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Found 7 results

  1. Dean Pomerleau

    Nuts and Mortality

    Al Pater posted the following prospective study [1] (thanks Al!) on the association between nut intake and mortality amongst a group of 20,000 middle aged Italians. It found that compared with people who didn't consume nuts, people who consumed them more than 8 times per month had about a 50% reduction in all-cause mortality risk during the 4 years of followup, largely due to reduced cancer risk. They found the nut eaters also had lower levels of inflammation. Not surprisingly, nut consumption was more beneficial for those who otherwise didn't adhere to a Mediterranean diet. More evidence that nuts are a very healthy food! --Dean ------------- [1] Br J Nutr. 2015 Sep;114(5):804-11. doi: 10.1017/S0007114515002378. Nut consumption is inversely associated with both cancer and total mortality in a Mediterranean population: prospective results from the Moli-sani study. Bonaccio M(1), Di Castelnuovo A(1), De Curtis A(1), Costanzo S(1), Bracone F(1), Persichillo M(1), Donati MB(1), de Gaetano G(1), Iacoviello L(1). Author information: (1)1Department of Epidemiology and Prevention,IRCCS Istituto Neurologico Mediterraneo,Neuromed,86077 Pozzilli,Isernia,Italy. Nut intake has been associated with reduced inflammatory status and lower risk of CVD and mortality. The aim of this study was to examine the relationship between nut consumption and mortality and the role of inflammation. We conducted a population-based prospective investigation on 19 386 subjects enrolled in the Moli-sani study. Food intake was recorded by the Italian version of the European Project Investigation into Cancer and Nutrition FFQ. C-reactive protein, leucocyte and platelet counts and the neutrophil:lymphocyte ratio were used as biomarkers of low-grade inflammation. Hazard ratios (HR) were calculated using multivariable Cox proportional hazard models. During a median follow-up of 4·3 years, 334 all-cause deaths occurred. As compared with subjects who never ate nuts, rare intake (≤2 times/month) was inversely associated with mortality (multivariable HR=0·68; 95 % CI 0·54, 0·87). At intake ≥8 times/month, a greater protection was observed (HR=0·53; 0·32, 0·90). Nut intake (v. no intake) conveyed a higher protection to individuals poorly adhering to the Mediterranean diet (MD). A significant reduction in cancer deaths (HR=0·64; 95 % CI 0·44, 0·94) was also observed, whereas the impact on CVD deaths was limited to an inverse, but not significant, trend. Biomarkers of low-grade inflammation were reduced in nut consumers but did not account for the association with mortality. In conclusion, nut intake was associated with reduced cancer and total mortality. The protection was stronger in individuals with lower adherence to MD, whereas it was similar in high-risk groups (diabetics, obese, smokers or those with the metabolic syndrome), as compared with low-risk subjects. Inflammation did not explain the observed relationship. PMID: 26313936 [PubMed - in process]
  2. The below paper is pdf-availed and not available via Sci-Hub, so to present the figure, the only results shown in the paper, it is below. As with many studies of its ilk, the Mediterranean diet results compared to the low-fat diet seem biased to me. Why is the low-fat diet just as high in saturated fat as the olive oil one when the latter is relatively high in saturated fat and general recommendations are for a saturated level of no more than 7% saturated fat? Mediterranean Diet Reduces Serum Advanced Glycation End Products and Increases Antioxidant Defenses in Elderly Adults: A Randomized Controlled Trial. Lopez-Moreno J, Quintana-Navarro GM, Delgado-Lista J, Garcia-Rios A, Delgado-Casado N, Camargo A, Perez-Martinez P, Striker GE, Tinahones FJ, Perez-Jimenez F, Lopez-Miranda J, Yubero-Serrano EM. J Am Geriatr Soc. 2016 Apr;64(4):901-4. doi: 10.1111/jgs.14062. No abstract available. PMID: 27100598 To the Editor: A growing body of evidence indicates that oxidative stress and chronic inflammation are primary risk factors underlying the aging process and age-related diseases.[1, 2] Addressing these mechanisms could have implications for aging and lead to new therapeutic approaches to these conditions. Advanced glycation end products (AGEs), compounds derived from glycation of proteins and lipids as result of the Maillard reaction, are generated in vivo as a normal consequence of metabolism. Recent studies reveal the contribution of AGEs, particularly methylglyoxal (MG) and N-carboxymethyllysine (CML), the principal forms of AGEs, in the origin and progression of chronic diseases and during the aging process, increasing oxidative stress and inflammation.[3-5] Although endogenous AGE formation represents a minor component of the total body pool of AGEs, dietary AGEs (dAGEs) are considered the most important source of AGEs.[6] New evidence suggests that an AGE-restricted diet is an effective way to reduce the body's total AGE concentration and decrease oxidative stress and inflammation in different populations.[7] Nevertheless, there is still a paucity of data with respect to the influence of dietary fat type on modulation of endogenous AGE levels. The purpose of the current study was to determine whether the quantity and quality of dietary fat could modify serum AGE (sCML and sMG) levels and the expression of genes related to oxidative stress, inflammation, and AGE metabolism in healthy elderly adults. Methods Twenty participants (aged ≥65; 10 male, 10 female) were randomly assigned to receive, in a crossover design, three isocaloric diets for 4-week periods each: Mediterranean diet (38% of energy from fat: 24% monounsaturated fatty acids (MUFA; provided by virgin olive oil), 10% saturated fatty acids (SFA), 4% polyunsaturated fatty acids (PUFA)); Western diet rich in saturated fat (38% of energy as fat: 12% MUFA, 22% SFA, 4% PUFA); low-fat, high-carbohydrate diet enriched in omega-3 PUFA of vegetable origin (omega-3 diet) (28% of energy as fat: 10% SFA, 12% MUFA, 8% PUFA with 2% alpha-linolenic acid). At the end of the dietary intervention period, subjects were given a breakfast with the same fat composition as consumed in each of the diets after a 12-hour fast. Blood samples were collected at the end of each diet period (fasting state) and 4 hours after breakfast (postprandial state). The human investigation review committee of the Reina Sofia University Hospital approved the study protocol according to institutional and Good Clinical Practice guidelines.[8] Dietary AGE content;[9] CML and MG levels; and AGE receptor-1 (AGER1), receptor for AGEs (RAGE), and glyoxalase I (GloxI) messenger ribonucleic acid levels (mRNA) in peripheral mononuclear cells were determined. PASW Statistics, version a8, SPSS statistical software (SPSS, Inc., Chicago, IL) was used for statistical analysis. Analysis of variance for repeated measures was performed, followed by Bonferroni correction for multiple comparisons. Pearson correlation analyses were performed to examine correlations between dAGE levels and other parameters related to oxidative stress and inflammation. Differences were considered to be significant at P < .05. All data presented are expressed as means and standard errors. Results During the SFA diet, participants consumed more dAGEs than after the other diets, with the Mediterranean diet providing the lowest amount of food-related AGEs, and the omega-3 diet having an intermediate content (Figure 1A). Figure 1. (A) Dietary advanced glycation end product (AGE) levels after 4 weeks of each dietary intervention, (B) fasting and postprandial serum levels of methylglyoxal (MG), © and N-carboxymethyllysine (CML), fasting and postprandial levels of (D) AGE receptor-1 (AGER1) messenger ribonucleic acid (mRNA), (E) receptor for AGE (RAGE) mRNA, and (F) glyoxalase I (GloxI) mRNA in peripheral mononuclear cells according to the different diets consumed. Data were analyzed using analysis of variance for repeated measures. All values represent means and standard errors. Bars with different superscript letters depict statistically significantly differences (P < .05). p1 = diet effect; p2 = time effect; p3 = diet by time interaction. Fasting and postprandial sMG and sCML were higher after the SFA diet than after the Mediterranean diet, with an intermediate effect for the omega-3 diet (P = .005) (Figure 1B, C). Moreover, sMG levels decreased significantly more during the postprandial phase in Mediterranean diet group (P = .03) (Figure 1B). Fasting and postprandial AGER1 and GloxI mRNA levels, with antioxidant properties, were higher after the Mediterranean diet than after the SFA diet (all P < .005). Furthermore, AGER1 and GloxI mRNA levels were significantly greater during the postprandial state than in the fasting state after the Mediterranean and omega-3 diets (all P < .005) (Figure 1D, E). Fasting and postprandial RAGE mRNA levels, an AGE receptor that induces oxidative stress and inflammation, were lower after the Mediterranean diet than the other diets (all P < .005), with an intermediate effect for the omega-3 diet during the postprandial state (P = .007). RAGE mRNA levels were significantly lower during the postprandial state after the Mediterranean and omega-3 diets than during the fasting state (P = .004) (Figure 1F). A positive correlation was found between sMG and sCML, with genes and markers related to oxidative stress and inflammation such as RAGE, matrix metallopeptidase 9, plasma 8-hydroxydeoxyguanosine, and oxidized low-density lipoprotein levels, and a negative correlation with genes and markers related to antioxidant defenses such as GloxI, glutathione peroxidase, and thioredoxin (data not shown). Discussion The present study showed that consumption of a Mediterranean diet reduces oxidant AGEs and increases antioxidant defenses in the fasting and postprandial states, as lower sCML and sMG levels, higher AGER1 and GloxI, and lower RAGE mRNA levels than with the SFA diet manifested, with an intermediate effect of the omega-3 diet. The Mediterranean diet may have protective effects against oxidative stress and inflammation, providing low AGE content and reducing circulating AGEs in elderly people, which may have favorable effects on the aging process and be linked to the benefits of consuming a Mediterranean diet on the prevalence of age-related conditions. Inhibition of AGE formation may limit oxidative and inflammatory damage in tissues, retarding the progression of pathophysiology and improving quality of life during aging.
  3. Thanks once again to Al Pater for finding this new study [1]. Researchers followed 2400 Chinese people for 3 years and compared their adherence to a Mediterranean diet (MD) with their bone mineral density (BMD) score. From the full text, Al pulled out the key passage: Of the nine components, higher intakes of whole grain, fruit, nuts, and a lower intake of red and processed meats were significantly associated with a higher BMD at several bone sites. No significant associations were found for the other five components (vegetable, legume, fish, MUF/SF, and alcohol) in this study (Supplemental Table 1). After excluding the non-significant components from the calculation of the aMed scores, more significant associations were observed. It was interesting that some foods considered healthy (whole grains, fruit and nuts) were associated with higher BMD, but others (vegetables, legumes, fish, olive oil) were not. This would seem to suggest something else is going on besides the simple explanation that people who eat a better diet are more likely to engage other health (and bone) promoting practices too, like exercise. --Dean --------------------------- [1] Sci Rep. 2016 May 9;6:25662. doi: 10.1038/srep25662. Adherence to the Mediterranean diet is associated with a higher BMD in middle-aged and elderly Chinese. Chen GD, Dong XW, Zhu YY, Tian HY, He J, Chen YM. Free Full text: http://www.nature.com/articles/srep25662 Abstract Previous studies showed that better adherence to the Mediterranean diet (MD) is associated with lower risk of chronic diseases, but limited data are available on bone health. We investigated the association of the MD with bone mineral density (BMD) in Chinese adults. We included 2371 participants aged 40-75 years in this community-based cross-sectional study. Dietary information was assessed at baseline and a 3-year follow-up. Alternate Mediterranean diet (aMed) scores were calculated. BMD was determined at the second survey. After adjusting for potential covariates, higher aMed scores were positively and dose-dependently associated with BMD (all P-trends < 0.05). The BMD values were 1.94% (whole body), 3.01% (lumbar spine), 2.80% (total hip), 2.81% (femur neck), 2.62% (trochanter), and 2.85% (intertrochanter) higher in the quintile 5 (highest, vs. quintile 1) aMed scores for all of the subjects (all P-values < 0.05). Similar associations were found after stratifying by gender (P-interaction = 0.338-0.968). After excluding the five non-significant components of vegetables, legumes, fish, monounsaturated to saturated fat ratio, and alcohol intake from the aMed scores, the percentage mean differences were substantially increased by 69.1-150% between the extreme quintiles. In conclusion, increased adherence to the MD shows protective associations with BMD in Chinese adults. PMID: 27157300
  4. Why, if the olive oil of the Mediterranean diet is the bee's knees, does it not compare favorably with oils such as fish/n-3 oils when used as a placebo? http://www.ncbi.nlm.nih.gov/pubmed/?term=olive+randomized+placebo
  5. Al Pater posted [1], a study single-blind clinical trial comparing breast cancer rates among subjects assigned to two version of a Mediterranean diet (one supplemented with EVOO and one supplemented with nuts) or to a "low-fat" control diet. Actually the controls only received advice to reduce dietary fat. They didn't actually comply, since (from supplemental material) the end of trial fat intake as a percentage of total cal: Med-EVOO 41%, Med-Nut 39%, Control Diet 37%. So its really comparing a breast cancer risk between a Mediterranean diet with nuts or EVOO to a standard crappy diet. What they found was that women on either the Med-EVOO diet or the Med-Nut diet had a lower risk of breast cancer, but only the Med-EVOO groups risk reduction (0.32, 95% CI, 0.13-0.79) was statistically significant. The Med-Nut group's risk was 0.59 (95% CI, 0.26-1.35) compared with controls. So once again, a Mediterranean diet is shown to be good for avoiding cancer, this time breast cancer. --Dean ---------- [1] JAMA Intern Med. 2015 Nov 1;175(11):1752-60. doi: 10.1001/jamainternmed.2015.4838. Mediterranean Diet and Invasive Breast Cancer Risk Among Women at High Cardiovascular Risk in the PREDIMED Trial: A Randomized Clinical Trial. Toledo E, Salas-Salvadó J, Donat-Vargas C, Buil-Cosiales P, Estruch R, Ros E, Corella D, Fitó M, Hu FB, Arós F, Gómez-Gracia E, Romaguera D, Ortega-Calvo M, Serra-Majem L, Pintó X, Schröder H, Basora J, Sorlí JV, Bulló M, Serra-Mir M, Martínez-González MA. Full text via sci-hub.io: http://archinte.jamanetwork.com.sci-hub.io/article.aspx?articleid=2434738 Abstract IMPORTANCE: Breast cancer is the leading cause of female cancer burden, and its incidence has increased by more than 20% worldwide since 2008. Some observational studies have suggested that the Mediterranean diet may reduce the risk of breast cancer. OBJECTIVE: To evaluate the effect of 2 interventions with Mediterranean diet vs the advice to follow a low-fat diet (control) on breast cancer incidence. DESIGN, SETTING, AND PARTICIPANTS: The PREDIMED study is a 1:1:1 randomized, single-blind, controlled field trial conducted at primary health care centers in Spain. From 2003 to 2009, 4282 women aged 60 to 80 years and at high cardiovascular disease risk were recruited after invitation by their primary care physicians. INTERVENTIONS: Participants were randomly allocated to a Mediterranean diet supplemented with extra-virgin olive oil, a Mediterranean diet supplemented with mixed nuts, or a control diet (advice to reduce dietary fat). MAIN OUTCOMES AND MEASURES: Breast cancer incidence was a prespecified secondary outcome of the trial for women without a prior history of breast cancer (n = 4152). RESULTS: After a median follow-up of 4.8 years, we identified 35 confirmed incident cases of breast cancer. Observed rates (per 1000 person-years) were 1.1 for the Mediterranean diet with extra-virgin olive oil group, 1.8 for the Mediterranean diet with nuts group, and 2.9 for the control group. The multivariable-adjusted hazard ratios vs the control group were 0.32 (95% CI, 0.13-0.79) for the Mediterranean diet with extra-virgin olive oil group and 0.59 (95% CI, 0.26-1.35) for the Mediterranean diet with nuts group. In analyses with yearly cumulative updated dietary exposures, the hazard ratio for each additional 5% of calories from extra-virgin olive oil was 0.72 (95% CI, 0.57-0.90). CONCLUSIONS AND RELEVANCE: This is the first randomized trial finding an effect of a long-term dietary intervention on breast cancer incidence. Our results suggest a beneficial effect of a Mediterranean diet supplemented with extra-virgin olive oil in the primary prevention of breast cancer. These results come from a secondary analysis of a previous trial and are based on few incident cases and, therefore, need to be confirmed in longer-term and larger studies. PMID: 26365989
  6. "Mediterranean diet ... in [high risk] individuals ... associations with all-cause (HR = 1.02; 95 % CI 0.90-1.15) and CV mortality (0.94; 95 % CI 0.76-1.15) were not significant." Predictive role of the Mediterranean diet on mortality in individuals at low cardiovascular risk: a 12-year follow-up population-based cohort study. Bo S, Ponzo V, Goitre I, Fadda M, Pezzana A, Beccuti G, Gambino R, Cassader M, Soldati L, Broglio F. J Transl Med. 2016 Apr 12;14(1):91. doi: 10.1186/s12967-016-0851-7. PMID: 27071746 Free Article http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830057/ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4830057/pdf/12967_2016_Article_851.pdf Abstract BACKGROUND: Adherence to the Mediterranean diet reduces the risk of all-cause and cardiovascular (CV) mortality and the incidence of CV events. However, most previous studies were performed in high-risk individuals. Our objective was to assess whether the adherence to the Mediterranean diet, evaluated by the MED score, was associated with all-cause and CV mortality and incidence of CV events in individuals at low CV risk from a population-based cohort, after a 12-year mean follow-up. METHODS: A cohort of 1658 individuals completed a validated food-frequency questionnaire in 2001-2003. The MED score was calculated by a 0-9 scale. Anthropometric, laboratory measurements, and the vital status were collected at baseline and during 2014. The baseline CV risk was estimated by the Framingham risk score. Participants were divided into two groups: individuals at low risk (CV < 10) and individuals with CV risk =/>10. RESULTS: During a 12-year mean follow-up, 220 deaths, 84 due to CV diseases, and 125 incident CV events occurred. The adherence to the Mediterranean diet was low in 768 (score 0-2), medium in 685 (score 4-5) and high in 205 (score >6) individuals. Values of BMI, waist circumference, fasting glucose and insulin significantly decreased from low to high diet adherence only in participants with CV risk =/>10. In a Cox-regression model, the hazard ratios (HRs) in low-risk individuals per unit of MED score were: HR = 0.83 (95 % CI 0.72-0.96) for all-cause mortality, HR = 0.75 (95 % CI 0.58-0.96) for CV mortality, and HR = 0.79 (95 % CI 0.65-0.97) for CV events, after multiple adjustments. In individuals with CV risk =/>10, the MED score predicted incident CV events (HR = 0.85; 95 % CI 0.72-0.99), while the associations with all-cause (HR = 1.02; 95 % CI 0.90-1.15) and CV mortality (0.94; 95 % CI 0.76-1.15) were not significant. CONCLUSIONS: Greater adherence to the Mediterranean diet was associated with reduced fatal and non fatal CV events, especially in individuals at low CV risk, thus suggesting the usefulness of promoting this nutritional pattern in particular in healthier individuals. KEYWORDS: All-cause mortality; Cardiovascular mortality; Cardiovascular risk; Mediterranean diet
  7. Sthira, you'll love this one [1] posted by Al Pater (thanks Al!) to the CR email list. It compared various group lifestyle interventions, including yoga, walking, Mediterranean diet and group smoking cessation classes for their effect over the following 10 years on risk of cardiovascular disease. It found: [Y]oga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). Of course, the effectiveness of a treatment is dependent on subject compliance and treatment efficacy. That's why smoking cessation treatments were almost completely ineffective - almost nobody quits for very long. The authors acknowledge this, saying: We have presented a rank order of strategies that do not include taking any pills or medication. As such, non-adherence with lifestyle change and other health behaviors, including pill-taking, is of concern and may dilute intervention effects. Our calculations are based on intention to-treat rates from the clinical trials, which incorporate non-adherence. For a current smoker, successfully quitting smoking is the most effective lifestyle change. Smoking cessation is, however, difficult to achieve and group therapy for stopping smoking has only a small probability of success. From an intention-to-treat perspective, if yoga is as effective as reported in currently published meta-analyses, then yoga could be considered among the strongest lifestyle interventions for reducing CVD risk. Too bad they didn't include a dance intervention group. Based on the benefits of dance discussed here, I bet it might have done best of all! --Dean ---------- [1] Comparative Effectiveness of Personalized Lifestyle Management Strategies for Cardiovascular Disease Risk Reduction. Chu P, Pandya A, Salomon JA, Goldie SJ, Hunink MG. J Am Heart Assoc. 2016 Mar 29;5(3). pii: e002737. doi: 10.1161/JAHA.115.002737. PMID: 27025969 Free Article http://jaha.ahajournals.org/content/5/3/e002737.full http://jaha.ahajournals.org/content/5/3/e002737.full.pdf+html Abstract BACKGROUND: Evidence shows that healthy diet, exercise, smoking interventions, and stress reduction reduce cardiovascular disease risk. We aimed to compare the effectiveness of these lifestyle interventions for individual risk profiles and determine their rank order in reducing 10-year cardiovascular disease risk. METHODS AND RESULTS: We computed risks using the American College of Cardiology/American Heart Association Pooled Cohort Equations for a variety of individual profiles. Using published literature on risk factor reductions through diverse lifestyle interventions-group therapy for stopping smoking, Mediterranean diet, aerobic exercise (walking), and yoga-we calculated the risk reduction through each of these interventions to determine the strategy associated with the maximum benefit for each profile. Sensitivity analyses were conducted to test the robustness of the results. In the base-case analysis, yoga was associated with the largest 10-year cardiovascular disease risk reductions (maximum absolute reduction 16.7% for the highest-risk individuals). Walking generally ranked second (max 11.4%), followed by Mediterranean diet (max 9.2%), and group therapy for smoking (max 1.6%). If the individual was a current smoker and successfully quit smoking (ie, achieved complete smoking cessation), then stopping smoking yielded the largest reduction. Probabilistic and 1-way sensitivity analysis confirmed the demonstrated trend. CONCLUSIONS: This study reports the comparative effectiveness of several forms of lifestyle modifications and found smoking cessation and yoga to be the most effective forms of cardiovascular disease prevention. Future research should focus on patient adherence to personalized therapies, cost-effectiveness of these strategies, and the potential for enhanced benefit when interventions are performed simultaneously rather than as single measures. KEYWORDS: cardiovascular risk reduction; comparative effectiveness; lifestyle modification