Tuesday, July 17, 2018

Early supper associated with lower risk of breast and prostate cancer

IMAGE: Early supper associated with breast and prostate cancer risk. view more 
Credit: ISGlobal
Having an early supper or leaving an interval of at least two hours before going to bed are both associated with a lower risk of breast and prostate cancer. Specifically, people who take their evening meal before 9 pm or wait at least two hours before going to sleep have an approximate 20% lower risk of those types of cancer compared to people who have supper after 10pm or those who eat and go to bed very close afterwards, respectively. These were the main conclusions of a new study by the Barcelona Institute for Global Health (ISGlobal), a centre supported by the "la Caixa" Banking Foundation. The study is the first to analyse the association between cancer risk and the timing of meals and sleep.
Previous studies of the link between food and cancer have focused on dietary patterns--for example, the effects of eating red meat, fruit and vegetables and the associations between food intake and obesity. However, little attention has been paid to other factors surrounding the everyday act of eating: the timing of food intake and the activities people do before and after meals. Recent experimental studies have shown the importance of meal timing and demonstrated the health effects of eating late at night.
The aim of the new study, published in the International Journal of Cancer, was to assess whether meal timing could be associated with risk of breast and prostate cancer, two of the most common cancers worldwide. Breast and prostate cancers are also among those most strongly associated with night-shift work, circadian disruption and alteration of biological rhythms. The study assessed each participant's lifestyle and chronotype (an individual attribute correlating with preference for morning or evening activity).
The study, which formed part of the MCC-Spain project, co-financed by the CIBER of Epidemiology and Public Health (CIBERESP), included data from 621 cases of prostate cancer and 1,205 cases of breast cancer, as well as 872 male and 1,321 female controls selected randomly from primary health centres. The participants, who represented various parts of Spain, were interviewed about their meal timing, sleep habits and chronotype and completed a questionnaire on their eating habits and adherence to cancer prevention recommendations.
"Our study concludes that adherence to diurnal eating patterns is associated with a lower risk of cancer," explained ISGlobal researcher Manolis Kogevinas, lead author of the study. The findings "highlight the importance of assessing circadian rhythms in studies on diet and cancer", he added.
If the findings are confirmed, Kogevinas noted, "they will have implications for cancer prevention recommendations, which currently do not take meal timing into account". He added: "The impact could be especially important in cultures such as those of southern Europe, where people have supper late."
ISGlobal researcher Dora Romaguera, the last author of the study, commented: "Further research in humans is needed in order to understand the reasons behind these findings, but everything seems to indicate that the timing of sleep affects our capacity to metabolise food."
Animal experimental evidence has shown that the timing of food intake has "profound implications for food metabolism and health", commented Romaguera.

Majority of older adults with probable dementia are likely unaware they have it

A Johns Hopkins Medicine analysis of information gathered for an ongoing and federally sponsored study of aging and disability adds to evidence that a substantial majority of older adults with probable dementia in the United States have never been professionally diagnosed or are unaware they have been.
A report of the findings was published in the July issue of the Journal of General Internal Medicine. Most of the findings, the researchers say, confirm previous similar estimates, but unaccompanied visits to a doctor or clinic emerged as a newly strong risk factor for lack of formal diagnosis or awareness of diagnosis.
"There is a huge population out there living with dementia who don't know about it," says Halima Amjad, M.D., M.P.H., assistant professor of medicine at the Johns Hopkins University School of Medicine and the study's lead author. "The implications are potentially profound for health care planning and delivery, patient-physician communication and much more," she says.
Overall, Amjad says, "If dementia is less severe and people are better able to perform day-to-day tasks independently, symptoms of cognitive loss are more likely masked, especially for patients who visit the doctor without a family member or friend who may be more aware of the patient's symptoms."
An estimated 5.7 million people in the United States live with dementia, according to the Alzheimer's Association, but only half of those have a documented, official diagnosis by a physician. Timely diagnosis is important for maintaining or improving health and planning care, says Amjad, so it's important to identify which populations are less likely to be diagnosed or less likely to be aware of their diagnosis.
Building on previous research, which identified activities and living conditions linked to dementia diagnosis, Amjad sought this time to pinpoint at-risk populations nationwide.
To do so, Amjad and the research team drew on data from the National Health and Aging Trends Study, an ongoing study of Medicare recipients ages 65 and older across the United States, and selected those who met criteria for probable dementia in 2011 and had three years of continuous fee-for-service Medicare claims before 2011. The latter information helped the researchers determine whether participants' physicians had billed for dementia diagnosis and/or care.
The research team identified 585 such adults and examined demographic data such as highest level of education attained, race/ethnicity and income, as well as data on whether participants were able to perform activities such as laundry, shopping or cooking on their own.
Among those with probable dementia, 58.7 percent were determined to be either undiagnosed (39.5 percent) or unaware of their diagnosis (19.2 percent).
Participants who were Hispanic, had less than a high school education, attended medical visits alone or were deemed more able to perform daily tasks were more likely to be undiagnosed. Specifically, those with at least a high school education had a 46 percent lower chance of being undiagnosed compared with those who had less education; and those who attended medical visits alone were twice as likely to be undiagnosed than those who were accompanied.
Participants who were diagnosed but unaware of their diagnosis had less education, attended visits alone more often and had fewer functional impairments. Those with at least a high school education had a 58 percent lower chance of being unaware compared with those who had less education. Those who attended medical visits alone were about twice as likely to be unaware than those who were accompanied. Each activity impairment decreased the chance of being unaware of diagnosis by 28 percent.
While Amjad acknowledges that the study is limited by potentially inaccurate self-reporting of dementia diagnoses, possible discrepancies between medical record documentation and billing codes, and the use of older data, she says the findings will likely help physicians be more alert to people who may need more careful screening.
"There are subsets of people doctors can focus on when implementing cognitive screening, such as minorities, those with lower levels of education and those who come in by themselves," says Amjad.
Looking forward, Amjad plans to study whether documentation of a dementia diagnosis is meaningful if patients and family members don't understand what a diagnosis means.

While men lose more weight on low-carb diets, women show improved artery flexibility

According to the Centers for Disease Control and Prevention, an estimated 1 out of 3 American adults live with higher than normal blood sugar levels known as prediabetes. Researchers from the University of Missouri School of Medicine recently found that while men may lose more weight on low-carb diets, women actually see better improvements in artery flexibility. It's a finding that may help pre-diabetic women reduce their risk for heart disease through a low-carb diet.

"Previous research has shown that as women age, their blood vessels stiffen more so than men, putting them at an increased risk of heart disease," said Elizabeth Parks, PhD, professor of nutrition and exercise physiology at MU. "Contrary to what you may think, you actually don't want stiff blood vessels. Rather, you want flexible vessels that expand slowly as the blood flows through them. Our study found that low-carb diets helped reduce the stiffness of arteries in women, which can, in turn, reduce their risk of developing serious heart conditions."

To illustrate this, Parks compares good vessels to be like a rubber hose and aging causing vessels to become stiff, similar to a plastic pipe. When you pour water through a rubber hose, the hose bends and flexes as the water makes its way through. When you pour water through a solid pipe, the water travels through the pipe quickly. In the human body, for good health, we want flexible, pliable, resilient arteries.

As part of the study, 20 middle-aged, pre-diabetic men and women were given carb-restricted meals provided by the MU Nutrition Center for Health for two weeks and were supplied meal planning instructions for an additional two weeks. Over the four-week period, the men in the study lost 6.3 percent of their body weight, while women lost 4.4 percent. However, using an arterial stiffness measurement called pulse wave velocity, the women showed reduced blood flow speeds of 1 meter per second, while men showed no changes in blood flow speed.
"Vascular stiffness is a natural process of aging that can be accelerated by obesity, insulin resistance and metabolic syndrome," said Parks, who also serves as associate director of the MU Clinical Research Center. "Our study is the first to demonstrate that weight loss can reduce arterial stiffness in as little as four weeks and that dietary carbohydrate restriction may be an effective treatment for reducing aortic stiffness in women."
The study, "Effect of carbohydrate restriction-induced weight loss on aortic pulse wave velocity in overweight men and women," recently was published online by Applied Physiology, Nutrition and Metabolism. In addition to Parks, study authors also include Majid Syed-Abdul, Qiong Hu, Miriam Jacome-Sosa, Jaume Padilla and Camila Manrique-Acevedo with the MU School of Medicine. Colette Heimowitz, an expert in low-carb diets from the company, Atkins Nutritionals, was also an author. The study was funded by the University of Missouri and Atkins Nutritional, who also provided some of the foods subjects ate. Parks is a member of the Scientific Advisory Board of Atkins Nutritionals Inc, led by Heimowitz. The other study authors declare that they have no conflicts of interest. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

As we get parched, cognition can easily sputter

Anyone lost in a desert hallucinating mirages knows that extreme dehydration discombobulates the mind. But just two hours of vigorous yard work in the summer sun without drinking fluids could be enough to blunt concentration, according to a new study.

Cognitive functions often wilt as water departs the body, researchers at the Georgia Institute of Technology reported after statistically analyzing data from multiple peer-reviewed research papers on dehydration and cognitive ability. The data pointed to functions like attention, coordination and complex problem solving suffering the most, and activities like reacting quickly when prompted not diminishing much.

"The simplest reaction time tasks were least impacted, even as dehydration got worse, but tasks that require attention were quite impacted," said Mindy Millard-Stafford, a professor in Georgia Tech's School of Biological Sciences.

Less fluid, more goofs

As the bodies of test subjects in various studies lost water, the majority of participants increasingly made errors during attention-related tasks that were mostly repetitive and unexciting, such as punching a button in varying patterns for quite a few minutes. There are situations in life that challenge attentiveness in a similar manner, and when it lapses, snafus can happen.

"Maintaining focus in a long meeting, driving a car, a monotonous job in a hot factory that requires you to stay alert are some of them," said Millard-Stafford, the study's principal investigator. "Higher-order functions like doing math or applying logic also dropped off."

The researchers have been concerned that dehydration could raise the risk of an accident, particularly in scenarios that combine heavy sweating and dangerous machinery or military hardware.

Millard-Stafford and first author Matthew Wittbrodt, a former graduate research assistant at Georgia Tech and now a postdoctoral researcher at Emory University, published their meta-analysis of the studies in the latest edition of the journal Medicine & Science in Sports & Exercise.
It can happen quickly

There's no hard and fast rule about when exactly such lapses can pop up, but the researchers examined studies with 1 to 6 percent loss of body mass due to dehydration and found more severe impairments started at 2 percent. That level has been a significant benchmark in related studies.
"There's already a lot of quantitative documentation that if you lose 2 percent in water it affects physical abilities like muscle endurance or sports tasks and your ability to regulate your body temperature," said Millard-Stafford, a past president of the American College of Sports Medicine. "We wanted to see if that was similar for cognitive function."

The researchers looked at 6,591 relevant studies for their comparison, then narrowed them down to 33 papers with scientific criteria and data comparable enough to do metadata analysis. They focused on acute dehydration, which anyone could experience during exertion, heat and/or not drinking as opposed to chronic dehydration, which can be caused by a disease or disorder.

One day to lousy

How much fluid loss adds up to 2 percent body mass loss?

"If you weigh 200 pounds and you go work out for a few of hours, you drop four pounds, and that's 2 percent body mass," Millard-Stafford said. And it can happen fast. "With an hour of moderately intense activity, with a temperature in the mid-80s, and moderate humidity, it's not uncommon to lose a little over 2 pounds of water."

"If you do 12-hour fluid restriction, nothing by mouth, for medical tests, you'll go down about 1.5 percent," she said. "Twenty-four hours fluid restriction takes most people about 3 percent down."
And that begins to affect more than cognition or athletic abilities.

"If you drop 4 or 5 percent, you're going to feel really crummy," Millard-Stafford said. "Water is the most important nutrient."

She warned that older people can dry out more easily because they often lose their sensation of thirst and also, their kidneys are less able to concentrate urine, which makes them retain less fluid. People with high body fat content also have lower relative water reserves than lean folks.

Don't overdo water

Hydration is important, but so is moderation.

"You can have too much water, something called hyponatremia," Millard-Stafford said. "Some people overly aggressively, out of a fear of dehydration, drink so much water that they dilute their blood and their brain swells."

This leads to death in rare, extreme cases, for example, when long-distance runners constantly drink but don't sweat much and end up massively overhydrating.

"Water needs to be enough, just right," Millard-Stafford said.

Also, she warned that while salt avoidance may be good for sedentary people or hypertension patients, whoever sweats needs some salt as well, or they won't retain the water they drink.

The scent of coffee appears to boost performance in math

Drinking coffee seems to have its perks. In addition to the physical boost it delivers, coffee may lessen our risk of heart disease, diabetes and dementia. Coffee may even help us live longer. Now, there's more good news: research at Stevens Institute of Technology reveals that the scent of coffee alone may help people perform better on the analytical portion of the Graduate Management Aptitude Test, or GMAT, a computer adaptive test required by many business schools.

The work, led by Stevens School of Business professor Adriana Madzharov, not only highlights the hidden force of scent and the cognitive boost it may provide on analytical tasks, but also the expectation that students will perform better on those tasks. Madzharov, with colleagues at Temple University and Baruch College, recently published their findings in the Journal of Environmental Psychology.

"It's not just that the coffee-like scent helped people perform better on analytical tasks, which was already interesting," says Madzharov. "But they also thought they would do better, and we demonstrated that this expectation was at least partly responsible for their improved performance." In short, smelling a coffee-like scent, which has no caffeine in it, has an effect similar to that of drinking coffee, suggesting a placebo effect of coffee scent.

In their work, Madzharov and her team administered a 10-question GMAT algebra test in a computer lab to about 100 undergraduate business students, divided into two groups. One group took the test in the presence of an ambient coffee-like scent, while a control group took the same test - but in an unscented room. They found that the group in the coffee-smelling room scored significantly higher on the test.

Madzharov and colleagues wanted to know more. Could the first group's boost in quick thinking be explained, in part, by an expectation that a coffee scent would increase alertness and subsequently improve performance?

The team designed a follow-up survey, conducted among more than 200 new participants, quizzing them on beliefs about various scents and their perceived effects on human performance. Participants believed they would feel more alert and energetic in the presence of a coffee scent, versus a flower scent or no scent; and that exposure to coffee scent would increase their performance on mental tasks. The results suggest that expectations about performance can be explained by beliefs that coffee scent alone makes people more alert and energetic.

Madzharov, whose research focuses on sensory marketing and aesthetics, is looking to explore whether coffee-like scents can have a similar placebo effect on other types of performance, such as verbal reasoning. She also says that the finding - that coffee-like scent acts as a placebo for analytical reasoning performance - has many practical applications, including several for business.

"Olfaction is one of our most powerful senses," says Madzharov. "Employers, architects, building developers, retail space managers and others, can use subtle scents to help shape employees' or occupants' experience with their environment. It's an area of great interest and potential."

Monday, July 16, 2018

Subjective Cognitive Decline Among Adults Aged ≥45 Year

Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss within the previous 12 months (1,2) and one of the earliest noticeable symptoms of Alzheimer’s disease (Alzheimer’s), a fatal form of dementia (i.e., a decline in mental abilities severe enough to interfere with everyday life) (1). Alzheimer’s is the most common form of dementia, although not all memory loss results from Alzheimer’s (3). To examine SCD, CDC analyzed combined data from the 2015 and 2016 Behavioral Risk Factor Surveillance System (BRFSS) surveys. Overall, 11.2% of adults aged ≥45 years reported having SCD, 50.6% of whom reported SCD-related functional limitations. Among persons living alone aged ≥45 years, 13.8% reported SCD; among persons with any chronic disease, 15.2% reported SCD. Adults should discuss confusion or memory loss with a health care professional who can assess cognitive decline and address possible treatments and issues related to chronic disease management, medical care, and caregiving.
Respondents who answered affirmatively to the question “During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?” were classified as having SCD. Respondents with SCD were asked if SCD caused them to give up day-to-day activities such as cooking, cleaning, taking medications, driving, or paying bills; how often they needed and could receive necessary assistance with those activities; how often SCD interfered with their ability to work, volunteer, or engage in social activities; and whether they had discussed SCD with a health care professional. Respondents who reported “always,” “usually,” or “sometimes” (as opposed to “rarely” or “never”) giving up day-to-day activities or interference with ability to work, volunteer, or engage in social activities were classified as having SCD-related functional limitations.
Among adults aged ≥45 years, 11.2% reported SCD, 50.6% of whom reported SCD-related functional difficulties (Table 1). SCD prevalence increased with age, from 10.4% among adults aged 45–54 years to 14.3% among those aged ≥75 years and was lower among college graduates (7.0%) than among those with less than high school education (18.2%). The prevalence of SCD-related functional difficulties among college graduates (30.8%) was half that of those without a high school diploma (64.9%). Among persons living alone, 13.8% reported SCD; 55.7% of those reported SCD-related functional difficulties (Table 1).

The prevalence of SCD varied by state (Table 2). The lowest prevalence of SCD was reported in South Dakota (6.0%), and the highest was reported in Nevada (16.3%).

Nearly twice the percentage of persons reporting SCD-related functional limitations had talked to a health care professional (58.1%) compared with those without functional limitations (30.4%) (Table 3). Among persons with a functional difficulty, 81.1% reported having given up household activities or chores because of SCD, and 73.3% reported that SCD interfered with their ability to work, volunteer, or engage in social activities.


SCD can be a symptom of early-stage dementia conditions, including Alzheimer’s (1,2). Not everyone who reports SCD will develop dementia, but some studies have shown that half of older adults with subjective memory complaints go on to develop more severe cognitive decline within 7–18 years (1,4,5). Even without progression to more severe cognitive impairment, SCD might signify a decreased ability for self-care. Inability to perform activities important to daily living such as preparing meals or managing money affect the ability to live independently and might also affect the ability to socialize or remain fully employed.
These findings are similar to those from an analysis of persons aged ≥60 years in 21 states from the 2011 BRFSS survey, which found a 12.7% prevalence of SCD (6). In that study, the highest prevalence was among Hispanics (16.9%) and the lowest was among non-Hispanic blacks (11.8%), in contrast to the current study, which found the highest prevalence among non-Hispanic American Indians and Alaska Natives (19.6%) and the lowest among non-Hispanic Asians or Native Hawaiians/Other Pacific Islanders (6.8%). The inclusion of additional states and the expansion of the age groups might have contributed to these differences.
In both 2011 (6) and 2015–2016, a higher SCD prevalence was found among adults aged ≥75 years than among those aged 45–74 years. This is similar to the prevalence of Alzheimer’s, according to 2018 data from the Alzheimer’s Association, which found an estimated 3% of persons aged 65–74 years, 17% of persons aged 75–84 years, and 32% of persons aged ≥85 years had Alzheimer’s (1,7). This analysis found a higher prevalence of SCD and related functional limitations in persons with less formal education, similar to previously reported patterns of higher dementia prevalence in persons with less formal education (8).
Younger adults might be more likely to attribute limitations in their lifestyle to SCD or might be more sensitive to its effects. Conversely, older adults might be less aware of the effects of SCD or consider it a normal part of aging. Among persons aged 45–54 years, 10.4% reported SCD, and 59.8% of those persons reported SCD-related limitations that affected work, household chores, or social activities. Although Alzheimer’s is rare in persons aged <65 45="" a="" adults="" aged="" alzheimer="" among="" and="" are="" be="" can="" cognitive="" consume="" contribute="" could="" decline="" dementia="" disorders="" early="" economic="" finding="" functional="" goods="" have="" health="" i="" impacts.="" important="" in="" indicate="" like="" limitations="" memory="" might="" most="" of="" peak="" precursor="" prime="" productive="" related="" retirements="" s.="" salaries="" scd="" services="" symptoms="" that="" the="" their="" these="" to="" when="" workers="" working="" years="" younger="">9
). An inability to work during these years might have financial implications for these adults and their families. Persons with SCD-related functional limitations might have to reduce their time working or leave the workforce entirely; in this study, nearly three fourths of those with a functional difficulty reported that SCD interfered with their ability to engage in activities outside the home, including working. Fewer than half (45.4%) of respondents with SCD reported speaking to a health care professional about it. More than half of those with SCD-related functional limitations reported speaking to a health care professional about SCD compared with fewer than one third of persons without such limitations, suggesting that limitations in ability to perform instrumental activities of daily living might prompt discussion with a health care professional. Persons might incorrectly believe that cognitive decline is an inevitable part of aging, which could discourage them from consulting a health care professional. CDC encourages persons with confusion or memory loss to talk to a health care professional. After evaluation, even if treatment of symptoms is not an option, early assessment of cognitive issues can facilitate addressing potential safety issues, discussion of advanced care planning, including the need for caregiving, and ensuring receipt of appropriate information and referrals (10). Early assessment is important because memory issues can affect a person’s ability to manage their health; among those reporting other chronic health conditions, 15.2% also had SCD.
The findings in this report are subject to at least three limitations. First, data on SCD are self-reported. Whereas the SCD module was cognitively tested, it is not administered alongside an objective measure of cognitive performance. Therefore, the accuracy of the reports of SCD is unknown. Second, response bias might affect response to SCD questions and might underestimate SCD prevalence. Finally, BRFSS is not administered to persons with known cognitive problems who might not generate reliable data. In addition, BRFSS is only administered to noninstitutionalized adults, excluding adults living in long-term care facilities, where a proportion of residents have SCD. Therefore, these results cannot be used to estimate the prevalence of SCD across all U.S. populations.
Cognitive decline is an important public health issue affecting older adults, their families, and their caregivers, as well as the economy and health care system. As a precursor to dementia, including Alzheimer’s, SCD can impair a person’s ability to care for themselves by limiting their ability to work, particularly those adults who report SCD in their prime working years (i.e., 45–54 years). Estimating the prevalence of SCD might allow states to plan for those who might develop dementia in the future.

Thursday, July 12, 2018

An orange a day keeps macular degeneration away: 15-year study

A new study has shown that people who regularly eat oranges are less likely to develop macular degeneration than people who do not eat oranges.

Researchers at the Westmead Institute for Medical Research interviewed more than 2,000 Australian adults aged over 50 and followed them over a 15-year period.

The research showed that people who ate at least one serving of oranges every day had more than a 60% reduced risk of developing late macular degeneration 15 years later.

Lead Researcher Associate Professor Bamini Gopinath from the University of Sydney said the data showed that flavonoids in oranges appear to help prevent against the eye disease.

"Essentially we found that people who eat at least one serve of orange every day have a reduced risk of developing macular degeneration compared with people who never eat oranges," she said.
"Even eating an orange once a week seems to offer significant benefits.

"The data shows that flavonoids found in oranges appear to help protect against the disease."
Associate Professor Gopinath said that until now most research has focused on the effects of common nutrients such as vitamins C, E and A on the eyes.

"Our research is different because we focused on the relationship between flavonoids and macular degeneration.

"Flavonoids are powerful antioxidants found in almost all fruits and vegetables, and they have important anti-inflammatory benefits for the immune system.
"We examined common foods that contain flavonoids such as tea, apples, red wine and oranges.
"Significantly, the data did not show a relationship between other food sources protecting the eyes against the disease," she said.
One in seven Australians over 50 have some signs of macular degeneration. Age is the strongest known risk factor and the disease is more likely to occur after the age of 50.
There is currently no cure for the disease.
The research compiled data from the Blue Mountains Eye Study, a benchmark population-based study that started in 1992.
It is one of the world's largest epidemiology studies, measuring diet and lifestyle factors against health outcomes and a range of chronic diseases.
"Our research aims to understand why eye diseases occur, as well as the genetic and environmental conditions that may threaten vision," Associate Professor Gopinath concluded