Fluctuating personal income may be associated with an increased heart disease risk

Sudden, unpredictable drops in personal income during young adulthood are associated with an increased risk of developing heart disease and/or dying from any cause, according to new research in the American Heart Association's journal Circulation.

In the United States, the recent rise in income inequality suggests that a larger proportion of the population faces poverty and economic difficulties. In addition, while most people experience some income change, income volatility has been on the rise and has reached a record high level since 1980.

The study found that the biggest fluctuations in personal income were significantly associated with nearly double the risk of death and more than double the risk for cardiovascular diseases, such as heart attacks, strokes, heart failure or death during the following 10 years compared to a similar group of people with less fluctuation in personal income. Women and African-Americans were more likely to experience high income volatility and income drops than white men.

"Income volatility presents a growing public health threat, especially when federal programs, which are meant to help absorb unpredictable income changes, are undergoing continuous changes, and mostly cuts," said study lead author Tali Elfassy, Ph.D., assistant professor at the University of Miami Miller School of Medicine in Florida.

"While this study is observational in nature and certainly not an evaluation of such programs, our results do highlight that large negative changes in income may be detrimental to heart health and may contribute to premature death," Elfassy said.

The study analyzed data from the ongoing Coronary Artery Risk Development in Young Adults (CARDIA) study that is following 3,937 people living in four diverse U.S. cities - Birmingham, Alabama; Minneapolis, Minnesota; Chicago, Illinois; and Oakland, California.
Participants were aged 23-35 years old in 1990 when the study began.
The researchers collected data on changes in income in five assessments from 1990 to 2005. They measured income volatility as the percent change in income from one measurement to the next, and income drop as a decrease of 25 percent or more from the previous assessment. Between 2005 and 2015, the researchers assessed fatal and non-fatal cardiovascular events and all causes of death using medical records and death certificates.
The study was not able to determine the cause of the association between income volatility and health because it was observational and not designed to prove cause and effect.

One in 10 adults in US has food allergy, but nearly 1 in 5 think they do

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Over 10 percent of adults in the U.S. -- over 26 million -- are estimated to have food allergy, according to a study published in JAMA Network Open that was led by Ruchi Gupta, MD, MPH, from Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University. However, researchers found that 19 percent of adults think they are currently food allergic, although their reported symptoms are inconsistent with a true food allergy, which can trigger a life-threatening reaction. Results are based on a nationally representative survey of over 40,000 adults.

"While we found that one in 10 adults have food allergy, nearly twice as many adults think that they are allergic to foods, while their symptoms may suggest food intolerance or other food related conditions," says lead author Ruchi Gupta, MD, MPH, from Lurie Children's, who also is a Professor of Pediatrics at Northwestern University Feinberg School of Medicine. "It is important to see a physician for appropriate testing and diagnosis before completely eliminating foods from the diet. If food allergy is confirmed, understanding the management is also critical, including recognizing symptoms of anaphylaxis and how and when to use epinephrine."

Researchers discovered that only half of adults with convincing food allergy had a physician-confirmed diagnosis, and less than 25 percent reported a current epinephrine prescription.
Researchers also found that nearly half of food-allergic adults developed at least one of their food allergies as an adult.

"We were surprised to find that adult-onset food allergies were so common," says Dr. Gupta. "More research is needed to understand why this is occurring and how we might prevent it."

The study data indicate that the most prevalent food allergens among U.S. adults are shellfish (affecting 7.2 million adults), milk (4.7 million), peanut (4.5 million), tree nut (3 million), fin fish (2.2 million), egg (2 million), wheat (2 million), soy (1.5 million), and sesame (.5 million).
"Our data show that shellfish is the top food allergen in adults, that shellfish allergy commonly begins in adulthood, and that this allergy is remarkably common across the lifespan," says Dr. Gupta. "We need more studies to clarify why shellfish allergy appears to be so common and persistent among U.S. adults."

Metabolic syndrome patients need more vitamin C to break cycle of antioxidant depletion

A higher intake of vitamin C is crucial for metabolic syndrome patients trying to halt a potentially deadly cycle of antioxidant disruption and health-related problems, an Oregon State University researcher says.
That's important news for the estimated 35 percent of the U.S. adult population that suffers from the syndrome.
"What these findings are really saying to people as we move out of the rich-food holiday season and into January is eat your fruits and vegetables," said Maret Traber, a professor in the OSU College of Public Health and Human Sciences and Ava Helen Pauling Professor at Oregon State's Linus Pauling Institute. "Eat five to 10 servings a day and then you'll get the fiber, you'll get the vitamin C, and you'll really protect your gut with all of those good things."
A diet high in saturated fat results in chronic low-grade inflammation in the body that in turn leads to the development of metabolic syndrome, a serious condition associated with cognitive dysfunction and dementia as well as being a major risk factor for cardiovascular disease, fatty liver disease and type 2 diabetes.
A patient is considered to have metabolic syndrome if he or she has at least three of the following conditions: abdominal obesity, high blood pressure, high blood sugar, low levels of "good" cholesterol, and high levels of triglycerides.
Findings published in Redox Biology suggest the type of eating that leads to metabolic syndrome can prompt imbalances in the gut microbiome, with impaired gut function contributing to toxins in the bloodstream, resulting in vitamin C depletion, which subsequently impairs the trafficking of vitamin E.
It's a treadmill of antioxidant disruption that serves to make a bad situation worse; antioxidants such as vitamins C and E offer defense against the oxidative stress brought on by inflammation and the associated free radicals, unstable molecules that can damage the body's cells.
"Vitamin C actually protects vitamin E, so when you have lipid peroxidation, vitamin E is used up and vitamin C can regenerate it," Traber said. "If you don't have the vitamin C, the vitamin E gets lost and then you lose both of those antioxidants and end up in this vicious cycle of depleting your antioxidant protection."
Lipid peroxidation is the oxidative degradation of polyunsaturated fatty acids that are a major component of living cells; it's the process by which free radicals try to stabilize themselves by stealing electrons from cell membranes, causing damage to the cell.
"If there's too much fat in the diet, it causes injury to the gut," Traber said. "Bacterial cell walls can then leak from the gut and slip into circulation in the body, and they're chased down by neutrophils."
Neutrophils are the most abundant type of white blood cells, a key part of the immune system. Neutrophils attack bacteria with hypochlorous acid: bleach.
"The white blood cells are scrubbing with bleach and that destroys vitamin C," Traber said. "The body is destroying its own protection because it got tricked by the gut dysbiosis into thinking there was a bacterial invasion."
And without intervention, the process keeps repeating.
"People with metabolic syndrome can eat the same amount of vitamin C as people without metabolic syndrome but have lower plasma concentrations of vitamin C," Traber said. "We're suggesting that's because this slippage of bacterial cell walls causes the whole body to mount that anti-inflammatory response."
Vitamin C is found in fresh vegetables and fruits; sources of vitamin E include almonds, wheat germ and various seeds and oils.
Federal dietary guidelines call for 65 to 90 milligrams daily of vitamin C, and 15 milligrams of vitamin E.

Consumption of one egg every day = a lower risk of type 2 diabetes

Consumption of one egg every day seems to associate with a blood metabolite profile that is related to a lower risk of type 2 diabetes, a new study conducted in the University of Eastern Finland shows. The findings were published in Molecular Nutrition and Food Research.

Eggs remain one of the most controversial food items. High intake of eggs has traditionally been discouraged, mainly due to their high cholesterol content. However, eggs are also a rich source of many bioactive compounds that can have beneficial effects on health. This means that the health effects of consuming eggs are difficult to determine based solely on their cholesterol content.
The investigators have previously shown that eating roughly one egg per day was associated with a lower risk of developing type 2 diabetes among middle-aged men participating in the Kuopio Ischaemic Heart Disease Risk Factor Study in eastern Finland.

"The purpose of the current study was to explore potential compounds that could explain this association using non-targeted metabolomics, a technique that enables a broad profiling of chemicals in a sample," says Early Stage Researcher and lead author of the study Stefania Noerman from the University of Eastern Finland.

The study found that the blood samples of men who ate more eggs included certain lipid molecules that positively correlated with the blood profile of men who remained free of type 2 diabetes. In addition, the researchers identified several biochemical compounds in blood that predicted a higher risk of developing type 2 diabetes, including the amino acid tyrosine.

The study suggests some plausible mechanisms which could at least partly explain the inverse association between egg intake and the previously observed lower risk of developing type 2 diabetes.
"Although it is too early to draw any causal conclusions, we now have some hints about certain egg-related compounds that may have a role in type 2 diabetes development. Further detailed investigations with both cell models and intervention studies in humans that use modern techniques, such as metabolomics, are needed to understand the mechanisms behind physiological effects of egg intake," Early Stage Researcher Noerman concludes.

Persistent hot flashes may lead to increased risk of breast cancer

Studies examining the association between vasomotor symptoms (VMS) and breast cancer are not new, but results have been inconsistent. A new larger-scale study concludes that women participating in the Women's Health Initiative (WHI) trials who had persistent VMS are more likely to be diagnosed with breast cancer than women who never experienced VMS. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Data was gathered from more than 25,000 women who participated in the WHI for this latest study that sought to identify an association between VMS (which includes symptoms such as hot flashes and night sweats) and breast cancer. Through 17.9 years' follow-up of these women, 1,399 incident breast cancers were seen. Women with persistent VMS (defined as symptoms that lasted 10 or more years) had a higher breast cancer incidence than women who never experienced VMS.
Although breast cancer-specific mortality was higher in women with persistent VMS, the difference was not statistically significant, which meant that persistent VMS did not influence breast cancer survival rates.

The possible link between VMS and breast cancer continues to be studied because of a common association with hormones. Specifically, hormone therapy has proven to be the most effective treatment for VMS, whereas sex hormone levels also are related to postmenopause breast cancer risk.
Study results appear in the article, "Persistent vasomotor symptoms and breast cancer in the Women's Health Initiative."

"In this large group of women who were not users of hormone therapy, persistent hot flashes and night sweats for 10 or more years were associated with a slight but significant increase in breast cancer incidence," says Dr. JoAnn Pinkerton, NAMS executive director. "Other risk factors included an elevated body mass index of more than 30 and current alcohol use. More studies are needed in women who have persistent hot flashes to understand their cardiovascular and cancer risks."

Is very low LDL-C harmful?

A major Cardiovascular (CV) risk factor is low-density Lipoprotein Cholesterol (LDL-C). A lot of evidence that was accumulated supports a linear association between LDL-C levels and CV risk. However, whether the lower limit of LDL-C might offer CV benefits without any safety concerns is still a topic of debate.

This review discusses data from studies of several safety events that have been associated with low LDL-C levels achieved with major lipid-lowering drug.

Commonly with the use of a combination of statins with ezetimibe or proprotein convertase subtilisin kexin 9 inhibitors, several large trials have evaluated the safety or reducing LDL-C to levels lower than 50 mg/dl or even lower than 25 mg/dl. Most of the trials showed CV benefits which were observed with LDL-C levels of 50 mg/dl or less compared with higher levels. Favorable results for LDL-C levels lower than 25 mg/dl are limited.

Of importance, cancer and hemorrhagic stroke incidences were not increased in patients attaining LDL-C lower than 40-50 mg/dl. In terms of safety, the reduction of LDL-C to such levels was not associated with any significant adverse event. Data regarding the impact of lowering LDL-C with neurocognitive disorders are contradictory; nevertheless, most studies stand in favor of neurocognitive safety with LDL-C reductions to low levels.

To head off late-life depression, check your hearing

A new study found that elderly individuals with age-related hearing loss had more symptoms of depression; the greater the hearing loss, the greater the risk of having depressive symptoms. The findings suggest that treatment of age-related hearing loss, which is underrecognized and undertreated among all elderly, could be one way to head off late-life depression.

The study was published online in JAMA Otolaryngology-Head & Neck Surgery.

"Most people over age 70 have at least mild hearing loss, yet relatively few are diagnosed, much less treated, for this condition," says lead author Justin S. Golub, MD, MS, assistant professor of otolaryngology-head & neck surgery at Columbia University Vagelos College of Physicians and Surgeons. "Hearing loss is easy to diagnose and treat, and treatment may be even more important if it can help ease or prevent depression."

Age-related hearing loss is the third-most common chronic condition in older adults. The condition is known to raise the risk of other conditions, such as cognitive impairment and dementia. But there are few large studies asking whether hearing loss may lead to depression in the elderly -- particularly in Hispanics, a group in which depression may be underdiagnosed because of language and cultural barriers.

The researchers analyzed health data from 5,239 individuals over age 50 who were enrolled in the Hispanic Community Health Study/Study of Latinos. Each participant had an audiometric hearing test -- an objective way to assess hearing loss -- and was screened for depression.
The researchers found that individuals with mild hearing loss were almost twice as likely to have clinically significant symptoms of depression than those with normal hearing. Individuals with severe hearing loss had over four times the odds of having depressive symptoms.
The study looked for an association at a single point in time, so it can't prove that hearing loss causes depressive symptoms. "That would have to be demonstrated in a prospective, randomized trial," says Golub. "But it's understandable how hearing loss could contribute to depressive symptoms. People with hearing loss have trouble communicating and tend to become more socially isolated, and social isolation can lead to depression."
Although the study focused on Hispanics, the results could be applied to anyone with age-related hearing loss, according to the researchers. "In general, older individuals should get their hearing tested and consider treatment, if warranted," says Golub.