Broccoli and kale top the shopping list for lowering blood pressure

Cruciferous vegetables, including broccoli, cabbage, kale, and cauliflower have been found to lower blood pressure, in comparison to root and squash vegetables, in middle-aged and older Australian adults with elevated blood pressure.

 

In a randomised, controlled, crossover trial, researchers from Edith Cowan University (ECU) found that consuming four serves a day of cruciferous vegetables resulted in a significant reduction in blood pressure, compared with four serves a day of root and squash vegetables including carrot, potato, sweet potato and pumpkin.

 

“Compounds called glucosinolates, which are found almost exclusively in cruciferous vegetables, have been shown to lower blood pressure in animals, but evidence in humans has thus far been limited,” ECU PhD student Ms Emma Connolly said.

 

Additionally, cruciferous vegetables also contain several other components that likely provide additional benefits in lowering blood pressure, such as nitrate and vitamin K.

 

“Hypertension, or high blood pressure, is the leading risk factor for heart disease, with its prevalence increasing with age,” Ms Connolly said.

 

“Increasing vegetable intake is widely recommended to reduce heart disease risk, and previous observational studies have shown, cruciferous vegetables like broccoli, cabbage, and Brussels sprouts, have stronger relationships with lower heart disease risk than other vegetables. However, while these vegetables are consumed globally, cruciferous vegetables typically make up a small portion of total vegetable intake.”

 

ECU NHMRC Emerging Leader and Heart Foundation Postdoctoral Fellow Dr Lauren Blekkenhorst noted that less than 1 in 15 Australian adults currently meet recommendations for vegetable intake, which has continued to drop over the years.

 

“Cruciferous vegetables are the lowest consumed group of vegetables. If people can increase their intake of this group of vegetables, they will receive more bang for their buck in terms of in lowering blood pressure and reducing the subsequent risk of developing heart disease later in life.”

 

“To maintain these health benefits, you should have to ideally consume these vegetables on most days of the week.”

The study was conducted over a six-week period, with participants completing two 2-week dietary interventions, separated by a 2-week ‘wash-out’ period where they followed their normal diet.

 

During one intervention period participants consumed four serves of cruciferous vegetables per day as soups with lunch and dinner, while during the other intervention period they consumed a root and squash vegetable soup. The blood pressure of participants was measured continuously for 24 hours before and after both 2-week intervention periods and showed a 2.5 mmHg difference in blood pressure reduction for eating cruciferous vegetables compared to root and squash vegetables.

 

Background diet and lifestyle remained consistent throughout the study, indicating the reduction in blood pressure seen was not influenced by these factors.

 

This amount of lowered blood pressure can translate to roughly 5% lower risk of experiencing a heart attack or stroke.

 

The Heart Foundation has welcomed the research results, with Manager for Heart Health, Kym Lang saying the research finding was fascinating.

 

“The Heart Foundation encourages people to eat a variety of vegetables every day as part of a heart-healthy eating pattern. You can experiment with adding cruciferous vegetables, like broccoli or kale, to your meals.

 

"The Heart Foundation is proud to have supported this research that builds on the importance of vegetables in a heart-healthy eating pattern. We look forward to continuing to learn more about the role cruciferous vegetables play in heart health."

 

The research was published in BMC Medicine.

 

 

Is a low-carb diet a nutritious diet? Yes, new study shows

 

Over the last decade, low-carbohydrate (i.e., low-carb) eating patterns have doubled in popularity.1 Substantial research also suggests a low-carb lifestyle is an effective way to support overall health, including managing or even reversing type 2 diabetes.2-6 Yet, skepticism remains around the nutritional quality of low-carb diets, with some arguing that reducing carb intake leads to over-consuming protein or fat and under-consuming essential nutrients.

That misconception has been put to rest with a new study in Frontiers in Nutrition, which demonstrated that well-constructed low-carb eating patterns can meet, and sometimes even safely exceed, people’s nutrient needs.

The study assessed the nutrient adequacy of three different 7-day low-carb meal plans: two ketogenic diets – one that averaged approximately 20 grams of net carbs per day, one that provided an average of about 40 grams of net carbs per day – and one more liberalized plan that contained an average of around 100 grams of net carbs per day. (Net carbs equate to total grams of carbohydrate minus total grams of fiber consumed.)  All three plans met the consensus definition of a low-carb diet, which includes less than 130 grams of carbs per day.6

All three low-carb meal plans safely exceeded nutrient needs for vitamins A, C, D, E, K, thiamin, riboflavin, niacin, folate and vitamins B6 and B12 for both men and women aged 31-70.

“Many Americans struggle get the nutrients they need from typical food choices,” notes study co-author Beth Bradley, PhD, Department of Nutrition and Food Sciences, University of Vermont. “Our findings suggest that, in addition to their well-established ability to support weight management, low-carb eating patterns can actually help promote better diet quality and close critical nutrient gaps.”

Only for certain sub-populations with higher needs did a few nutrients fall slightly short in the low-carb meal plans (e.g., iron for younger women and calcium for older adults).

Notably, the two meal plans containing 40 grams and 100 grams of net carbohydrates, respectively, also provided more than enough fiber for women aged 31-70. Given low-carb diets are especially popular among middle-age women, meeting the nutrients needs of this population is especially relevant.1

“The idea that a low-carb diet must also be low in fiber is simply not supported by the data,” Dr. Bradley explains. “High-fiber foods are actually an important part of a low-carb lifestyle, in part because fiber-rich food choices can help lower net carbohydrate intake. Non-starchy vegetables, nuts and seeds, and, in moderation, even higher-carb fruits, starchy vegetables and whole grains can contribute fiber to the diet while keeping overall net carb intake in check, especially in the more liberal low-carb approach.”

While all three of the low-carb meal plans were higher than the Recommended Dietary Allowance (RDA) for protein, protein levels still fell within the Acceptable Macronutrient Distribution Range of 10-35% of daily calories. In other words, the meal plans provided more protein than what is needed to prevent deficiency but did not deliver an excessive amount that would be considered unsafe.

Though lower in saturated fat and sodium compared to the average American diet, the meal plans also slightly exceeded recommendations for saturated fat and sodium. However, they also offered more beneficial omega-6 to omega-3 and sodium to potassium ratios.

“Nutrition is often more complex than simply tallying the totals you see on a menu or a food label,” says Dr. Bradley. “Which foods your nutrients come from and how they fit within the broader context of your overall diet may play a more important role in determining health outcomes. For example, a better omega-6 to omega-3 ratio has been linked to a lower risk of cardiovascular disease and type 2 diabetes. And similarly, a more optimal sodium to potassium ratio may help lower risk of high blood pressure and heart disease.”

The latest study findings add to the robust and growing evidence base demonstrating the role a lower-carb lifestyle can play in supporting good diet quality, overall well-being and the management or reversal of diet-related disease. While some people (e.g., younger women, older adults) may benefit from dietary supplements to meet all of their individual needs, the low-carb diet provides a strong nutritional foundation for health.

Three top ways to stop smoking

A major new scientific review of evidence published in the journal Addiction has identified three top strategies for quitting smoking:

• Varenicline -- a prescription drug sold under the brand names Chantix and Champix among others.
• Cytisine -- a plant-based compound available under prescription in the United Kingdom, in Canada as an over-the-counter natural health product (Cravv®) and throughout central and eastern Europe.
• Nicotine e-cigarettes.

These work best when combined with behavioural support, such as counselling. Bupropion and nicotine replacement therapy (NRT) are also effective, especially NRT patches combined with fast acting forms like gum.  There is strong evidence to support behavioural counselling and financial incentives for smoking cessation, even without additional medication.

The Cochrane Tobacco Addiction Group (CTAG) has provided systematic reviews of the highest quality for almost 30 years.  This summary outlines the key findings from the fourteen Cochrane reviews that CTAG published between 2021 and 2023.  Three Cochrane reviews included in this summary are particularly noteworthy:

• The updated Cochrane review on nicotine replacement therapy (NRT) for smoking cessation found high-certainty evidence that combining a fast-acting form of NRT (gum, lozenges, sprays) with NRT patches helped more people to quit than single-form NRT alone.
• The Cochrane review of electronic cigarettes for smoking cessation is a living systematic review: review authors search for new studies monthly and update the review whenever new data emerge. The latest update concluded that there was high‐certainty evidence that e-cigarettes with nicotine increase quit rates compared with NRT and moderate‐certainty evidence that they increase quit rates compared with e-cigarettes without nicotine.
• The 2023 Cochrane review of pharmacological and e-cigarette interventions for smoking cessation included all drugs licensed as treatments for smoking cessation anywhere in the world, as well as e-cigarettes with or without nicotine. The review included 319 studies (157,179 participants). The most effective interventions were nicotine e‐cigarettes, varenicline and cytisine, all of which had high certainty evidence, closely followed by combination NRT (i.e. the use of a patch and fast-acting form of NRT together).
• The updated Cochrane review on nicotine receptor partial agonists (varenicline and cytisine) for smoking cessation found that, in studies directly comparing cytisine and varenicline, there may be no difference from either medication for quitting smoking.  The review included 75 trials.

Lead author Dr Jonathan Livingstone-Banks says “Quitting smoking is difficult, and some people find it harder to quit than others, but tobacco is uniquely deadly among legal consumer products, so it’s important to seek help quitting. There’s a range of effective forms of support for smoking cessation, and cytisine, varenicline and e-cigarettes are all evidence-based ways to greatly increase people’s chances of successfully quitting smoking.”

Travel could be the best defense against ageing

Forget about retinol night creams, researchers from Edith Cowan University (ECU) believe travel could be the best way to defy premature ageing.

 

For the first time, an interdisciplinary study has applied the theory of entropy to tourism, finding that travel could have positive health benefits, including slowing down the signs of ageing.

 

Entropy is classified as the general trend of the universe towards death and disorder. The entropy perspective suggests that tourism could trigger entropy changes, where positive experiences might mitigate entropy increase and enhance health, while negative experiences may contribute to entropy increase and compromise health.

“Ageing, as a process, is irreversible. While it can’t be stopped, it can be slowed down,” ECU PhD candidate Ms Fangli Hu said.

Ms Hu noted that positive travel experiences could enhance individuals’ physical and mental wellness through exposure to novel environments, engagement in physical activities and social interaction, and the fostering of positive emotions. These potential benefits have been acknowledged through practices such as wellness tourism, health tourism, and yoga tourism.

 

“Tourism isn’t just about leisure and recreation. It could also contribute to people’s physical and mental health,” Ms Hu added.

 

Travel therapy: Slowing down the clock

 

Travel therapy could serve as a groundbreaking health intervention when viewed through an entropy lens, she added. As an important aspect of the environment, positive travel experiences may help the body sustain a low-entropy state by modulating its four major systems.

 

Tourism typically exposes people to new surroundings and relaxing activities, and novel settings can stimulate stress responses and elevate metabolic rates, positively influencing metabolic activities and the body’s self-organising capabilities. These contexts may also trigger an adaptive immune system response.

Ms Hu said that this reaction improves the body’s ability to perceive and defend itself against external threats.

 

“Put simply, the self-defence system becomes more resilient. Hormones conducive to tissue repair and regeneration may be released and promote the self-healing system’s functioning.”

 

Leisurely travel activities might help alleviate chronic stress, dampen overactivation of the immune system, and encourage normal functioning of the self-defence system. Engaging in recreation potentially releases tension and fatigue in the muscles and joints. This relief helps maintain the body’s metabolic balance and increases the anti–wear-and-tear system’s effectiveness. Organs and tissues can then remain in a low-entropy state,” Ms Hu explained.

 

Travel encompasses physical activities such as hiking, climbing, walking, and cycling. Physical exertion can boost metabolism, energy expenditure, and material transformation, all of which help coordinate self-organising systems.

 

“Participating in these activities could enhance the body’s immune function and self-defence capabilities, bolstering its hardiness to external risks. Physical exercise may also improve blood circulation, expedite nutrient transport, and aid waste elimination to collectively maintain an active self-healing system. Moderate exercise is beneficial to the bones, muscles, and joints in addition to supporting the body’s anti–wear-and-tear system,” Ms Hu said.

 

On the flip side, the research has pointed out that tourists could face challenges such as infectious diseases, accidents, injuries, violence, water and food safety issues, and concerns related to inappropriate tourism engagement.

 

“Conversely, tourism can involve negative experiences that potentially lead to health problems, paralleling the process of promoting entropy increase. A prominent example is the public health crisis of COVID-19.”

 

The Principle of Entropy Increase: A Novel View of How Tourism Influences Human Health was published in the Journal of Travel Research earlier this year.

Eating fish but not omega-3 supplements during pregnancy =lower likelihood of autism diagnosis

 

 

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Credit: NIH Environmental influences on Child Health Outcomes (ECHO) Program

Eating any amount of fish during pregnancy was associated with about a 20% lower likelihood of autism spectrum disorder (ASD) diagnosis, particularly in females, and a slight reduction in autism-related traits in offspring, according to a new study funded by the Environmental influences on Child Health Outcomes (ECHO) Program at the National Institutes of Health.

However, researchers did not find the same association with supplements containing omega-3 fatty acids.

Fish is an important source of omega-3 fatty acids, an essential nutrient during pregnancy for supporting maternal health and child neurodevelopment. A recent analysis of ECHO Cohort data revealed that about 25% of the pregnant participants reported never eating fish or consuming it less than once a month during their pregnancy. Even fewer participants reported taking omega-3 fish oil supplements.

ECHO Cohort researchers wanted to see whether low fish consumption and omega-3 supplement use during pregnancy might be associated with the occurrence of an autism diagnosis or parent-reported autism-related traits.

“Our study contributes to a growing body of evidence that demonstrates the role that prenatal diet can play in autism-related outcomes in offspring,” said ECHO Cohort researcher Emily Oken, MD, MPH, of Harvard Medical School.

Dr. Oken said the findings underscored the need for better public health messaging about guidelines for fish consumption for pregnant people, considering the low fish intake in the U.S. and the rising diagnoses of autism.

What happened during the study?

Researchers analyzed data from about 4,000 participants, examining the relationships among fish intake, supplement use, and neurodevelopmental outcomes related to autism.

Fish consumption and omega-3 supplement use were measured with dietary information reported by participants. Participants’ fish consumption was categorized as less than once a month, more than once a month but less than weekly, weekly, and two or more servings per week. About 20% of adult participants reported no fish intake, and most reported not using omega-3 or fish oil supplements.

The researchers then looked at the relationship between maternal fish intake and omega-3 fish oil supplement use during pregnancy and the occurrence of clinician-diagnosed autism and parent-reported autism-related traits. These traits were measured using the Social Responsiveness Scale (SRS), a widely used survey completed by parents or caregivers. Higher scores on the SRS indicate the presence of more autism-related behaviors. 

Consuming fish during pregnancy was associated with a lower likelihood of offspring being diagnosed with autism and a slight decrease in total SRS scores compared to not eating fish. These results were consistent across all levels of fish consumption, from "any" amount or "less than once per week" to "more than twice per week." No significant associations were found between omega-3 fish oil supplements and autism diagnosis compared to no use.

Experts recommend that people consume additional omega-3 fatty acids during pregnancy. Prenatal fish intake is a key source of omega-3 fatty acids that are critical for fetal brain development. However, fish and omega-3 fatty acid supplementation in the U.S. is low.

“This study provides yet more evidence for the safety and benefit of regular fish consumption during pregnancy,” said Dr. Oken. “Other proven benefits include lower risk for preterm birth and improved cognitive development.”

Dr. Oken led this collaborative research published in the American Journal of Clinical Nutrition.

Oken, E. & Lyall, K. (2024) Association of maternal fish consumption and ω-3 supplement use during pregnancy with child autism-related outcomes: results from a cohort consortium analysis. American Journal of Clinical Nutrition. 10.1016/j.ajcnut.2024.06.013

Ability to cope well with adversity in older age linked to lower death risk

The ability to cope well with, and adapt to, challenging life circumstances and events in older age is linked to a lower risk of death, suggests a large nationally representative study, published in the open access journal BMJ Mental Health.

The findings underscore the importance of efforts to bolster mental resilience, conclude the researchers.

The available evidence suggests that mental resilience is a dynamic and active process influenced by various factors, including sex, hormones, and the genes regulating the body’s stress response. This capacity is believed to evolve and vary across different periods of the life cycle, say the researchers.

In older age, good coping skills can help offset the negative impact of long term conditions and subsequent disability. And while the ability to bounce back physically after illness and trauma is associated with slower ageing and the risk of death, it’s not clear if mental resilience might have similar effects, they explain.

To explore this further, the researchers mined the US Health and Retirement Study (HRS), a long term nationally representative study of US adults aged at least 50. This study began in 1992 and includes information on the economic, health, marital and family status of participants who are monitored every 2 years. 

The researchers drew on two waves (2006–08) of HRS data, when questions on mental resilience were collected for the first time, and included a total of 10,569 participants with complete data in the final analysis. Their average age was 66; 59% of them were women.

Mental resilience was assessed using a validated scale encompassing qualities, such as perseverance, calmness, a sense of purpose, self-reliance and the recognition that certain experiences have to be faced alone. The average score of the entire sample was 9.18 (range 0-12). 

Participants were followed up until death or the end of May 2021, whichever came first. During an average tracking period of 12 years, 3489 people died. 

An almost linear association emerged between mental resilience score and death from any cause: the higher the score, the lower was the risk of death, with this association stronger in women than in men.  

Resilience scores were divided into quartiles (25%) and linked to 10-year survival probabilities. These were 61% for those in the bottom quartile (1), rising to 72% and 79% for the middle quartiles (2 and 3), and 84% for those in the top quartile (4). 

Survival analysis showed that those in the highest quartile were 53% less likely to die in the next 10 years than those in the lowest. 

This association remained statistically significant after adjusting for marital status, sex, race, and weight (BMI), but fell to 46% after factoring in ill health (diabetes, cancer, and cardiovascular disease) and to 38% after factoring in an unhealthy lifestyle. 

In all, the risk of death was 20% lower (2nd quartile), 27% lower (3rd), and 38% lower (4th) in those with higher mental resilience scores than it was in those with the lowest scores (Ist quartile), once potentially influential factors had been accounted for.

This is an observational study, and as such, no firm conclusions can be drawn about causality. And the researchers acknowledge that the potential influence of genetic and hormonal factors and childhood adversity weren’t considered. The analysis also relied on baseline data, overlooking potentially influential changes during the monitoring period. 

“Various factors, including but not limited to, meaning in life, positive emotions, self-rated health and satisfaction with social support, have been identified as potential influences on psychological resilience,” they explain. 

“Triggering these positive emotions may enhance the protective effects of psychological resilience and mitigate the negative impact of accumulated adversity on mental health in adults.”

They conclude: “The findings underscore the potential effectiveness of interventions aimed at promoting psychological resilience in order to mitigate mortality risks.”

How hope beats mindfulness when times are tough

A recent study finds that hope appears to be more beneficial than mindfulness at helping people manage stress and stay professionally engaged during periods of prolonged stress at work. The study underscores the importance of looking ahead, rather than living “in the moment,” during hard times.

Mindfulness refers to the ability of an individual to focus attention on the present, in a way that is open, curious and not judgmental. Essentially, the ability to be fully in the moment.

“There’s a lot of discussion about the benefits of mindfulness, but it poses two challenges when you’re going through periods of stress,” says Tom Zagenczyk, co-author of a paper on the work and a professor of management in North Carolina State University’s Poole College of Management. “First, it’s hard to be mindful when you’re experiencing stress. Second, if it’s a truly difficult time, you don’t necessarily want to dwell too much on the experience you’re going through.

“Because hope is inherently forward looking, while mindfulness is about appreciating your current circumstances, we wanted to see how each of these two mindsets influenced people’s well-being and professional attitudes during difficult times,” Zagenczyk says. “The COVID pandemic presented us with an unfortunate, but useful, opportunity to explore this topic. And we chose to focus on the performing arts since that sector was particularly hard hit by the pandemic.”

For the study, researchers recruited 247 professional musicians from the organization MusiCares to take two surveys, one month apart. The first survey was given in September 2021. In addition to collecting broad demographic data, study participants were asked about their thoughts and experiences at the beginning of the pandemic – March to August 2020. They were also asked questions aimed at capturing how hopeful and mindful they were from September 2020 through March 2021.

The second survey was given in October 2021 and asked study participants questions aimed at capturing work engagement, work tensions, how positive their emotions were, and the extent to which they were experiencing distress.

The researchers then used statistical techniques to identify relationships between hope, mindfulness, and outcomes related to their personal well-being and attitudes toward work.

“Fundamentally, our findings tell us that hope was associated with people being happy, and mindfulness was not,” says Kristin Scott, study co-author and a professor of management at Clemson University. “And when people are hopeful – and happy – they experience less distress, are more engaged with their work, and feel less tension related to their professional lives.”

“Being mindful can be tremendously valuable – there are certainly advantages to living in the moment,” says Sharon Sheridan, study co-author and an assistant professor of management at Clemson. “But it’s important to maintain a hopeful outlook – particularly during periods of prolonged stress. People should be hopeful while being mindful – hold on to the idea that there’s a light at the end of the tunnel.”

While the study focused on musicians during an extreme set of circumstances, the researchers think there is a takeaway message that is relevant across industry sectors.

“Whenever we have high levels of job stress, it’s important to be hopeful and forward looking,” says Emily Ferrise, study co-author and a Ph.D. student at Clemson. “And to the extent possible, there is real value for any organization to incorporate hope and forward thinking into their corporate culture – through job conditions, organizational communications, etc.”

“Every work sector experiences periods of high stress,” says Zagenczyk. “And every company should be invested in having happy employees who are engaged with their work.”

The paper, “Work-related Resilience, Engagement and Wellbeing Among Music Industry Workers During the Covid-19 Pandemic: A Multiwave Model of Mindfulness and Hope,” is published open-access in the journal Stress and Health.