Thursday, September 20, 2018

Regular, low-intensity exercise reduces severity of stroke


People who walk just 35 minutes a day may have less severe strokes


People who participate in light to moderate physical activity, such as walking at least four hours a week or swimming two to three hours a week, may have less severe strokes than people who are physically inactive, according to a study published in the September 19, 2018, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"Stroke is a major cause of serious disability, so finding ways to prevent stroke or reduce the disability caused by stroke are important," said study author Katharina S. Sunnerhagen, MD, PhD, of the University of Gothenburg in Sweden. "While exercise benefits health in many ways, our research suggests that even simply getting in a small amount of physical activity each week may have a big impact later by possibly reducing the severity of a stroke."
For the study, researchers looked at two Swedish stroke registries and identified 925 people with an average age of 73 who had a stroke. The registries included data on stroke severity based on symptoms such as eye, arm and facial movements, level of consciousness and language skills. Of study participants, 80 percent had a mild stroke.
To determine physical activity, participants were asked after the stroke how much they moved or exercised during leisure time before the stroke. Questions about duration and intensity of exercise were used to determine the average amount of physical activity. Relatives were asked to confirm exercise levels when needed.
Light physical activity was defined as walking at least four hours a week. Moderate physical activity was defined as more intense exercise such as swimming, brisk walking, or running two to three hours a week. Of study participants, 52 percent said they were physically inactive before having their stroke.
It is important to note that participants reporting on their own physical activity after having a stroke is a limitation of the study. It is possible that memory may be affected by a stroke, and more so in people with more severe stroke.
Researchers found that people who engaged in light to moderate physical activity before their stroke were twice as likely to have a mild stroke rather than a moderate or severe stroke when compared to people who were physically inactive. Of 481 people who were physically inactive, 354 had mild stroke, or 73 percent. Of 384 who engaged in light physical activity, 330 had mild stroke, or 85 percent. Of 59 people who engaged in moderate physical activity, 53 had mild stroke, or 89 percent. Researchers found that light and moderate physical activity were equally beneficial.
"There is a growing body of evidence that physical activity may have a protective effect on the brain and our research adds to that evidence," said Sunnerhagen. "Further research is needed to better understand just how physical activity influences the severity of a stroke. Finally, physical inactivity should be monitored as a possible risk factor for severe stroke."
Sunnerhagen noted that the difference in physical activity did not account for a large amount of the difference in stroke severity. When combined with younger age, greater physical activity accounted for only 6.8 percent of the difference between the two groups.
Sunnerhagen also stated that the study does not prove that physical activity reduces stroke severity; it only shows an association.


Stroke significantly impacts the ability of individuals to function independently. Research suggests that individuals who are physically active before suffering a stroke tend to have better outcomes.
In an editorial in this week's Neurology, Nicole Spartano, PhD, research assistant professor of medicine at Boston University School of Medicine (BUSM), agrees that a recent study (Reinholdsson et. al.), which proposes that individuals who reported being physically active (defined as either two hours of moderate intensity or four hours of light activity per week) before their stroke had milder symptoms. She attributes this protection to maintenance of a complex network of blood vessels within the brain. "Animal studies have shown that exercise promotes redundancies in the cerebrovascular system, in which multiple arteries feed the same brain regions. While the mechanism for an active lifestyle's effect on stroke severity is not fully understood, current literature seems to suggest that these individuals may be protected."
Spartano acknowledges that while these studies are promising, more work remains to be done. "Further research will need to investigate the specific doses of physical activity (frequency, duration, and intensity) and contexts that can provide the most benefit for cerebrovascular health." She also notes larger studies that gather data about baseline level of physical activity before their stroke may help to remove some bias from the data. "A study design that assesses lifestyle factors retrospectively through self-report is prone to recall bias, potentially influenced by disease status/severity."
Ultimately, Spartano is optimistic that further study in this area can make a major difference in lowering the impact of stroke on patients' function and independence. "Reducing the size and severity of stroke has great potential to benefit individual and public health."

High gluten diet in pregnancy linked to increased risk of diabetes in children



A high gluten intake by mothers during pregnancy is associated with an increased risk of their child developing type 1 diabetes, suggests a study published by The BMJ today.
However, the researchers say that further studies are needed to confirm or rule out these findings before any changes to dietary recommendations could be justified.
Gluten is a general name for the proteins found in wheat, rye, and barley and is suggested to affect the development of type 1 diabetes. In animal studies, a gluten free diet during pregnancy almost completely prevented type 1 diabetes in offspring, but no intervention study has been undertaken in pregnant women.
To better understand the nature of this association, researchers led by Julie Antvorskov at the Bartholin Institute in Denmark in collaboration with researchers at Denmark's Statens Serum Institut, set out to examine whether gluten intake during pregnancy is associated with subsequent risk of type 1 diabetes in children.
They analysed data for 63,529 pregnant women enrolled into the Danish National Birth Cohort between January 1996 and October 2002.
Women reported their diet using a food frequency questionnaire at week 25 of pregnancy and information on type 1 diabetes in their children was obtained through the Danish Registry of Childhood and Adolescent Diabetes.
Average gluten intake was 13 g/day, ranging from less than 7 g/day to more than 20 g/day, and the researchers identified 247 cases of type 1 diabetes (a rate of 0.37%) among the participants' children.
After taking account of potentially influential factors, such as mother's age, weight (BMI), total energy intake, and smoking during pregnancy,they found that the child's risk of type 1 diabetes increased proportionally with the mother's gluten intake during pregnancy (per 10 g/day increase).
For example, children of women with the highest gluten intake (20 g/day or more) versus those with the lowest gluten intake (less than 7 g/day) had double the risk of developing type 1 diabetes over a mean follow-up period of 15.6 years.
This is an observational study, so no firm conclusions can be drawn about cause and effect. However, the researchers say this was a high quality study with a large sample size, and they were able to adjust for a number of factors that could have affected the results.
The mechanisms that might explain this association are not known, but could include increased inflammation or increased gut permeability (so-called leakiness of the gut), they write. However, more evidence is needed before changes to dietary recommendations could be justified, they conclude.
In a linked editorial, researchers at the National Institute for Health and Welfare in Finland, say further studies are needed "to identify whether the proposed association really is driven by gluten, or by something else in the grains or the diet."
The authors agree that it is too early to change dietary recommendations on gluten intake in pregnancy, but say doctors, researchers, and the public "should be aware of the possibility that consuming large amounts of gluten might be associated with an increased risk for the child to develop type 1 diabetes, and that further studies are needed to confirm or rule out these findings, and to explore possible underlying mechanisms."

Mediterranean-style diet may lower women's stroke risk



Following a Mediterranean-style diet may reduce stroke risk in women over 40 but not in men - according to new research led by the University of East Anglia.

A new report, published today in the American Heart Association's journal Stroke, reveals that a diet high in fish, fruit, vegetables, nuts and beans, and lower in meat and dairy, reduces stroke risk among white adults who are at high risk of cardiovascular disease.

The study is one of the largest and longest-running efforts to evaluate the potential benefits of the Mediterranean-style diet in lowering the risk of stroke.

It shows that the diet may be especially protective in women over 40 regardless of menopausal status or hormone replacement therapy.

Researchers from UEA, the University of Aberdeen and the University of Cambridge collaborated to study the intake of key components of a traditional Mediterranean-style diet including high intakes of fish, fruits and nuts, vegetables, cereal foods and potatoes and lower meat and dairy consumption.

Over a 17-year period, researchers examined the diets of more than 23,000 participants and compared stroke risk among four groups ranked highest to lowest by how closely they adhered to a Mediterranean style diet.

Study participants (23,232 white adults, aged between 40 and 77) were from the EPIC-Norfolk study, the UK Norfolk arm of the multi-centre European Prospective Investigation into Cancer study.
In participants who most closely followed a Mediterranean-style diet, the reduced onset of stroke was:
  • 17 per cent in all adults;
  • 22 per cent in women; and
  • 6 per cent in men (which researchers said could have been due to chance).
Lead researcher Prof Ailsa Welch, from UEA's Norwich Medical School, said: "This research shows us that following a Mediterranean-style diet rich in fish, fruits and nuts, vegetables and beans, and lower in meat and dairy, may reduce stroke risk for women over 40.
"But a healthy, balanced diet is important for everyone both young and old," she added.
"It is unclear why we found differences between women and men, but it could be that components of the diet may influence men differently than women.
"We are also aware that different sub-types of stroke may differ between genders. Our study was too small to test for this, but both possibilities deserve further study in the future."
There was also a 13 per cent overall reduced risk of stroke in participants already at high risk of cardiovascular disease across all four groups of the Mediterranean-diet scores. However, this was driven mainly by the associations in women who showed a 20 per cent reduced stroke risk. This benefit appeared to be extended to people in low risk group although the possibility of chance finding cannot be ruled out completely.
"Our findings provide clinicians and the public with information regarding the potential benefit of eating a Mediterranean-style diet for stroke prevention, regardless of cardiovascular risk," said study co-author Prof Phyo Myint, from the University of Aberdeen.
Researchers used seven-day diet diaries, which had not been done before in such a large population. Seven-day diaries are more precise than food-frequency questionnaires and participants write down everything they eat and drink over the period of a week.
Eduardo Sanchez, chief medical officer for prevention at the American Heart Association, who was not part of this study, said: "The American Heart Association recommends a heart-healthy and brain-healthy dietary pattern that includes a variety of fruits and vegetables, whole grains, low-fat dairy products, fish, poultry, beans, non-tropical vegetable oils and nuts and limits saturated fat, trans fat, sodium, red meat, sweets and sugar-sweetened beverages; this dietary pattern reduces risk factors and risk for heart disease and stroke.
"This study provides more evidence that supports AHA's recommendation."

High-intensity exercise = same cell benefits in fewer minutes


A few minutes of high-intensity interval or sprinting exercise may be as effective as much longer exercise sessions in spurring beneficial improvements in mitochondrial function, according to new research. The small study is published ahead of print in the American Journal of Physiology--Regulatory, Integrative and Comparative Physiology.

Mitochondria, the energy centers of the cells, are essential for good health. Previous research has found that exercise creates new mitochondria and improves the function of existing mitochondria. Altered mitochondrial function in response to a single session of exercise generates signals that may lead to beneficial changes in the cells, lowering the risk for chronic disease. High-intensity interval exercise consists of short bursts of high-intensity aerobic exercise--physical activity that raises the heart rate--alternating with brief recovery periods. Whether the intensity of a workout affects mitochondrial response is unclear.

A team of researchers studied eight young adult volunteers as they participated in cycling workouts of varying intensity.
  • Moderate intensity consisted of 30 minutes of continuous exercise at 50 percent peak effort.
  • High-intensity interval exercise consisted of five four-minute cycling sessions at 75 percent peak effort, each separated by one minute of rest.
  • Sprint cycling consisted of four 30-second sessions at maximum effort, each separated by 4.5 minutes of recovery time.
The research team measured the amount of energy the volunteers spent on each workout and compared mitochondrial changes in the participants' thigh muscles before and after each exercise session. The researchers found that levels of hydrogen peroxide--a type of molecule involved in cell signaling called "reactive oxygen species" that contains oxygen and hydrogen--in different parts of the mitochondria change after exercise. While too much reactive oxygen species can be damaging to the cells, the researchers noted that the volunteers' levels were an appropriate amount to potentially promote cell responses that benefit metabolic function rather than cause damage.
In addition, the research team found that fewer minutes of higher-intensity exercise produced similar mitochondrial responses compared to a longer moderate-intensity activity. "A total of only two minutes of sprint interval exercise was sufficient to elicit similar responses as 30 minutes of continuous moderate-intensity aerobic exercise," the researchers wrote. "This suggests that exercise may be prescribed according to individual preferences while still generating similar signals known to confer beneficial metabolic adaptions. These findings have important implications for improving our understanding of how exercise can be used to enhance metabolic health in the general population."

Fish-rich diets may boost babies' brain development



Women could enhance the development of their unborn child's eyesight and brain function by regularly eating fatty fish during pregnancy. This is the suggestion from a small-scale study led by Kirsi Laitinen of the University of Turku and Turku University Hospital in Finland, in the Springer Nature-branded journal Pediatric Research. The research supports previous findings that show how important a prospective mother's diet and lifestyle choices are for the development of her baby.
According to Laitinen, a mother's diet during pregnancy and breastfeeding is the main way that valuable long-chain polyunsaturated fatty acids become available to a foetus and infant brain during the period of maximum brain growth during the first years of a child's life. Such fatty acids help to shape the nerve cells that are relevant to eyesight and particularly the retina. They are also important in forming the synapses that are vital in the transport of messages between neurons in the nervous system.
In this study, Laitinen and her colleagues analysed the results of 56 mothers and their children drawn from a larger study. The mothers had to keep a regular food diary during the course of their pregnancy. Fluctuations in their weight before and during pregnancy were taken into account, along with their blood sugar level and blood pressure. Aspects such as whether they smoked or developed diabetes related to pregnancy were also noted.
The team recorded the levels of nutritional long-chain polyunsaturated fatty acid sources in the mother's diet and blood serum, and the levels in the blood of their children by the age of one month. Their children were further tested around their second birthday using pattern reversal visual evoked potentials (pVEP). This sensitive and accurate, non-invasive method is used to detect visual functioning and maturational changes occurring within a young child's visual system.
The subsequent analyses of the visual test results revealed that infants whose mothers ate fish three or more times a week during the last trimester of their pregnancy fared better than those whose mothers ate no fish or only up to two portions per week. These observations were further substantiated when the serum phospholipid fatty acid status was evaluated.
"The results of our study suggest that frequent fish consumption by pregnant women is of benefit for their unborn child's development. This may be attributable to long-chain polyunsaturated fatty acids within fish, but also due to other nutrients like vitamin D and E, which are also important for development," explains Laitinen.
"Our study therefore highlights the potential importance of subtle changes in the diet of healthy women with uncompromised pregnancies, beyond prematurity or nutritional deficiencies, in regulating infantile neurodevelopment," adds Laitinen, who believes that their results should be incorporated into counselling given to pregnant women about their diets.

Tuesday, September 18, 2018

Eating foods with low nutritional quality ratings linked to cancer risk


The consumption of foods with higher scores on the British Food Standards Agency nutrient profiling system (FSAm-NPS), reflecting a lower nutritional quality, is associated with an increased risk of developing cancer, according to a study published this week in PLOS Medicine. The study, conducted by Mélanie Deschasaux of the French National Institute for Health and Medical Research (INSERM U1153/Inra/Cnam/Paris 13 University-EREN), France and colleagues, in association with the WHO-IARC, suggests broad potential for the use of FSAm-NPS-based package labeling (e.g. Nutri-Score) to promote healthy food choices in European settings.

Helping consumers make healthier food choices is a key challenge for the prevention of cancer and other chronic diseases. European authorities are considering implementing a unique nutrition label as a system to reflect the nutritional quality of food products, among which the five-color Nutri-Score derived from the FSAm-NPS, used in France and recently endorsed by Belgian authorities. How the consumption of foods with high/low FSAm-NPS scores relates to cancer risk has been studied in national and regional cohorts but has not been characterized in diverse European populations.

In their study, Deschasaux and colleagues analyzed food intake data from 471,495 adults from the European Prospective Investigation into Cancer and Nutrition (EPIC, 1992-2014, median follow-up: 15.3 y), among whom there were 49,794 incident cancer cases (main locations: breast, n = 12,063; prostate, n = 6,745; colon-rectum, n = 5,806). The researchers assigned each participant's diet a FSAm-NPS Dietary Index (DI), and computed multi-adjusted Cox proportional hazards models to describe any associations between the FSAm-NPS DI and cancer risks.

Absolute cancer rates in those with high and low (quintiles 5 and 1) FSAm-NPS DI were 81.4 and 69.5 cases/10,000 person-years, respectively. The researchers found that a higher FSAm-NPS DI, reflecting a lower nutritional quality of food consumed, was associated with a higher risk of total cancer (HR for Q5 versus Q1: 1.07; 95% CI: 1.03-1.10, P-trend < 0.001). Higher FSAm-NPS DI were specifically associated with higher risks of cancers of the colon-rectum, upper aerodigestive tract and stomach, lung for men, and liver and postmenopausal breast for women (all P < 0.05). The main study limitation was the use of self-reported dietary data, collected once at baseline.

The authors state, "This supports the relevance of the FSAm-NPS as underlying nutrient profiling system for front-of-pack nutrition labels, as well as for other public health nutritional measures."

Monday, September 17, 2018

Resveratrol is an effective add-on to NSAIDS to treat knee osteoarthritis

In what researchers state is the first pilot clinical trial to assess the effects of resveratrol on pain severity and levels of inflammatory biomarkers in patients with mild to moderate knee osteoarthritis, the scientists compared treatment with a nonsteroidal anti-inflammatory drug (NSAID) combined with either resveratrol or placebo over 90 days. Pain severity decreased significantly with resveratrol and blood levels of several inflammatory biomarkers were significantly reduced, accorded to the results published in Journal of Medicinal Food, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Click here to read the full-text article free on the Journal of Medicinal Food website through October 17, 2018.

The article entitled "Resveratrol Supplementation Reduces Pain and Inflammation in Knee Osteoarthritis Patients Treated with Meloxicam: A Randomized Placebo-Controlled Study" was coauthored by Saad Abdulrahman Hussain, Al-Rafidain University College (Baghdad, Iraq), Bushra Hassan Marouf, University of Sulaimani (Kurdistan Region, Iraq), and Ziyad Serdar Ali and Runj Simko Ahmmad, Shar Teaching Hospital (Kurdistan Region, Iraq).

Resveratrol, a polyphenol extracted from grape seeds has proven anti-inflammatory properties. The orally administered resveratrol, given as an adjuvant with meloxicam, led to a significant reduction in the total pain score and to significantly lower levels of serum biomarkers of inflammation common in knee osteoarthritis including TNF-α, interleukin IL-1ß, and IL-6.