Eating beans, peas, chickpeas or lentils may help lose weight and keep it off

Eating one serving a day of beans, peas, chickpeas or lentils could contribute to modest weight loss, a new study suggests.

Eating about 3/4 cup (130 grams) each day of these foods known as pulses led to a weight loss of 0.34 kilograms (just over half a pound), in a systematic review and meta-analysis of all available clinical trials on the effects of eating pulses.

The paper, by lead author Dr. Russell de Souza, a researcher with the Li Ka Shing Knowledge Institute of St. Michael's Hospital, was published today in The American Journal of Clinical Nutrition.

The research builds on previous work by the hospital's Clinical Nutrition and Risk Factor Modification Centre, that a daily serving of pulses makes people feel fuller than if they ate a control diet, and that eating pulses can significantly reduce "bad cholesterol."

"Despite their known health benefits, only 13 per cent of Canadians eat pulses on any given day and most do not eat the full serving," Dr. de Souza said. "So there is room for most of us to incorporate dietary pulses in our diet and realize potential weight management benefits."

The United Nations and the Food and Agriculture Organization have designated 2016 as the International Year of Pulses.

The meta-analysis looked at 21 clinical trials involving 940 adult men and women, who lost an average of 0.34 kg (0.75 pounds) over six weeks with the addition of a single serving of pulses to the diet--and without making a particular effort to reduce other foods.

Pulses have a low glycemic index (meaning that they are foods that break down slowly) and can be used to reduce or displace animal protein as well as "bad" fats such as trans-fat in a dish or meal.

Dr. de Souza noted that 90 per cent of weight loss interventions fail, resulting in weight regain, which may be due in part to hunger and food cravings.

"This new study fits well with our previous work, which found that pulses increased the feeling of fullness by 31 per cent, which may indeed result in less food intake." said Dr. de Souza.

Another recently published systematic review and meta-analysis found that eating on average one serving a day of beans, peas, chickpeas or lentils can also reduce "bad cholesterol" by five per cent and therefore lower the risk of cardiovascular disease.

Knowing which foods make people feel fuller longer may help them lose weight and keep it off.

"Though the weight loss was small, our findings suggest that simply including pulses in your diet may help you lose weight, and we think more importantly, prevent you from gaining it back after you lose it," Dr. de Souza said.

Exercise keeps muscles -- and you -- young

A University of Guelph professor has uncovered the "secret" to staying strong as we age - superb fitness.

Geoff Power found elderly people who were elite athletes in their youth or later in life - and who still compete as masters athletes -- have much healthier muscles at the cellular level compared to those of non-athletes.

His research was published recently in the Journal of Applied Physiology.

The study compared world-class track and field athletes in their 80s with people of the same age who are living independently. There have been few such studies of aging and muscle weakening in masters athletes in this age group.

"One of the most unique and novel aspects of this study is the exceptional participants," said Power, who joined U of G's Department of Human Health and Nutritional Sciences last fall.

"These are individuals in their 80s and 90s who actively compete in world masters track and field championships. We have seven world champions. These individuals are the crème de la crème of aging."

The study found that athletes' legs were 25 per cent stronger on average and had about 14 per cent more total muscle mass.

In addition, the athletes had nearly one-third more motor units in their leg muscles than non-athletes.

More motor units, consisting of nerve and muscle fibres, mean more muscle mass and subsequently greater strength.

With normal aging, the nervous system lose motor neurons, leading to a loss of motor units, reduced muscle mass, less strength, speed and power. That process speeds up substantially past age 60.

"Therefore, identifying opportunities to intervene and delay the loss of motor units in old age is of critical importance," Power said.

Power led the study as a visiting PhD student from Western University and the Canadian Centre for Activity and Aging at McGill University. He joined U of G last fall after a three-year post-doc at the University of Calgary.

In another recent study, published in the American Journal of Physiology - Cell Physiology, he looked at muscle fibre samples from the same elite athlete/non-athlete group.

Power studies healthy aging from cells to the whole body. "Exercise is definitely an important contributor to functional performance," he said, adding that even non-athletes can benefit. "Staying active, even later in life, can help reduce muscle loss."

But, he adds, "we cannot rule out the importance of genetics." He said further research is needed to determine whether muscle health in elite athletes comes from training or genes.

Carb-loading: acute and detrimental effect on the heart

Drinking a high carbohydrate shake can have an acute and detrimental effect on heart function, a study published in the Journal of the American College of Cardiology (JACC) has found.

A team of researchers from Vanderbilt and the University of Alabama at Birmingham (UAB) studied 33 individuals who were given an acute carbohydrate load in the form of a 264-kilocalorie shake. They studied the subjects' blood levels for six hours looking for a number of things, chief among them whether this acute metabolic challenge could alter the heart's production of atrial natriuretic peptide (ANP). ANP is a hormone that helps the body get rid of excess salt and reduces blood pressure.

Researchers know through previous studies that obese people make less ANP, predisposing them to salt retention and hypertension.

If a high dietary carbohydrate load suppresses circulating ANP concentrations, this would be a disadvantage to obese individuals who have lower ANP levels to begin with, the authors wrote in the JACC study.

Before the participants began the study, they were normalized on a standard diet for a couple of days to remove any background dietary variability. The investigators observed that drinking the high-carb shake led to a 25 percent reduction in ANP in participants over the course of several hours.

"The carbohydrate load had a significant and notable effect on circulating ANP levels. Experimental studies suggest that it's not good to make less ANP," said senior author Thomas Wang, M.D., chief of the Division of Cardiovascular Medicine, adding that "carb loading" may not be ideal for the body.

The investigators also looked at the mechanism for the decrease in ANP levels. They were able to reproduce the findings in mice, and found that the principal driver for the acute reduction in ANP appeared to be the increase in glucose.

"When you take in a high-carb shake a lot of things happen, including increases in glucose and insulin. However, the increase in glucose appears to be the main thing driving the drop in NP levels," Wang said.

UAB's Pankaj Arora, M.D., first author of the JACC study, helped to work out the novel chemical pathways that mediated the effect of glucose on heart cells.

This novel mechanism involved a molecule known as miR-425, which the research group has previously described as an inhibitor of ANP production. The glucose causes the cells to make more miR-425, and that, in turn, causes a reduction in ANP.

Soccer is great for older players' health

---

A new scientific study shows that long-term recreational soccer training produces a number of marked improvements in health profile for 63-75 year old untrained men -- including a reduced risk of developing cardiovascular diseases and diabetes. The research project was carried out at the Copenhagen Centre for Team Sport and Health at Copenhagen University, and the findings have just been published in the international journal PLOS ONE.

The study shows that regular participation in recreational soccer improved the health, physical fitness and muscle function of the 63-75 year old men in the study, and significantly reduced body weight.

Both short-term and long-term effects

As the study went on over a full year, the researchers were able to examine both the immediate effects and the long-term benefits of the training.

"Even after 4 months' soccer training, the cardiovascular fitness scores improved by 15%, interval work capacity increased by 43% and functional capacity by 30%. And after a year we also saw a 3% reduction in BMI purely from the loss of fat mass, with an increased ability to control blood sugar and an improved capacity to handle harmful oxygen radicals, which could otherwise cause increased oxidative stress in the body and have a harmful effect on many vital cell functions."

So says Thomas Rostgaard Andersen, who conducted the study as part of his recently completed PhD project at the Copenhagen Centre for Team Sport and Health at Copenhagen University's Department of Nutrition, Exercise and Sports.

"The improvements contribute significantly to reducing the risk of developing cardiovascular diseases and diabetes," he concludes.

Soccer preserves muscle mass

The training also had a positive effect on muscle mass.

"As we get older, we lose muscle mass, and that reduces our ability to maintain a physically active lifestyle. That is why it is important to preserve muscle mass into our later years, if we are to manage by ourselves for longer when we are old. In this study we saw how the participants reduced their body weight without losing muscle mass. This is very important for our ability to do ordinary day-to-day things, such as walking upstairs, tidying the garden and doing the shopping," explains Professor Jens Bangsbo, who was responsible for the project and heads the Copenhagen Centre for Team Sport and Health.

"Similar changes are typically observed after periods of strength training, and this underlines the fact that recreational soccer is an effective alternative to the training that is normally carried out to preserve muscle mass in older people. And soccer training is also sociable and fun, which motivate and keep inactive people exercising," he says.

Everyone completed the training period, and many are still playing soccer today

This is best illustrated by the fact that all the test subjects completed the full 52 weeks of training. This is not often seen in this type of study. And most of the participants are still playing soccer together twice a week -- two years after the research period finished.

"We asked some men to go out on a pitch. Then we gave them a ball -- and they started playing! And the fitter they got, the better and more intensively they trained. And they are sticking at it. It is self-regulating and easily accessible. It is for everyone. And that is completely unique among team games," says Thomas Rostgaard Andersen.

"The project has important societal aspects. More accessible facilities and recruiting older people to recreational soccer could help to reduce the challenges many older people face on the health and social front," concludes Jens Bangsbo.

Long naps, daytime sleepiness tied to greater risk of metabolic syndrome

Taking long naps or being excessively tired during the day is associated with a higher risk for developing metabolic syndrome, according to a study scheduled for presentation at the American College of Cardiology's 65th Annual Scientific Session.

Specifically, napping for 40 minutes or longer was associated with a steep increase in the risk of developing metabolic syndrome--a collection of health conditions such as high blood pressure, high cholesterol, excess fat around the waist and high blood sugar that all increase a person's risk for heart disease. Being overtired during the day was also associated with an increased risk of metabolic syndrome.

"Taking naps is widely prevalent around the world," said Tomohide Yamada, M.D., Ph.D., diabetologist at the University of Tokyo and lead author of the study. "So, clarifying the relationship between naps and metabolic disease might offer a new strategy of treatment, especially as metabolic disease has been increasing steadily all over the world."

This meta-analysis evaluated data from 21 observational studies involving 307,237 Asian and Western subjects and builds on previous work by Yamada and his colleagues that tied lengthy naps and daytime sleepiness to a greater prevalence of heart disease and type-2 diabetes. This study is the group's largest analysis to date of data collected from a number of countries.

Participants reported their daytime sleepiness by answering questions like, "Do you have a problem with sleepiness during the day," and their napping habits by answering questions like "Do you take a daytime nap" or "Do you sleep during the day." Researchers compared participants' answers to their history of metabolic syndrome, type-2 diabetes and obesity.

The results showed a J-shaped relationship between time spent napping and metabolic syndrome risk. Subjects who napped for less than 40 minutes did not show any increased risk for metabolic syndrome, but beyond 40 minutes, risk sharply rose. Napping for 90 minutes appeared to increase metabolic syndrome risk by as much as 50 percent, as did being excessively tired during the day. Interestingly, there was a slight dip or decrease in the risk of metabolic syndrome among those napping less than 30 minutes.

As previously reported, napping for longer than an hour or being excessively tired during the day each corresponded to a 50 percent increase in type-2 diabetes. The study did not show a relationship between time spent napping and obesity, despite the close links between obesity, diabetes and metabolic syndrome.

An earlier study by Yamada and colleagues, published in the June 2015 issue of Sleep tied naps longer than an hour to an 82 percent increase in cardiovascular disease and a 27 percent increase in all cause death. They also presented data at the Annual Meeting of the European Association for the Study of Diabetes in September 2015 that showed diabetes risk increased by 56 percent if subjects were fatigued and by 46 percent if they took naps longer than an hour.

Interestingly, all three studies showed a slight decrease in risk for their respective conditions when subjects napped for under a half an hour, though Yamada said more studies are needed to confirm this finding. The National Sleep Foundation advocates naps of 20 and 30 minutes to improve alertness without leaving sleepers groggy afterward.

"Sleep is an important component of our healthy lifestyle, as well as diet and exercise," Yamada said. "Short naps might have a beneficial effect on our health, but we don't yet know the strength of that effect or the mechanism by which it works."

Still, the results demonstrate a need for more research on how people's sleep habits influence metabolic syndrome and cardiovascular disease. All told, one in three American adults do not get enough sleep, according to the U.S. Centers for Diseases Control and Prevention.

Yamada said future research should aim to identify the potential cardiovascular benefits of short naps, as well as the mechanism by which long naps, daytime sleepiness and metabolic syndrome influence each other, and whether clinicians might eventually be able to use a patients' nap habits as a predictor for other health problems. Although this study included data from more than 300,000 participants, it may not be representative of the world population. Data was also dependent on self-reporting nap times, as opposed to objectively measuring sleep time in a lab or with a sleep tracker.
 

 

 

High serum omega-6 polyunsaturated fatty acid concentrations linked to lower risk of type 2 diabetes

A new study from the University of Eastern Finland shows that high serum omega-6 polyunsaturated fatty acid concentrations are linked to a significantly reduced risk of type 2 diabetes. The findings were published in the American Journal of Clinical Nutrition.

It has been speculated that a high intake of omega-6 polyunsaturated fatty acids may increase the risk of several chronic diseases, as these fatty acids have been suggested to promote low-grade inflammation, among other things. However, studies conducted on humans have not established a link between even a high intake of omega-6 fatty acids and inflammation. Furthermore, omega-6 fatty acids have beneficial effects on, for example, glucose metabolism. Earlier research has systematically linked especially linoleic acid, which is the most common omega-6 fatty acid, to a reduced risk of cardiovascular diseases and type 2 diabetes. However, scientific evidence relating to the health effects of other omega-6 polyunsaturated fatty acids is not as inconclusive.

The serum fatty acid concentrations of 2,189 men aged between 42 and 60 years and with no baseline type 2 diabetes diagnosis were analysed at the onset of the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. During a follow-up of 19 years, 417 men were diagnosed with type 2 diabetes.

The study found that high serum omega-6 polyunsaturated fatty acid concentrations were associated with a 46% lower risk of developing type 2 diabetes during the follow-up. When analysing the independent associations of different omega-6 polyunsaturated fatty acids, a similarly significant association was found between high serum linoleic and arachidonic acid concentrations and a lower risk of type 2 diabetes. However, high serum gamma-linolenic and dihomo-γ-linolenic acid concentrations were linked to a higher risk.

The study indicates that high serum linoleic and arachidonic acid concentrations are linked to a lower risk of type 2 diabetes. The serum linoleic acid concentration is determined by the person's diet, and the main sources of linoleic acid are vegetable oils, nuts and seeds. Arachidonic acid is present in meat and eggs; however, the human body can also make arachidonic acid from linoleic acid.
Gamma-linolenic acid and dihomo-γ-linolenic acid are mainly formed in the human body from linoleic acid. Their concentrations in serum are very low in comparison to, for example, linoleic acid.

The association of gamma-linolenic acid and dihomo-γ-linolenic acid with a higher risk of type 2 diabetes has been observed in some earlier studies, but the underlying reason remains unknown.
All in all, however, this study as well as several earlier ones suggest that polyunsaturated omega-6 fatty acids have a beneficial impact on the risk of type 2 diabetes.

Mindfulness meditation offers relief for low-back pain

Mindfulness based stress reduction (MBSR) and cognitive-behavioral therapy (CBT) may prove more effective than usual treatment in alleviating chronic low-back pain, according to a new study funded by the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health.

Researchers from the Group Health Cooperative, Seattle, and the University of Washington, Seattle, conducted a study, published in the Journal of the American Medical Association, in which 342 participants aged 20 to 70 used one of the two mind and body approaches or sought usual care for one year. At 26 and 52 weeks, participants using MBSR and CBT had greater improvement in function and back pain compared to the group that remained in standard care.

Though pain intensity and some mental health measures improved in both groups, those using CBT did not see improvement beyond 26 weeks. Those using MBSR, however, continued to see improvement at 52 weeks, leading researchers to conclude MBSR may be an effective treatment for chronic low-back pain.

MBSR brings together elements of mindfulness meditation and yoga, whereas CBT is a form of psychotherapy that trains individuals to modify specific thoughts and behaviors.

For the study, participants in the group using MBSR and the group using CBT attended a two-hour group session on their respective approach per week for eight weeks and supplemented their treatment with workbooks and CDs for practice at home. The study was led by Daniel Cherkin, Ph.D., a senior scientific investigator at the Group Health Research Institute, Seattle.

Couples’ pre-pregnancy caffeine consumption linked to miscarriage risk

NIH study finds daily multivitamin before and after conception greatly reduces miscarriage risk.

A woman is more likely to miscarry if she and her partner drink more than two caffeinated beverages a day during the weeks leading up to conception, according to a new study from researchers at the National Institutes of Health and Ohio State University, Columbus. Similarly, women who drank more than two daily caffeinated beverages during the first seven weeks of pregnancy were also more likely to miscarry.

The study was published online in Fertility and Sterility.

“Our findings provide useful information for couples who are planning a pregnancy and who would like to minimize their risk for early pregnancy loss,” said the study’s first author, Germaine Buck Louis, Ph.D., director of the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The researchers analyzed data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study, which was established to examine the relationship between fertility, lifestyle and exposure to environmental chemicals. The LIFE Study enrolled 501 couples from four counties in Michigan and 12 counties in Texas, from 2005 to 2009.

For the current study, researchers compared such lifestyle factors as cigarette use, caffeinated beverage consumption and multivitamin use among 344 couples with a singleton pregnancy from the weeks before they conceived through the seventh week of pregnancy.

The researchers reported their results using a statistical concept known as a hazard ratio, which estimates the chances of a particular health outcome occurring during the study time frame. For example, the researchers evaluated caffeinated beverage consumption in terms of the daily likelihood of pregnancy loss over a given time period. A score greater than 1 indicates an increased risk for pregnancy loss each day following conception, and a score less than 1 indicates a reduced daily risk.

Of the 344 pregnancies, 98 ended in miscarriage, or 28 percent. For the preconception period, miscarriage was associated with female age of 35 or above, for a hazard ratio of 1.96 (nearly twice the miscarriage risk of younger women). The study was not designed to conclusively prove cause and effect. The study authors cited possible explanations for the higher risk, including advanced age of sperm and egg in older couples or cumulative exposure to substances in the environment, which could be expected to increase as people age.

Both male and female consumption of more than two caffeinated beverages a day also was associated with an increased hazard ratio: 1.74 for females and 1.73 for males. Earlier studies, the authors noted, have documented increased pregnancy loss associated with caffeine consumption in early pregnancy. However, those studies could not rule out whether caffeine consumption contributed to pregnancy loss or was a sign of an unhealthy pregnancy. It’s possible, the authors wrote, that these earlier findings could have been the result of a healthy pregnancy, rather than caffeine consumption interfering with pregnancy. For example, the increase in food aversions and vomiting associated with a healthy pregnancy led the women to give up caffeinated beverages.

Because their study found caffeine consumption before pregnancy was associated with a higher risk of miscarriage, it’s more likely that caffeinated beverage consumption during this time directly contributes to pregnancy loss.

“Our findings also indicate that the male partner matters, too,” Dr. Buck Louis said. “Male preconception consumption of caffeinated beverages was just as strongly associated with pregnancy loss as females’.”

Finally, the researchers saw a reduction in miscarriage risk for women who took a daily multivitamin. During the preconception period, researchers found a hazard ratio of 0.45 — a 55-percent reduction in risk for pregnancy loss. Women who continued to take the vitamins through early pregnancy had a hazard ratio of 0.21, or a risk reduction of 79 percent. The authors cited other studies that found that vitamin B6 and folic acid — included in preconception and pregnancy vitamin formulations — can reduce miscarriage risk. Folic acid supplements are recommended (link is external) for women of childbearing age, as their use in the weeks leading up to and following conception reduces the risk for having a child with a neural tube defect.

Infrequent home computer use may be indicative of early cognitive decline

A new study sheds light on a powerful tool that may detect signs of Alzheimer's disease before patients show any symptoms of cognitive decline: the home computer.

An early online version of this paper detailing the findings has been published and is scheduled for publication in the Journal of Alzheimer's Disease (volume 52, issue 2).

OHSU researchers have found a significant correlation between infrequent daily computer use and brain imaging signs commonly seen in early-stage Alzheimer's patients.

Using an MRI scan, the researchers measured the volume of the hippocampus -- a brain region integral to memory function -- in adults aged 65 years and older who were cognitively intact and dementia-free.

Diminished hippocampal volume is a well-known sign, or biomarker, of Alzheimer's disease and the eventual development of dementia.

The study, led by Lisa Silbert, M.D., with the OHSU Layton Center for Aging & Alzheimer's Disease, found that an additional hour of computer use a day was associated with a .025 percent larger hippocampal volume. A smaller hippocampal volume is an indicator of increased risk for developing Alzheimer's disease. The researchers will continue to follow these participants to see if their smaller hippocampal volume and decreased computer use predict future cognitive decline.

Silbert and colleagues hypothesize that the reason that patients with smaller hippocampal volumes may spend less time using their home computer is it requires the use of multiple cognitive domains, including executive function, attention and memory.

The researchers have been following a group of volunteers in Portland for nine years through a suite of embedded technology in their homes. These tools allow the researchers to assess their mobility, sleep, socialization, computer use and medication intake. The purpose of this monitoring is to identify meaningful changes in everyday life that don't involve the participants taking tests or going to doctor appointments.

Exercise may slow brain aging by 10 years for older people

 

Exercise in older people is associated with a slower rate of decline in thinking skills that occurs with aging. People who reported light to no exercise experienced a decline equal to 10 more years of aging as compared to people who reported moderate to intense exercise, according to a population-based observational study published in the March 23, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology. 

"The number of people over the age of 65 in the United States is on the rise, meaning the public health burden of thinking and memory problems will likely grow," said study author Clinton B. Wright, MD, MS, of the University of Miami in Miami, Fla., and member of the American Academy of Neurology. "Our study showed that for older people, getting regular exercise may be protective, helping them keep their cognitive abilities longer." 

For the study, researchers looked at data on 876 people enrolled in the Northern Manhattan Study who were asked how long and how often they exercised during the two weeks prior to that date. An average of seven years later, each person was given tests of memory and thinking skills and a brain MRI, and five years after that they took the memory and thinking tests again. 

Of the group, 90 percent reported light exercise or no exercise. Light exercise could include activities such as walking and yoga. They were placed in the low activity group. The remaining 10 percent reported moderate to high intensity exercise, which could include activities such as running, aerobics, or calisthenics. They were placed in the high activity group. 

When looking at people who had no signs of memory and thinking problems at the start of the study, researchers found that those reporting low activity levels showed a greater decline over five years compared to those with high activity levels on tests of how fast they could perform simple tasks and how many words they could remember from a list. The difference was equal to that of 10 years of aging. The difference also remained after researchers adjusted for other factors that could affect brain health, such as smoking, alcohol use, high blood pressure and body mass index. 

"Physical activity is an attractive option to reduce the burden of cognitive impairment in public health because it is low cost and doesn't interfere with medications," said Wright. "Our results suggest that moderate to intense exercise may help older people delay aging of the brain, but more research from randomized clinical trials comparing exercise programs to more sedentary activity is needed to confirm these results."

Warning: High-intensity training could hurt you if you're not an athlete

High-intensity 'sprint training' may be gaining popularity at gyms, but if you're new to this form of exercise, the workout could do more harm than good.

A study by Canadian and European researchers found signs of stress in the muscle tissues of their non-athlete, untrained subjects after ultra-intense leg and arm cycling exercises. Perhaps more concerning, researchers reported the untrained subjects had a weakened ability to fight off free radicals, molecules that can alter DNA and harm healthy cells.

"Our study raises questions about what the right dose and intensity of exercise for the average person really is," said Robert Boushel, the study's senior author and director of the University of British Columbia's School of Kinesiology. "We need to be cautious about supporting sprint training in the general population."

The researchers analyzed tissue samples from their test subjects and found that their mitochondria, the powerhouse of cells, were only firing at half-power post-training, reducing their capacity to consume oxygen and their ability to fight off damage from free radicals. High levels of free radicals in the body have been linked to a number of medical conditions, including cancer, premature aging and organ damage.

The potential long-term adverse effects of high-intensity sprint training are unknown, but Boushel and other researchers are continuing to study different levels of exercise, measuring the dosing of training against different biomarkers for health.

"If you're new to going to the gym, participating in high-intensity 'sprint' classes may increase your performance but might not be healthy for you," said Boushel.

Seasoned athletes and those who are well trained have built up antioxidant enzymes in their bodies to protect against free radicals, said Boushel. He recommended beginners start slowly and gradually increase intensity over time, under the supervision of a trained professional or kinesiologist.

Prolonged daily sitting linked to 3.8 percent of all-cause deaths

Sedentary behavior, particularly sitting, has recently become a prevalent public health topic and target for intervention. As work and leisure activities shift from standing to sitting, increased sitting time is starting taking a toll on our bodies. A new study in the American Journal of Preventive Medicine found that sitting for more than three hours per day is responsible for 3.8% of all-cause mortality deaths. Investigators also estimate that reducing sitting time to less than three hours per day would increase life expectancy by an average of 0.2 years. 

In order to properly assess the damaging effects of sitting, the study analyzed behavioral surveys from 54 countries around the world and matched them with statistics on population size, actuarial table, and overall deaths. Researchers found that sitting time significantly impacted all-cause mortality, accounting for approximately 433,000, or 3.8%, of all deaths across the 54 nations in the study. They also found that sitting had higher impact on mortality rates in the Western Pacific region, followed by European, Eastern Mediterranean, American, and Southeast Asian countries, respectively. 

This type of information is crucial to evaluating the effect sitting has on our lives, especially in light of recent research that shows prolonged sitting is associated with an increased risk of death, regardless of activity level. Researchers now believe that periods of moderate or vigorous physical activity might not be enough to undo the detrimental effects of extended sitting. 

While researchers found that sitting contributed to all-cause mortality, they also estimated the impact from reduced sitting time independent of moderate to vigorous physical activity. "It was observed that even modest reductions, such as a 10% reduction in the mean sitting time or a 30-minute absolute decrease of sitting time per day, could have an instant impact in all-cause mortality in the 54 evaluated countries, whereas bolder changes (for instance, 50% decrease or 2 hours fewer) would represent at least three times fewer deaths versus the 10% or 30-minute reduction scenarios," explained lead investigator Leandro Rezende, MSc, Department of Preventive Medicine, University of Sao Paulo School of Medicine. 

Studies are beginning to show us exactly how detrimental prolonged sitting is for our health, even when coupled with exercise; however, changing habits is a difficult proposition. "Although sitting is an intrinsic part of human nature, excessive sitting is very common in modern societies," commented Rezende. "Sedentary behavior is determined by individual, social, and environmental factors, all strongly influenced by the current economic system, including a greater number of labor-saving devices for commuting, at home and work, and urban environment inequalities that force people to travel longer distances and live in areas that lack support for active lifestyles."

The results of this analysis show that reducing sitting time, even by a small amount, can lead to longer lives, but lessening time spent in chairs may also prompt people to be more physically active in general. "Although sitting time represents a smaller impact compared with other risk factors, reducing sitting time might be an important aspect for active lifestyle promotion, especially among people with lower physical activity levels," emphasized Rezende. "In other words, reducing sitting time would help people increase their volumes of physical activity along the continuum to higher physical activity levels."

The public health burden of prolonged sitting is real. Accounting for 3.8% of all-cause mortality in this study, sitting is shortening the lives of people across the world. "The present findings support the importance of promoting active lifestyles (more physical activity and less sitting) as an important aspect for premature mortality prevention worldwide, and therefore the need for global action to reduce this risk factor."

Women who sunbathe are likely to live longer

New research looks into the paradox that women who sunbathe are likely to live longer than those who avoid the sun, even though sunbathers are at an increased risk of developing skin cancer.

An analysis of information on 29,518 Swedish women who were followed for 20 years revealed that longer life expectancy among women with active sun exposure habits was related to a decrease in heart disease and noncancer/non-heart disease deaths, causing the relative contribution of death due to cancer to increase.

Whether the positive effect of sun exposure demonstrated in this observational study is mediated by vitamin D, another mechanism related to UV radiation, or by unmeasured bias cannot be determined. Therefore, additional research is warranted.

"We found smokers in the highest sun exposure group were at a similar risk as non-smokers avoiding sun exposure, indicating avoidance of sun exposure to be a risk factor of the same magnitude as smoking," said Dr. Pelle Lindqvist, lead author of the Journal of Internal Medicine study. "Guidelines being too restrictive regarding sun exposure may do more harm than good for health."

More elderly using dangerous drug combinations

One in six older adults now regularly use potentially deadly combinations of prescription and over-the-counter medications and dietary supplements -- a two-fold increase over a five-year period, according to new research at the University of Illinois at Chicago.

Dima Mazen Qato, assistant professor of pharmacy systems, outcomes and policy, and her colleagues examined changes in medication use in a nationally representative sample of older adults between the ages of 62 and 85. In contrast to many existing studies of medication use by the elderly, these investigators conducted in-home interviews to accurately identify what people were actually taking.

According to the study, older adults using at least five prescription medications (a status known as polypharmacy) rose from 30.6 percent in 2005 to 35.8 percent in 2011.

Factors that may account for the rise include the implementation of Medicare Part D, changes in treatment guidelines, and the increased availability of generics for many commonly used drugs.

As an example, the use of simvastatin (Zocor) -- the most commonly used prescription medication in the older adult population, which became available as a generic in 2006 -- doubled from 10.3 percent to 22.5 percent, Qato said. Zocor is used to treat high cholesterol and may reduce the risk of heart attack and stroke.

Despite limited evidence of their clinical benefit, dietary supplements are being used by a growing number of older individuals, the study found -- an increase from 51.8 percent to 63.7 percent over the same time period, with nearly a 50 percent growth in the number of people using multiple supplements. The largest increase was found in the use of omega-3 fish oils -- a dietary supplement with limited evidence of cardiovascular benefits -- which rose from 4.7 percent of people surveyed in 2005 to 18.6 percent in 2011.

Fifteen potentially life-threatening drug combinations of the most commonly used medications and supplements in the study were also identified. Nearly 15 percent of older adults regularly used at least one of these dangerous drug combinations in 2011, compared to 8 percent in 2005.

More than half of the potential interactions involved a nonprescription medication or dietary supplement, Qato said. Preventative cardiovascular medications such as statins (cholesterol-lowering drugs, particularly simvastatin), anti-platelet drugs (such as clopidogrel and aspirin, used to prevent blood clots), and supplements (specifically omega-3 fish oil) accounted for the vast majority of these interacting drug combinations.

Cardiovascular prevention efforts and treatment guidelines promoting primary prevention may be undermined by these interactions, Qato said.

"Many older patients seeking to improve their cardiovascular health are also regularly using interacting drug combinations that may worsen cardiovascular risk," she said. "For example, the use of clopidogrel in combination with the proton-pump inhibitor omeprazole, aspirin, or naproxen -- all over-the-counter medications -- is associated with an increased risk of heart attacks, bleeding complications, or death. However, about 1.8 percent -- or 1 million -- older adults regularly use clopidogrel in interacting combinations."

Health care professionals should carefully consider the adverse effects of commonly used prescription and nonprescription medication combinations when treating older adults, Qato said, and counsel patients about the risks. "Improving safety in the use of interacting medication combinations has the potential to reduce preventable, potentially fatal, adverse drug events," she said.

While it is not known how many older adults in the U.S. die of drug interactions, Qato said, "the risk seems to be growing, and public awareness is lacking."

Only 2.7 percent of the U.S. adult population achieves all four healthy lifestyle behaviors

Only 2.7 percent of the U.S. adult population achieves all four of some basic behavioral characteristics that researchers say would constitute a "healthy lifestyle" and help protect against cardiovascular disease, a recent study concluded.

In this study, researchers from Oregon State University and the University of Mississippi examined how many adults succeed in four general barometers that could help define healthy behavior: a good diet, moderate exercise, a recommended body fat percentage and being a non-smoker. It's the basic health advice, in other words, that doctors often give to millions of patients all over the world.

Such characteristics are associated with a lower risk of cardiovascular disease as well as many other health problems, such as cancer and type 2 diabetes.

"The behavior standards we were measuring for were pretty reasonable, not super high," said Ellen Smit, senior author on the study and an associate professor in the OSU College of Public Health and Human Sciences. "We weren't looking for marathon runners."

From the perspective of public health, the findings of the research were not encouraging, Smit said.

"This is pretty low, to have so few people maintaining what we would consider a healthy lifestyle," she said. "This is sort of mind boggling. There's clearly a lot of room for improvement."

Part of the value of this study, the researchers said, is that the results are based on a large study group, 4,745 people from the National Health and Nutrition Examination Survey. It also included several measured behaviors, rather than just relying on self-reported information.

Measurements of activity were done with an accelerometer, a device people wore to determine their actual level of movement, with a goal of 150 minutes of moderate-to-vigorous activity a week. Blood samples were done to verify a person was a non-smoker. Body fat was measured with sophisticated X-ray absorptiometry, not just a crude measurement based on weight and height. A healthy diet was defined in this study as being in about the top 40 percent of people who ate foods recommended by the USDA.

The lifestyle characteristics were then compared to "biomarkers" of cardiovascular health. Some are familiar, such as blood pressure, cholesterol and glucose levels. Others are more sophisticated, such as C-reactive protein, fasting triglycerides, homocysteine and other data that can provide evidence of cardiovascular risk.

Many people, of course, accomplished one or more of the four basic lifestyle goals, such as not smoking or being adequately active. The most striking finding was how few people accomplished all the goals.

"I would expect that the more healthy lifestyles you have, the better your cardiovascular biomarkers will look," Smit said.

Indeed, the researchers found that having three or four healthy lifestyles, compared to none, generally was associated with better cardiovascular risk biomarkers, such as lower serum cholesterol and homocysteine levels. Having at least one or two healthy lifestyle characteristics, compared to none, was also associated with better levels of some cardiovascular risk biomarkers.

Among the other findings of the research:

• Although having more than one healthy lifestyle behavior is important, specific health characteristics may be most important for particular cardiovascular disease risk factors.
• For healthy levels of HDL and total cholesterol, the strongest correlation was with normal body fat percentage.
• A total of 71 percent of adults did not smoke, 38 percent ate a healthy diet, 10 percent had a normal body fat percentage, and 46 percent were sufficiently active.
• Only 2.7 percent of all adults had all four healthy lifestyle characteristics, while16 percent had three, 37 percent had two, 34 percent had one, and 11 percent had none.
• Women were more likely to not smoke and eat a healthy diet, but less likely to be sufficiently active.
• Mexican American adults were more likely to eat a healthy diet than non-Hispanic white or black adults.
• Adults 60 years and older had fewer healthy characteristics than adults ages 20-39, yet were more likely to not smoke and consume a healthy diet, and less likely to be sufficiently active.

Vegans may lack essential nutrient intake, Mayo Clinic study reports

The health benefits of a plant-based diet is well-known, but the question remains: Could vegans be at risk for deficiency of essential nutrients? A retrospective review by Mayo Clinic physicians recently published in the Journal of the American Osteopathic Association indicated that vegans should ensure adequate intake of a few nutrients.

According to a 2012 Gallup poll, two percent of the U.S. population follows a vegan diet, which is a strict plant-based diet that excludes all animal-derived foods. Increasingly, people are choosing to follow this diet for ethical, environmental, religious and health concerns. With the growing popularity of plant-based diets, the Mayo Clinic team compiled a review of recent literature to monitor and advise vegans to ensure proper nutritional intake. Nutrients of concern are vitamin B-12, iron, calcium, vitamin D, protein and omega-3 fatty acids.

"We found that some of these nutrients, which can have implications in neurologic disorders, anemia, bone strength and other health concerns, can be deficient in poorly planned vegan diets," says Heather Fields, M.D., Community and Internal Medicine at Mayo Clinic in Arizona. Contrary to popular belief, "Vegans have not been shown to be deficient in protein intake or in any specific amino acids."

The study points out that some vegans rely heavily on processed foods and may not eat a sufficient variety of fruits, vegetables and whole grains. A whole food, plant-based diet is commendable, and a well-planned vegan diet can be adequate to achieve proper nutrition, but requires some education.

The Mayo Clinic review team recommends that health care providers monitor vegan patients for adequate blood levels of vitamin B-12, iron, ferritin, calcium and vitamin D.

Older women lose much of their advantage in living active lives

In a reversal of a long-standing pattern, a new study shows that older women in the U.S. have lost ground relative to older men in the number of years they can expect to live free from disabilities past age 65.

The study, funded by the National Institute on Aging, was conducted by Vicki Freedman of the University of Michigan Institute for Social Research, Douglas Wolf of Syracuse University and Brenda Spillman of the Urban Institute.

An article on the findings was published online today by the American Journal of Public Health.

"Just a few decades ago, older women used to live more years than men without needing help taking care of themselves or managing basic household activities," Freedman said. "But that does not appear to be the case anymore."

The researchers used data from 1982, 2004 and 2011 drawn from two large studies of disability trends in the U.S. among representative samples of Medicare enrollees.

Over the full 30-year period, they found that men's active life expectancy at age 65 increased by more than four years.

During the same period, women's active life expectancy at age 65 increased by only 1.4 years.

"Older men have been living longer and experiencing disability at later ages than they used to, while older women have experienced smaller increases in life expectancy and even smaller postponements in disability," Freedman said. "As a result, older women no longer can expect to live more active years than older men, despite their longer lives."

The differences at age 85 are really striking, she said.

"Men this age can now expect nearly four-and-a-half additional active years, up from two-and-a-half years three decades ago," Freedman said. "Women this age can expect to live only about two-and-a-half years free from disability, just about the same amount as in 1982."

The loss of advantage for women appears to be occurring at more modest levels of disability. For both men and women at age 65, the number of years expected to be lived with severe disability remained stable between 1982 and 2011 at one-and-a-half years for men and three years for women.

According to the researchers, the reasons that women have lost ground relative to men in active life expectancy are complex. To help older women, they suggest a greater focus on quality rather than quantity of life.

"Women are more likely than men to develop a number of debilitating conditions including arthritis, depressive symptoms, fall-related fractures, and Alzheimer's disease and related dementias that have implications for active life," Freedman said. "Enhanced attention to these and other preventable causes of limitations among older women could extend active life and help offset impending long-term care pressures related to population aging."

Link between Omega-3 supplementation and reduction in depression

According to the World Health Organization, depression is a major cause of disease burden worldwide, affecting an estimated 350 million people. According to the National Institutes of Mental Health, in 2014, an estimated 15.7 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.

A new meta-analysis published in Translational Psychiatry supports the link between intake of EPA and DHA omega-3 fatty acids, the kind found in fish, and reduction in major depressive disorder (MDD). The meta-analysis includes 13 studies with 1233 participants and, according to the authors, showed a benefit for EPA and DHA comparable to effects reported in meta-analyses of antidepressants (see Figure 1). The effect was greater in studies supplementing higher doses of EPA and performed in patients already on antidepressants.

"This new meta-analysis nuances earlier research on the importance of long chain omega-3s in MDD management", said Dr. Roel JT Mocking, the study's lead author and researcher at the Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, The Netherlands. "Omega-3 supplements may be specifically effective in the form of EPA in depressed patients using antidepressants. This could be a next step to personalizing the treatment for depression and other disorders."

Additionally, this study underscores the importance of EPA and DHA omega-3s for overall health and well-being, and supports an existing body of research on the connection between omega-3s and depression.

Women who take the birth control pill less likely to suffer serious knee injuries

Researchers from The University of Texas Medical Branch at Galveston have found that women who take the birth control pill, which lessen and stabilize estrogen levels, were less likely to suffer serious knee injuries. The findings are currently available in Medicine & Science in Sports & Exercise, the official journal of the American College of Sports Medicine.

Female athletes are 1.5 to 2 times more likely than their male counterparts to injure their anterior cruciate ligament, or ACL. The ACL is a ligament that connects the top and bottom portions of the knee. Damage to this ligament is a serious athletic injury that can be career altering. Return-to-play rates after ACL injury are as low as 49 percent among soccer players. Also, this injury may lead to lifelong issues with knee instability, altered walking gait and early onset arthritis.

Using a national insurance claims and prescription database of 23,428 young women between 15 and 19, the study found that women with an ACL knee injury who were taking the birth control pill were less likely to need corrective surgery than women of the same age with ACL injuries who do not use the birth control pill.

Researchers have proposed that the female hormone estrogen makes women more vulnerable to ACL injury by weakening this ligament. A previous investigation found that more ACL injuries in women occur during the points of their menstrual cycle when estrogen levels are high.

"Birth control pills help maintain lower and more consistent levels of estrogen, which may prevent periodic ACL weakness," said lead author and M.D. - Ph.D. student Aaron Gray. "With this in mind, we examined whether oral contraceptive use protected against ACL injuries that require surgery in women."

Women between15-19 in need of ACL reconstructive surgery, the age group with the highest rates of ACL injuries by a wide margin, were 22 percent less likely to be using the birth control pill than non-injured women of the same age.

Gray said that puberty might explain the high number of ACL injury cases in young women of this age. During puberty, there is a sharp rise in estrogen levels as well as growth spurts in the legs. Following one of these growth spurts, it takes time for the adolescent to develop good coordination with their newly elongated limbs.

"Young athletes currently use birth control pills for various reasons including more predictable cycles and lighter periods," Gray said. "Injury risk reduction could potentially be added to that list with further, prospective investigations."

Healthy heart fights the decline in brain function that sometimes accompanies aging

A healthy heart may have major benefits for preventing the decline in brain function that sometimes accompanies aging, according to new research in Journal of the American Heart Association.

Researchers studied a racially diverse group of older adults and found that having more ideal cardiovascular health factors was associated with better brain processing speed at the study's start and less cognitive decline approximately six years later.

The researchers from the University of Miami and Columbia University used the American Heart Association's "Life's Simple Seven®" definition of cardiovascular health, which includes tobacco avoidance, ideal levels of weight, physical activity, healthy diet, blood pressure, cholesterol and glucose.

"Achieving the health metrics of Life's Simple 7® is associated with a reduced risk of strokes and heart attacks, even among the elderly. And the finding that they may also impact cognitive, or brain function underscores the importance of measuring, monitoring and controlling these seven factors by patients and physicians," said Hannah Gardener, Sc.D., the study's lead author and assistant scientist in neurology at the Miller School of Medicine, University of Miami, in Florida.

At the beginning of the study, 1,033 participants in the Northern Manhattan Study (average age 72; 65 percent Hispanic, 19 percent black and 16 percent white), were tested for memory, thinking and brain processing speed. Brain processing speed measures how quickly a person is able to perform tasks that require focused attention. Approximately six years later, 722 participants repeated the cognitive testing, which allowed researchers to measure performance over time.

The researchers found:

• Having more ideal cardiovascular health factors was associated with better brain processing speed at the initial assessment.
• The association was strongest for being a non-smoker, having ideal fasting glucose and ideal weight.
• Having more cardiovascular health factors was associated with less decline over time in processing speed, memory and executive functioning. Executive
• function in the brain is associated with focusing, time management and other cognitive skills.
•  

While this study suggests achieving ideal cardiovascular health measures is beneficial to brain function, future studies are needed to determine the value of routinely assessing and treating risk factors, such as high blood pressure, in order to reduce brain function decline.

Gardener said similar studies in race and ethnically diverse populations, with different profiles of educational attainment, literacy and employment status, are needed to generalize the findings to other populations.

"In addition, further study is needed to identify the age ranges, or periods over the life course, during which cardiovascular health factors and behaviors may be most influential in determining late-life cognitive impairment, and how behavioral and health modifications may influence cognitive performance and mitigate decline over time."

You're likely burning more calories than you thought when you're walking

Walking is the most common exercise, and many walkers like to count how many calories are burned.

Little known, however, is that the leading standardized equations used to predict or estimate walking energy expenditure -- the number of calories burned -- assume that one size fits all. They've been in place for close to half a century and were based on data from a limited number of people.

A new study at Southern Methodist University, Dallas, found that under firm, level ground conditions, the leading standards are relatively inaccurate and have significant bias. The standards predicted too few calories burned in 97 percent of the cases researchers examined, said SMU physiologist Lindsay Ludlow.

A new standardized equation developed by SMU scientists is about four times more accurate for adults and kids together, and about two to three times more accurate for adults only, Ludlow said.

"Our new equation is formulated to apply regardless of the height, weight and speed of the walker," said Ludlow, a researcher in the SMU Locomotor Laboratory of biomechanics expert Peter Weyand. "And it's appreciably more accurate."

Ludlow and her colleagues report the new equation in the Journal of Applied Physiology, "Energy expenditure during level human walking: seeking a simple and accurate predictive solution." The article is published in the March 1, 2016 issue, and available online at http://jap.physiology.org/content/120/5/481.long.

"The economy of level walking is a lot like shipping packages - there is an economy of scale," said Weyand, a co-author on the paper. "Big people get better gas mileage when fuel economy is expressed on a per-pound basis."

The SMU equation predicts the calories burned as a person walks on a firm, level surface. Ongoing research is expanding the algorithm to predict the calories burned while walking up- and downhill, and while carrying loads, Ludlow said.

SMU's research is funded by the U.S. Department of Defense Medical and Materiel Command. The grant is part of a larger DOD effort to develop load-carriage decision-aid tools to assist foot soldiers.

The research comes at a time when greater accuracy combined with mobile technology, such as wearable sensors like Fitbit, is increasingly being used in real time to monitor the body's status. The researchers note that some devices use the old standardized equations, while others use a different method to estimate the calories burned.

New equation considers different-sized people

To provide a comprehensive test of the leading standards, SMU researchers compiled a database using the extensive walking metabolism data available in the existing scientific literature to evaluate the leading equations for walking on level ground.

"The SMU approach improves upon the existing standards by including different-sized individuals and drawing on a larger database for equation formulation," Weyand said.

The new equation achieves greater accuracy by better incorporating the influence of body size, and by specifically incorporating the influence of height on gait mechanics. Specifically:

Bigger people burn fewer calories on a per pound basis of their body weight to walk at a given speed or to cover a fixed distance;
The older standardized equations don't account for size differences well, assuming roughly that one size fits all.
Accuracy of standardized equations had not previously undergone comprehensive evaluation

The exact dates are a bit murky, but the leading standardized equations, known by their shorthand as the "ACSM" and "Pandolf" equations, were developed about 40 years ago for the American College of Sports Medicine and for the military, Ludlow said.

The Pandolf method, for example, draws on walking metabolism data from six U.S. soldiers, she said. Both the Pandolf and ACSM equations were developed on a small number of adult males of average height.

The new more accurate equation will prove useful. Predicting energy expenditure is common in many fields, including those focused on health, weight loss, exercise, military and defense, and professional and amateur physical training.

"Burning calories is of major importance to health, fitness and the body's physiological status," Weyand said. "But it hasn't been really clear just how accurate the existing standards are under level conditions because previous assessments by other researchers were more limited in scope."

Energy expenditure estimates could assist with monitoring the body's physiological status

Accurate estimations of the rate at which calories are burned could potentially help predict a person's aerobic power and likelihood for executing a task, such as training for an athletic competition or carrying out a military objective.

In general, the new metabolic estimates can be combined with other physiological signals such as body heat, core temperature and heart rate to improve predictions of fatigue, overheating, dehydration, the aerobic power available, and whether a person can sustain a given intensity of exercise.

Military seeks solutions to overburdened soldier problem

The military has a major interest in more accurate techniques to help address their problem of over-burdened soldiers.

"These soldiers carry incredible loads -- up to 150 pounds, but they often need to be mobile to successfully carry out their missions," said Weyand, a professor of Applied Physiology and Wellness in the SMU Simmons School of Education.

Accurately predicting how many calories a person expends while walking could supply information that can help soldiers avoid thermal stress and fatigue in the field, especially troops deployed to challenging environments.

"Soldiers incur a variety of physiological and musculoskeletal stresses in the field," Weyand said. "Our metabolic modeling work is part of a broader effort to provide the Department of Defense with quantitative tools to help soldiers."

Omega-3 fatty acids shown to exert a positive effect on the aging brain

Changes in cognitive function and memory decline form a normal part of aging. However, in neurodegenerative diseases such as Alzheimer's disease or mild cognitive impairment (the pre-dementia phase of Alzheimer's disease), these changes occur more quickly. There are currently no effective treatments for these diseases. Physicians and researchers are constantly looking for new treatment methods that will maintain their patients' cognitive performance and independence for as long as possible. Targeted prevention is another essential component when trying to preserve cognitive function for as long as possible.

"Ideally, any measures used should be aimed at long-term prevention. This means that measures must be suitable for use in healthy older adults, and should be easy to integrate into day-to-day life," says Dr. Nadine Külzow, a researcher at Charité's Department of Neurology. Nutritional supplements represent one such option. "A number of different dietary components, including omega-3 fatty acids, are currently thought to have a direct effect on nerve cell function. This is why we decided to study the effects on memory function of a daily dose of 2,200 milligrams taken for a duration of six months," says Dr. Külzow.

Study participants who received omega-3 fatty acids showed greater improvements on an object location memory task than participants who received a placebo containing sunflower oil. However, there was no evidence of improved performance on a verbal learning test. "Results from this study suggest that a long-term approach to prevention is particularly effective in preserving cognitive function in older individuals. A targeted approach involving dietary supplements can play a central role in this regard," concluded the researchers. Whether or not the improvements recorded can make a noticeable difference in day-to-day life will need to be investigated as part of a larger clinical study. As a next step, however, the researchers are planning to test the effect of supplementation with a combination of omega-3 fatty acids and vitamin B. According to research conducted at Oxford, this combination may be associated with synergistic effects.

The sounds of eating may reduce how much you eat

New doctor's orders: No earbuds, no music, and no watching TV while eating.

Researchers at Brigham Young University and Colorado State University have found that the noise your food makes while you're eating can have a significant effect on how much food you eat.

The "Crunch Effect," as they call it, suggests you're likely to eat less if you're more conscious of the sound your food makes while you're eating. Therefore, watching loud TV or listening to loud music while eating can mask eating sounds that keep you in check.

"For the most part, consumers and researchers have overlooked food sound as an important sensory cue in the eating experience," said study coauthor Gina Mohr, an assistant professor of marketing at CSU.

"Sound is typically labeled as the forgotten food sense," adds Ryan Elder, assistant professor of marketing at BYU's Marriott School of Management. "But if people are more focused on the sound the food makes, it could reduce consumption."

To be clear, the researchers are not talking about the sizzle of bacon, the crack of crème brulee or popcorn popping. The effect comes from the sound of mastication: chewing, chomping, crunching.

Elder and Mohr carried out three separate experiments on the effect of that "food sound salience" and found even suggesting people think of eating sounds (through an advertisement) can decrease consumption.

The most fascinating experiment discovered people eat less when the sound of the food is more intense. In that study, participants wore headphones playing either loud or quiet noise while they ate snacks. Researchers found the louder noise masked the sound of chewing and subjects in that group ate more--4 pretzels compared to 2.75 pretzels for the "quiet" group.

"When you mask the sound of consumption, like when you watch TV while eating, you take away one of those senses and it may cause you to eat more than you would normally," Elder said. "The effects many not seem huge--one less pretzel--but over the course of a week, month, or year, it could really add up."

Elder and Mohr said the main takeaway for people should be the idea of mindfulness. In other words, being more mindful of not just the taste and physical appearance of food, but also of the sound it makes can help in "nudge" consumers to eat less.

So next time you eat, pull out your earbuds and tune into the sweet sounds of your food.

The study is newly published in the academic journal Food Quality and Preference.

Blueberries could help fight Alzheimer's

The blueberry, already labeled a 'super fruit' for its power to potentially lower the risk of heart disease and cancer, also could be another weapon in the war against Alzheimer's disease. New research being presented today further bolsters this idea, which is being tested by many teams. The fruit is loaded with healthful antioxidants, and these substances could help prevent the devastating effects of this increasingly common form of dementia, scientists report.

The researchers present their work today at the 251st National Meeting & Exposition of the American Chemical Society (ACS). ACS, the world's largest scientific society, is holding the meeting here through Thursday. It features more than 12,500 presentations on a wide range of science topics.

"Our new findings corroborate those of previous animal studies and preliminary human studies, adding further support to the notion that blueberries can have a real benefit in improving memory and cognitive function in some older adults," says Robert Krikorian, Ph.D., leader of the research team. He adds that blueberries' beneficial effects could be due to flavonoids called anthocyanins, which have been shown to improve animals' cognition.

Currently 5.3 million people suffer from Alzheimer's disease. But that number is expected to increase, Krikorian notes, as the U.S. population ages. By 2025, the number of Americans with this degenerative disorder could rise 40 percent to more than 7 million, and it could almost triple by 2050, according to the Alzheimer's Association.

In an effort to find ways to slow down this alarming trend, Krikorian and colleagues at University of Cincinnati Academic Health Center conducted two human studies to follow up on earlier clinical trials.

One study involved 47 adults aged 68 and older, who had mild cognitive impairment, a risk condition for Alzheimer's disease. The researchers gave them either freeze-dried blueberry powder, which is equivalent to a cup of berries, or a placebo powder once a day for 16 weeks.

"There was improvement in cognitive performance and brain function in those who had the blueberry powder compared with those who took the placebo," Krikorian says. "The blueberry group demonstrated improved memory and improved access to words and concepts." The team also conducted functional magnetic resonance imaging (fMRI), which showed increased brain activity in those who ingested the blueberry powder.

The second study included 94 people aged 62 to 80, who were divided into four groups. The participants didn't have objectively measured cognitive issues, but they subjectively felt their memories were declining. The groups received blueberry powder, fish oil, fish oil and powder or placebo.

"The results were not as robust as with the first study," Krikorian explained. "Cognition was somewhat better for those with powder or fish oil separately, but there was little improvement with memory." Also, fMRI results also were not as striking for those receiving blueberry powder. He says that the effect may have been smaller in this case because these participants had less severe issues when they entered the study.

Krikorian said the two studies indicate that blueberries may be more effective in treating patients with cognitive impairments, but may not show measurable benefit for those with minor memory issues or who have not yet developed cognitive problems.

In the future, the team plans to conduct a blueberry study with a younger group of people, aged 50 to 65. The group would include people at risk of developing Alzheimer's, such as those who are obese, have high blood pressure or high cholesterol. This work could help the researchers determine if blueberries could help prevent the onset of Alzheimer's symptoms.

Staying active socially helps lessen the decline in well-being people often experience late in life

Staying active socially despite health-related challenges appears to help lessen the decline in well-being people often experience late in life, according to research published by the American Psychological Association.

"Our results indicate that living a socially active life and prioritizing social goals are associated with higher late-life satisfaction and less severe declines toward the end of life," said study lead author Denis Gerstorf, PhD, of Humboldt University. The research was published in the journal Psychology and Aging.

Gerstorf and his colleagues analyzed data from over 2,900 now deceased participants in the nationwide German Socio-Economic Panel Study (48 percent women, average age at death 74). The German SOEP is a nationally representative annual longitudinal survey of approximately 30,000 adult residents in former West Germany from 1984 to 2013 and former East Germany from 1990 to 2013. Participants in the SOEP provide information annually on household composition, employment, occupations, earnings, health and satisfaction indicators.

In this study, the researchers compared well-being (as measured by answers on a scale of 0 to 10 to the question, "How satisfied are you with your life concurrently, all things considered?"), participation in social activities, social goals (how important they found participating in social or political activities) and family goals (how much they valued their marriage or relationships with their children) during the last few years in life.

The research team, including scholars from Arizona State University, Cornell University, Pennsylvania State University, and the University of British Columbia, found that being socially active and having social goals were associated with higher well-being late in life, but family goals were not. This association was independent of other relevant variables including age at death, gender, education as well as key health indicators (e.g., disability, hospital stays).

One particularly intriguing observation was that while low social participation and lack of social goals independently were associated with lower levels of well-being, when combined they each magnified the other's effect.

Valuing and pursuing social goals may contribute to well-being by boosting feelings of competence, concern for the next generation and belonging, said Gerstorf. Similarly, investing one's remaining physical and psychological resources into socially oriented activities can be advantageous at a number of different levels (e.g., boosting well-being directly by carrying out joyful activities or indirectly by facilitating self-esteem and a sense of control or promoting physical and cognitive functioning).

"A socially engaged lifestyle often involves cognitive stimulation and physical activity, which in turn may protect against the neurological and physical factors underlying cognitive decline," said Gert Wagner from the German Institute for Economic Research, one of the co-authors. "Our results indicate that social orientation is related to maintaining well-being for as long as possible into the very last years of life."

As to why family-oriented goals did not appear to lessen the decline in well-being, Gerstorf said it may have to do with the complexity of family relationships later in life, but more research would be required to determine it.

"Family life is often a mixed bag and represents not only a source of joy, but also of worry and tensions, stress, and sorrow. For example, valuing one's partner often makes people vulnerable to declines in well-being when the partner suffers from cognitive or physical limitations," said Gerstorf. "Similarly, relationships with adult children can be ambivalent, especially when children differ in values and have not attained (in the eyes of their parents) educational and interpersonal success."

Chinese exercises may improve cardiovascular health

Traditional Chinese exercises such as Tai Chi may improve the health and well-being of those living with heart disease, high blood pressure or stroke, according to new research published in the Journal of the American Heart Association.

"Traditional Chinese exercises are a low-risk, promising intervention that could be helpful in improving quality of life in patients with cardiovascular diseases -- the leading cause of disability and death in the world," said Yu Liu, Ph.D., study co-author, and dean of the School of Kinesiology, at Shanghai University of Sport in China. "But the physical and psychological benefits to these patients of this increasingly popular form of exercise must be determined based on scientific evidence."

Chen Pei-Jie, Ph.D., the study's lead author and president of Shanghai University of Sport in China and his team reviewed 35 studies, including 2,249 participants from 10 countries.

They found, among participants with cardiovascular disease, Chinese exercises helped reduce systolic blood pressure (the top number) by more than 9.12 mm Hg and diastolic blood pressure (the bottom number) by more than 5 mm Hg on average.

They also found small, but statistically significant drops in the levels of bad cholesterol (low-density lipoprotein) and triglycerides. Chinese exercises also seemed to improve quality of life and reduce depression in patients with cardiovascular disease. However, traditional Chinese exercises did not significantly improve participant's heart rate, aerobic fitness level or scores on a general health questionnaire.

The review only analyzed studies which randomly assigned participants to groups performing traditional Chinese exercises (most commonly Tai Chi, Qigong and Baduanjin), engaging in another form of exercise or making no change in activity level.

note that although their review provided a good overview of the impact of traditional Chinese exercises on cardiovascular risk factors, several limitations: inclusion criteria varied across studies; participants were followed for a year or less; traditional Chinese exercises take many different forms and most results were evaluated by study leaders who knew which group participants had been assigned to, potentially biasing results.

Liu and his team have been studying the benefits of traditional Chinese exercises on a range of diseases for more than 5 years. They plan to conduct new randomized controlled trials to confirm the effect of different types of traditional Chinese exercises on chronic diseases.

Mindfulness: more thoughtful food choices and better recognition off when we are hungry, satisfied or full

Given the high stress levels, extended periods of screen time and regular social outings many Americans experience day-to-day in environments where high-calorie foods are readily available, it can be easy to fall into the habit of mindless eating - where we're too distracted to pay attention to how much, what and why we're eating. Research suggests that practicing mindfulness - or taking the time to bring awareness to present-moment experiences with an open attitude of curiosity and non-judgment - can be effective in allowing us to make more thoughtful food choices and recognize when we are hungry, satisfied or full. The latest research in this area led by Jennifer Daubenmier, PhD, Assistant Professor at the Osher Center for Integrative Medicine at the University of California, San Francisco, suggests that the impact of mindful eating could be even greater.

"Whether eating snacks while watching the game or grazing by the dessert tray at the office event, we often find ourselves overeating not because we're hungry, but because the food looks delicious, we're distracted, or we wish to soothe away unpleasant feelings," explains Dr. Daubenmier. "Our study suggests that mindful eating can go further than making healthy food choices and recognizing when we're full; it could improve glucose levels and heart health to a greater extent than behavioral weight-loss programs that do not teach mindful eating."

Dr. Daubenmier and her colleagues evaluated the effects of a mindfulness-based weight-loss intervention on adults with obesity, and although no statistically significant differences in weight loss were found compared to the control group, the mindfulness intervention showed greater improvements in certain cardiometabolic outcomes tied to Type 2 Diabetes and cardiovascular disease up to one year after the intervention ended. The research is published in the March issue of Obesity, the scientific journal of The Obesity Society.

To conduct the study, the researchers randomized nearly 200 adults with obesity to a mindfulness intervention or an active attention control group over a five-and-a-half month period, with a subsequent one-year follow up. Both groups were given identical diet and exercise guidelines. Participants in the mindfulness intervention received added training on mindfulness meditation and how to practice awareness of their thoughts, feelings, and bodily sensations during eating and exercise. At 18 months after the start of the intervention, participants in the mindfulness program lost an estimated 4.3% of body weight on average, which was 3.7 pounds more than those in the control group but not enough to reach statistical significance. Nevertheless, the authors found that the mindfulness program had more positive effects on fasting blood glucose at 18 months and a ratio of triglycerides to HDL-cholesterol levels at 12 months (a difference of -4.1 mg/dL and -0.57, respectively), both of which are linked to Type 2 Diabetes and cardiovascular disease.

"Most behavioral weight-loss interventions do not place as much emphasis on managing mindless eating, and previous studies on the topic have not included attention controls or long term follow-up to better study the contribution of mindfulness components over time," said Deborah Tate, PhD, spokesperson for The Obesity Society. "This research points to some of the potential benefits of enhancing the mindfulness components of behavioral weight loss."

Longer-term studies with more participants are needed to confirm the findings.

Burning more calories linked with greater gray matter volume, reduced Alzheimer's risk

Whether they jog, swim, garden or dance, physically active older persons have larger gray matter volume in key brain areas responsible for memory and cognition, according to a new study by researchers at the University of Pittsburgh School of Medicine and UCLA.

The findings, published today in the Journal of Alzheimer's Disease, showed also that people who had Alzheimer's disease or mild cognitive impairment experienced less gray matter volume reduction over time if their exercise-associated calorie burn was high.

A growing number of studies indicate physical activity can help protect the brain from cognitive decline, said investigator James T. Becker, Ph.D., professor of psychiatry, Pitt School of Medicine. But typically people are more sedentary as they get older, which also is when the risk for developing Alzheimer's disease and other dementias increases.

"Our current treatments for dementia are limited in their effectiveness, so developing approaches to prevent or slow these disorders is crucial," Dr. Becker said. "Our study is one of the largest to examine the relationship between physical activity and cognitive decline, and the results strongly support the notion that staying active maintains brain health."

Led by Cyrus Raji, M.D., Ph.D., formerly a student at Pitt School of Medicine and now a senior radiology resident at UCLA, the team examined data obtained over five years from nearly 876 people 65 or older participating in the multicenter Cardiovascular Health Study. All participants had brain scans and periodic cognitive assessments. They also were surveyed about how frequently they engaged in physical activities, such as walking, tennis, dancing and golfing, to assess their calorie expenditure or energy output per week.

Using mathematical modeling, the researchers found that the individuals who burned the most calories had larger gray matter volumes in the frontal, temporal and parietal lobes of the brain, areas that are associated with memory, learning and performing complex cognitive tasks. In a subset of more than 300 participants at the Pitt site, those with the highest energy expenditure had larger gray matter volumes in key areas on initial brain scans and were half as likely to have developed Alzheimer's disease five years later.

"Gray matter houses all of the neurons in your brain, so its volume can reflect neuronal health," Dr. Raji explained. "We also noted that these volumes increased if people became more active over five years leading up to their brain MRI."

He added that advancements in technology might soon make it feasible to conduct baseline neuroimaging studies of people who already have mild cognitive impairment or who are at risk for a dementia disorder, with the aim of prescribing lifestyle approaches such as physical activity to prevent further memory deterioration.

"Rather than wait for memory loss, we might consider putting the patient on an exercise program and then rescan later to see if there are any changes in the brain," Dr. Raji said.

Heart attacks could be reduced by rethinking the way we prescribe statins

Millions of people today take statins to help lower their cholesterol level. Currently statins are prescribed to patients based on their future risk of cardiovascular disease - mainly driven by age - which excludes many individuals who may benefit from them. A new study led by the Research Institute of the McGill University Health Centre (RI-MUHC) in Montreal, with collaborators from the United-States, is changing the way we think about prescribing statins. The research team has developed a new approach to determine which individuals should receive these important medications. The findings, which are published online in Circulation, the journal of the American Heart Association, could improve prevention of heart disease, especially in younger people.

"Our study is changing the way we think about prescribing statins; we should not only be considering who is at risk of heart disease but, more importantly, who would benefit from these medications," says study-lead author, Dr. George Thanassoulis, who is the director of Preventive and Genomic Cardiology at the MUHC and an associate professor in Medicine at McGill University. "For example, younger patients who have high cholesterol, are frequently considered too young to be at risk for heart attack in the short term, but our analysis shows that they would benefit from treatment, even in the short term, and therefore should be eligible for statin treatment."

The research team performed their modelling study using data from 2,134 participants from the National Health and Nutrition Examination Survey - a nationally-representative US cohort, between 2005 and 2010, representing 71.8 million Americans potentially eligible for statins. Two approaches for statin eligibility were compared: a ten-year risk based approach, currently in use, and an individualized benefit approach. The latter method of determining who should receive statins was found to produce greater eligibility.

"Using a benefit-based approach, we identified 9.5 million lower-risk Americans not currently eligible for statin treatment, who had the same or greater expected benefit from statins as higher-risk individuals," explains Dr. Thanassoulis. "These individuals were lower-risk because they were younger but they also had higher levels of low-density lipoprotein cholesterol which we have known to be an important cause of heart disease. Targeting statin treatment to this group would prevent an additional 266,000 heart attacks and strokes over 10 years,"

"This strategy will transform cardiovascular prevention for the better," adds study's co-author, Dr. Allan Sniderman, MUHC cardiologist and full professor in Medicine at McGill University. "For too many, the present approach starts too late; an earlier start will multiply the lives saved."

Dr. Thanassoulis and collaborators are now developing a Web interface to extend the use of this calculation model to physicians. Researchers hope this new way will help develop guideline recommendations that better identify individuals who meaningfully benefit from statin therapy.

Practicing tai chi reduces risk of falling in older adults

Recently, researchers compared the effects of tai chi to leg strengthening exercises (a physical therapy called "lower extremity training," or LET) in reducing falls. Falls are a leading cause of serious injuries in older adults and can lead to hospitalization, nursing home admission, and even death. Arthritis, heart disease, muscle weakness, vision and balance problems, dementia, and other age-related health problems can increase an older adult's risk for experiencing a fall. The study is published in the Journal of the American Geriatrics Society.

In their study, researchers assigned 368 people 60-years-old and older who had received medical attention for a fall into one of two groups. The first group received hour-long individual tai chi classes conducted by tai chi instructors every week for 24 weeks. Tai chi is an exercise practice developed in China hundreds of years ago. It combines certain postures and gentle movements with mental focus, breathing, and relaxation. Tai chi can be practiced while you're walking, standing, or even seated. Deep breathing, weight shifting, and leg stepping movements are part of the practice. The second group received individual, hour-long LET sessions for 24 weeks conducted by physical therapists. Sessions included stretching, muscle strengthening, and balance training.

The researchers asked participants in both groups to complete at least 80 percent of their sessions, and also to practice either tai chi or LET at home every day during the six- month program and the 12-month follow-up. During the course of the study, all participants kept diaries and recorded any falls they experienced, and they shared their diaries with researchers each month.

After six months of training, people in the tai chi group were significantly less likely to experience an injury-causing fall than were people in the LET group. Even a year after taking the training, people who took tai chi were about 50 percent less likely to experience an injury-causing fall compared to people in the LET group.

Though participants in the study took individualized tai chi classes at home, "I suggest that older adults learn tai chi exercises in a class, and practice at home at least once a day," said Mau-Roung Lin, PhD, Professor and Director of the Institute of Injury Prevention and Control, Taipei Medical University in Taipei, Taiwan, a co-author of the study.

Leaner bodies, less heart disease and diabetes risk found in people with higher levels of linoleic acid

Risk of heart disease and diabetes may be lowered by a diet higher in a lipid found in grapeseed and other oils, but not in olive oil, a new study suggests.

Researchers at The Ohio State University found that men and women with higher linoleic acid levels tended to have less heart-threatening fat nestled between their vital organs, more lean body mass and less inflammation.

And higher linoleic acid levels also meant lower likelihood of insulin resistance, a precursor to diabetes.

This finding could have obvious implications in preventing heart disease and diabetes, but also could be important for older adults because higher lean body mass can contribute to a longer life with more independence, said Ohio State's Martha Belury, a professor of human nutrition who led the research.

But there's a catch. Low-cost cooking oils rich in linoleic acid have been disappearing from grocery shelves, fueled by industry's push for plants that have been modified to produce oils higher in oleic acid.

"Vegetable oils have changed. They're no longer high in linoleic acid," said Belury, an expert in dietary fats and part of Ohio State's Food Innovation Center.

The research appears online in the journal Molecular Nutrition & Food Research.

The research team also looked at the health effects of oleic acid, found in olive oil and some other vegetable oils, as well as long-chain omega-3 fatty acids, found in fatty fish including salmon and tuna.

Though inflammation decreased as blood levels of those fatty acids rose, higher levels of oleic acid or long-chain omega-3s did not appear to have any relationship to body composition or signs of decreased diabetes risk despite longstanding recommendations that people eat more of these "healthy" fats.

"It really kind of popped out and surprised us," Belury said.

Previous research found that taking linoleic acid supplements increased lean body mass and lowered fat in the midsection. As little as a teaspoon and a half was all it took, Belury said. The current study is the first study to examine linoleic acid alongside body composition and other health markers in people who hadn't been given supplements or prescriptive diets, she said.

Because of previous research showing cardiovascular benefits of linoleic acid, the American Heart Association in 2009 recommended people take in at least 5 to 10 percent of their energy in the form of omega-6 fatty acids, which includes linoleic acid.

But U.S. consumption of linoleic acid is declining because of genetic modification of plants for food manufacturers seeking oils higher in oleic acid, Belury said.

There's been a pronounced shift in the last five years, she said, and it is linked to the push against trans fats. When linoleic acid is made solid (hydrogenated) for processed foods, it is more likely to convert to trans fat than its oleic cousin.

So oils, notably safflower, sunflower and soybean, now routinely contain less linoleic acid - it often makes up less than 20 percent of the fatty acids in commonly purchased oils, based on food labels and confirmed by testing in her lab, Belury said.

Grapeseed oil for now remains an excellent source of linoleic acid, which constitutes about 80 percent of its fatty acids, she said. Corn oil also remains a decent source, she said.

The team used data from two previous studies that focused on stress and included 139 people. In those studies, researchers assessed body composition using DXA scanning, an advanced way of measuring fat and muscle mass.

They tested blood drawn after the men and women fasted for 12 hours, calculating the amount of linoleic acid (and other fatty acids) in red blood cells. All of the linoleic acid in our bodies comes from food sources.

They also evaluated the blood for insulin resistance and two markers of inflammation that are connected with disease.

Then they plotted results for each health category against the group's results for each of the three fat categories: linoleic acid, oleic acid and long-chain omega-3 fatty acids.

Belury said the study doesn't explain the apparent interplay between linoleic acid and measures of risk for heart disease and diabetes. It shows an association between those things, but not a cause and effect. And its power is limited because it relied on looking back on two previous research efforts and those involved middle-aged men and women who were slightly healthier on average than the general population.

The study participants lived in and around Columbus, Ohio. It's possible that the results would have been different in a population with diets that tend to be higher in omega-3 rich fatty fish, Belury said.