Heart healthy behaviors may help reverse rapid cell aging

 

The benefits gained with higher lifestyle scores may be associated with the positive influence of heart disease risk factors on the aging of the body and its cells, finds a new study in the Journal of the American Heart Association

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Research Highlights:

• The benefits gained from better heart health may be related to a process involved in the aging of the body and its cells, researchers found in a study of more than 5,000 adults with a mean age of 56 years.
• People with rapid cell aging may offset the increased risk of heart disease, stroke and death by managing their heart disease risk factors and adopting more heart-healthy behaviors, researchers said.

The benefit of better heart health may be associated with the positive impact of heart healthy lifestyle factors on biological aging (the age of the body and its cells), according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

“Our study findings tell us that no matter what your actual age is, better heart-healthy behaviors and managing heart disease risk factors were associated with a younger biological age and a lower risk of heart disease and stroke, death from heart disease and stroke and death from any cause,” said Jiantao Ma, Ph.D., senior study author and an assistant professor in the division of nutrition epidemiology and data science at the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

This study analyzed whether a chemical modification process known as DNA methylation, which regulates gene expression, may be one mechanism by which cardiovascular disease health factors affect cell aging and the risk of death. DNA methylation levels are the most promising biomarker to estimate biological age. To some degree, biological age is determined by your genetic makeup, and it can also be influenced by lifestyle factors and stress.

Researchers examined health data for 5,682 adults (mean age of 56 years; 56% of participants were women) who were enrolled in the Framingham Heart Study, an ongoing, large, multigenerational research project aimed at identifying risk factors for heart disease. Using interviews, physical exams and laboratory tests, all participants were assessed using the American Heart Association’s Life’s Essential 8 tool. The tool scores cardiovascular health between 0-100 (with 100 being the best) using a composite of four behavioral measures (dietary intake, physical activity, hours slept per night and smoking status) and four clinical measurements (body mass index, cholesterol, blood sugar and blood pressure). Each participant was also assessed using four tools that estimate biological age based on DNA methylation and a fifth tool that assesses a person’s genetic tendency towards accelerated biological aging. Participants were followed for 11-14 years for new-onset cardiovascular disease, cardiovascular death or death from any cause.

The analysis found:

• For each 13-point increase in an individual’s Life’s Essential 8 score, the risk of developing cardiovascular disease for the first time was reduced by about 35%, death from cardiovascular disease was reduced by 36% and death from any cause was reduced by 29%.
• In participants with a genetic risk profile making them more likely to have an accelerated biological age, the Life’s Essential 8 score had a larger impact on outcomes potentially via DNA methylation, i.e., DNA methylation accounted for 39%, 39%, and 78% reduction in the risk of cardiovascular disease , cardiovascular death and all-cause death, respectively.
• Overall, about 20% of the association between Life’s Essential 8 scores and cardiovascular outcomes was estimated to be due to the impact of cardiovascular health factors on DNA methylation; in contrast, for participants at higher genetic risk, the association was almost 40%.

“While there are a few DNA methylation-based, biological age calculators commercially available, we don’t have a good recommendation regarding whether people need to know their epigenetic age,” Ma said. “Our message is that everyone should be mindful of the eight heart disease and stroke health factors: eat healthy foods; be more active; quit tobacco; get healthy sleep; manage weight; and maintain healthy cholesterol, blood sugar and blood pressure levels.”

Randi Foraker, Ph.D., M.A., FAHA, co-author of the Life’s Essential 8: Updating and Enhancing the American Heart Association’s Construct of Cardiovascular Health, said the findings are consistent with prior research.

“We know that modifiable risk factors and DNA methylation are independently associated with cardiovascular disease. What this study adds is that DNA methylation may serve as a mediator between risk factors and cardiovascular disease,” said Foraker, who is a professor of medicine at the Institute for Informatics, Data Science and Biostatistics and director of the Center for Population Health Informatics, both at Washington University School of Medicine in St. Louis, Missouri. “The study highlights how cardiovascular health can impact biological aging and has important implications for healthy aging and prevention of cardiovascular disease and potentially other health conditions.”

Study details, background and design:

• The study analyzed health data for a subgroup of participants who attended the Framingham Heart Study exams in the offspring group from 2005 to 2008 and the third-generation group from 2008 to 2011.   
• Participants were followed for an average of 14 years for children of original participants and 11 years for the grandchildren.
• Health outcomes for the analysis included the development of cardiovascular disease (coronary heart disease, heart attack, stroke or heart failure), death from any cardiovascular disease or death from any cause.
• Results were adjusted for sex, age and alcohol use. Results for all-cause death were adjusted for the presence of cancer (excluding non-melanoma skin cancer) or heart disease at study enrollment. Participants already diagnosed with heart disease at study enrollment were excluded from the analysis of new-onset cardiovascular disease.
• The four tools to measure DNA methylation-based epigenetic age scores were based on established algorithms for DunedinPACE Score, PhenoAge, DNAmTL and GrimAge. A fifth tool, GrimAge PGS, assessed genetic tendency towards accelerated biological aging.

Because the study is an analysis of previously collected health data, it cannot prove a cause-and-effect relationship between cardiovascular health risk factors and DNA methylation. In addition, DNA methylation measures were  from a single time point, which limits the validity of the mediation effect. The study’s findings are also limited because the participants were predominantly of European ancestry, so the interactions of Life’s Essential 8 and genetic aging found in this study may not be generalizable to people of other races or ethnicities.

“Currently, we are expanding our research to include people of other racial and ethnic groups to further investigate the relationship of cardiovascular risk factors and DNA methylation,” Ma said.

According to the American Heart Association’s 2024 Heart Disease and Stroke Statistics, heart disease and stroke claimed more lives in the U.S. in 2021 than all forms of cancer and chronic lower respiratory disease combined, and also accounted for approximately 19.91 million global deaths.

Too much exercise could actually trigger a hot flash

 

New study suggests that despite significant benefits of physical activity, acute increases in activity could increase the odds of hot flashes reported during waking and sleeping periods

Hot flashes affect roughly 80% of women during the years around menopause. Despite how common they are and how much research has been conducted relative to what causes them, much remains unknown. A new study suggests that acute changes in physical activity, temperature, and humidity may play a role in the hot flash experience. Results of the survey are published online today in Menopause, the journal of The Menopause Society.

As one of the most frequently experienced menopause symptoms, hot flashes are sudden heat dissipation events that often involve an increase in heat transfer from the body’s core to the skin, as well as sweating. Previous medical studies have shown that a reduction in estradiol levels during the menopause transition leads to changes in the hypothalamus that control body temperature.

Physical activity has many benefits for health and wellness. However, physical activity can increase body temperature and, therefore, has been suspected in influencing the hot flash experience. In a previous study, all women who reported a history of hot flashes experienced a hot flash in response to acute laboratory exercise, whereas asymptomatic women did not exhibit the same response. But few studies to date have used ambulatory monitoring to study the effect of physical activity on hot flashes.

More recent results have shown that performing greater amounts of moderate physical activity than usual in a day was related to more subjectively reported hot flashes. However, researchers acknowledged that it was equally important to objectively evaluate hot flashes through physical monitoring because not all hot flashes are noticeable, especially at night when women may not wake up as a result of a hot flash.

Beyond exercise, researchers have also theorized that ambient temperature and humidity also may have an effect on hot flashes, but the results in natural settings have been less clear, including the fact that the relationship between temperature and hot flashes may be different between sleep and wake periods.

This newest study involved nearly 200 participants across the three menopause stages (premenopause, perimenopause, and postmenopause). Data indicate that there are significantly higher odds of acute increases in physical activity preceding both objective and subjective hot flashes during waking and sleeping periods. In addition, restlessness and increased microclimate temperature at night may precede hot flashes, suggesting that certain behavior measures, such as using lighter blankets and fans, may be beneficial.

Survey results are published in the article “Acute increases in physical activity and temperature are associated with hot flash experience in midlife women.”

“This study shows a link between increases in physical activity and subsequent subjective and objective hot flashes during both waking and sleeping periods. Clinicians may advise patients of this link while acknowledging the multiple well-known benefits of physical activity. Because temperature during sleep affected the odds of having a hot flash, modifications such as the use of lighter-weight blankets and sleepwear, as well as keeping the room temperature cooler, may help with nighttime hot flashes,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

For more information about menopause and healthy aging, visit www.menopause.org.

Introducing peanut in infancy prevents peanut allergy into adolescence

 

Peer-Reviewed Publication

NIH/NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

 

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SILHOUETTES OF INFANTS, YOUNG CHILDREN AND TEENAGERS, ALONG WITH ILLUSTRATIONS OF LUNCH-FOOD CONTAINERS TYPICAL FOR EACH AGE GROUP.

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CREDIT: NIAID

Feeding children peanut products regularly from infancy to age 5 years reduced the rate of peanut allergy in adolescence by 71%, even when the children ate or avoided peanut products as desired for many years. These new findings, from a study sponsored and co-funded by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID), provide conclusive evidence that achieving long-term prevention of peanut allergy is possible through early allergen consumption. The results were published today in the journal NEJM Evidence. 

“Today’s findings should reinforce parents’ and caregivers’ confidence that feeding their young children peanut products beginning in infancy according to established guidelines can provide lasting protection from peanut allergy,” said NIAID Director Jeanne Marrazzo, M.D., M.P.H. “If widely implemented, this safe, simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year.”

The new research findings come from the LEAP-Trio study, which builds on the seminal results of the Learning Early About Peanut Allergy (LEAP) clinical trial and the subsequent LEAP-On study, both sponsored and co-funded by NIAID. 

During the LEAP trial, half of the participants regularly consumed peanut products from infancy until age 5 years, while the other half avoided peanut during that period. Researchers found that early introduction of peanut products reduced the risk of peanut allergy at age 5 by 81%. Subsequently, children from LEAP who participated in LEAP-On were asked to avoid eating peanut products from ages 5 to 6 years. Investigators found that most children from the original peanut-consumption group remained protected from peanut allergy at age 6. 

The LEAP investigators designed the LEAP-Trio study to test whether the protection gained from early consumption of peanut products would last into adolescence if the children could choose to eat peanut products in whatever amount and frequency they wanted. Those children who were allergic to peanut at age 6 were advised to continue avoiding it.  

The study team enrolled 508 of the original 640 LEAP trial participants—nearly 80%—into the LEAP-Trio study. The children averaged 13 years of age at enrollment. Two hundred and fifty-five participants had been in the LEAP peanut-consumption group and 253 in the LEAP peanut-avoidance group. 

The LEAP-Trio study team assessed the adolescents for peanut allergy primarily through an oral food challenge. This involved giving participants gradually increasing amounts of peanut in a carefully controlled setting to determine if they could safely consume at least 5 grams of peanut, the equivalent of more than 20 peanuts. The study team also surveyed participants about their recent patterns of peanut consumption and verified the self-reports through measurements of peanut in dust from participants’ beds, a technique previously validated by LEAP investigators. 

The LEAP-Trio investigators found that 15.4% of participants from the early childhood peanut-avoidance group and 4.4% from the early childhood peanut-consumption group had peanut allergy at age 12 or older. These percentages reflected 38 of 246 participants from the peanut-avoidance group and 11 of 251 from the peanut-consumption group. (Complete data was unavailable for 11 of the 508 participants enrolled.) These results showed that regular, early peanut consumption reduced the risk of peanut allergy in adolescence by 71% compared to early peanut avoidance. 

The researchers also found that although participants in the LEAP peanut-consumption group ate more peanut products throughout childhood than the other participants overall, the frequency and amount of peanut consumed varied widely in both groups and included periods of not eating peanut products. This demonstrated that the protective effect of early peanut consumption lasted without the need to eat peanut products consistently throughout childhood and early adolescence. 

For detailed advice on how to safety introduce peanut into an infant’s diet, consult the Addendum Guidelines for the Prevention of Peanut Allergy in the United States.

The NIAID-funded Immune Tolerance Network (ITN) conducted LEAP, LEAP-On and LEAP-Trio under the leadership of Gideon Lack, M.D. Dr. Lack is a professor of pediatric allergy at King's College London and head of the Children's Allergy Clinical Academic Group in the KHP Institute of Women and Children's Health at Evelina London.

Additional information about the LEAP-Trio study is available at ClinicalTrials.gov under study identifier NCT03546413.

Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population

Source:

https://bmjmedicine.bmj.com/content/3/1/e000451

 Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke. For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99).

Conclusions Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

Health and economic benefits of breastfeeding quantified

 

Peer-Reviewed Publication

PLOS

 

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HEALTH BENEFITS AND HEALTHCARE SAVINGS ASSOCIATED TO BREASTFEEDING INFOGRAPHIC.

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CREDIT: BERENGERE CHABANIS, CC0 (HTTPS://CREATIVECOMMONS.ORG/PUBLICDOMAIN/ZERO/1.0/)

Breastmilk can promote equitable child health and save healthcare costs by reducing childhood illnesses and healthcare utilization in the early years, according to a new study published this week in the open-access journal PLOS ONE by Tomi Ajetunmobi of the Glasgow Centre for Population Health, Scotland, and colleagues.

Breastfeeding has previously been found to promote development and prevent disease among infants. In Scotland – as well as other developed countries – low rates of breastfeeding in more economically deprived areas are thought to contribute to inequalities in early childhood health. However, government policies to promote child health have made little progress and more evidence on the effectiveness of interventions may be needed.

In the new study, researchers used administrative datasets on 502,948 babies born in Scotland between 1997 and 2009. Data were available on whether or not infants were breastfed during the first 6-8 weeks, the occurrence of ten common childhood conditions from birth to 27 months, and the details of hospital admissions, primary care consultations and prescriptions.

Among all infants included in the study, 27% were exclusively breastfed, 9% mixed fed and 64% formula fed during the first 6-8 weeks of life. The rates of exclusively breastfed infants ranged from 45% in the least deprived areas to 13% in the most deprived areas.

The researchers found that, within each quintile of deprivation, exclusively breastfed infants used fewer healthcare services and incurred lower costs compared to infants fed any formula milk. On average, breastfed infants had lower average costs of hospital care per admission (£42) compared to formula-fed infants (£79) in the first six months of life and fewer GP consultations (1.72, 95% CI: 1.66 - 1.79) than formula-fed infants (1.92 95% CI: 1.88 – 1.94). At least £10 million of healthcare costs could have been avoided if all formula-fed infants had instead been exclusively breastfed for the first 6-8 weeks of life, the researchers calculated.

The authors conclude that breastfeeding has a significant health and economic benefit and that increasing breastfeeding rates in the most deprived areas could contribute to the narrowing of inequalities in the early years.

 The freely available article in PLOS ONE: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0300267

Eating more ultra-processed foods tied to cognitive decline, stroke

 

– People who eat more ultra-processed foods like soft drinks, chips and cookies may have a higher risk of having memory and thinking problems and having a stroke than those who eat fewer processed foods, according to a new study published in the May 22, 2024, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study does not prove that eating ultra-processed foods causes memory and thinking problems and stroke. It only shows an association.

Ultra-processed foods are high in added sugar, fat and salt, and low in protein and fiber. They include soft drinks, salty and sugary snacks, ice cream, hamburger, canned baked beans, ketchup, mayonnaise, packaged breads and flavored cereals. Unprocessed or minimally processed foods include meats such as simple cuts of beef, pork and chicken, and vegetables and fruits.

“While a healthy diet is important in maintaining brain health among older adults, the most important dietary choices for your brain remain unclear,” said study author W. Taylor Kimberly, MD, PhD, of Massachusetts General Hospital in Boston. “We found that increased consumption of ultra-processed foods was associated with a higher risk of both stroke and cognitive impairment, and the association between ultra-processed foods and stroke was greater among Black participants.”

For the study, researchers looked at 30,239 people age 45 or older who self-identified as Black or white. They were followed an average of eleven years.

 

Participants filled out questionnaires about what they ate and drank. Researchers determined how much ultra-processed food people ate by calculating the grams per day and comparing it to the grams per day of other foods to create a percentage of their daily diet. That percentage was calculated into four groups, ranging from the least processed foods to the most processed foods.

Of the total participants, researchers looked at 14,175 participants for cognitive decline and 20,243 participants for stroke. Both groups had no history of cognitive impairment or stroke.

By the end of the study, 768 people were diagnosed with cognitive impairment and 1,108 people had a stroke.

For those in the cognitive group, people who developed memory and thinking problems consumed 25.8% of their diet in ultra-processed foods, compared to 24.6% for those who did not develop cognitive problems.

After adjusting for age, sex, high blood pressure and other factors that could affect risk of dementia, researchers found that a 10% increase in the amount of ultra-processed foods eaten was associated with a 16% higher risk of cognitive impairment.

They also found that eating more unprocessed or minimally processed foods was linked with a 12% lower risk of cognitive impairment.

For those in the stroke group, people who had a stroke during the study consumed 25.4% of their diet in ultra-processed foods, compared to 25.1% for those who did not have a stroke.

After adjustments, researchers found greater intake of ultra-processed foods was linked to an 8% increase in risk of stroke, while greater intake of unprocessed or minimally processed foods was linked to a 9% decreased risk of stroke.

The effect of ultra-processed food consumption on stroke risk was greater among Black participants, with a 15% relative increase in risk of stroke.

“Our findings show that the degree of food processing plays an important role in overall brain health,” Kimberly said. “More research is needed to confirm these results and to better understand which food or processing components contribute most to these effects.”

A limitation of the study was that only participants who self-identified as Black or white were included in the study, so results may not be generalizable to people from other populations.

Subtle cognitive decline precedes end to driving for older adults

 

Peer-Reviewed Publication

One of the thorniest decisions facing older adults is when to give up their keys and stop driving. A new study by researchers at Washington University School of Medicine in St. Louis could provide guidance in helping seniors plan ahead. The researchers found that impaired cognitive function foreshadows the decision for many seniors to stop driving — more so than age or molecular signs of Alzheimer’s disease. Even very slight cognitive changes are a sign that retirement from driving is imminent. Further, women are more likely to stop driving than men, the study showed.

The findings suggest that routine cognitive testing — in particular, the kind of screening designed to pick up the earliest, most subtle decline — could help older adults and their physicians make decisions about driving to maximize safety while preserving independence as long as possible.

“Many older drivers are aware of changes occurring as they age, including subjective cognitive decline,” said corresponding author Ganesh M. Babulal, PhD, OTD, an associate professor of neurology. “Doctors should discuss such changes with their older patients. If risk is identified early, there is more time to support the remaining capacity and skills, extending the time they can drive safely, and to plan for a transition to alternative transportation options to maintain their independence when the time comes to stop driving.”

The study is published May 22 online in Neurology, the medical journal of the American Academy of Neurology.

Adults over age 65 are the most careful drivers on the road. They are less likely than drivers in any other age group to speed or to drive in bad weather, at night or under the influence of substances. Despite these precautions, age-related changes such as slower reaction time, impaired vision and cognitive decline still put older drivers at risk of crashes, and when such crashes happen, older drivers are more likely to be killed or seriously injured than younger drivers are. At the same time, giving up driving is not without its own risks. People who stop driving are more likely to develop depression and become isolated.

The American Academy of Neurology concluded in 2010 that cognitive impairment, as measured by a score greater than zero on the Clinical Dementia Rating (CDR) scale, was the best predictor of stopping driving. The CDR scale goes from zero, indicating normal cognitive function, to three, indicating severe dementia. But the CDR, which was developed at Washington University in 1982, is designed to detect impairments significant enough to affect daily life. Studies have shown that a person’s cognitive skills can deteriorate for years before a CDR score indicates trouble.

Babulal and colleagues set out to determine the role of other factors, including subtle cognitive changes, in the decision to step away from the wheel. They studied 283 people with an average age of 72 who drove at least once a week and who had no cognitive impairments at the start of the study. The researchers were primarily interested in determining when and why each participant stopped driving.

The participants underwent cognitive tests at the start and then every year for an average of 5.6 years. The cognitive testing included the CDR and a preclinical Alzheimer’s cognitive composite (PACC) score, which is designed to detect subtle cognitive changes in people who score as unimpaired on the CDR. The participants also underwent brain scans and donated cerebrospinal fluid at the start of the study and then every two to three years, so the researchers could look for molecular signs of Alzheimer’s disease. At baseline, about one-third of the people met the criteria for preclinical Alzheimer’s disease based on levels of biomarkers for the disease — amyloid plaques and tau tangles — in the brain and cerebrospinal fluid.

During the study, 24 people stopped driving, 15 people died, and 46 people developed cognitive impairment as measured by a CDR score greater than zero.

Analysis showed that three factors predicted who would stop driving during the study: cognitive impairment, worsening PACC scores, and being a woman. People who met the criteria for cognitive impairment by scoring 0.5 or greater on the CDR were 3.5 times more likely to stop driving than were those who remained at zero, and people with lower scores on the PACC were 30% more likely to stop driving than were those with higher scores. Age and the presence of biomarkers of Alzheimer’s disease were not tied to the decision to stop driving.

The biggest effect was seen regarding gender, with women four times more likely to stop driving during the course of the study than men were.

“We know from past studies that there isn’t a difference in driving ability between men and women,” Babulal said. “What we have shown in prior work is that women are often more aware of their abilities, are more willing to admit that they are no longer able to safely drive, and plan more in advance to transition out of driving compared to their male counterparts. It is highly recommended that older male drivers talk with their providers about driving and consider stopping driving earlier.”

Doctors do not routinely counsel older patients on driving cessation, a fact that Babulal sees as a missed opportunity to promote healthy aging.

“There are things we can do to help people adapt to age-related changes,” Babulal said. “Driver rehabilitation programs, often led by occupational therapists, can provide specialized training and strategies for older drivers to adjust to physical and cognitive changes to maintain driving capacity. Community support programs provide a forum for older adults to share experiences and learn from each other about safe driving practices and alternative transportation options. Ultimately, most people will need to stop driving, but by starting the conversation early, we can better support older adults’ independence and quality of life.”

Young people are increasingly using Wegovy and Ozempic

 

Peer-Reviewed Publication

Public interest in weight loss drugs like Wegovy and Ozempic is surging, but national data on dispensing patterns in the United States are surprisingly scarce. 

Now, a national study from Michigan Medicine shows that the use of these weight loss drugs is increasing rapidly in adolescents and young adults 12-25 years, especially females. 

Using 2020 - 2023 data from a national database representing 92% of pharmacies, the study team found a 594% increase in the monthly number of adolescents and young adults using Wegovy, Ozempic, and other glucagon-like peptide-1 receptor agonists (GLP-1RAs). 

For females, this increase was even more pronounced. 

The number of female adolescents 12-17 years using GLP-1RAs increased 588%, compared with 504% for male adolescents. 

The number of female young adults 18-25 years using GLP-1 RAs increased 659%, compared with 481% for male young adults. 

“This is the first study to document national trends in GLP-1RA dispensing in any population, including youth, said Joyce Lee, MD, MPH, the lead author of the paper. Lee is a pediatric endocrinologist and Professor of Pediatrics in the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan Medical School, the C.S. Mott Children's Hospital, and the Caswell Diabetes Institute. 

GLP-1RAs were approved for type 2 diabetes in 2005 and for weight management in 2014. 

Interest in these drugs surged in 2021 when semaglutide was approved for weight management in adults under the brand name Wegovy, and increased even further when Wegovy was approved for weight management in adolescents at the end of 2022. 

The report finds that endocrinologists, family medicine physicians and nurse practitioners were among the top prescribers of GLP-1 RAs to youth, suggesting that these clinicians should be the focus of efforts to ensure safe and appropriate prescribing. 

For example, because the biggest usage increase occurred in females, clinicians need to educate female patients about the potential safety risks of these GLP-1 RAs during pregnancy. 

The report also found that dispensing of Ozempic increased in youth, even though Ozempic is not approved in children for type 2 diabetes or weight management. 

“This finding suggests increasing off-label use of Ozempic for weight management in adolescents and young adults,” said Kao-Ping Chua, MD, the senior author of the paper and a member of the CHEAR Center.

Lee adds that some concerns have been raised about both the cost of GLP-1 RAs, which are expensive and meant to be taken over the longterm, as well as the unknown effects of these drugs on growth and development in youth. 

“The increasing use of GLP-1 RAs highlights the importance of understanding the long-term safety, efficacy, and cost-effectiveness of GLP-1RAs in adolescents and young adults,” she said.

Epidural linked to reduction in serious complications after childbirth

 

Peer-Reviewed Publication

Having an epidural during labour is associated with a marked reduction in serious complications in the first few weeks after giving birth, finds a study published by The BMJ today. 

Doctors refer to these complications as severe maternal morbidity (SMM), which can include heart attack, heart failure, sepsis, and hysterectomy.

 Epidural analgesia is recommended for women with known risk factors for SMM, such as obesity, certain underlying conditions, or having more than one baby. These women are said to have a ‘medical indication’ for epidural analgesia in labour. Women delivering prematurely also carry a higher risk of SMM.

Some research suggests that epidural analgesia in labour may reduce the risk of SMM, though evidence is limited.

To address this, a team from the University of Glasgow in collaboration with the University of Bristol set out to determine the effect of labour epidural on SMM and explore whether this was greater in women with a medical indication for epidural in labour, or those in preterm labour.

Their findings are based on Scottish National Health Service data for 567,216 mothers in labour (average age 29, 93% white) delivering vaginally or via unplanned caesarean section in Scotland between 2007 and 2019.

Medical records were used to identify any of the 21 conditions defined as SMM by the US Centers for Disease Control and Prevention or a critical care admission occurring at any point from date of delivery to 42 days after giving birth.

Factors such as mother’s age, ethnicity, weight, smoking history and pre-existing conditions, as well as birth location and gestational age at birth were also taken into account.

Of the 567,216 women, 125,024 (22%) had an epidural in labour and SMM occurred in 4.3 per 1000 births.

Having an epidural was associated with a 35% relative risk reduction in SMM in all women in the study. Greater reductions were seen among women with a medical indication for epidural (50% risk reduction) compared to those without (33% risk reduction) and in women delivering preterm (47% risk reduction) compared to term or post-term (no evidence of reduced risk).

Notably, among the 77,439 women in the study who were at higher risk of severe maternal morbidity, only 19,061 (24.6%) received an epidural.

Possible explanations for these findings include closer monitoring of both mother and baby during labour, blunting of physiological stress responses to labour, and faster escalation to obstetric interventions if needed, note the authors. 

The relatively low use of epidural, particularly in those with clinical indications may reflect women not fully understanding the potential benefits, as it is a woman’s choice that determines whether or not she has an epidural.

This is an observational study so no firm conclusions can be drawn about cause and effect, and the authors acknowledge several limitations that may have influenced their results. The study also involved predominantly white women delivering in Scotland, which may limit generalisability to ethnically diverse populations or different healthcare settings, they add.

However, this was a large, well-designed study that reflects contemporary obstetric and anaesthetic practices, and results were similar after further analyses, supporting the robustness of the findings. 

As such, the authors conclude: “These findings substantiate the current practice of recommending epidural analgesia during labour to women with known risk factors, underscores the importance of ensuring equitable access to such treatment, and highlights the importance of supporting women from diverse backgrounds to be able to make informed decisions relating to epidural analgesia during labour.”

These findings suggest that epidural analgesia may be a viable protective option for at-risk pregnancies and decision makers should consider this new benefit to improve maternal health outcomes, say researchers in a linked editorial.

They point to the importance of understanding the mechanisms behind this protective effect and recognising inequalities in uptake, with much lower rates in, for example, minority ethnic groups and socioeconomically deprived communities.

With this in mind, these findings “might serve as a catalyst for initiatives aimed at improving equitable access to epidural analgesia during labour, potentially mitigating SMM and improving maternal health outcomes across diverse socioeconomic and ethnic backgrounds,” they conclude.

Exercise goals in minutes or steps equally beneficial

 

New research from Brigham and Women’s Hospital researchers reveals that both step and time-based exercise targets are equivalently associated with improved health outcomes, extended lifespan, and reduced risk of cardiovascular disease

Peer-Reviewed Publication

 

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NEW RESEARCH FROM BRIGHAM AND WOMEN’S HOSPITAL RESEARCHERS REVEALS THAT BOTH STEP AND TIME-BASED EXERCISE TARGETS ARE EQUIVALENTLY ASSOCIATED WITH IMPROVED HEALTH OUTCOMES, EXTENDED LIFESPAN, AND REDUCED RISK OF CARDIOVASCULAR DISEASE

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CREDIT: BRIGHAM AND WOMEN'S HOSPITAL

In the age of smartwatches, monitoring step counts has never been easier, but current physical activity guidelines do not explicitly recommend specific step counts for health. A new study from researchers at Brigham and Women’s Hospital, a founding member of Mass General Brigham, suggests that both step and time-based exercise targets are equivalently associated with lower risks of early death and cardiovascular disease. Thus, whether one chooses a time or step goal may not be as important as choosing a goal aligned with personal preferences. Results are published in JAMA Internal Medicine.

Physical activity reduces the risk of acquiring chronic illness and infection, and promotes longevity. The current U.S. guidelines, last updated in 2018, recommend that adults engage in at least 150 minutes of moderate to vigorous physical activity (e.g., brisk walking) or 75 minutes of vigorous activity (e.g., jogging) per week. At that time, most of the existing evidence on health benefits came from studies where participants self-reported their physical activity. Few data points existed on the relationship between steps and health. Fast forward to the present – with wearables being ubiquitous, step counts are now a popular metric among many fitness tracking platforms. How do time-based goals stack up against step-based ones? Investigators sought to answer this question.

“We recognized that existing physical activity guidelines focus primarily on activity duration and intensity but lack step-based recommendations,” said lead author Rikuta Hamaya, MD, PhD, MS, a researcher in the Division of Preventive Medicine at BWH. “With more people using smartwatches to measure their steps and overall health, we saw the importance of ascertaining how step-based measurements compare to time-based targets in their association with health outcomes – is one better than the other?”

For this study, investigators collected data from 14,399 women who participated in the Women’s Health Study, and who were healthy (free from cardiovascular disease and cancer). Between 2011 and 2015, participants aged 62 years and older were asked to wear research grade wearables for seven consecutive days to record their physical activity levels, only removing the devices for sleep or water-related activities. Throughout the study period, annual questionnaires were administered to ascertain health outcomes of interest, in particular, death from any cause and cardiovascular disease. Investigators followed up with participants through the end of 2022.

At the time of device wear, researchers found that participants engaged in a median of 62 minutes of moderate-to-vigorous intensity physical activity per week and accumulated a median of 5,183 steps per day. During a median follow-up of 9 years, approximately 9% of participants had passed and roughly 4% developed cardiovascular disease. Higher levels of physical activity (whether assessed as step counts or time in moderate-to-vigorous activity) were associated with large risk reductions in death or cardiovascular disease – the most active quarter of women had 30-40% risk reductions compared with the least active quarter. And, individuals in the top three quartiles of physical activity outlived those in the bottom quartile by an average of 2.22 and 2.36 months respectively, based on time and step-based measurements, at nine years of follow-up. This survival advantage persisted regardless of differences in body mass index (BMI).

While both metrics are useful in portraying health status, Hamaya explained that each has its advantages and downsides. For one, step counts may not account for differences in fitness levels. For example, if a 20-year-old and 80-year-old both walk for 30 minutes at moderate intensity, their step counts may differ significantly. Conversely, steps are straightforward to measure and less subject to interpretation compared to exercise intensity. Additionally, steps capture even sporadic movements of every day life, not just exercise, and these kinds of daily life activities likely are those carried out by older individuals.

"For some, especially for younger individuals, exercise may involve activities like tennis, soccer, walking, or jogging, all of which can be easily tracked with steps. However, for others, it may consist of bike rides or swimming, where monitoring the duration of exercise is simpler. That's why it's important for physical activity guidelines to offer multiple ways to reach goals. Movement looks different for everyone, and nearly all forms of movement are beneficial to our health,” said Hamaya.

The authors note that this study incorporates only a single assessment of time and step-based physical activity metrics. Further, most women included in the study were white and of higher socioeconomic status. Finally, this study was observational, and thus causal relations cannot be proven. In the future, Hamaya aims to collect more data via a randomized controlled trial to better understand the relationship between time and step-based exercise metrics and health.

Senior author I-Min Lee, MBBS, ScD, an epidemiologist in the Division of Preventive Medicine at BWH, concluded, "The next federal physical activity guidelines are planned for 2028. Our findings further establish the importance of adding step-based targets, in order to accommodate flexibility of goals that work for individuals with differing preferences, abilities and lifestyles."

My supplements - Updated

  Newest additions:

Astaxanthin

Along with boosting your immune system, astaxanthin may also help to reduce inflammation. In particular, this pigment acts on reactive oxygen species to reduce proteins that can cause inflammatory diseases like celiac disease, rheumatoid arthritis, heart disease, and diabetes

Ginseng

Ginseng is one of the most popular food supplements in the world. It is made out of various plants and herbs and is thought to provide many benefits, with numerous studies pointing at possible anti-inflammatory and antioxidant benefits as well as anti-cancer effects. A group of researchers at the Universitat Oberta de Catalunya (UOC) has now found that it can also be helpful for exercise.According to the findings of the study, which was carried out as part of a master's degree final project and was recently published in the open-access journal Nutrients, taking ginseng has a direct effect on reducing fatigue and helps muscles to recover after sport.

https://healthnewsreport.blogspot.com/2024/02/ginseng-speeds-up-recovery-and-reduces.html

Aspirin

Cardiologists: risk of internal bleeding outweighs cardiovascular benefits unless person is at heightened risk, but this ignores aspirins benefits vs cancer and other medical problems"

Aspirin: Cognitive Benefits

Health Benefits of Aspirin: Pancreatic, Prostate, Skin, Endometrial, Throat and Bowel Cancer

Health Benefits of Aspirin: Colorectal Cancer

Health Benefits of Aspirin: Breast, Ovarian and Cervical Cancer

Health Benefits of Aspirin - General Cancer Benefits

Health Benefits of Aspirin: Miscellaneous Benefits

An alternative theory on how aspirin may thwart cancer

 Cocoa flavanol supplement shows promise for reducing cardiovascular risk, https://healthnewsreport.blogspot.com/.../cocoa-shown-to...

Co-enzyme Q-10

I began taking Co-enzyme Q10 to fight potential muscle pain from the statin I take, but have discovered substantial offered additional benefits (see http://healthnewsreport.blogspot.com/2015/06/health-benefits-of-coenzyme-q10.html).

 

Glucosamine

 

see http://healthnewsreport.blogspot.com/2020/12/glucosamine-may-reduce-overall-death.html

Lutein 

Lutein is a carotenoid with reported anti-inflammatory properties. A large body of evidence shows that lutein has several beneficial effects, especially on eye health. In particular, lutein is known to improve or even prevent age-related macular disease which is the leading cause of blindness and vision impairment.

 

NAC/Glycine

Supplementation with GlyNAC - a combination of glycine and N-acetylcysteine as precursors of the natural antioxidant glutathione - could improve many age-associated defects in older humans to improve muscle strength and cognition, and promote healthy aging.

https://healthnewsreport.blogspot.com/2021/03/glynac-improves-multiple-defects-in.html

Pterostilbene

• Pterostilbene has been shown to minimize oxidative stress on cells, combat free radicals, and have anti-inflammatory effects. Similar to an improved version of Resveratrol, this compound has been shown to keep DNA in good repair, preventing DNA damage and promoting longevity!
• PROMOTE HEALTHY BLOOD SUGAR LEVELS - Pterostilbene supplementation may promote normal glucose and triglyceride levels. It is associated with upregulation of PPAR expression, and may be effective for facilitating healthy blood sugar.

 

• Ultra Omega-3 1000 EPA

A new study published in Mayo Clinic Proceedings provides the most comprehensive analysis of the role of omega-3 dosage on cardiovascular prevention to date. The meta-analysis, which is an in-depth review of 40 clinical trials, provides authoritative evidence for consuming more EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) omega-3 fats.

The research concludes that EPA and DHA omega-3 intake is associated with reduced risk of coronary heart disease (CHD) events, the cause of 7.4 million deaths globally each year, and reduced risk of myocardial infarction (heart attack), including fatal heart attack.

Specifically, the study found that EPA+DHA supplementation is associated with a statistically significant reduced risk of:

 

• Fatal myocardial infarction (35 percent)
• Myocardial infarction (13 percent)
• CHD events (10 percent)
• CHD mortality (9 percent)

see http://healthnewsreport.blogspot.com/2016/10/health-benefits-of-fish-oil.html)

 

 

 

Vitamin B-12

 

(see http://healthnewsreport.blogspot.com/2016/10/health-benefits-of-vitamin-b12.html)

 

Zinc

 

see https://healthnewsreport.blogspot.com/2014/07/8-ways-zinc-affects-human-body.html

 

A few times a week

 

 

 

Choline

 

Choline supplementation may help combat Alzheimer's disease

Dietary guidelines advisory committee reinforces need for increased choline intake

 

 

Probiotic

Probiotic reduces 'bad' and total cholesterol

Two daily doses of a probiotic lowered key cholesterol-bearing molecules in the blood as well as “bad” and total cholesterol, in a study presented at the American Heart Association’s Scientific Sessions 2012.

 

Taurinne

Study shows that amino acid taurine could be used in anti-aging therapy

https://healthnewsreport.blogspot.com/2022/07/study-shows-that-amino-acid-taurine.html

Vitamin D3

 (see http://healthnewsreport.blogspot.com/2016/10/heath-benefits-of-vitamin-d.html)

Also: A review of clinical trials has found that higher vitamin D intake was associated with a 15 percent decreased likelihood for developing type 2 diabetes in adults with prediabetes. The review is published in Annals of Internal Medicine.