 

More specifically, the team’s findings provide a comprehensive view of the relationship between dietary patterns, health outcomes, and the critical role of eating behavior in the context of type 2 diabetes and mental health. 

The team found that eating foods rich in fresh fruits and vegetables, whole grains, lean protein, and low-fat dairy is associated with a reduced risk of type 2 diabetes and mental health disorders such as depression and anxiety. Conversely, a diet with a large number of processed foods was found to have a negative effect, increasing the susceptibility to type 2 diabetes, depression, and anxiety.  

Additionally, the research team found that a diet with energy-dense foods but lacking in essential nutrients, such as omega-3 fatty acids, vitamin D, vitamin E, vitamin B6, vitamin B12, folate, selenium, chromium, and magnesium, is associated with the exacerbation of unfavorable symptoms in both mental health and the development of type 2 diabetes. This connection emphasizes the importance of nutrient-rich dietary choices for overall health and well-being. 

“Current scientific evidence underscores the potential benefits of adopting a well-balanced dietary regimen in decreasing anxiety and depression symptoms while enhancing glycemic control in individuals with diabetes,” said Basiri. 

“Exploring the Interrelationships between Diabetes, Nutrition, Anxiety, and Depression: Implications for Treatment and Prevention Strategies” was published in Nutrients in September 2023 with Mason Master of Science in Nutrition students Blessing Seidu and Mark Rudich as co-authors.  

“Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence” was published in Nutrients in September 2023 with Seidu and Mason Professor Lawrence Cheskin as co-authors. 

Following a Mediterranean diet reduces the risk of cognitive decline in older people

 Old people who follow a Mediterranean diet are at a lower risk of cognitive decline, according to a study published in the journal Molecular Nutrition and Food Research. The study provides new evidence for a better understanding of the biological mechanisms related to the impact of the diet on cognitive health in the ageing population.

The study is led by Mireia Urpí-Sardá, adjunct lecturer and member of the Biomarkers and Nutritional & Food Metabolomics research group of the Faculty of Pharmacy and Food Sciences, the Institute for Nutrition and Food Safety (INSA-UB), the Food and Nutrition Torribera Campus of the University of Barcelona, and the CIBER on Frailty and Healthy Ageing (CIBERFES).

This European study, part of the Joint Programming Initiative “A Healthy Diet for a Healthy Life” (JPI HDHL) was carried out over twelve years and it involved 840 people over 65 years of age (65% of whom were women) in the Bourdeaux and Dijon regions of France.

Healthy diet and cognitive performance

According to Cristina Andrés-Lacueva, UB professor and head of the CIBERFES group, “within the framework of the study, a dietary metabolomic index has been designed —based on biomarkers obtained from the participants’ serum— on the food groups that form part of the Mediterranean diet. Once this index is known, its association with cognitive impairment is evaluated”.

in the study, baseline levels of saturated and unsaturated fatty acids, gut microbiota-derived polyphenol metabolites and other phytochemicals in serum that reflect individual bioavailability were chosen as biomarkers. Some of these indicators have not only been recognized as marks of exposure to the main food groups of the Mediterranean diet but have also been held responsible for the health benefits of the Mediterranean dietary pattern.

The metabolome or set of metabolites — related to food and derived from gut microbiota activity — was studied through a large-scale quantitative metabolomic analysis from the serum of the participants without dementia, from the beginning of the study. Cognitive impairment was assessed by five neuropsychological tests over twelve years.

As a result, the study reveals a protective association between the score of the Mediterranean diet based on serum biomarkers and cognitive decline in older people.

Biomarkers to study the benefits of the diet

According to Mercè Pallàs, professor at the UB Neurosciences Institute (UBneuro), "the use of dietary pattern indices based on food-intake biomarkers is a step forward towards the use of more accurate and objective dietary assessment methodologies that take into account important factors such as bioavailability".

Expert Alba Tor-Roca, first author of the study and CIBERFES researcher at the UB, explains that “we found that adherence to Mediterranean diet assessed by a panel of dietary biomarkers is inversely associated with long-term cognitive decline in older people. These results support the use of these indicators in long-term follow-up assessments to observe the health benefits associated with the Mediterranean diet or other dietary patterns and therefore, guide personalized counselling at older ages”.

14-hour fasting improves hunger, mood and sleep

 

Reports and Proceedings

KING'S COLLEGE LONDON

Eating in a ten-hour window is associated with higher energy and mood and lower hunger levels, new results from the largest UK community science study of its kind shows1 .

Results from the trial are presented today by researchers from King’s College London at the European Nutrition Conference.

Intermittent fasting (IF), or restricting your food consumption to a set window, is a popular weight loss regime. A ten-hour window means limiting your daily eating schedule to ten hours and fasting for the remaining 14 hours. For example, if you eat your first bite at 9am, you must eat your last bite by 7pm. 

Despite some IF advocates commonly promoting restrictive eating windows as low as six hours, findings detailed in the abstract show even eating within a less restrictive window of ten hours still has positive health benefits, such as changes in mood, energy and hunger. 

Those who were consistent with their eating window had greater benefits than those who varied their eating window day to day.

Dr Sarah Berry from King’s College London and chief scientist at ZOE said: “This is the largest study outside of a tightly controlled clinic to show that intermittent fasting can improve your health in a real world setting. What's really exciting is that the findings show that you don’t have to be very restrictive to see positive results. A ten-hour eating window, which was manageable for most people, and improved mood, energy levels and hunger. We found for the first time that those who practised time-restricted eating, but were not consistent day to day, did not have the same positive health effects as those who were dedicated every day. ”  

37,545 people on the ZOE Health app completed the core intervention period of three weeks. Participants were asked to eat as normal for the first week and then a ten-hour eating window for two weeks. 

More than 36,231 participants opted for additional weeks and 27,371 users were classified as highly engaged. Highly engaged participants were 78% female, with a mean age of 60 and a BMI of 25.6. 

Participants with a longer eating window before the intervention saw an even greater benefit to their health.

Kate Bermingham PhD, from King’s College London and ZOE, said: “This study adds to the growing body of evidence showing the importance of how you eat. The health impact of food is not just what you eat but the time at which you choose to consume your meals, and eating window is an important dietary behaviour that can be beneficial for health. Findings shows that we don’t need to be eating all the time. Many people will feel satiated and even lose weight if they restrict their food to a ten-hour window.” 

Shortening sleep time increases diabetes risk in women

 -A new study at Columbia University has found that shortening sleep by just 90 minutes for six weeks increased insulin resistance in women who are accustomed to getting adequate sleep. The effect was even more pronounced in postmenopausal women.

The recommended amount of sleep for optimal health is between seven and nine hours per night, yet about one-third of Americans get less than the minimum recommended amount.  

The findings are the first to show that a mild sleep deficit, maintained for six weeks, causes changes in the body that raise the risk of developing diabetes in women. Previous trials showing the adverse impact on insulin sensitivity included mostly men and focused on the effects of very severe sleep restriction over a short period of time.  

Women and sleep 

The new study looked at women in particular because studies suggest that poor sleep may have a greater impact on women’s cardiometabolic health than men’s.  

“Throughout their lifespan, women face many changes in their sleep habits due to childbearing, child-rearing, and menopause,” says study leader Marie-Pierre St-Onge, PhD, associate professor of nutritional medicine and director of the Center of Excellence for Sleep and Circadian Research at Columbia University Vagelos College of Physicians and Surgeons. “And more women than men have the perception they aren’t getting enough sleep.” 

Studying the health impacts of chronic sleep loss is difficult. Some studies, performed in a laboratory setting, have shown that a brief period of total or partial sleep deprivation impairs glucose metabolism. But such studies do not reflect the typical experience of being mildly sleep-deprived, which means getting by on roughly six hours of sleep for long periods of time.  

Study design 

To look at the impact of mild, chronic sleep deprivation, the researchers enrolled 38 healthy women, including 11 postmenopausal women, who routinely slept at least seven hours each night. 

In the study, the participants underwent two study phases in random order. In one phase, they were asked to maintain their adequate sleep; in the other, they were asked to delay their bedtime for an hour and a half, shortening their total sleep time to around six hours. Each of these phases lasted for six weeks. 

Remarkably, all of the study participants were able to reduce their nightly sleep duration during the arduous six-week sleep-restriction phase. Compliance with sleep schedules was measured with wearable devices. Throughout the study, the researchers measured insulin, glucose, and body fat. 

Study results 

The study found that curtailing sleep by 90 minutes for six weeks increased fasting insulin levels by over 12% overall and by more than 15% among premenopausal women.  

Insulin resistance increased by nearly 15% overall and by more than 20% among postmenopausal women. Average blood sugar levels remained stable for all participants throughout the study. 

“Over a longer period of time, ongoing stress on insulin-producing cells could cause them to fail, eventually leading to type 2 diabetes,” St-Onge says. 

Although increased abdominal fat is a key driver of insulin resistance, the researchers found that the effects of sleep loss on insulin resistance were not due to increases in fat.  

“The fact that we saw these results independent of any changes in body fat, which is a known risk factor for type 2 diabetes, speaks to the impact of mild sleep reduction on insulin-producing cells and metabolism,” St-Onge says.  

“The bottom line is that getting adequate sleep each night may lead to better blood sugar control and reduced risk for type 2 diabetes, especially among postmenopausal women.” 

Next steps 

In recent years, epidemiological studies have suggested that people whose sleep varies from day to day also have a higher risk of developing diabetes. St-Onge and colleagues will look at whether stabilizing sleep patterns among people with variable sleep schedules improves blood sugar control. Additional studies will look at whether restoring sleep for people who routinely don’t get enough may improve glucose metabolism. 

Gargling with salt water may help prevent Covid hospitalization

 As Covid and its health effects move into a fourth year, those who become infected may be searching for remedies to improve their respiratory symptoms and keep them out of the hospital. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Anaheim, Calif. determined that both a low- and high-dose saline regimen appeared to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections.

“Between 2020 and 2022, individuals aged 18-65 years with positive PCR test for SARS-CoV-2 infection were randomly selected to undergo low- or high-dose saline regimens for 14 days,” says Sebastian Espinoza, lead author of the study. “The low- and high-saline solutions consisted of 2.13 grams and 6 grams of salt dissolved in 8 ounces of warm water, respectively. Gargling and nasal rinsing was done four times a day for 14 days. Primary outcomes included frequency and duration of symptoms associated with SARS-CoV-2 infection; secondary outcomes included hospital or ICU admission, mechanical ventilatory support, or death. Exclusion criteria were chronic hypertension or participation in another interventional study. Those on the low- and high-dose saline solutions, as well as those in the reference population, had similar rates of vaccination.”

58 individuals were allocated to either the low (27) or high (28) saline regimens; 3 were lost to follow-up. There were no significant differences in the primary or secondary outcomes of the study between these two groups. During the study period, 9,398 individuals with positive SARS-CoV-2 infection were evaluated and were the reference population. The hospitalization rates in the low- (18.5%) and high- (21.4%) saline regimens were significantly lower than in the reference population (58.8%.) No significant differences were noted in other outcomes among these groups.

“Our goal was to examine saline nasal irrigation and gargling for possible association to improved respiratory symptoms associated with coronavirus infection,” says Jimmy Espinoza, MD, co-author of the study. “We found that both saline regimens appear to be associated with lower hospitalization rates compared to controls in SARS-CoV-2 infections. We hope more studies can be done to further investigate the association.”

Any activity is better for your heart than sitting – even sleeping

Peer-Reviewed Publication

UNIVERSITY COLLEGE LONDON

The study, supported by the British Heart Foundation (BHF) and published in the European Heart Journal, is the first to assess how different movement patterns throughout the 24-hour day are linked to heart health. It is the first evidence to emerge from the international Prospective Physical Activity, Sitting and Sleep (ProPASS) consortium.

Cardiovascular disease, which refers to all diseases of the heart and circulation, is the number one cause of mortality globally. In 2021, it was responsible for one in three deaths (20.5m), with coronary heart disease alone the single biggest killer. Since 1997, the number of people living with cardiovascular disease across the world has doubled and is projected to rise further1.

In this study, researchers at UCL analysed data from six studies, encompassing 15,246 people from five countries, to see how movement behaviour across the day is associated with heart health, as measured by six common indicators2. Each participant used a wearable device on their thigh to measure their activity throughout the 24-hour day and had their heart health measured.

The researchers identified a hierarchy of behaviours that make up a typical 24-hour day, with time spent doing moderate-vigorous activity providing the most benefit to heart health, followed by light activity, standing and sleeping compared with the adverse impact of sedentary behaviour3.

The team modelled what would happen if an individual changed various amounts of one behaviour for another each day for a week, in order to estimate the effect on heart health for each scenario. When replacing sedentary behaviour, as little as five minutes of moderate-vigorous activity had a noticeable effect on heart health.

For a 54-year-old woman with an average BMI of 26.5, for example, a 30-minute change translated into a 0.64 decrease in BMI, which is a difference of 2.4%. Replacing 30 minutes of daily sitting or lying time with moderate or vigorous exercise could also translate into a 2.5 cm (2.7%) decrease in waist circumference or a 1.33 mmol/mol (3.6%) decrease in glycated haemoglobin4.

Dr Jo Blodgett, first author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “The big takeaway from our research is that while small changes to how you move can have a positive effect on heart health, intensity of movement matters. The most beneficial change we observed was replacing sitting with moderate to vigorous activity – which could be a run, a brisk walk, or stair climbing – basically any activity that raises your heart rate and makes you breathe faster, even for a minute or two.”

The researchers pointed out that although time spent doing vigorous activity was the quickest way to improve heart health, there are ways to benefit for people of all abilities – it’s just that the lower the intensity of the activity, the longer the time is required to start having a tangible benefit. Using a standing desk for a few hours a day instead of a sitting desk, for example, is a change over a relatively large amount of time but is also one that could be integrated into a working routine fairly easily as it does not require any time commitment.

Those who are least active were also found to gain the greatest benefit from changing from sedentary behaviours to more active ones.

Professor Emmanuel Stamatakis, joint senior author of the study from the Charles Perkins Centre and Faculty of Medicine and Health at the University of Sydney, said: “A key novelty of the ProPASS consortium is the use of wearable devices that better differentiate between types of physical activity and posture, allowing us to estimate the health effects of even subtle variations with greater precision.”

Though the findings cannot infer causality between movement behaviours and cardiovascular outcomes, they contribute to a growing body of evidence linking moderate to vigorous physical activity over 24 hours with improved body fat metrics. Further long-term studies will be crucial to better understanding the associations between movement and cardiovascular outcomes.

Professor Mark Hamer, joint senior author of the study from UCL Surgery & Interventional Science and the Institute of Sport, Exercise & Health, said: “Though it may come as no surprise that becoming more active is beneficial for heart health, what’s new in this study is considering a range of behaviours across the whole 24-hour day. This approach will allow us to ultimately provide personalised recommendations to get people more active in ways that are appropriate for them.”

James Leiper, Associate Medical Director at the British Heart Foundation, said: “We already know that exercise can have real benefits for your cardiovascular health and this encouraging research shows that small adjustments to your daily routine could lower your chances of having a heart attack or stroke. This study shows that replacing even a few minutes of sitting with a few minutes of moderate activity can improve your BMI, cholesterol, waist size, and have many more physical benefits.

“Getting active isn’t always easy, and it’s important to make changes that you can stick to in the long-term and that you enjoy – anything that gets your heart rate up can help. Incorporating ‘activity snacks’ such as walking while taking phone calls, or setting an alarm to get up and do some star jumps every hour is a great way to start building activity into your day, to get you in the habit of living a healthy, active lifestyle.”