Tuesday, August 31, 2021

Light-to-moderate coffee drinking associated with health benefits

 



Up to three cups of coffee per day is associated with a lower risk of stroke and fatal heart disease, according to research presented at ESC Congress 2021.1,2

"To our knowledge, this is the largest study to systematically assess the cardiovascular effects of regular coffee consumption in a population without diagnosed heart disease," said study author Dr. Judit Simon, of the Heart and Vascular Centre, Semmelweis University, Budapest, Hungary.

"Our results suggest that regular coffee consumption is safe, as even high daily intake was not associated with adverse cardiovascular outcomes and all-cause mortality after a follow-up of 10 to 15 years," she continued. "Moreover, 0.5 to 3 cups of coffee per day was independently associated with lower risks of stroke, death from cardiovascular disease, and death from any cause."

Even though coffee is among the most consumed beverages in the world, little is known about the long-term impact of regular consumption on cardiovascular health.

This study investigated the association between usual coffee intake and incident heart attack, stroke and death. The study included 468,629 participants of the UK Biobank with no signs of heart disease at the time of recruitment. The average age was 56.2 years and 55.8% were women.

Participants were divided into three groups according to their usual coffee intake: none (did not consume coffee on a regular basis, 22.1%), light-to-moderate (0.5 to 3 cups/day, 58.4%) and high (more than 3 cups/day, 19.5%).

The researchers estimated the association of daily coffee consumption with incident outcomes over a median follow-up of 11 years using multivariable models. The analyses were adjusted for factors that could influence the relationship including age, sex, weight, height, smoking status, physical activity, high blood pressure, diabetes, cholesterol level, socioeconomic status, and usual intake of alcohol, meat, tea, fruit and vegetables.

Compared to non-coffee drinkers, light-to-moderate consumption was associated with a 12% lower risk of all-cause death (hazard ratio [HR]=0.88, p<0.001), 17% lower risk of death from cardiovascular disease (HR=0.83, p=0.006), and 21% lower risk of incident stroke (HR=0.79; p=0.037).

To examine the potential underlying mechanisms, the researchers analysed the association between daily coffee intake and heart structure and function over a median follow-up of 11 years. For this, they used data from 30,650 participants who underwent cardiac magnetic resonance imaging (MRI), which is considered the gold standard for the assessment of cardiac structure and function.

Dr. Simon said: "The imaging analysis indicated that compared with participants who did not drink coffee regularly, daily consumers had healthier sized and better functioning hearts. This was consistent with reversing the detrimental effects of ageing on the heart."

She concluded: "Our findings suggest that coffee consumption of up to 3 cups per day is associated with favourable cardiovascular outcomes. While further studies are needed to explain the underlying mechanisms, the observed benefits might be partly explained by positive alterations in cardiac structure and function."


Monday, August 30, 2021

Health wearable devices effectively promote bodyweight in overweight/obese individuals

 


Being overweight remains a significant public health challenge, of which physical inactivity is a major contributor. Physical activity wearables have the potential to encourage physical activity; however, there is a lack of evidence pointing to the most effective method. As a result, the goal of this study was to perform a systemic review of randomized controlled trials (RCTs) investigating the effect of health wearable-based physical activity interventions on body mass index (BMI) and bodyweight reduction in overweight/obese individuals with chronic health conditions.

Of 641 screened records, 31 studies (2268 patients) from December 2019 to September 2020 were included in the analysis. Included studies met the following criteria: participants were overweight/obese and/or had at least one chronic comorbidity and studied the effect of health-wearable interventions on weight or BMI. The six comparison groups included four wearable interventions, one comparison group (non-health wearable physical activity) and control group (usual care, waitlist). Network geometry and network meta-analysis were used to compare the effect of each intervention on the primary outcome.

Results stated that the commercial health-wearable only and the accelerometer/pedometer-only groups were most effective at reducing bodyweight compared with the control. With respect to BMI reduction, commercial health wearable-only and multicomponent accelerometer/pedometer interventions were found to be most effective. One of the key strengths of this study was its use of strict criteria which allowed for a homogenous sample. However, due to insufficient direct comparisons available to assess BMI reduction, the results for this outcome must be interpreted with caution. As a whole, these results suggest that the use of health wearable-based physical activity interventions may help achieve modest bodyweight and/or BMI reductions.

Click to read the study in British Journal of Sports Medicine


More on benefits of eating walnuts

 Eating about ½ cup of walnuts every day for two years modestly lowered levels of low-density lipoprotein (LDL) cholesterol, known as “bad cholesterol,” and reduced the number of total LDL particles and small LDL particles in healthy, older adults, according to new research published today in the American Heart Association’s flagship journal Circulation.

Walnuts are a rich source of omega-3 fatty acids (alpha-linolenic acid), which have been shown to have a beneficial effect on cardiovascular health.

“Prior studies have shown that nuts in general, and walnuts in particular, are associated with lower rates of heart disease and stroke. One of the reasons is that they lower LDL-cholesterol levels, and now we have another reason: they improve the quality of LDL particles,” said study co-author Emilio Ros, M.D., Ph.D., director of the Lipid Clinic at the Endocrinology and Nutrition Service of the Hospital Clínic of Barcelona in Spain. “LDL particles come in various sizes. Research has shown that small, dense LDL particles are more often associated with atherosclerosis, the plaque or fatty deposits that build up in the arteries. Our study goes beyond LDL cholesterol levels to get a complete picture of all of the lipoproteins and the impact of eating walnuts daily on their potential to improve cardiovascular risk.”

In a sub-study of the Walnuts and Healthy Aging study, a large, two-year randomized controlled trial examining whether walnuts contribute to healthy aging, researchers evaluated if regular walnut consumption, regardless of a person’s diet or where they live, has beneficial effects on lipoproteins.

This study was conducted from May 2012 to May 2016 and involved 708 participants between the ages of 63 and 79 (68% women) who were healthy, independent-living adults residing in Barcelona, Spain, and Loma Linda, California.

Participants were randomly divided into two groups: active intervention and control. Those allocated to the intervention group added about a half cup of walnuts to their usual daily diet, while participants in the control group abstained from eating any walnuts. After two years, participants’ cholesterol levels were tested, and the concentration and size of lipoproteins were analyzed by nuclear magnetic resonance spectroscopy. This advanced test enables physicians to more accurately identify lipoprotein features known to relate to the risk of cardiovascular disease.

The two-year study had a 90% retention rate (632 participants completed the study). Complete lipoprotein analyses were available in 628.

Among key findings of all study participants:

  • At 2 years, participants in the walnut group had lower LDL cholesterol levels - by an average of 4.3 mg/dL, and total cholesterol was lowered by an average of 8.5 mg/dL.
  • Daily consumption of walnuts reduced the number of total LDL particles by 4.3% and small LDL particles by 6.1%. These changes in LDL particle concentration and composition are associated with a lower risk of cardiovascular disease.
  • Intermediate Density Lipoprotein (IDL) cholesterol also decreased. It is known that IDL cholesterol is a precursor to LDL and refers to a density between that of low-density and very-low-density lipoproteins. In the last decade, IDL cholesterol has emerged as a relevant lipid cardiovascular risk factor independent of LDL cholesterol.
  • LDL cholesterol changes among the walnut group differed by sex; in men, LDL cholesterol fell by 7.9% and in women by 2.6%.

“While this is not a tremendous decrease in LDL cholesterol, it’s important to note that at the start of the study all our participants were quite healthy, free of major non-communicable diseases. However, as expected in an elderly population, close to 50% of participants were being treated for both high blood pressure and hypercholesterolemia. Thanks in part to statin treatment in 32%, the average cholesterol levels of all the people in our study were normal,” Ros said. “For individuals with high blood cholesterol levels, the LDL cholesterol reduction after a nut-enriched diet may be much greater.”

“Eating a handful of walnuts every day is a simple way to promote cardiovascular health. Many people are worried about unwanted weight gain when they include nuts in their diet,” Ros said. “Our study found that the healthy fats in walnuts did not cause participants to gain weight.”

The major limitation of this investigation is that both participants and researchers knew who was and was not eating walnuts. However, the study did involve two very different populations with distinct diets. “The outcomes were similar in both groups, so we can safely apply the results of this study to other populations,” Ros said. More research is also needed to clarify the different LDL results in men and women.

According to the American Heart Association, walnuts are especially high in omega-3 fatty acids, the same heart-healthy fat found in oily fish. A serving size is a small handful or 1.5 ounces of whole nuts or 2 tablespoons of nut butter.

Customization of diet may promote mental wellbeing in young adults


Peer-Reviewed Publication

Healthy dietary patterns are associated with higher frequency of exercise and mental wellbeing in young adults, according to new research led by faculty at Binghamton University, State University of New York. 

“Young adults are known to be at a higher risk for mental distress,” said Lina Begdache, assistant professor of health and wellness studies at Binghamton University. “The impact of diet on mood has been highlighted in previous studies. However, most studies depicting the role of nutrients on mood were performed on a wide-range of ages, and generalized the results to both sexes.”

The researchers invited adults aged 18–29 years to complete a food-mood questionnaire. The anonymous questionnaire was distributed to several institutional listservs and via several social media platforms targeting young adults. A multi-level analysis, including machine learning techniques, was used to assess these relationships. The results suggest that, for young men and women, healthy dietary patterns are associated with higher frequency of exercise and mental wellbeing, and vice-versa. However, this study also investigated the impact of food groups and exercise within a dietary pattern on mental wellbeing. 

“The study fills several gaps in the literature, namely that exercise significantly mediates the effect of food groups to promote mental wellbeing,” said Begdache. “Another interesting hypothesis generated from our results is that despite following a healthy diet and lifestyle, if triggers of mental distress (such as caffeine) exceed certain thresholds, mood is negatively impacted. Additionally, the results provide compelling evidence that mental health is modulated not only by a dietary pattern but by the weight (concentration) of food groups and exercise frequency, which needs further investigation.” Another interesting observation is that exercise may be mediating the effect of food. For instance, exercise within a healthy dietary pattern maximizes the beneficial effect of healthy food and minimizes the impact of triggers.

Begdache said that it would be good to use the information gained from this research to tailor dietary intake based on sex to optimize mental wellbeing. Diet and mood recording may be helpful to pinpoint the potential triggers or preventers of mental distress.

Going forward, the researchers are studying the impact of stress and comparing some dietary factors between athletes and non-athletes to study the impact of exercise.

Also contributing to this research were Helen Najjar from the Dept. of Biomedical Engineering at Binghamton University; former Binghamton University undergraduate student Dylan F. Witt; Hamed Kianmehr from the University of Florida; and Nasim S. Sabounchi from the CUNY Graduate School of Public Health & Health Policy.

The paper, “A Differential Threshold of Breakfast, Caffeine and Food Groups May Be Impacting Mental Well-Being in Young Adults: The Mediation Effect of Exercise,” was published in Frontiers in Nutrition.

How can I avoid heart disease or stroke?

The European Society of Cardiology (ESC) Guidelines on cardiovascular disease prevention in clinical practice are published online today in European Heart Journal.1

As much as 90% of the risk of a heart attack, stroke, or peripheral arterial disease (PAD) can be explained by smoking, poor eating habits, lack of physical activity, abdominal obesity, high blood pressure, raised blood lipid levels, diabetes, psychosocial factors, or alcohol. These guidelines focus on atherosclerotic cardiovascular disease (CVD), which affects the arteries. As the inside of the arteries become clogged up by fatty deposits, they can no longer supply enough blood to the body. This process is the main cause of heart attacks, strokes, PAD and sudden death where arteries become completely blocked. The most important way to prevent these conditions is to adopt a healthy lifestyle throughout life, especially not smoking, and to treat risk factors.

Recommendations are provided for healthy adults of all ages, as well as patients with established CVD or diabetes. Identifying who will benefit most from preventive treatments, such as blood pressure and lipid lowering therapies, is central to prevention efforts and therefore the estimation of CVD risk is the cornerstone of the guidelines.

Targets for blood lipids, blood pressure, and glycaemic control in diabetes remain as recommended in recent ESC guidelines on dyslipidaemias, hypertension or diabetes. The current guidelines introduce a stepwise approach to intensifying preventive treatments, while always taking into consideration potential benefit, other conditions, psychosocial factors and patient preferences. In healthy people, for example, the stepwise approach starts with recommendations for everyone: smoking cessation, adopting a healthy lifestyle, and maintaining a systolic blood pressure below 160 mmHg. The recommendations are then tailored according to the 10-year risk of CVD (calculated by a health professional using available risk scores).

“Individualised decisions using risk estimation and a stepwise approach to therapies is more complex than a one-size-fits-all approach, but reflects the diversity of patients and patient characteristics in everyday clinical practice, and is essential to give the right patient the right treatment,” said guidelines task force chairperson Professor Frank Visseren of the University Medical Centre Utrecht, the Netherlands.

A new section is devoted to communication of risk in the shared decision making process. The aims are for individuals to understand their risk, the anticipated risk reduction with preventive actions, the pros and cons of intervention, and their own priorities. In healthy people, the standard approach is to calculate the likelihood of CVD within 10 years. Young people may find estimations of lifetime risk and lifetime benefit of preventive action more informative, since their 10-year risk is generally low.

Stopping smoking is potentially the most effective of all preventive measures, with substantial reductions in heart attacks or death. The CVD risk in smokers under 50 years of age is five-fold higher than in non-smokers. Quitting must be encouraged in all smokers, and passive smoking should be avoided where possible. For the first time, the guidelines explicitly state that smoking cessation is recommended, and remains beneficial, regardless of weight gain. While evidence suggests that e-cigarettes may be more effective than nicotine-replacement therapy for smoking cessation, the long-term effects on cardiovascular and lung health are unclear and dual use with tobacco cigarettes should be avoided.

Regarding exercise, adults of all ages should strive for at least 150−300 minutes a week of moderate-intensity, or 75−150 minutes a week of vigorous-intensity, aerobic physical activity, or an equivalent combination. For the first time it is recommended to reduce sedentary time and engage in at least light activity throughout the day. Also new is to consider wearable activity trackers to increase activity. The guidelines state: “Most important is to encourage activity that people enjoy and/or can include in their daily routines, as such activities are more likely to be sustainable.”

Regarding nutrition, a healthy diet is recommended for all individuals to prevent CVD. This should emphasise plant-based foods including whole grains, fruits, vegetables, pulses, and nuts. New recommendations include the adoption of a Mediterranean or similar diet; restricting alcohol intake to a maximum of 100 g per week (a standard drink contains 8 to 14 g); eating fish, preferably fatty, at least once a week; and restricting consumption of meat, particularly processed meat.

In terms of body weight, it is recommended that overweight and obese people lose weight to lower blood pressure, blood lipids, and the risk of diabetes, and thereby reduce the likelihood of CVD. For the first time, the guidelines state that bariatric surgery should be considered for obese individuals at high risk of CVD when a healthy diet and exercise do not result in maintained weight loss.

Mental disorders such as anxiety are associated with an increased risk of CVD and a worse prognosis for those already diagnosed with CVD. A new recommendation is to provide intensified support to patients with these conditions to improve adherence to lifestyle changes and drug treatment. Also new is to consider referral to psychotherapeutic stress management for patients with CVD and stress.

The guidelines recommend policy interventions at the population level to improve heart health and promote healthy choices. These include measures to lower air pollution, reduce fossil fuel use, and limit carbon dioxide emissions. Other measures are greater availability of school playground spaces, and legislation that restricts marketing unhealthy food to children on television, the internet, social media, and food packaging. E-cigarettes, which are addictive, should be subject to similar marketing controls as standard cigarettes, especially flavoured varieties that appeal to children. Labelling alcohol with caloric content and health warnings may be considered.

As summarised by guidelines task force chairperson Professor François Mach of Geneva University Hospital, Switzerland, “CVD prevention requires an integrated, interdisciplinary approach that puts healthy people and patients at the centre and considers other health conditions, and environmental factors including air pollution.”

Leading cancer centers urge vaccination to protect against HPV and other diseases


NCI-designated cancer centers, AACI members and other cancer centers and medical groups endorse HPV vaccination and cancer screening to eliminate cancers caused by the virus.

Today, St. Jude Children’s Research Hospital, 15 leading academic and freestanding cancer centers with membership in the Association of American Cancer Institutes (AACI), all National Cancer Institute (NCI)-designated cancer centers—among them 70 AACI members—and other organizations have issued a joint statement urging the nation’s health care systems, physicians, parents, children and young adults to get human papillomavirus (HPV) vaccinations and other recommended vaccinations back on track during National Immunization Awareness Month. 

The call to action comes during National Immunization Awareness Month. The organizations urge the following actions as children head back to school:

  • Health care systems’ staff and providers should immediately identify and contact parents of adolescents who are due for vaccinations and encourage them to complete vaccinations.
  • Parents should have their adolescent children vaccinated as soon as possible. A list of recommended vaccines is available on the U.S. Centers for Disease Control and Prevention (CDC) website.

Dramatic drops in annual well-child visits and immunizations during the COVID-19 pandemic have caused a significant vaccination gap and lag in vital preventive services among U.S. children and adolescents. HPV vaccinations have been especially affected. The pandemic also has increased health disparities, leaving underserved adolescents at even greater risk for missed doses of this cancer prevention vaccine.

Back-to-school season and vaccinations

"It is ‘back to school’ time in the U.S. and an ideal time to catch up on any missed vaccines for our children, including the cancer-preventing HPV vaccination, to keep children, schools and communities protected,” said Heather Brandt, Ph.D., director of the HPV Cancer Prevention Program at St. Jude and coordinator for the joint statement from NCI Cancer Centers and the AACI. "Parents should know that recommended vaccinations may be administered at the same time as the COVID-19 vaccination for children 12 and older."

AACI Executive Director Jennifer W. Pegher added: “HPV prevention, screening and treatment is a major goal of AACI cancer centers. COVID-19 vaccination is a good opportunity for parents to get their children the HPV vaccine and other recommended vaccines.”

Brandt and her colleagues are advocates for the HPV vaccine, which is key to preventing several types of cancer. Nearly 80 million Americans – 1 out of every 4 people – are infected with HPV, a virus that causes six types of cancers. Of those millions, nearly 36,000 will be diagnosed with HPV-related cancers this year. Despite those staggering figures and the availability of a vaccine to prevent HPV infections, HPV vaccination rates remain significantly lower than other recommended adolescent vaccines in the U.S.

Even before the COVID-19 pandemic, HPV vaccination rates in the United States also lagged far behind those of other countries. According to 2019 data from the CDC, only 54% of adolescents were up to date on the HPV vaccine. Those numbers have declined dangerously since the pandemic:

The pandemic has caused a gap in all vaccinations, including HPV, and especially for adolescents, according to the CDC. As of August 2021, recommended vaccinations for adolescents remain in greater deficit as compared to those for younger children:

  • Whooping cough (Tdap) – down 16.7%
  • HPV cancer prevention – down 18.4%
  • Meningitis (Meningococcal conjugate) – down 13.7%

“Disparities in adherence to recommended vaccinations remain a major concern because not all children have experienced the pandemic in the same ways,” Brandt said. “Adolescents with private insurance may be missing hundreds of thousands of doses of HPV vaccine in addition to the known deficits experienced among adolescents who are publicly insured.”

HPV vaccine recommendations

The U.S. has recommended routine HPV vaccination for females since 2006, and for males since 2011. Current recommendations are for routine vaccination at ages 11 or 12 or starting at age 9. Catch-up HPV vaccination is recommended through age 26. Adults aged 27 through 45 should talk with their health care providers about HPV vaccination because some people who have not been vaccinated might benefit. The HPV vaccine series consists of two doses for children who get the first dose at ages 9–14, three doses for immunocompromised people and three doses for those who start the series at age 15 or older.

More information on HPV is available from the CDC and National HPV Vaccination Roundtable. The cancer centers and institutes unanimously share the goal of sending a powerful message to health care providers, parents and adolescents about the importance of HPV vaccination for the elimination of HPV-related cancers. National organizations endorsing this statement include the Association of American Cancer Institutes; American Association for Cancer Research; American Cancer Society; American Society of Clinical Oncology; American Society of Pediatric Hematology/Oncology; American Society of Preventive Oncology; and the Prevent Cancer Foundation.

National Immunization Awareness Month is an annual observance held in August to highlight the importance of vaccination for people of all ages.

Replacing salt with a low-sodium alternative lowers the risk of stroke

 Replacing salt with a low-sodium alternative lowers the risk of stroke in people with high blood pressure or prior stroke, according to late breaking research presented in a Hot Line session today at ESC Congress 2021and published in the New England Journal of Medicine2.

Both elevated sodium intake and low potassium intake are associated with high blood pressure and an increased risk of cardiovascular disease and premature death.3,4 Salt substitutes, which replace part of the sodium chloride in regular salt with potassium chloride, have been shown to lower blood pressure5 but their effects on heart disease, stroke, and death had been uncertain. In addition, there had been concerns about causing hyperkalaemia in people with chronic kidney disease leading to cardiac arrhythmias and sudden death.

The Salt Substitute and Stroke Study (SSaSS) compared the effect of reduced sodium salt substitute versus regular salt on stroke, cardiovascular events, mortality and clinical hyperkalaemia.6 SSaSS was an open, cluster-randomised, trial that enrolled participants between April 2014 and January 2015. Participants were adults with either previous stroke or age 60 years and above with poorly controlled blood pressure.7

The trial was conducted in 600 villages in rural areas of five provinces in China. Two counties within each province were chosen that represented the socioeconomic development level of rural counties in that province. Approximately 35 individuals were recruited from each village – for a total of 20,995 participants. Participants were cluster-randomised by village in a 1:1 ratio to provision of salt substitute or continued use of regular salt.

Participants in intervention villages were given free salt substitute (about 75% sodium chloride and 25% potassium chloride) as a replacement for regular salt and advised to use it for all cooking, seasoning and food preservation. They were also encouraged to use the salt replacement more sparingly than they previously used salt to maximise their sodium reduction. Sufficient salt substitute was provided to cover the needs of the entire household (about 20 g per person per day). Participants in control villages continued their usual habits.

The average age of participants was 65.4 years and 49.5% were female. Some 72.6% had a history of stroke and 88.4% had a history of hypertension.

During an average follow up of 4.74 years, more than 3,000 people had a stroke, more than 4,000 died and more than 5,000 had a major cardiovascular event. The risk of stroke was reduced with salt substitute compared to regular salt (29.14 versus 33.65 per 1,000 patient-years; rate ratio [RR] 0.86; 95% confidence interval [CI] 0.77–0.96; p=0.006).

Regarding secondary outcomes, major cardiovascular events (non-fatal stroke, non-fatal acute coronary syndrome, vascular death) were reduced with salt substitute (49.09 versus 56.29 per 1,000 patient-years; RR 0.87; 95% CI 0.80–0.94; p<0.001) as was total mortality (39.27 versus 44.61 per 1,000 patient-years; RR 0.88; 95% CI 0.82–0.95; p<0.001). 

Regarding safety, there was no increased risk of serious adverse events attributed to clinical hyperkalaemia with salt substitute compared to regular salt (3.35 versus 3.30 per 1,000 patient years; RR 1.04; 95% CI 0.80–1.37; p=0.76). Neither were any other risks identified.

Principal investigator Professor Bruce Neal of the George Institute for Global Health, Sydney, Australia said: “This study provides clear evidence about an intervention that could be taken up very quickly at very low cost. A recent modelling study done for China projected that 365,000 strokes and 461,000 premature deaths could be avoided each year in China if salt substitute was proved to be effective.8 We have now showed that it is effective, and these are the benefits for China alone. Salt substitution could be used by billions more with even greater benefits.”

He added: “The trial result is particularly exciting because salt substitution is one of the few practical ways of achieving changes in the salt people eat. Other salt reduction interventions have struggled to achieve large and sustained impact.’’

‘’Importantly, salt substitute is very easy to manufacture and it is not expensive. A kilo of regular salt, which lasts for months, costs about US$1.08 in China. The price for a kilo of salt substitute is $1.62/kg,’’ he said. “It is primarily lower-income and more disadvantaged populations that add large amounts of salt during food preparation and cooking.9 This means that salt substitute has the potential to reduce health inequities related to cardiovascular disease.”


Mouth-to-mouth bystander CPR preferable method for pediatric cardiac arrest


Compression-only CPR still recommended for adults

Rescue breathing cardiopulmonary resuscitation (CPR) had superior neurological outcomes compared with compression-only CPR or no CPR at all in infants, children and adolescents, according to a new analysis published today in the Journal of the American College of Cardiology.

Over 5,000 Americans under the age of 18 experience an out-of-hospital cardiac arrest (OHCA) each year. CPR is a life-saving emergency technique used to help a person whose breathing or heart may have stopped. National and statewide efforts focus on teaching compression-only CPR (CO-CPR) to improve the likelihood of bystander CPR. While current guidelines recommend CO-CPR for adults with OHCA, children more commonly experience OHCA caused by asphyxiation for which CO-CPR may be less effective, leading to worse neurological outcomes compared to rescue breathing CPR (RB-CPR).

Data for this study came from the Cardiac Arrest Registry to Enhance Survival (CARES) database, an established collaboration between the Centers for Disease Control and Prevention and the Department of Emergency Medicine at Emory University School of Medicine, which includes data from 145 million people in 28 states across the United States. A total of 10,429 pediatric cases were pulled from January 2013 to December 2019. Age groups included infants (less than one year of age), children (one to 11 years) and adolescents (12 to 18 years). Bystander CPR was defined as being administered by a family member, layperson, or a layperson with medical training.

Pediatric CPR was most commonly performed due to cardiac problems (44.4% of cases), respiratory problems (32.8%), drowning (8.8%), drug overdose (1.8%), electrocution or exsanguination (both at 0.2%) or other medical causes (11.9%). Cardiac arrests were more common in infants, males, and white and Black children compared to children of other races/ethnicities. Family members or laypersons were most likely to perform CO-CPR, whereas laypersons with medical training were more likely to perform RB-CPR.

In analyzing the data, the researchers found that OHCAs with RB-CPR and CO-CPR independently had better neurological outcomes compared with no CPR performed at all. However, compared with CO-CPR, RB-CPR was associated with higher odds of favorable neurological outcomes for infants, children and adolescents. The analysis found RB-CPR was also associated with higher odds of overall survival compared with CO-CPR.

Compared with children and adolescents, infants were found to have different outcomes when it came to CO-CPR and RB-CPR. The researchers found RB-CPR resulted in better outcomes than CO-CPR for all pediatric age groups. However, the researchers also found performing CO-CPR was better than no CPR in children and adolescents, but not infants; neurologically favorable survival in infants was only observed with RB-CPR. The researchers concluded that RB-CPR should continue to be the recommended form of CPR for infants.

“One of the most important findings of our investigation is that compression-only CPR is currently the most commonly performed type of CPR for pediatric cardiac arrest in the United States,” said Maryam Y. Naim, MD, MSCE, a pediatric cardiac intensive care physician in the division of cardiac critical care medicine at Children’s Hospital of Philadelphia, and lead author of the study. “Current public health campaigns focus on teaching compression-only CPR, and while this has improved outcomes in adults, it is possible this had disadvantaged children, particularly infants who did not show a benefit in outcome with compression-only CPR. Bystander CPR education should continue to emphasize rescue breathing CPR for those under 18, especially infants, and teach lay rescuers how to perform rescue breathing CPR.”

“This new study adds important data to the limited published literature on this topic,” said Gene Yong-Kwang Ong, MBBS, consultant in the department of pediatric emergency medicine in Kandang Kerbau Hospital in Singapore, and author of the accompanying editorial comment. “Given that infants were consistently reported to suffer the worst clinical outcomes, and with this finding that bystander rescue breathing CPR could improve neurologically favorable survival, it behooves us to look into this in a timely manner. There needs to be important discussions in light of this data.”

This study has several limitations, including utilizing observational data, and a lack of data on dispatcher instruction, the quality of CPR and training of the lay rescuer. In addition, the type of bystander CPR included in CARES registry was not available for all arrests. The researchers recommend the findings to be validated in larger studies.


Sunday, August 29, 2021

Latest Health Research

 Aging

Postponed retirement slows cognitive decline

*Participating in the labor market until the age of 67 slows cognitive decline and is protective against cognitive impairment, study indicates* Participating in the labor market until the age of 67 slows cognitive decline and is protective against cognitive impairment, such as that caused by Alzheimer’s. This protective effect appears to hold regardless of gender and educational or occupational attainment. These findings were recently published in the journal *SSM Population Health.* The team of researchers with Jo Mhairi Hale, Maarten J. Bijlsma, and Angelo Lorenti, all affiliat... read more

Having a good listener improves your brain health
[image: Social Support and Cognitive Performance] CAPTION Higher social listener availability slowed cognitive decline even as brain volume decreased. CREDIT NYU Langone Health Supportive social interactions in adulthood are important for your ability to stave off cognitive decline despite brain aging or neuropathological changes such as those present in Alzheimer’s disease, a new study finds. In the study publishing August 16 in *JAMA Network Open*, researchers observed that simply having someone available most or all of the time whom you can count on to listen to you when ... read more

Mentally stimulating jobs linked to lower risk of dementia in old age
People with mentally stimulating jobs have a lower risk of dementia in old age than those with non-stimulating jobs, finds a study published by *The BMJ* today. One possible explanation is that mental stimulation is linked to lower levels of certain proteins that may prevent brain cells forming new connections (processes called axonogenesis and synaptogenesis). Cognitive stimulation is assumed to prevent or postpone the onset of dementia. But trial results have varied and most recent long term studies have suggested that leisure time cognitive activity does not reduce risk of d... read more

Key mental abilities can actually improve during aging
It’s long been believed that advancing age leads to broad declines in our mental abilities. Now new research from Georgetown University Medical Center offers surprisingly good news by countering this view. The findings, published August 19, 2021, in *Nature Human Behaviour*, show that two key brain functions, which allow us to attend to new information and to focus on what’s important in a given situation, can in fact improve in older individuals. These functions underlie critical aspects of cognition such as memory, decision making, and self-control, and even navigation, math, ... read more

Lack of exercise and poor nutrition could increase the risk of diseases like dementia
New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that both diet and exercise can influence the risk of cognitive decline (CD) and dementia by potentially influencing hippocampal neurogenesis (the process by which the brain produces new brain cells) long before their onset. The study, published in *Alzheimer's & Dementia*: The Journal of the Alzheimer's Association, suggests that altered neurogenesis in the brain could potentially represent an early biomarker for both CD and dementia. The investigation studied how ... read more
Health News Report1 week ago

Exercise

Moderate-vigorous physical activity is the most efficient at improving fitness
Physical fitness is a powerful predictor of health outcomes In the largest study performed to date to understand the relationship between habitual physical activity and physical fitness, researchers from Boston University School of Medicine (BUSM) have found that higher amount of time spent performing exercise (moderate-vigorous physical activity) and low-moderate level activity (steps) and less time spent sedentary, translated to greater physical fitness . “By establishing the relationship between different forms of habitual physical activity and detailed fitness measures, we... read more


Isometric resistance training effectivesin reducing office blood pressure
When was the last time you had your blood pressure checked? High blood pressure affects 1.13 billion people around the globe and in 2019, it accounted for 10.8 million deaths. Worldwide, it’s the leading risk factor for mortality. More than a third of the Australian population over the age of 18 has high blood pressure, yet it’s estimated 50 per cent of Australians don’t realise they’re living with it. As high blood pressure puts you at high risk of having a heart attack or stroke (cardiovascular disease), it’s important to keep track of your blood pressure. People over the age o... read more

Regular exercise, even in polluted areas, can lower risk of death
Regular exercise, even performed in areas with air pollution, can reduce the risk of death from natural causes, according to new research in *CMAJ* (*Canadian Medical Association Journal*) *https://www.cmaj.ca/lookup/doi/10.1503/cmaj.202729*. “Habitual exercise reduces the risk of death regardless of exposure to air pollution, and air pollution generally increases the risk of death regardless of habitual exercise. Thus, habitual exercise should be promoted as a health improvement strategy, even for people residing in relatively polluted areas,” writes Dr. Xiang Qian Lao, Jockey C... read more

Hypothermia may go unnoticed when exercising in the cold
In a study published this month in *Physiology & Behavior,* research teams at the University of Tsukuba, led by Takeshi Nishiyasu, and at Niigata University of Health and Welfare, led by Tomomi Fujimoto, have found that, when exercising, people cannot perceive decreases in their core body temperature caused by the cold as well as they can when they are resting. This research has implications for recreational activities in colder climates, such as hiking and skiing. Body temperature is maintained in several ways. Although your body subconsciously adjusts energy, fluid secretion, a... read more


COVID

Largest real-world study of COVID-19 vaccine safety 
The Clalit Research Institute, in collaboration with researchers from Harvard University, analyzed one of the world’s largest integrated health record databases to examine the safety of the Pfizer/BioNTech BNT162B2 vaccine against COVID-19. The study provides the largest peer-reviewed evaluation of the safety of a COVID-19 vaccine in a nationwide mass-vaccination setting. The study was conducted in Israel, an early global leader in COVID-19 vaccination rates. Previous efforts to characterize vaccine safety have relied on voluntary active reporting by vaccinated individuals, which... read more

The combination of mask wearing and keeping windows open is best for reducing Covid-19 risk in cars
As the country prepares to live in a post-Covid-19 world and car travel – including taxi and car-sharing services that mix households – returns to normal, new research from the University of Surrey has confirmed that keeping car windows open to draw in fresh air is key to reducing the risk of contracting the virus in vehicle environments – but there are trade-offs. In a paper published by* Environment International,* Surrey's renowned Global Centre for Clean Air Research (GCARE) explored what motorists must consider to make sure their in-car environments are as Covid-secure as ... read more

COVID-19 is most transmissible 2 days before and 3 days after symptoms appear
New study also finds that infected individuals are more likely to be asymptomatic if they contracted the virus from someone who was asymptomatic Each wave of the pandemic has underscored just how gravely contagious COVID-19 is, but there is less clarity among experts on exactly when—and to what extent—infected individuals are most likely to spread the virus. Now, a new study co-led by a Boston University School of Public Health (BUSPH) researcher has found that individuals infected with the virus are most contagious two days before, and three days after, they develop symptoms. *... read more

Researchers from Case Western Reserve University, University Hospitals Cleveland Medical Center (UH), BIOHM Health LLC, and the Louis Stokes Cleveland VA Medical Center have published a paper in the *Frontiers of Nutrition*, proposing a hypothesis and theory about a microbiome-driven approach to combating depression during the COVID-19 pandemic. In their paper, Mahmoud A. Ghannoum, PhD, FAAM, FIDSA, and colleagues, write that significant stressors brought about and exacerbated by COVID-19 are associated with startling surges in mental health illnesses, specifically those related... read more

Antacid famotidine improves the odds of survival for COVID-19 patients, especially when it is combined with aspirin
In the early days of the COVID-19 pandemic, doctors in Wuhan noticed something surprising. Many of the elderly patients who survived the virus were poor: not exactly the demographic you would expect to fare well in a health crisis. A review of the survivors’ medical records revealed that a significant number suffered from chronic heartburn and were taking an inexpensive drug called famotidine, the key ingredient in Pepcid. (Wealthier patients tended to take the more costly drug omeprazole, found in Prilosec.) Was an over-the-counter acid suppressant helping people survive COVID... read more

Existing drugs and a supplement, lactoferrin, kill SARS-CoV2 in cells
Could the next therapy for COVID-19 already be at your local pharmacy? Since the beginning of the pandemic, researchers worldwide have been looking for ways to treat COVID-19. And while the COVID-19 vaccines represent the best measure to prevent the disease, therapies for those who do get infected remain in short supply. A new groundbreaking study from U-M reveals several drug contenders already in use for other purposes—including one dietary supplement—that have been shown to block or reduce SARS-CoV2 infection in cells. The study, published recently in the *Proceedings of the... read more

Diet

How saturated fat from various foods relates to cardiovascular disease.
A study in more than 100,000 individuals has found a potential link between eating saturated fat from meat and developing heart disease. The preliminary research is presented at ESC Congress 2021.1 Study author Dr. Rebecca Kelly of the Nuffield Department of Population Health, University of Oxford, UK said: “The association seen between saturated fat and cardiovascular disease risk in observational studies has previously been unclear; our findings are important because they provide a possible explanation — that the relationship may vary depending on the food source. We found tha... read more

Mediterranean diet shows promise in men with erectile dysfunction
A Mediterranean diet is associated with improvements in erectile dysfunction, according to research presented at ESC Congress 2021.1 Men with hypertension are twice as likely to have erectile dysfunction as their peers with normal blood pressure.2 Erectile dysfunction is primarily considered a disorder of the small arteries, which lose the ability to dilate and augment flow. Declining testosterone levels in middle age contribute to its onset. Previous research has shown that fitness is linked with improved survival in men with hypertension,3 while the Mediterranean diet lowers bl... read more

Drinking sufficient water could prevent heart failure
Staying well hydrated throughout life could reduce the risk of developing heart failure, according to research presented at ESC Congress 2021.1 “Our study suggests that maintaining good hydration can prevent or at least slow down the changes within the heart that lead to heart failure,” said study author Dr. Natalia Dmitrieva of the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, Bethesda, US. “The findings indicate that we need to pay attention to the amount of fluid we consume every day and take action if we find that we drink too little.” ... read more

Gut bacteria and flavonoid-rich foods are linked and improve blood pressure levels
Hypertension Journal Report — Flavonoid-rich foods, including berries, apples, pears and wine, appear to have a positive effect on blood pressure levels, an association that is partially explained by characteristics of the gut microbiome, according to new research published today in *Hypertension*, an American Heart Association journal. “Our gut microbiome plays a key role in metabolizing flavonoids to enhance their cardioprotective effects, and this study provides evidence to suggest these blood pressure-lowering effects are achievable with simple changes to the daily diet,” s... read more

Pecan-enriched diet shown to reduce cholesterol
While the proper pronunciation of pecan remains a subject of debate, University of Georgia researchers have shown the tree nut can dramatically improve a person’s cholesterol levels. Participants at risk for cardiovascular disease who ate pecans during an eight-week intervention showed significant improvements in total cholesterol, triglycerides and low-density lipoprotein (LDL), or “bad” cholesterol, in a study conducted by researchers in the UGA College of Family and Consumer Sciences. “This dietary intervention, when put in the context of different intervention studies, was e... read more

Small changes in diet could help you live healthier, more sustainably
Eating a hot dog could cost you 36 minutes of healthy life, while choosing to eat a serving of nuts instead could help you gain 26 minutes of extra healthy life, according to a University of Michigan study. The study, published in the journal Nature Food, evaluated more than 5,800 foods, ranking them by their nutritional disease burden to humans and their impact on the environment. It found that substituting 10% of daily caloric intake from beef and processed meats for a mix of fruits, vegetables, nuts, legumes and select seafood could reduce your dietary carbon footprint by one-... read more

New study disproves “fast carbs make you fat” claim
A study recently published in *Advances in Nutrition*, a peer-reviewed nutrition journal from the American Society for Nutrition, concludes that high-glycemic (high-GI) foods (often called “fast carbs”) are no more likely than low-GI foods (often called “slow carbs”) to lead to weight gain – and no less likely to lead to diet-induced weight loss. Undertaken to assess the hypothesis that high-GI foods promote fat storage and increase risk of obesity by causing a rapid increase in blood sugar and insulin secretion, and that low-GI foods do the opposite, the comprehensive study ana... read more

People who eat a diet rich in vitamin K have up to a 34 percent lower risk of atherosclerosis-related cardiovascular disease
New Edith Cowan University (ECU) research has found that people who eat a diet rich in vitamin K have up to a 34 percent lower risk of atherosclerosis-related cardiovascular disease (conditions affecting the heart or blood vessels). Researchers examined data from more than 50,000 people taking part in the Danish Diet, Cancer, and Health study over a 23-year period. They investigated whether people who ate more foods containing vitamin K had a lower risk of cardiovascular disease related to atherosclerosis (plaque build-up in the arteries). There are two types of vitamin K found ... read more

Low glycemic diet shows meaningful improvements for people with diabetes
For people with diabetes, sticking to a low glycemic diet results in small but important improvements in blood sugar levels, cholesterol, weight and other risk factors, finds a study published by *The BMJ* today. These improvements were seen over and above existing drug or insulin therapy, suggesting that a low glycaemic diet might be especially helpful as add-on treatment to help those with diabetes better achieve their targets, say the researchers. The glycaemic index (GI) rates how quickly different foods affect blood sugar levels and research has shown that low-GI foods, such... read more

New research from Harvard explores link between walnut consumption and life expectancy
*Findings show a connection between regular walnut consumption and greater longevity, as well as reduced risk of death from cardiovascular diseases* According to a study by researchers from the Harvard T.H. Chan School of Public Health, higher walnut consumption – both in terms of the amount and frequency – may be associated with a lower risk of death and an increase in life expectancy among older adults in the U.S., compared to those who do not consume walnuts. “What we’ve learned from this study is that even a few handfuls of walnuts per week may help promote longevity, especia... read more

Previous summary:
Latest Health Research - Diet


General Health

Sunlight makes you fall in love
Researchers at Tel Aviv University have found that exposure to ultraviolet radiation from sunlight enhances romantic passion in humans. In the study both men and women were exposed to UVB (ultraviolet radiation type B) under controlled conditions, and the findings were unequivocal: increased levels of romantic passion in both genders. The study revealed that exposure to sunlight affects the regulation of the endocrine system responsible for the release of sexual hormones in humans. The study was led by PhD student Roma Parikh and Ashchar Sorek from the laboratory of Prof. Carm... read more


Stress busting techniques lead to healthier behaviors
Learning new ways to manage stress can naturally lead to a healthier lifestyle and greater wellbeing, new research suggests. People who developed and practised strategies for coping with worry and rumination were found to sleep better, drink less alcohol and eat healthier food, analysis of several studies from around the world has shown. Worry is often concerned with feared future events, while rumination is continuously thinking about stressors encountered in the past. Both are common coping responses to stress. The research team were aiming to establish whether reducing these re... read more

FIghting depression during COVID-19 pandemic: Researchers propose lifestyle changes, diet and probiotics for rebalancing microbiome
Researchers from Case Western Reserve University, University Hospitals Cleveland Medical Center (UH), BIOHM Health LLC, and the Louis Stokes Cleveland VA Medical Center have published a paper in the *Frontiers of Nutrition*, proposing a hypothesis and theory about a microbiome-driven approach to combating depression during the COVID-19 pandemic. In their paper, Mahmoud A. Ghannoum, PhD, FAAM, FIDSA, and colleagues, write that significant stressors brought about and exacerbated by COVID-19 are associated with startling surges in mental health illnesses, specifically those related... read more

Engaging in diverse daily activities is associated with a diverse set of emotions, but beneficial nevertheless.
New research shows that keeping busy with a variety of activities can elicit both positive and negative emotions, and some of the relationship could depend on your age. A new study published in the *Journal of Gerontology* finds that engaging in diverse daily activities is associated with a diverse set of emotions. "Experiencing a broad spectrum of emotions is adaptive and beneficial to health because it means having a more balanced and nuanced appraisal of daily life," said Soomi Lee, assistant professor of aging studies in the University of South Florida College of Behavioral a... read more

The U.S. Preventive Services Task Force (USPSTF) has lowered the recommended starting age of screening for type 2 diabetes
The U.S. Preventive Services Task Force (USPSTF) has lowered the recommended starting age of screening for type 2 diabetes from age 40 to 35 and recommends screening for prediabetes and type 2 diabetes in overweight or obese adults ages 35 to 70. The USPSTF also recommends that clinicians should offer or refer patients with prediabetes to effective preventive interventions. Diabetes is the leading cause of kidney failure and new cases of blindness and is associated with an increased risk of cardiovascular disease. Screening asymptomatic adults for prediabetes and type 2 diabetes ... read more

Think leisure is a waste? That may not bode well for your mental health
More stress and less happiness for those who are skeptical of fun Feeling like leisure is wasteful and unproductive may lead to less happiness and higher levels of stress and depression, new research suggests. In a series of studies, researchers examined the effects of a common belief in modern society: that productivity is the ultimate goal and time’s a-wasting if you’re just having fun. People who most strongly agreed with this belief not only enjoyed leisure less, but also reported poorer mental health outcomes, said Selin Malkoc, co-author of the study and associate professo... read more

Too much time on a computer, watching TV or other sedentary activities raises stroke risk
Adults younger than age 60 whose days are filled with sedentary leisure time (which includes using the computer, TV, or reading) and little physical activity have a higher stroke risk than people who are more physically active, according to new research published today in *Stroke*, a journal of the American Stroke Association, a division of the American Heart Association. According to American Heart Association statistics, U.S. adults spend an average of 10.5 hours a day connected to media such as smartphones, computers or television watching, and adults ages 50 to 64 spend the mo... read more

Lack of exercise and poor nutrition could increase the risk of diseases like dementia
New research from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has found that both diet and exercise can influence the risk of cognitive decline (CD) and dementia by potentially influencing hippocampal neurogenesis (the process by which the brain produces new brain cells) long before their onset. The study, published in *Alzheimer's & Dementia*: The Journal of the Alzheimer's Association, suggests that altered neurogenesis in the brain could potentially represent an early biomarker for both CD and dementia. The investigation studied how ... read more

Just 10% of kids with ADHD outgrow it, study finds
*Researchers said that attention deficit hyperactive disorder waxes and wanes over a lifetime* Most children diagnosed with attention deficit hyperactive disorder (ADHD) don’t outgrow the disorder, as widely thought. It manifests itself in adulthood in different ways and waxes and wanes over a lifetime, according to a study published Aug.13 in the *American Journal of Psychiatry.* “It's important for people diagnosed with ADHD to understand that it's normal to have times in your life where things maybe more unmanageable and other times when things feel more under control,” said... read more

Vitamins and Supplements

Existing drugs and a supplement, lactoferrin, kill SARS-CoV2 in cells
Could the next therapy for COVID-19 already be at your local pharmacy? Since the beginning of the pandemic, researchers worldwide have been looking for ways to treat COVID-19. And while the COVID-19 vaccines represent the best measure to prevent the disease, therapies for those who do get infected remain in short supply. A new groundbreaking study from U-M reveals several drug contenders already in use for other purposes—including one dietary supplement—that have been shown to block or reduce SARS-CoV2 infection in cells. The study, published recently in the *Proceedings of the... read more

New analysis of landmark scurvy study leads to update on vitamin C needs
Peer-Reviewed Publication It was wartime and food was scarce. Leaders of England’s effort to wage war and help the public survive during World War II needed to know: Were the rations in lifeboats adequate for survival at sea? And, among several experiments important for public as well as military heath, how much vitamin C did a person need to avoid the deadly disease scurvy? In one experiment at the Sorby Research Institute in Sheffield, called the “shipwreck” experiment, volunteers were fed only what the navy carried in lifeboats. The grueling experiment resulted in more water an... read more


Does vitamin D improve muscle health?
Vitamin D supplementation does not have beneficial effects on muscle function, strength, or mass, according to an analysis of all available data from relevant randomized controlled clinical trials. The analysis, which is published in the *Journal of Bone and Mineral Research*, included 54 trials involving 8,747 individuals. Overall, there were no benefits of vitamin D over placebo for improving muscle health. On the contrary, vitamin D appeared to have detrimental effects in terms of increased time spent performing what’s called the Timed Up and Go test, a decrease in maximum str... read more
Health News Report1 week ago

Vitamin D may protect against young-onset colorectal cancer
Consuming higher amounts of Vitamin D – mainly from dietary sources – may help protect against developing young-onset colorectal cancer or precancerous colon polyps, according to the first study to show such an association. The study, recently published online in the journal *Gastroenterology*, by scientists from Dana-Farber Cancer Institute, the Harvard T.H. Chan School of Public Health, and other institutions, could potentially lead to recommendations for higher vitamin D intake as an inexpensive complement to screening tests as a colorectal cancer prevention strategy for adul... read more
Health News Report1 week ago



Sleep

Short naps don’t relieve sleep deprivation
A nap during the day won't restore a sleepless night, says the latest study from Michigan State University's Sleep and Learning Lab. "We are interested in understanding cognitive deficits associated with sleep deprivation. In this study, we wanted to know if a short nap during the deprivation period would mitigate these deficits," said Kimberly Fenn, associate professor of MSU, study author and director of MSU's Sleep and Learning Lab. "We found that short naps of 30 or 60 minutes did not show any measurable effects." The study was published in the journal Sleep and is among the ... read more

Previous summary: