Friday, August 21, 2020

A healthy lifestyle for cardiovascular health also promotes good eye health

This new study found that ideal cardiovascular health, indicative of a healthy lifestyle, was associated with lower odds for developing ocular diseases, particularly diabetic retinopathy, reports The American Journal of Medicine

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IMAGE: NORMAL RETINA VS. RETINA WITH DIABETIC RETINOPATHY. view more

CREDIT: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, ALL RIGHTS RESERVED.

Philadelphia, August 20, 2020 - In a new study, investigators found that ideal cardiovascular health, which is indicative of a healthy lifestyle, was associated with lower odds for ocular diseases especially diabetic retinopathy. These findings appearing in the American Journal of Medicine, published by Elsevier, suggest that interventions to prevent cardiovascular diseases may also hold promise in preventing ocular diseases.

Globally, about 2.2 billion people suffer from ocular diseases leading to vision impairment or blindness. Approximately half of these cases could have been prevented. The leading causes of vision impairment or blindness are age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma.

"Earlier studies have observed associations between eye diseases and individual lifestyle factors such as smoking, obesity, or hypertension," explained lead investigator Duke Appiah, PhD, MPH, Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA. "It is known that these metrics of ideal cardiovascular health do not work alone and may interact additively to result in diseases. However, prior to our research, no other studies have comprehensively evaluated the association of all of the metrics of ideal cardiovascular health with ocular diseases."

Most ocular diseases show few symptoms at early stages and many people may not seek medical care despite readily available treatments. A recent online nationwide survey consisting of all racial and ethnic groups in the United States conducted by the Wilmer Eye Institute at Johns Hopkins University School of Medicine showed that 88 percent of the 2,044 respondents considered good vision to be vital to overall health with 47 percent of them rating losing their vision as the worst disease that could ever happen to them. Alarmingly, 25 percent did not have any knowledge about ocular diseases and their risk factors.

This research shows that following healthy lifestyle and behavior habits can all contribute to good cardiovascular health as assessed by adherence to the American Heart Association's prescription for health metric known as Life's Simple Seven (LS7). LS7 is based on the status of seven cardiovascular disease risk factors: not smoking, regular physical activity, healthy diet, maintaining normal weight, and controlling cholesterol, blood pressure, and blood glucose levels.

Practicing these healthy lifestyles together was found to be associated with lower odds for age-related macular degeneration, diabetic retinopathy, cataract, and glaucoma. Individuals with optimal cardiovascular health had 97 percent lower odds for diabetic retinopathy compared to individuals with inadequate cardiovascular health.

Investigators evaluated data from 6,118 adults aged 40 or more years old who took part in the 2005-2008 National Health and Nutrition Examination Survey. The average age of participants was 57 years old, 53 percent of whom were women. A one unit increase in LS7 scores was associated with reduced odds for age-related macular degeneration, diabetic retinopathy, and glaucoma.

"Overall, we believe that primary prevention and early detection approaches of ocular diseases are important, considering that over half of all deaths from ocular diseases and cardiovascular diseases are known to be preventable," commented co-investigators Noah De La Cruz, MPH, and Obadeh Shabaneh, MPH, both from the Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Since there is a significant overlap of the risk factors for ocular diseases and cardiovascular disease, the investigators recommended that screening for ocular diseases be incorporated into existing clinical and population-based screenings for cardiovascular diseases.

"We hope that our study findings will encourage adherence to healthy lifestyles in order to prevent these age-related diseases while also leading to increased collaborations between cardiologists, optometrists, and ophthalmologists in order to better prevent cardiovascular and ocular diseases," noted Dr. Appiah.

Eat more eggs?

Low-carb, high-fat diet effect on older populations

UNIVERSITY OF ALABAMA AT BIRMINGHAM

A new study, published in Nutrition and Metabolism, from researchers with the University of Alabama at Birmingham's Nutrition Obesity Research Center observed improvements in body composition, fat distribution and metabolic health in response to an eight-week, very low-carbohydrate diet.

Older adults with obesity are at particularly high risk of developing cardiometabolic disease such as Type 2 diabetes and cardiovascular disease. Rather than total fat mass, deposition of fat in certain areas, such as the abdominal cavity and skeletal muscle, may confer this greatest risk of disease development.

The study's lead author is Amy Goss, Ph.D., RDN, an assistant professor with UAB's Department of Nutrition Sciences. Goss says her team aimed to determine if a very low-carbohydrate, or VLCD, high-fat diet would deplete these fat depots and preserve lean mass without intentional caloric restriction in older adults with obesity, thereby improving outcomes related to cardiometabolic disease, such as insulin sensitivity and the lipid profile.

"After the eight-week intervention, despite the recommendation to consume a weight-maintaining diet, the group consuming the very low-carbohydrate diet lost more weight and total fat mass than the control diet group," Goss said.

Egg consumption was an important part of the VLCD prescription. Goss and her team provided eggs to the participants in this diet group and asked them to consume at least three per day.

"While eggs were a part of this study, we can't conclude that our findings are a result of daily egg consumption; but I think what we can conclude is that whole eggs can be incorporated into the diet in a healthful way without adversely impacting blood cholesterol in older adults," she said.

The primary difference in fat lost between the two groups was from the abdominal cavity and the skeletal muscle depots.

"We also found significant improvements in the overall lipid profile that would reflect decreased risk of cardiovascular disease," Goss said. "Further, insulin sensitivity improved in response to the very low-carbohydrate diet reflecting reduced risk of Type 2 diabetes. Overall, we observed improvements in body composition, fat distribution and metabolic health in response to an eight-week, very low-carbohydrate diet."

VLCD effect on diabetes

Goss says VLCDs are a therapeutic option for many conditions, including Type 2 diabetes, obesity and non-alcoholic fatty liver disease.

"This study extends previous research to show that it can be a safe, therapeutic option for older adults in their 70s experiencing obesity," she said. "This is the first study to demonstrate depletion of 'metabolically harmful' fat depots while preserving skeletal muscle during weight loss in response to a VLCD in older adults."

Goss adds that there is quite a bit of evidence about the benefits of a very low-carbohydrate diet in younger populations, and this study was one of the first to test this dietary approach to improve outcomes related to obesity in adults older than age 65 -- a population at particularly high risk of other diseases and in need of therapeutic interventions to improve health while preserving skeletal muscle mass to prevent or delay functional decline with age.

A good or bad egg?

"Historically, eggs have received a bad rap beginning with the nutrition guidelines on egg consumption set forth by the American Heart Association in 1968," Goss said. "It was recommended that no more than three whole eggs be consumed each week."

Goss adds that the concern stemmed from the cholesterol and saturated fat content of the egg yolk. Since then, these recommendations have loosened because more recent research demonstrated the negligible impact of dietary cholesterol on blood cholesterol. And just this month, the Dietary Guideline Advisory Committee issued recommendations to increase the consumption of eggs across the lifespan, including pregnant and lactating women, and also as a first food for infants and toddlers.

"This historical first for the Dietary Guidelines Committee recognized eggs as an important, nutrient-rich food source, as eggs are a rich source of protein, choline, B12, selenium, vitamin D and a long list of other nutrients vital to growth and development as well as maintenance of muscle mass," Goss said.

Wednesday, August 19, 2020

A healthy diet may reduce risk of Parkinson's

Eating veggies, nuts linked to fewer symptoms that may precede the disease

AMERICAN ACADEMY OF NEUROLOGY

MINNEAPOLIS - While movement problems are the main symptoms of Parkinson's disease, people with the disease often have non-motor symptoms such as constipation, daytime sleepiness and depression 10 or more years before the movement problems start. A new study suggests that eating a healthy diet in middle age may be linked to having fewer of these preceding symptoms. The study is published in the August 19, 2020, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"While this study does not show cause and effect, it certainly provides yet another reason for getting more vegetables, nuts and legumes in your diet," said study author Samantha Molsberry, Ph.D., of Harvard University in Boston, Mass. "More research is needed to determine whether eating a healthy diet could delay or even prevent the development of Parkinson's disease among people who have these preceding symptoms already."

The study involved 47,679 people who were asked about their diet every four years starting in the 1980s when they were middle-aged. Then in 2012, people were asked whether they had two conditions that are common in people who are later diagnosed with Parkinson's disease: constipation and a sleep disorder called rapid eye movement sleep behavior disorder, which includes acting out dreams during sleep by movement such as flailing arms or shouting or screaming. In 2014-2015, 17,400 of the participants were asked about five more symptoms that can precede Parkinson's disease: loss of sense of smell, impaired color vision, excessive daytime sleepiness, body pain and depression.

The researchers looked at how closely people's diets followed either the alternate Mediterranean diet, which is similar to the Mediterranean diet but includes only whole grains and does not consider dairy, or the Alternative Healthy Eating Index. Both diets encourage eating fruit, vegetables, whole grains, nuts and legumes and discourage eating red meat. They divided the participants into five groups based on how closely they followed the diets.

The study found that the people with the highest adherence to the diets were less likely to have three or more symptoms that precede Parkinson's disease than the people with the lowest adherence. Those in the high group for adherence to the Mediterranean diet were 33% less likely to have three or more symptoms than those in the low adherence group. These results were found after researchers adjusted for other factors that could affect the risk of developing these preceding symptoms, such as physical activity, smoking and body mass index (BMI). The researchers found a similarly strong relationship between following the Alternative Healthy Eating Index diet pattern and having three or more of these non-motor symptoms.

Among the 29,899 women in the study, 37% of the low adherence group had constipation, compared to 32% of the high adherence group. Among the 11,493 women with all of the non-motor symptoms measured, 15% of the low group had body pain, compared to 13% of the high group. In the same 11,493 women, 17% of the low group had symptoms of depression, compared to 14% of the high group. Among the 17,770 men in the study, 22% in the low adherence group had constipation, compared to 12% of the high adherence group. Among the 5,907 men with data on all of the non-motor symptoms, 14% of the low group and 16% had body pain and 13% of the low group and 12% of the high group had symptoms of depression. Molsberry noted that body pain and depression may have occurred at a higher rate in the study than in the general population due to the study design, but that this was also accounted for in the statistical analysis.

Looking at individual food groups, the researchers found that eating more vegetables, nuts, legumes and consuming a moderate amount of alcohol were all associated with a lower risk of having three or more of the preceding symptoms. Moderate alcohol consumption was considered no more than one drink per day for women and no more than two drinks per day for men.

"We need to emphasize that, while these symptoms are associated with an increased risk of Parkinson's disease, especially in combination, experiencing any or several of these symptoms does not necessarily mean that a person will eventually develop Parkinson's disease," Molsberry said.

A limitation of the study was that participants were not asked about preceding symptoms at the start of the study, so some people may have already had these symptoms, which could have influenced their diet.

Tuesday, August 18, 2020

High fructose diet in pregnancy impacts metabolism of offspring

An increased level of fructose intake during pregnancy can cause significant changes in maternal metabolic function and milk composition and alter the metabolism of their offspring, researchers from the University of Otago, Wellington, have found.

The research, which was led by Dr Clint Gray, a Research Fellow in the Department of Paediatrics and Child Health, found increasing the fructose in the diets of female guinea pigs led to highly significant and consistent changes in the free fatty acids circulating in the blood of their offspring. This was despite the offspring consuming no fructose themselves.

The research is published in the international journal Frontiers in Endocrinology.

First author, PhD student Erin Smith, says "previous research has shown poor quality nutrition during pregnancy can predispose offspring to long-term consequences, including the development of obesity, diabetes and cardiovascular disease later in life".

"However, there has been a lack of data examining the impact of increased fructose intake before and during pregnancy and subsequent adverse effects on lactation, foetal development and offspring metabolic function."

The two experimental groups were fed either a control diet or a fructose diet prior to and during pregnancy. The fructose group was given supplementary fructose water to replicate increased sugar-sweetened beverage intake 60 days prior to mating and until the delivery of their offspring. Fructose made up 16.5 per cent of their diets, closely resembling the average human consumption of fructose/sugar in Western countries, which is estimated at about 14 per cent of average daily caloric intake.

"We found fructose had a significant impact on a pregnant females' metabolic status and the free fatty acid content of their milk. We also provide the first evidence that offspring born from fructose-fed mothers display a very specific pattern of increased free fatty acids and altered lipid metabolism that persists throughout early life."

Ms Smith says it is well known that increased levels of circulating free fatty acids increases the risk of obesity, insulin resistance, type 2 diabetes and cardiovascular disease - with increased fatty acid synthesis shown to occur following fructose consumption.

She says the evidence suggests suboptimal maternal diets, such as diets high in fructose and refined sugars, may be contributing to the rise in metabolic diseases in humans observed during the past 40 to 50 years.

"Our study emphasises the importance of limiting added refined fructose, such as sugar-sweetened beverages, and striving for a more nutritionally balanced diet in women prior to and during pregnancy and lactation."

Multivitamin, mineral supplement linked to less-severe, shorter-lasting illness symptoms

OREGON STATE UNIVERSITY

CORVALLIS, Ore. - Older adults who took a daily multivitamin and mineral supplement with zinc and high amounts of vitamin C in a 12-week study experienced sickness for shorter periods and with less severe symptoms than counterparts in a control group receiving a placebo.

The findings by Oregon State University researchers were published in the journal Nutrients.

The research by scientists at OSU's Linus Pauling Institute involved 42 healthy people ages 55 to 75 and was designed to measure the supplement's effects on certain immune system indicators. It also looked at bloodstream levels of zinc and vitamins C and D while taking the supplement, as these micronutrients are important for proper immune function.

The immune indicators, including white blood cells' ability to kill incoming pathogens, were unaltered in the group receiving the supplement.

The multivitamin group showedimproved vitamin C and zinc status in the blood. Most intriguingly, illness symptoms reported by this group were less severe and went away faster than those experienced by the placebo group.

The same percentage of participants in each group reported symptoms, but days of sickness in the supplement group averaged fewer than three compared to more than six for the placebo group.

"The observed illness differences were striking," said corresponding author Adrian Gombart, professor of biochemistry and biophysics in the OSU College of Science and a principal investigator at the Linus Pauling Institute. "While the study was limited to self-reported illness data and we did not design the study to answer this question, the observed differences suggest that additional larger studies designed for these outcomes are warranted - and, frankly, overdue."

As people get older, the risk of vitamin and mineral deficiencies that contribute to age-related immune system deficiencies rises. Across the United States, Canada and Europe, research suggests more than one-third of older adults are deficient in at least one micronutrient, often more than one.

"That likely contributes to a decline in the immune system, most often characterized by increased levels of inflammation, reduced innate immune function and reduced T-cell function," Gombart said. "Since multiple nutrients support immune function, older adults often benefit from multivitamin and mineral supplements. These are readily available, inexpensive and generally regarded as safe."

The multivitamin supplement used in the study focused on vitamins and minerals typically thought to help immunity. It contained 700 micrograms of vitamin A; 400 international units of vitamin D; 45 milligrams of vitamin E; 6.6 milligrams of vitamin B6; 400 micrograms of folate; 9.6 micrograms of vitamin B12; 1,000 milligrams of vitamin C; 5 milligrams of iron; 0.9 milligrams of copper; 10 milligrams of zinc; and 110 micrograms of selenium.

"Supplementation was associated with significantly increased circulating levels of zinc and vitamin C, and with illness symptoms that were less severe and shorter lasting," Gombart said. "This supports findings that stretch back decades, even to the days of Linus Pauling's work with vitamin C. Our results suggest more and better designed research studies are needed to explore the positive role multivitamin and mineral supplementation might play in bolstering the immune system of older adults."

High intensity physical activity in early life could lead to stronger bones in adulthood

UNIVERSITY OF BRISTOL

The research, which analysed data from 2,569 participants of the Children of the 90s health study, found that more time spent doing moderate-to-vigorous intensity physical activity (MVPA) from age 12 years was associated with stronger hips at age 25 years, whereas time spent in light intensity activity was less clearly associated with adult hip strength.

Peak bone mass occurs in young adulthood and is considered to be a marker of the risk of fracture and osteoporosis in later life. Hip fractures make up a large proportion of the osteoporosis disease burden.

Researchers looked at data from healthy individuals who had physical activity measured up to 4 times using accelerometers worn as part of clinical assessments at age 12, 14, 16 and 25 years. This is a device that measures a person's movement for the whole time they wear it.

Researchers also found evidence to suggest that adolescent MVPA was more important than MVPA in adulthood, and that MVPA in early adolescence may be more important than in later adolescence. There was also some evidence that higher impact activity (consistent with jumping; assessed once in a subsample in late adolescence using custom accelerometer) was related to stronger hips at age 25.

Dr Ahmed Elhakeem, lead author and Senior Research Associate in Epidemiology, said: "The unique availability of repeated accelerometer assessments over many years beginning at age 12 within the Children of the 90s cohort, allowed us to describe the trajectory of time spent in different physical activity intensities through early life and to examine how this might relate to adult hip strength. The results highlight adolescence as a potentially important period for bone development through high intensity exercise, which could benefit future bone health and prevent osteoporosis in later life. We have also confirmed other studies showing that levels of MVPA decline through adolescence. Our findings show it is really important to support young people to remain active at this age"

Francesca Thompson, Clinical and Operations Director at the Royal Osteoporosis Society (ROS), said: "The ROS is working closely at the moment with Public Health England to review the importance of exercise for bone health in children. The findings from this study are welcome as they provide further evidence that children need to be doing moderate to vigorous intensity physical activity during their early adolescence to maximise bone strength in later life and reduce the risk of painful fractures. Supporting and encouraging young people to be more physically active needs to be a priority for bone as well as general health."

Using a public restroom? Mask up!

Flushing public restroom toilets or urinals can spew clouds of particles carrying viruses, including COVID-19

AMERICAN INSTITUTE OF PHYSICS

Volume 90%

VIDEO: DYNAMIC VIRUS MOVEMENT WITH URINAL FLUSHING. view more

CREDIT: JI-XIANG WANG

WASHINGTON, August 18, 2020 -- Think you don't need to worry about COVID-19 while using a public restroom? A group of researchers from Yangzhou University in China recently reported that flushing public restroom toilets can release clouds of virus-laden aerosols for you to potentially inhale.

If that's not cringeworthy enough, after running additional computer simulations, they've concluded that flushing urinals does likewise. In Physics of Fluids, from AIP Publishing, the group shares its work simulating and tracking virus-laden particle movements when urinals are flushed.

The researchers' work clearly shows public restrooms can be dangerous places for potentially becoming infected from a virus, especially during the COVID-19 pandemic. Other work has shown that both feces- and urine-based virus transmission is possible.

"To do this, we used a method of computational fluid dynamics to model the particle movement that occurs with the act of flushing," said Xiangdong Liu. "The specific models are the volume of fluids model and discrete phase model."

Flushing a urinal, much like flushing a toilet, involves an interaction between gas and liquid interfaces. The result of the flushing causes a large spread of aerosol particles to be released from the urinal, which the researchers simulated and tracked.

What the simulations revealed is disturbing. The trajectory of the tiny particles ejected by flushing a urinal "manifests an external spread type, with more than 57% of the particles traveling away from the urinal," said Liu.

But that's not all. When men use urinals within a public restroom, these tiny particles can reach their thigh within 5.5 seconds when compared to the toilet flush, which takes 35 seconds to reach slightly higher. Particles from urinals, however, "show a more violent climbing tendency," Liu said. "The climbing speed is much faster than toilet flushing."

Urinals are used more frequently within densely populated areas, and the researchers point out that particles will travel faster and farther, which poses a serious public health challenge.

This work underscores how important it is to wear a mask within public places but especially restrooms.

"From our work, it can be inferred that urinal flushing indeed promotes the spread of bacteria and viruses," says Liu. "Wearing a mask should be mandatory within public restrooms during the pandemic, and anti-diffusion improvements are urgently needed to prevent the spread of COVID-19."

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