Yoga and controlled breathing reduce depressive symptoms

A new study demonstrated that individuals with major depressive disorder had a significant reduction in depressive symptoms during a 12-week integrative health intervention that included Iyengar yoga classes and coherent breathing. Participants who took three yoga classes a week were more likely to achieve lower depression scores after 12 weeks than subjects who took two classes, according to the study published in The Journal of Alternative and Complementary Medicine, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available open access on The Journal of Alternative and Complementary Medicine website.

In the study, adults 18-64 years of age with major depressive disorder participated in either three (high-dose intervention) or two (low-dose) yoga classes per week and practiced coherent breathing at 5 breaths per minute. The researchers used a Depression Inventory measure to assess depressive symptoms in the 30 participants, at the beginning of the study and throughout the 12-week intervention.

"The practical findings for this integrative health intervention is that it worked for participants who were both on and off antidepressant medications, and for those time-pressed, the two times per week dose also performed well," says The Journal of Alternative and Complementary Medicine Editor-in-Chief John Weeks.

Brain Health Food Guide for Adults

"There is increasing evidence in scientific literature that healthy eating is associated with retention of cognitive function, but there is also a lot of misinformation out there," says Dr. Carol Greenwood, co-author of the Brain Health Food Guide, senior scientist at Baycrest's Rotman Research Institute (RRI) and professor at the University of Toronto's Department of Nutritional Sciences.

There is not a lot of evidence about individual foods, but rather classes of foods, says Dr. Greenwood, who is also a co-author of Mindfull, the first science-based cookbook for the brain. Older adults are encouraged to eat berries or cruciferous vegetables, such as cauliflower, cabbage and Brussels sprouts, rather than a specific type of berry or vegetable.

Research has found that dietary patterns similar to those outlined in the Brain Health Food Guide are associated with decreasing the risk of developing Alzheimer's disease by 36 per cent and mild cognitive impairment (a condition likely to develop into Alzheimer's) by 27 per cent.

Some tips suggested by the Brain Health Food Guide include:

• Focus on an overall pattern of healthy eating, not one specific "superfood" for brain health
• Eat fish, beans and nuts several times a week
• Include healthy fats from olive oil, nuts and fish in one's diet
• Add beans or legumes to soups, stews and stir-fried foods
• Embrace balance, moderation and variety

Depression doubles long-term risk of death after heart disease diagnosis

Depression is the strongest predictor of death in the first decade following a diagnosis of coronary heart disease, according to a new study by researchers at the Intermountain Medical Center Heart Institute in Salt Lake City.

The study, which is scheduled for presentation this week at the American College of Cardiology's 66th Annual Scientific Session in Washington, D.C., found people with coronary heart disease who are diagnosed with depression are about twice as likely to die compared with those who are not diagnosed with depression.

"Our study shows that it doesn't matter if depression emerges in the short term or a few years down the road - it's a risk factor that continually needs to be assessed," said Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute in Salt Lake City, and the study's lead author. "I think the take-home message is that patients with coronary disease need to be continuously screened for depression, and if found to be depressed, they need to receive adequate treatment and continued follow-up."

The Intermountain Medical Center Heart Institute study focused on patients diagnosed with a heart attack, stable angina or unstable angina, all of which are caused by a reduced flow of oxygen-rich blood to the heart, typically as a result of plaque buildup in the heart's arteries. These conditions fall under the umbrella term coronary heart disease, which is the most common form of heart disease and kills about 370,000 people in the United States annually.

Researchers have long understood heart disease and depression to have a two-way relationship, with depression increasing the likelihood of heart disease and vice versa. Whereas previous studies have investigated depression occurring within a few months of a coronary heart disease diagnosis, this new study is the first to shed light on the effects of depression over the long term.

"The majority of studies evaluating depression following a heart disease event have occurred within 30 days of the event," said May. "We sought to determine if the risk of all-cause mortality associated with depression varies with time between the diagnosis of heart disease and a follow-up depression diagnosis."

The research team analyzed health records from almost 25,000 Intermountain Healthcare patients tracked for an average of nearly 10 years following a diagnosis of coronary heart disease. About 15 percent of patients received a follow-up diagnosis of depression, a substantially larger proportion than the estimated rate of 7.5 to 10 percent in the general population.

Out of 3,646 people with a follow-up diagnosis of depression, half died during the study period, compared to 38 percent of the 20,491 people who did not have a depression diagnosis. This means people with depression were twice as likely to die compared to those without depression.

May says the results were surprising.

"I thought depression would be significant, but not the most significant predictor," she added.

After adjusting for age, gender, risk factors, other diseases, heart attack or chest pain, medications and follow-up complications, the results showed depression was the strongest predictor of death in this patient group. These results were consistent regardless of age, gender, the timing of depression onset, past history of depression or whether or not the patient had a heart attack.

Given the significant impact of depression on long-term survival, the researchers said clinicians should seek ways to better identify depression in patients with coronary heart disease, either by using patient questionnaires designed to screen for depression or by actively watching for signs of depression during follow-up examinations.

"It can be devastating to be diagnosed with coronary artery disease," May said. "Clinicians need to pay attention to the things their patients are expressing, in terms of both physical symptoms as well as emotional and nonverbal factors."

Signs of depression include persistent feelings of sadness, hopelessness or worthlessness; anxiety, irritability or restlessness; losing interest in hobbies and activities; fatigue or moving slowly; difficulty sleeping or concentrating; aches or pains without a clear physical cause; changes in appetite or weight; and thoughts of death or suicide.

Depression is linked with behaviors that can be detrimental to cardiovascular health, such as reduced physical activity, poor diet, increased smoking or alcohol use and reduced compliance with medical treatment.

"There is a lot more research that needs to be done with depression and heart disease, May said. "Moving forward, we would like to further assess treatment affects, severity of symptoms, and other comorbidities that may put a patient at an increased risk of death.

May will present the study on Friday, March 17, 2017, at 9:30 a.m., ET at the American College of Cardiology's 66th Annual Scientific Session in Washington, D.C. The meeting runs March 17-19.

A healthy diet improves sperm quality and fecundability of couples

Nowadays, in order to improve sperm quality and fertility changes, many fertility clinics recommend simple lifestyle changes such as increased physical activity, cognitive behavioural therapy or yoga to reduce stress, give advice on how to reduce alcohol and caffeine intake and provide lists of dietary recommendations. However, there is a lack of a proven scientific evidence regarding the role of diet in determining sperm parameters.

Researchers at the Human Nutrition Unit of the Universitat Rovira i Virgili (URV) and the Pere i Virgili Health Research Institute, (Tarragona-Spain) who are also members of the Ciberobn network of the Carlos III Health Institute, have conducted the first systematic review of all observational studies on sperm quality and male fecundability and their relationship with diet, food and nutrient consumption.

The results indicate that low sperm quality parameters are inversely associated with healthy diets rich in certain nutrients such as omega-3 fatty acids, certain antioxidants (vitamin E, vitamin C, β-carotene, selenium, zinc, cryptoxanthin and lycopene), other vitamins (vitamin D and folate) and low saturated fatty acids and trans-fatty acids. Fish, shellfish, seafood, poultry, cereals, vegetables and fruits, low-fat dairy and skimmed milk were positively associated with several sperm quality parameters. In contrast, diets rich in processed meat, soy foods, potatoes, full-fat dairy and total dairy products, cheese, coffee, alcohol, sugar-sweetened beverages and sweets have been associated with lower-quality sperm in some studies. A high intake of alcohol, caffeine, red meat and processed meat by males has a negative influence on the chance of pregnancy or fertilization rates of their partners.

According to the researchers, their review has provided a comprehensive overview of existing high-quality research into the effect of diet and the consumption of different foods and nutrients on fecundability and male fertility so that safer and more effective dietary recommendations can be made in the future.

These results highlight the fact that adherence to a healthy diet, e.g. the Mediterranean diet, by men could significantly improve their sperm quality and the fecundity of their partners.

Fish and mercury: Detailed consumption advisories would better serve women across US

Among women of childbearing age in the U.S., fish consumption has increased in recent years while blood mercury concentrations have decreased, suggesting improved health for women and their babies, a new study shows.

The research at Oregon State University also indicates fish consumption advisories tailored to specific regions and ethnic groups would help women of childbearing age to eat in even more healthy ways, including better monitoring of mercury intake.

Food from the ocean has a unique and valuable nutritional profile. Among seafood's many benefits are the omega-3 fatty acids that promote neurodevelopment, and the nutrients in seafood are especially important for pregnant women to pass on to developing fetuses.

But the main way people are exposed to toxic methylmercury -- a mercury atom with a methyl group, CH3, attached to it -- is through eating seafood. Thus the need for precise, nuanced fish consumption advisories, said Leanne Cusack of Oregon State University, the corresponding author on the study.

Comparatively less-toxic elemental mercury enters the ocean from natural sources such as volcanic eruptions and also from human activities like the burning of fossil fuels, which accounts for about two-thirds of the mercury that goes into the water.

Once in the ocean, the mercury is methylated, diffuses into phytoplankton and passes up the food chain, accumulating along the way.

A scallop or a shrimp, for example, can have a mercury concentration of less than 0.003 parts per million. A large predator like a tuna, on the other hand, can contain roughly 10 million times as much methylmercury as the water that surrounds it and have a concentration of many parts per million.

Exactly how the mercury in the ocean becomes methylated, scientists don't know.

Fish advisories are usually aimed at women of childbearing age because a developing fetus has greater sensitivity to the neurotoxic effects of methylmercury. Jointly, the U.S. Environmental Protection Agency and the Food and Drug Administration recommend women in that group eat two meals of low-mercury fish per week.

Using data from the ongoing National Health and Nutrition Examination Survey, Cusack's research group looked at fish consumption patterns with regard to blood mercury levels in U.S. women of childbearing age from 1999 to 2010.

Findings were recently published in the journal Environmental Health.

Women in the coastal regions, particularly the Northeast, were found to have the highest blood mercury concentrations; women living away from the sea, especially in the inland Midwest, had the lowest.

Coastal residents also ate fish the most frequently, with the species consumed varying by region. The type of fish most often consumed was shellfish in every part of the U.S. except for the inland West and inland Midwest.

As women's age and household income increased, so did their fish consumption frequency and blood mercury concentrations. Among ethnic groups, Asian Americans, Pacific Islanders, Alaska Natives and Native Americans ate fish the most often and showed the most mercury, and Mexican Americans consumed fish the least often and showed the smallest concentration of mercury.

"We also found total monthly fish consumption by women of reproductive age was higher than it had been in recent years, with women consuming more marine fish and shellfish but with no appreciable difference in the mean consumption of freshwater fish, tuna, swordfish and shark," said Cusack, a postdoctoral scholar in OSU's College of Public Health and Human Sciences.

"That's encouraging because marine and shellfish are associated with smaller increases in blood mercury. And also encouragingly, an average women who'd eaten fish nine or more times in the previous month had lower blood mercury levels than women who'd had fish at the same rate in 1999-2000."

The differences in consumption and mercury levels by race and region illustrate the need for tailored fish advisories, she said.

"They need to have information about fish types and quantities you can safely eat," Cusack said. "The more detailed they can be, the better.

"The main thing is we do need to increase fish consumption in this demographic," Cusack added. "It has been increasing since 1999, but it's still not at the level where we want to see it. People need to start consuming fish, and advisories need to focus on the benefits of consumption and not just the risks by providing a broad range of fish that are low in methylmercury and high in omega-3's."

Rapid blood pressure drops in middle age linked to dementia in old age

Middle-aged people who experience temporary blood pressure drops that often cause dizziness upon standing up may be at an increased risk of developing cognitive decline and dementia 20 years later, new Johns Hopkins Bloomberg School of Public Health research suggests.

The findings, being presented March 10 at the American Heart Association's EPI|LIFESTYLE 2017 Scientific Sessions in Portland, Ore., suggest that these temporary episodes - known as orthostatic hypotension - may cause lasting damage, possibly because they reduce needed blood flow to the brain. Previous research has suggested a connection between orthostatic hypotension and cognitive decline in older people, but this appears to be the first to look at long-term associations.

"Even though these episodes are fleeting, they may have impacts that are long lasting," says study leader Andreea Rawlings, PhD, MS, a post-doctoral researcher in the Department of Epidemiology at the Bloomberg School. "We found that those people who suffered from orthostatic hypotension in middle age were 40 percent more likely to develop dementia than those who did not. It's a significant finding and we need to better understand just what is happening."

An estimated four million to five million Americans currently have dementia and, as the population ages, that number is only expected to grow. There currently is no treatment and no cure for the condition.

For the study, the researchers analyzed data from the Atherosclerosis Risk in Communities (ARIC) cohort, a study of 15,792 residents in four communities in the United States, who were between the ages of 45 and 64 when the study began in 1987. For this study, they focused on the 11,503 participants at visit one who had no history of coronary heart disease or stroke. After 20 minutes lying down, researchers took the participants' blood pressure upon standing. Orthostatic hypotension was defined as a drop of 20 mmHg or more in systolic blood pressure or 10 mmHg or more in diastolic blood pressure. Roughly six percent of participants, or 703 people, met the definition.

These participants, who were on average 54 years old upon enrolling in the study, continued to be followed over the next 20 or more years. People with orthostatic hypotension at the first visit were 40 percent more likely to develop dementia than those who did not have it. They had 15 percent more cognitive decline.

Rawlings says it is not possible to tease out for certain whether the orthostatic hypotension was an indicator of some other underlying disease or whether the drop in blood pressure itself is the cause, though it is likely that the reduction in blood flow to the brain, however temporary, could have lasting consequences.

It also wasn't clear, she says, whether these participants had repeated problems with orthostatic hypotension over many years or whether they had just a brief episode of orthostatic hypotension at the original enrollment visit, as patients were not retested over time.

"Identifying risk factors for cognitive decline and dementia is important for understanding disease progression, and being able to identify those most at risk gives us possible strategies for prevention and intervention," Rawlings says. "This is one of those factors worth more investigation."

High-intensity aerobic training can reverse aging processes in adults

Everyone knows that exercise is good for you, but what type of training helps most, especially when you're older -- say over 65? A Mayo Clinic study says it's high-intensity aerobic exercise, which can reverse some cellular aspects of aging. The findings appear in Cell Metabolism.

Mayo researchers compared high-intensity interval training, resistance training and combined training. All training types improved lean body mass and insulin sensitivity, but only high-intensity and combined training improved aerobic capacity and mitochondrial function for skeletal muscle. Decline in mitochondrial content and function are common in older adults.

High-intensity intervals also improved muscle protein content that not only enhanced energetic functions, but also caused muscle enlargement, especially in older adults. The researchers emphasized an important finding: Exercise training significantly enhanced the cellular machinery responsible for making new proteins. That contributes to protein synthesis, thus reversing a major adverse effect of aging. However, adding resistance training is important to achieve significant muscle strength.

"We encourage everyone to exercise regularly, but the take-home message for aging adults that supervised high-intensity training is probably best, because, both metabolically and at the molecular level, it confers the most benefits," says K. Sreekumaran Nair, M.D., Ph.D., a Mayo Clinic endocrinologist and senior researcher on the study. He says the high-intensity training reversed some manifestations of aging in the body's protein function. He cautioned that increasing muscle strength requires resistance training a couple of days a week.

The study's goal was to find evidence that will help develop targeted therapies and exercise recommendations for individuals at various ages. Researchers tracked metabolic and molecular changes in a group of young and older adults over 12 weeks, gathering data 72 hours after individuals in randomized groups completed each type of exercise. General findings showed:

• Cardio respiratory health, muscle mass and insulin sensitivity improved with all training.
• Mitochondrial cellular function declined with age but improved with training.
• Increase in muscle strength occurred only modestly with high-intensity interval training but occurred with resistance training alone or when added to the aerobic training.
• Exercise improves skeletal muscle gene expression independent of age.
• Exercise substantially enhanced the ribosomal proteins responsible for synthesizing new proteins, which is mainly responsible for enhanced mitochondrial function.
• Training has little effect on skeletal muscle DNA energy transfer but promotes skeletal muscle protein expression with maximum effect in older adults.