Study finds link between bowel movement frequency and overall health

 Everybody poops, but not every day. New research by the Institute for Systems Biology (ISB) suggests bowel movement frequency is linked to long-term health. 

An ISB-led research team examined the clinical, lifestyle, and multi-omic data of more than 1,400 healthy adults. How often people poop, they found, can have a large influence on one’s physiology and health. Their findings will be published in the Cell Reports Medicine on July 16.

Researchers explored data from consenting participants of the consumer wellness company Arivale. The team focused on generally healthy adults and excluded those with certain health conditions or medication use. 

The research team categorized self-reported bowel movement frequency into four groups: constipation (one or two bowel movements per week), low-normal (between three and six bowel movements per week), high-normal (between one and three bowel movements per day), and diarrhea. 

Once categorized, the team looked for associations between bowel movement frequency and factors including demographics, genetics, gut microbiome, blood metabolites, and plasma chemistries. 

The study showed that age, sex, and body mass index (BMI) were significantly associated with bowel movement frequency. Specifically, younger people, women, and those with a lower BMI tended to have less frequent bowel movements. 

“Prior research has shown how bowel movement frequency can have a big impact on gut ecosystem function,” said Johannes Johnson-Martinez, the lead author of the study. “Specifically, if stool sticks around too long in the gut, microbes use up all of the available dietary fiber, which they ferment into beneficial short-chain fatty acids. After that, the ecosystem switches to fermentation of proteins, which produces several toxins that can make their way into the bloodstream.”

Indeed, the researchers also showed that the microbial composition of study participants’ gut microbiomes was a telltale sign of bowel movement frequency. Fiber-fermenting gut bacteria, often associated with health, appeared to thrive in a “Goldilocks zone” of bowel movement frequency, where people pooped between 1-2 times per day. However, bacteria associated with protein fermentation or the upper gastrointestinal tract tended to be enriched in those with constipation or diarrhea, respectively. 

Similarly, several blood metabolites and plasma chemistries showed significant associations with bowel movement frequency, suggesting potential links between bowel health and chronic disease risk. Specifically, microbially derived protein fermentation byproducts known to cause damage to the kidneys, like p-cresol-sulfate and indoxyl-sulfate, were enriched in the blood of individuals reporting constipation, while clinical chemistries associated with liver damage were elevated in individuals reporting diarrhea. 

Blood levels of indoxyl-sulfate, in particular, were significantly associated with reduced kidney function, providing preliminary support for a causal link between bowel movement frequency, gut microbial metabolism, and organ damage in this healthy cohort.

Unsurprisingly, those who reported eating a fiber-rich diet, better hydration, and regular exercise tended to find themselves in the bowel movement Goldilocks zone.

“Chronic constipation has been associated with neurodegenerative disorders and with chronic kidney disease progression in patients with active disease,” said Dr. Sean Gibbons, ISB associate professor and corresponding author of the paper. “However, it has been unclear whether or not bowel movement abnormalities are early drivers of chronic disease and organ damage, or whether these retrospective associations in sick patients are merely a coincidence. 

“Here, in a generally healthy population, we show that constipation, in particular, is associated with blood levels of microbially derived toxins known to cause organ damage, prior to any disease diagnosis,” Gibbons said. 

The study also explored associations between bowel movement frequency and anxiety and depression, indicating that mental health history is connected to how often one poops.

“Overall, this study shows how bowel movement frequency can influence all body systems, and how aberrant bowel movement frequency may be an important risk factor in the development of chronic diseases,” Gibbons said. “These insights could inform strategies for managing bowel movement frequency, even in healthy populations, to optimize health and wellness.” 

AREDS2 supplements slow disease progression during late stage of “dry” age-related macular degeneration

 

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AGE-RELATED MACULAR DEGENERATION AFFECTS THE MACULA, THE PART OF THE RETINA THAT PROVIDES CENTRAL VISION.

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CREDIT: NATIONAL EYE INSTITUTE

In a new analysis of data, researchers at the National Institutes of Health (NIH) have found that taking a daily supplement containing antioxidant vitamins and minerals slows progression of late-stage dry age-related macular degeneration (AMD), potentially helping people with late-stage disease preserve their central vision. Researchers reviewed the original retinal scans of participants in the Age-Related Eye Diseases Studies (AREDS and AREDS2) and found that, for people with late-stage dry AMD, taking the antioxidant supplement slowed expansion of geographic atrophy regions towards the central foveal region of the retina. The study was published in the journal Ophthalmology.

“We’ve known for a long time that AREDS2 supplements help slow the progression from intermediate to late AMD. Our analysis shows that taking AREDS2 supplements can also slow disease progression in people with late dry AMD,” said Tiarnan Keenan, M.D., Ph.D., of NIH’s National Eye Institute (NEI) and lead author of the study. “These findings support the continued use of AREDS2 supplements by people with late dry AMD.” 

In their new analysis, the researchers reviewed the original retinal scans of participants in the AREDS (total 318 participants, 392 eyes) and AREDS2 (total 891 participants, 1210 eyes) trials who developed dry AMD, calculating the position and expansion rate of their regions of geographic atrophy. For those people who developed geographic atrophy in their central vision, the supplements had little benefit. But for the majority who developed geographic atrophy far from the fovea, the supplements slowed the rate of expansion towards the fovea by approximately 55% over an average of three years. 

In early and intermediate AMD, the light-sensing retina at the back of the eye develops small yellow deposits of fatty proteins called drusen. When the disease progresses to the late stage, people can develop leaky blood vessels (“wet” AMD) or can lose regions of light-sensitive cells in the retina (“dry” AMD). The geographic atrophy in these regions slowly expands over time, causing people to progressively lose their central vision.

The original AREDS trial found that a supplement formula containing antioxidants (vitamin C, E, and beta-carotene), along with zinc and copper, could slow progression of intermediate to late-stage AMD. The subsequent AREDS2 trial found that substituting the antioxidants lutein and zeaxanthin for beta-carotene improved the efficacy of the supplement formula and eliminated certain risks. At the time, neither trial detected any further benefit once participants had developed late-stage disease. 

However, that original analysis did not account for a phenomenon in the dry form of late AMD called “foveal sparing.”  While all regions of the retina are sensitive to light, the region that gives us the highest acuity central vision is called the fovea. Many people with dry AMD first develop geographic atrophy outside this foveal region, and they only lose their central vision when the geographic atrophy regions expand into the foveal area. 

“Our high acuity central vision is essential for tasks like reading and driving. Given that there are few therapeutic options for people with late-stage dry AMD to retain or restore their vision, antioxidant supplementation is a simple step that may slow central vision loss, even for those with late disease,” Keenan said. “We plan to confirm these findings in a dedicated clinical trial in the near future.”

 

Learn more about AREDS and AREDS2

 AREDS 2 supplements are made of large amounts of certain vitamins and minerals.

Ingredient	Amount in AREDS 2
Vitamin C	500 milligrams (mg)
Vitamin E	400 International Units (IU)
Copper (cupric oxide)	2 mg
Zinc	80 mg
Beta-carotene	---------
Lutein	10 mg
Zeaxanthin	2 mg

You can’t get the right mix of these vitamins and minerals from food or from regular multivitamins. Only AREDS 2 supplements have the right ingredients in the right amounts to help slow vision loss from AMD.

Learn more about AREDS 2 ingredients

3 minutes of resistance exercise every half hour at night may improve sleep

Resistance exercise ‘activity breaks’ at night may improve sleep length, suggest the findings of a small comparative study published in the open access journal BMJ Open Sport & Exercise Medicine.

Three-minute breaks every 30 minutes over a period of 4 hours may be all that’s needed, the findings indicate.

Current recommendations discourage intense exercise before going to bed, on the grounds that it increases body temperature and heart rate, which can result in poorer sleep quality, say the researchers.

While activity breaks can improve metabolism after a meal, it’s not clear if they have any impact on sleep. Poor sleep is associated with an increased risk of cardiometabolic disorders, such as coronary heart disease and type 2 diabetes, explain the researchers.

To explore this further, the researchers recruited 30 non-smokers, aged 18 to 40, to their study. All of them reported clocking up more than 5 hours of sedentary time during the day at work and 2 hours in the evening.

To capture habitual physical activity and sleep patterns, participants wore an activity tracker worn continuously on their non-dominant wrist for 7 consecutive days. And they were asked to record the periods they didn’t wear it, the time they went to bed, and when they woke up. 

They were also asked to record any physical activity when not wearing the activity tracker, such as swimming or contact sport, and to record activities known to be inaccurately identified by the tracker, such as stationary cycling or yoga.

Each participant completed two 4-hour sessions in a controlled laboratory environment on the same day of the week, starting at around 17:00-17:30 hours, and separated by a minimum period of 6 days.

In one session, participants remained seated for 4 hours; in the other, they did 3 minutes of simple resistance exercise every 30 minutes over the 4-hour period. Afterwards participants returned to their normal, real-life environment.

Each activity break included 3 rounds of 3 exercises: chair squats, calf raises, and standing knee raises with straight leg hip extensions for 20 seconds each, in time with a video recording of a person doing the same exercises.

The activity tracker data showed that before the experiment, participants spent an average of 7 hours 47 minutes asleep, 10 hours 31 minutes sitting down, and 4 hours 55 minutes engaged in vigorous physical activity a day. 

Three out of four slept for the recommended 7 hours a night, while the rest slept either less than that (21%) or longer than 9 hours (4%).

The results, which are based on 28 participants, show that after the activity breaks, participants slept for an additional 27 minutes on average, compared with prolonged sitting. 

The average sleep duration was 7 hours 12 minutes, compared with 6 hours and 45 minutes after prolonged sitting. And while the time at which participants attempted to go to sleep was more or less the same, average wake times differed. Participants woke, on average, at 7:35 am after the prolonged sitting intervention and 8:06 am after regular activity breaks.

What’s more, there were no significant differences in sleep efficiency—uninterrupted sleep—or the number of awakenings during the night between the 2 interventions, indicating that activity breaks didn’t disrupt subsequent sleep, say the researchers. 

There were no statistically significant differences in activity patterns in the 24 hours following each intervention. But compared with prolonged sitting, regular activity breaks resulted in 18 fewer minutes of total physical activity—less than 2% of total wake time.

The researchers acknowledge various limitations to their findings. For example, the study involved small numbers of participants and was conducted in a laboratory setting, which may not reflect real life behaviour.

Further studies involving larger numbers of people in their normal home environment, and for a longer period, are therefore needed, emphasise the researchers.

But they nevertheless say: “These results add to a growing body of evidence that indicates evening exercise does not disrupt sleep quality, despite current sleep recommendations to the contrary.”

And they point out: “Adults accrue the longest periods of sedentary time and consume almost half their daily energy intake during the evening, added to which insulin sensitivity is lower at this time.”

By extending sleep duration, especially in those who sleep less than the recommended nightly total, activity breaks may potentially reduce cardiometabolic disease risk over the long term, they suggest.

The resistance exercises used in their study are simple to do, don’t require any equipment, and can even be done while streaming content, potentially increasing the chances of keeping up the routine, they add.

But they highlight: “While existing research indicates that evening exercise may not adversely impact sleep, the mechanisms by which [it] influences sleep quality remain unclear.”

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Links Between Pulse Consumption and Positive Health Outcomes

Eating More Pulses Reduces Risk of Type 2 Diabetes and Heart Disease

A newly published scoping review[i] in Nutrients consistently underscores the integral role of pulses (beans, peas, lentils and chickpeas) in the management of Type 2 Diabetes Mellitus (T2DM) and corroborates the beneficial effects of pulses on key cardiovascular biomarkers, such as LDL cholesterol and HDL cholesterol. A scoping review is an assessment and synthesis of the breadth of research available on a particular topic and is often used to help policymakers decide when evidence is sufficient for more in-depth analyses (i.e., systematic reviews) to make public health recommendations. This latest review adds to the body of evidence that substantiates the need for more research and future dietary guidance around increasing pulse consumption within healthful dietary patterns.

This assessment aimed to examine the amount and types of evidence available around how pulses contribute to overall human health.  Researchers identified thirty articles that studied lentils, chickpeas, common bean varieties (e.g., pinto, black, navy, red, kidney), black-eyed peas, cowpeas and split peas.  The health outcomes in these studies were multifaceted, ranging from lipid profiles to blood pressure, cardiovascular disease risk and mortality, type 2 diabetes and glycemic control, metabolic syndrome indicators, inflammatory markers, oxidative stress biomarkers, and hormonal profiles.  The most frequently assessed study outcomes included changes in low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, fasting blood sugar, hemoglobin A1c, waist circumference, and C-reactive protein or high-sensitivity C-reactive protein. 

“This scoping review highlights the potential role of pulses in maintaining health and preventing chronic disease,” states author Taylor C. Wallace, PhD, CFS, FACN, Principal and CEO at the Think Healthy Group and an Adjunct Associate Professor in the School or Medicine and Health Sciences at George Washington University.  “The studies examined underscore the potential of pulse consumption for enhancing long-term health, particularly among individuals with chronic conditions like Type 2 Diabetes Mellitus and Cardiovascular Disease. It provides a compendium of evidence that supports enhanced dietary guidance around consumption of pulses as part of a healthy dietary pattern.” Funding for this study was provided through an unrestricted educational grant from the American Pulse Association, who had no role in the study design, execution, or writing of the manuscript.

Interventional studies, which have the largest sample sizes for examining lipid profiles, corroborate the beneficial effects of pulses on key cardiovascular biomarkers, such as LDL cholesterol and HDL cholesterol. Interventions where pulses either replaced red meat or were added as fixed servings demonstrated pulses’ efficacy in dietary quality enhancement and favorable health outcomes. Research has shown that eating pulses can help prevent heart disease, attributed in part to the lowering effect of adequate pulse consumption on both total and LDL-cholesterol levels.[ii] Pulses’ low-fat content and presence of healthy mono- and polyunsaturated fats, along with a spectrum of essential micronutrients and bioactive compounds with antioxidant properties, further establish pulses as a nutritional powerhouse.[iii]

Studies that follow groups of people over time (cohort) demonstrate a reduction in Type 2 Diabetes Mellitus risk with increased pulse consumption. This is further supported by interventional studies that consistently document improvements in fasting glucose levels and insulin sensitivity when pulses are incorporated into diets. Eating pulses may help with the prevention of diabetes and the management of blood glucose levels.[iv] Research shows that eating pulses can help manage blood glucose/improve glycemic control by improving insulin sensitivity and lowering A1c.[v]

“This research accentuates the fact that pulses are beneficial for health in so many ways, underscoring dietary guidelines that endorse plant-based eating patterns,” said Tim McGreevy, CEO, of USA Pulses.  “The Dietary Guidelines for Americans 2020 – 2025 and the USDA’s Choose My Plate indicate that beans, chickpeas, peas, and lentils can be considered as part of the vegetable or protein groups. 

Health benefits of replacing butter with high-quality plant oils

Switching from a diet high in saturated animal fats to one rich in plant-based unsaturated fats affects the fat composition in the blood, which in turn influences long-term disease risk. A recent study published in Nature Medicine, conducted by a team of researchers from Chalmers University of Technology, Sweden, the German Institute of Human Nutrition, Germany and several other universities, shows that it is possible to accurately measure diet-related fat changes in the blood and directly link them to the risk of developing cardiovascular disease and type 2 diabetes.

“Our study confirms with even more certainty the health benefits of a diet high in unsaturated plant fats such as the Mediterranean diet and could help provide targeted dietary advice to those who would benefit most from changing their eating habits”, says Clemens Wittenbecher, research leader at Chalmers University of Technology and the study’s senior author.

The World Health Organisation (WHO) highlights the importance of healthy diets in preventing chronic diseases, recommending the replacement of saturated fats with plant-based unsaturated fats to reduce cardiometabolic risk. However, the certainty of these guidelines is moderate due to limitations in existing studies.

This new study addresses these limitations by closely analysing fats in the blood, also known as lipids, with a method called lipidomics. These very detailed lipid measurements enabled the researchers to link diet and disease in an innovative combination of different study types. This novel approach combines dietary intervention studies (that use highly controlled diets), with previously carried out cohort studies with long-term health tracking.

 

Diet trials to monitor how changes in food consumption affect blood fat

Part of this research was conducted in a dietary intervention study at the University of Reading, U.K., which involved 113 participants. For 16 weeks, one group consumed a diet high in saturated animal fats, while the other group followed a diet rich in unsaturated plant-based fats. Blood samples were analysed using lipidomics to identify specific lipid molecules reflecting the different diets each participant consumed.

"We summarised the effects on blood lipids with a multi-lipid score (MLS). A high MLS indicates a healthy blood fat profile, and a high intake of unsaturated plant fat and low intake of saturated animal fat can help achieving such positive MLS levels”, says Fabian Eichelmann from the German Institute of Human Nutrition Potsdam-Rehbruecke and first author of the study.

These MLS results from the dietary intervention study were then statistically related to the occurrence of cardiovascular disease and type 2 diabetes in large observational studies that had previously been carried out. These large cohort studies followed initially healthy participants for several years. This analysis of data from both sets of studies showed that participants with a higher MLS, which indicates a beneficial dietary fat composition, had a substantially reduced risk of developing cardiometabolic diseases.

 

Switching to a healthier diet, can have the most pronounced health benefits 

Additionally, the study examined whether individuals with low MLS levels, indicating high saturated fat content of the diet, specifically benefited from a healthier diet. The Mediterranean diet focuses on providing more unsaturated plant fats and was used in one of the large intervention trials, known as the PREDIMED trial. Using this study, the researchers found that diabetes prevention was indeed most pronounced in individuals with low MLS levels at the start of the study.

“Diet is so complex that it is often difficult to draw conclusive evidence from a single study. Our approach of using lipidomics to combine intervention studies with highly controlled diets and prospective cohort studies with long-term health tracking can overcome current limitations in nutrition research,” explains Clemens Wittenbecher.

 

Delaying diabetes with diet and exercise for 4 years results in better long-term health

 

Maintaining prediabetic status after diagnosis reduces risk of death decades later

 

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NON-DIABETES STATUS AFTER DIAGNOSIS OF IGT AND RISK OF OUTCOMES

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CREDIT: XIN QIAN AND GUANGWEI LI (CC-BY 4.0, HTTPS://CREATIVECOMMONS.ORG/LICENSES/BY/4.0/)

Individuals diagnosed with prediabetes can reduce their long-term risk of death and diabetes-related health complications if they delay the onset of diabetes for just four years through diet and exercise. Guangwei Li of the China-Japan Friendship Hospital and colleagues report these findings in a new study published July 9th in the open-access journal PLOS Medicine.

Type 2 diabetes is associated with an increased risk of death and disability, and imposes a significant economic burden on individuals and societies worldwide. Lifestyle changes, such as eating a healthy diet and getting more exercise, can delay or reduce the risk of developing diabetes in people diagnosed with impaired glucose tolerance – commonly called prediabetes. However, it is unknown how long a person must delay diabetes to ensure better long-term health.

In the new study, researchers looked at health outcomes from 540 prediabetic individuals who participated in the original Da Qing Diabetes Prevention Study, a six-year trial conducted in Da Qing City in China, starting in 1986. Participants belonged to either a control group or one of three lifestyle intervention groups, which involved following a healthy diet, getting more exercise, or both. The trial followed up with participants for more than 30 years.

Li’s team determined the long-term risk of death, cardiovascular events – like heart attack, stroke or heart failure – and other diabetes-related complications for trial participants. They found that individuals who remained non-diabetic for at least four years after their initial diagnosis had a significantly lower risk of dying and a significantly lower risk of experiencing a cardiovascular event compared to those who developed diabetes sooner. This protective effect was not observed in individuals who remained non-diabetic for less than the “four-year threshold.”

Overall, the analysis suggests that the longer a prediabetic person can delay developing diabetes, the better their long-term health outcomes will be. However, even just a few years of maintaining prediabetic status can yield benefits for years to come.

The authors add, “This study suggests that a longer duration of non-diabetes status in those with IGT has beneficial health outcomes and reduces mortality. The implementation of effective interventions targeting those with IGT should be considered as part of preventative management for diabetes and diabetes related vascular complications.”

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The freely available paper in PLOS Medicine: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004419

Cuts to processed meat intake bring a range of health benefits

 

Reducing consumption of processed meat by around one-third could prevent more than 350,000 cases of diabetes in the US over 10 years, a study suggests.

Cutting US adults’ processed meat intake by 30 per cent – the equivalent of around 10 slices of bacon a week – would also lead to tens of thousands of fewer cases of cardiovascular disease and colorectal cancer, researchers say.

A team from the University of Edinburgh’s Global Academy of Agriculture and Food Systems together with the University of North Carolina, Chapel Hill, has developed a simulation tool to estimate the health impacts of reducing consumption of processed meat and unprocessed red meat.

While many studies have identified links between high levels of processed meat consumption and chronic disease, few have evaluated the impact on multiple health outcomes. Some previous research also suggests unprocessed red meat may contribute to chronic disease risk but evidence is still limited.

The researchers used data from a Centers for Disease Control and Prevention (CDC) national health survey to create a simulated, representative sample of the US adult population – a so-called microsimulation.

Their microsimulation is the first to estimate the effects of reducing processed meat and unprocessed red meat consumption – from between 5 and 100 per cent – on multiple health outcomes in the US.

The team estimated how changes in meat consumption affect adults’ risk of diabetes, cardiovascular disease, colorectal cancer and death. The effects were evaluated in the overall population and separately based on age, sex, household income and ethnicity.

As well as preventing more than 350,000 cases of diabetes, cutting processed meat intake by 30 per cent would lead to 92,500 fewer cardiovascular disease cases and 53,300 fewer colorectal cancer cases over a decade, researchers say.

In this scenario, white males and those with an annual household income between $25,000 and $55,000 were found to experience the greatest health benefits. 

Researchers also analysed the impacts of reducing unprocessed red meat intake alone and cutting consumption of both processed meat and unprocessed red meat.

Reducing consumption of both by 30 per cent resulted in 1,073,400 fewer diabetes cases, 382,400 fewer cardiovascular disease cases and 84,400 fewer colorectal cancer cases.

Cutting unprocessed red meat intake alone by 30 per cent – which would mean eating around one less quarter-pound beef burger a week – resulted in more than 732,000 fewer diabetes cases. It also led to 291,500 fewer cardiovascular disease cases and 32,200 fewer colorectal cancer cases.

The finding that more disease cases were prevented by reducing unprocessed red meat compared to processed meat is partly due to the average daily intake of unprocessed red meat being higher than processed meat, at 47g a day versus 29g a day, respectively.

As less is known about the effect of eating unprocessed red meat on chronic disease risk, the team says these estimates should be interpreted with caution and that more research is needed.