Diet and exercise for obese mothers protects cardiovascular risk in infants

A lifestyle intervention of diet and exercise in pregnancy protects against cardiovascular risk in infants, a new study has found.

The study, published recently in the International Journal of Obesity by researchers from King’s College London and funded by the British Heart Foundation, found that 3-year-old children were more likely to exhibit risk factors for future heart disease if their mother was clinically obese during pregnancy. A behavioural lifestyle intervention reduced this risk.

In the UK, more than half the women attending antenatal care are clinically overweight or obese. There is increasing evidence to suggest that obesity in pregnancy is associated with cardiometabolic dysfunction in children, and that serious cardiovascular disease may begin in the womb.

The UPBEAT trial, conducted at Guy’s and St Thomas’ NHS Foundation Trust, randomised women with obesity (a BMI of over 30 kg/m2) in early pregnancy to a diet and exercise intervention or to standard pregnancy care. The intervention included one-to-one counselling, restricting dietary intake of saturated fat, eating foods with a low glycaemic index such as vegetables and legumes, moderate and monitored physical activity and tools to record exercise. The intervention arm saw improvements in weight gain in pregnancy, physical activity, a healthier diet, and a healthier metabolic profile across pregnancy.

Follow-up of the children at three years of age showed that children of women with clinical obesity had evidence of cardiac remodelling, a risk factor for future cardiovascular disease. Changes included increased heart muscle thickness, elevated resting heart rate, evidence of early impairment to the heart’s relaxation function and increased sympathetic nerve activity (‘fight or flight’ response) compared to women of normal weight. The children of women who were allocated to the intervention arm were protected from these early changes in heart structure and function. 

Study lead Dr Paul Taylor, from King’s College London, said: “Maternal obesity appears to adversely impact the developing fetal nervous system and fetal heart development which is apparent up to 3 years-of-age. A complex lifestyle intervention in pregnancy was associated with protection against cardiac remodelling in infants. We can hypothesise that these changes to the heart and its function will get worse over time, putting the child at increased risk of cardiovascular disease in the future.”

The study suggests that maternal obesity may have a lasting impact on the child’s cardiovascular health. Promoting dietary changes and physical activity during pregnancy may reduce this risk.

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JOURNAL

International Journal of Obesity

DOI

10.1038/s41366-022-01210-3 

 

Plant-based diet leads to greater reduction in harmful dietary advanced glycation end-products than diet with meat and dairy

 Eating a plant-based diet reduces inflammatory dietary advanced glycation end-products (AGEs) by 79%, compared to a 15% reduction for a diet that includes meat and dairy products, according to a new study by researchers with the Physicians Committee for Responsible Medicine published in Obesity Science & Practice. The decrease in AGEs was associated with an average weight loss of 14 pounds and improved insulin sensitivity.

“Simply swapping fatty meat and dairy products for a low-fat plant-based diet led to a significant decrease in advanced glycation end-products—inflammatory compounds found to a greater degree in animal products than plants,” says lead study author Hana Kahleova, MD, PhD, director of clinical research at the Physicians Committee for Responsible Medicine. “The decrease in AGEs was also associated with weight loss and improved insulin sensitivity.”

AGEs are compounds that are formed in the bloodstream when proteins or fats combine with glucose. AGEs cause inflammation and oxidative stress, which eventually lead to chronic diseases, including type 2 diabetes and cardiovascular disease.

AGEs may be ingested through the diet, and animal products are generally higher in AGEs than plant foods. AGEs are also formed during normal metabolism but are formed at an increased rate when a person has metabolic syndrome—high blood sugar, high cholesterol, high blood pressure, and insulin resistance.

In the study, 244 participants who were overweight were randomly assigned to an intervention group, which ate a low-fat plant-based diet, or control group, which made no dietary changes, for 16 weeks.

At the beginning and end of the study, body composition was measured and insulin sensitivity was assessed. Dietary AGEs were calculated based on self-reported dietary intake records. A dietary AGEs database was used to estimate dietary AGEs intake.

Dietary AGEs decreased by 79% in the plant-based group, compared to 15% in the control group. About 55% of the reduction of the dietary AGEs in the plant-based group was attributable to the reduction in meat intake, 26% to decreased dairy intake, and 15% to decreased consumption of added fats. The reduction in white meat consumption made the biggest difference in dietary AGEs coming from meat (59%), followed by processed meat (27%).

Body weight decreased by about 14 pounds (6.4 kg) in the plant-based group, compared with about 1 pound (0.5 kg) in the control group, largely due to a reduction in fat mass, notably visceral fat. Insulin sensitivity improved in the intervention group.

The authors say that these findings support prior observations of the favorable effects of low-AGEs diets on weight, body fat, and insulin resistance.

First medical guideline recommends new prescription medications for weight loss, ranks the most effective drugs

 

Diet and exercise fail for most adults who try to lose weight in the long-term. Today the American Gastroenterological Association (AGA) released new evidence-based guidelines strongly recommending that these patients with obesity use recently approved medications paired with lifestyle changes.

The following medications, paired with healthy eating and regular physical activity, are first-line medical options and result in moderate weight loss as noted as a percentage of body weight (reported as the difference compared to percent weight loss observed in the placebo group).

1. Semaglutide (Wegovy®), weight loss percentage: 10.8%
2. Phentermine-topiramate ER (Qsymia®), weight loss percentage: 8.5%
3. Liraglutide (Saxenda®), weight loss percentage: 4.8%
4. Naltrexone-Bupropion ER (Contrave®), weight loss percentage: 3.0%

“These medications treat a biological disease, not a lifestyle problem. Obesity is a disease that often does not respond to lifestyle interventions alone in the long-term,” says author Eduardo Grunvald, MD, University of California San Diego. “Using medications as an option to assist with weight loss can improve weight-related complications like joint pain, diabetes, fatty liver and hypertension.”

The prevalence of obesity in the United States has increased dramatically from 30.5% to 41.9% over the last twenty years.

“There have been changes in obesity treatment in recent years. This guideline is the first since diabetes drugs were approved for obesity treatment and provides clear information for doctors and their adult patients who struggle to lose weight or keep it off with lifestyle changes alone,” says Perica Davitkov.

Read the AGA Clinical Guidelines on Pharmacological Interventions for Adults with Obesity or the complete recommendations.

About obesity

Obesity is a medical condition in which too much body fat negatively impacts your health. It is healthy to have some body fat. In fact, a healthy level of body fat is needed to survive. But too much fat can be harmful to your body. Obesity is most often measured by body mass index (BMI), a calculation of body weight compared with height. BMI isn’t the only way to measure healthy weight. Learn more in the AGA GI Patient Center.

Resources

Obesity Guideline

Spotlight (one-page infographic)

Clinical Decision Support Tool

Do caffeine and alcohol affect fertility treatments?

A recent analysis published in Acta Obstetricia et Gynecologica Scandinavica found no association between women's caffeine consumption and pregnancy or live birth rate after fertility treatments, but women's alcohol consumption was associated with decreased pregnancy rate after treatments when weekly consumption was greater than 84 g (approximately 7 standard drinks).

Also, men's alcohol consumption was associated with decreased live birth rate after fertility treatments in women when weekly consumption was greater than 84 g.

The analysis included all relevant studies published before July 15, 2022. A total of 7 studies on caffeine consumption and 9 studies on alcohol consumption were included, with a total of 26,922 women and/or their spouse who underwent fertility treatment.

Compared with abstainers, the chance of achieving a pregnancy after fertility treatment decreased by 7% for women who consumed 84 g alcohol per week, and the chance of partners achieving a live birth decreased by 9% for men who consumed 84 g alcohol per week.

"Couples should be aware that some modifiable lifestyle factors such as drinking habits may affect their fertility treatment outcomes. But how these factors impact the reproductive system still needs more research to elucidate," said corresponding author Yufeng Li, MD, of Tongji Hospital, in China.

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/aogs.14464

Additional Information

NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com

About the Journal

Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical and research work from around the globe. The journal regularly publishes commentaries, reviews and original articles on a wide variety of topics.

About Wiley

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JOURNAL

Acta Obstetricia Et Gynecologica Scandinavica

DOI

10.1111/aogs.14464 

Study shows certain foods reduce hot flashes associated with menopause by 88%

Trial participants lost, on average, eight pounds in 12 weeks

A new study, published by the North American Menopause Society in the journal Menopause, found that a diet intervention is about as effective (88%) as hormone replacement therapy (70%-90%) for reducing menopausal hot flashes, without the associated health risks.

 

The WAVS trial—the Women’s Study for the Alleviation of Vasomotor Symptoms—found that a plant-based diet rich in soy reduced moderate to severe hot flashes by 88% and helped women lose, on average, eight pounds in 12 weeks.

 

“We do not fully understand yet why this combination works but it seems that these three elements are key—avoiding animal products, reducing fat, and adding a serving of soybeans,” explains lead researcher Neal Barnard, MD, president of the Physicians Committee and adjunct professor at the George Washington University School of Medicine. “Our results mirror the diets of places in the world, like pre-Westernized Japan and modern-day Yucatán Peninsula, where a low-fat, plant-based diet including soybeans is more prevalent and where postmenopausal women experience fewer symptoms.”

 

The study published today is the second phase of a two-part trial, the first of which was also published in Menopause in 2021. The fall timing of the first trial raised the question of whether this symptomatic improvement might have been attributed to cooler temperatures. But women who began the study as weather warmed up in the spring had the same benefit, ruling out the effect of outside temperature.

 

“These new results suggest that a diet change should be considered as a first-line treatment for troublesome vasomotor symptoms, including night sweats and hot flashes,” explains Dr. Barnard.

 

Included in the study were 84 postmenopausal women reporting two or more hot flashes per day. They were randomly assigned either to an intervention group—consisting of a low-fat, vegan diet, including half a cup of cooked soybeans daily—or to a control group that made no diet changes for 12 weeks.

 

“This study demonstrates the effectiveness of a dietary intervention for menopausal symptoms,” Dr. Barnard explains. “As well, it is precisely the diet that would be expected to reduce the health concerns of many women reaching menopause: an increasing risk of heart disease, breast cancer, and memory problems.”

 

Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit organization that promotes preventive medicine, conducts clinical research, and encourages higher standards for ethics and effectiveness in education and research.                                               -30-

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DOI

10.1097/GME.0000000000002080 

Spice containers pose contamination risk during food preparation

 

A government-funded study on the potential for cross-contaminating kitchen surfaces with pathogens during food preparation has pointed to an unlikely culprit for spreading sickness: spice containers.

Detailing findings in the Journal of Food Protection, Donald Schaffner, a Distinguished Professor in the Department of Food Science at the Rutgers School of Environmental and Biological Sciences who co-authored the study in collaboration with North Carolina State University colleagues, concluded that when consumers are preparing meals, spice containers can easily become cross-contaminated with health-threatening microorganisms. Cross-contamination is the process by which microbes are transferred from one substance or object to another, often with harmful effects.

The study was commissioned by the U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service.

“In addition to more obvious surfaces like cutting boards, garbage can lids and refrigerator handles, here’s something else that you need to pay attention to when you’re trying to be clean and sanitary in your kitchen,” Schaffner said. “Our research shows that any spice container you touch when you're preparing raw meat might get cross-contaminated. You’ll want to be conscious of that during or after meal preparation.”

Foodborne illnesses such as non-typhoidal Salmonella and Campylobacter account for nearly 2 million infections per year in the U.S., according to studies by the U.S. Centers for Disease Control and Prevention (CDC). A significant portion of those illnesses are derived from USDA-regulated food products, including chicken, turkey, beef, pork and game, according to the Interagency Food Safety Analytics Collaboration, a group formed in 2011 by the CDC, the USDA’s Food Safety and Inspection Service and the U.S. Food and Drug Administration. Scientists said they believe proper handling of food – including adequate cooking, consistent handwashing and sanitizing of kitchen surfaces and utensils – can combat cross-contamination.

“The purpose of this study was to determine the prevalence and degree of cross-contamination across a variety of kitchen surfaces during a consumer meal preparation event,” said Schaffner, who also is the Rutgers Agricultural Experiment Station’s Extension Specialist in Food Science

Researchers monitored the behavior of 371 adults cooking an identical turkey burger recipe in several kitchens of various sizes, ranging from small apartment-style kitchens to larger teaching kitchens, in extension centers and food banks. Participants prepared a meal consisting of raw ground turkey patties with a seasoning recipe, along with a prepackaged salad. To simulate the movement of a pathogen across a kitchen, researchers inoculated the meat ahead of time with a bacteriophage known as “MS2” to serve as a safe tracer. Bacteriophages are viruses that infect bacteria and have no effect on humans.

Participants weren’t informed that researchers would be examining their food safety behaviors until after they had prepared the meal. Once the meal had been prepared, researchers swabbed kitchen utensils, cleaning areas and kitchen surfaces to test for the presence of the MS2 tracer. Based on observations of participants’ behavior during cooking, researchers decided to take samples from some new categories of surfaces, such as spice containers and sink faucet handles.

The researchers found the most frequently contaminated objects were spice containers, with about 48 percent of the samples showing evidence of MS2 contamination. This prevalence of contamination was significantly different from many other surfaces sampled. Cutting boards and trash can lids were the second and third most contaminated. Faucet handles were the least contaminated object studied.

“We were surprised because we had not seen evidence of spice container contamination before,” Schaffner said. “Most research on the cross-contamination of kitchen surfaces due to handling of raw meat or poultry products has focused on kitchen cutting boards or faucet handles and has neglected surfaces like spice containers, trash bin lids and other kitchen utensils. This makes this study and similar studies from members of this group more comprehensive than previous studies.”

Researchers involved included Benjamin Chapman, professor and department head, Agricultural and Human Sciences, and Lee-Ann Jaykus, the William Neal Reynolds Distinguished Professor, Food, Bioprocessing and Nutrition Sciences, Margaret Kirchner, Savana Everhart, Lindsey Doring, Caitlin Smits, Jeremy Faircloth, Minh Duong, Rebecca Goulter, Lydia Goodson, Lisa Shelley and Ellen Thomas Shumaker, all of North Carolina State University; Sheryl Cates of RTI International; Christopher Bernstein of the Consumer Financial Protection Bureau; and Aaron Lavallee of the U.S. Department of Agriculture.

Birdsong is good for mental health

In the study, the researchers examined how traffic noise and birdsong affect mood, paranoia, and cognitive functioning by carrying out a randomized online experiment with 295 participants. These heard six minutes of either typical traffic noise or birdsong with varying numbers of different traffic sounds or birdsongs. Before and after hearing the sound clips, the participants filled in questionnaires assessing their mental health and performed cognitive tests. „Everyone has certain psychological dispositions. Healthy people can also experience anxious thoughts or temporary paranoid perceptions. The questionnaires enable us to identify people's tendencies without their having a diagnosis of depression, anxiety, and paranoia and to investigate the effect of the sounds of birds or traffic on these tendencies,“ says first author Emil Stobbe, Predoctoral Fellow at the Lise Meitner Group for Environmental Neuroscience at the Max Planck Institute for Human Development.

The present study suggests that listening to birdsong reduces anxiety and paranoia in healthy participants. Birdsong did not appear to have an influence on depressive states in this experiment. Traffic noise, however, generally worsened depressive states, especially if the audio clip involved many different kinds of traffic sounds. The positive influence of birdsong on mood is already known, but to the best of the authors‘ knowledge, this study is the first to reveal an effect on paranoid states. This was independent of whether the birdsong came from two or more different bird species.The researchers also found that neither birdsong nor traffic noise influenced cognitive performance.

In the researchers‘ view, the explanation for these effects is that birdsong is a subtle indication of an intact natural environment, detracting attention from stressors that could otherwise signal an acute threat. Taken together, the results suggest interesting avenues for further research and applications, such as the active manipulation of background noise in different situations or the examination of its influence on patients with diagnosed anxiety disorders or paranoia.

„Birdsong could also be applied to prevent mental disorders. Listening to an audio CD would be a simple, easily accessible intervention. But if we could already show such effects in an online experiment performed by participants on a computer, we can assume that these are even stronger outdoors in nature,“ says Stobbe. He is a member of the Lise Meitner Group for Environmental Neuroscience at the Max Planck Institute for Human Development in Berlin, which studies the effects of the physical environment on the individual. „We were recently able to perform a study showing that a one-hour walk in nature reduces brain activity associated with stress,“ adds the research group’s head Simone Kühn. „We cannot say yet which features of nature – smells, sounds, color, or a combination thereof – are responsible for the effect. The present study provides a further building block to clarify this issue,“ continues Kühn. What is clear is that nature improves mental health and well-being. So, out we go!

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JOURNAL

Scientific Reports

DOI

10.1038/s41598-022-20841-0