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SECOND OPINION | The science of sitting

CBC News Posted: Jun 17, 2017

http://www.cbc.ca/news/health/virus-sitting-sedentary-bats-coronavirus-1.4164993

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Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome.

Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, Chastin SFM, Altenburg TM, Chinapaw MJM; SBRN Terminology Consensus Project Participants.

Int J Behav Nutr Phys Act. 2017 Jun 10;14(1):75. doi: 10.1186/s12966-017-0525-8.

PMID: 28599680 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466781/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466781/pdf/12966_2017_Article_525.pdf

Abstract

BACKGROUND:

The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need.

METHOD:

First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey.

RESULTS:

Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided.

CONCLUSION:

It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors.

KEYWORDS:

Bouts; Breaks; Interruptions; Lying; Non-screen-based time; Physical inactivity; Reclining; Screen time; Sedentary behavior; Sitting; Standing; Stationary behavior

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Metformin, the aspirin of the 21<sup>st</sup> century: its role in gestational diabetes, prevention of preeclampsia and cancer, and the promotion of longevity.

Romero R, Erez O, Hüttemann M, Maymon E, Panaitescu B, Conde-Agudelo A, Pacora P, Yoon BH, Grossman LI.

Am J Obstet Gynecol. 2017 Jun 12. pii: S0002-9378(17)30739-1. doi: 10.1016/j.ajog.2017.06.003. [Epub ahead of print] Review.

PMID: 28619690

Abstract

Metformin is everywhere. Originally introduced in clinical practice as an anti-diabetic agent, its role as a therapeutic agent is expanding to include treatment of pre-diabetes, gestational diabetes, polycystic ovarian disease, and more recently, experimental studies, as well as observations in randomized clinical trials, suggest that metformin could have a place in the treatment or prevention of preeclampsia. This article provides a brief overview of the history of metformin in the treatment of diabetes, reviews the results of meta-analyses of metformin in gestational diabetes, and the treatment of obese non-diabetic pregnant women to prevent macrosomia. We highlight the results of a randomized clinical trial in which metformin administration in early pregnancy did not reduce the frequency of large-for-gestational-age infants (primary endpoint), but did decrease the frequency of preeclampsia (a secondary endpoint). The mechanisms by which metformin may prevent preeclampsia include a reduction in the production of anti-angiogenic factors (soluble vascular endothelial growth factor receptor-1 and soluble endoglin), and improving endothelial dysfunction, probably through an effect on the mitochondria. Another potential mechanism whereby metformin may play a role in the prevention of preeclampsia is its ability to modify cellular homeostasis and energy disposition, mediated by mTOR. Metformin has a molecular weight of 129 Dalton, and therefore, readily crosses the placenta. There is considerable evidence suggesting that this agent is safe during pregnancy. New literature on the role of metformin in the prevention of cancer, a chemotherapeutic adjuvant, and in prolonging life and protecting against aging, is briefly reviewed. Herein we discuss the mechanisms of action and potential benefits of metformin.

 

Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association.

Sacks FM, Lichtenstein AH, Wu JHY, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG, Stone NJ, Van Horn LV; American Heart Association.

Circulation. 2017 Jun 15. pii: CIR.0000000000000510. doi: 10.1161/CIR.0000000000000510. [Epub ahead of print] Review.

PMID: 28620111

Abstract

Cardiovascular disease (CVD) is the leading global cause of death, accounting for 17.3 million deaths per year. Preventive treatment that reduces CVD by even a small percentage can substantially reduce, nationally and globally, the number of people who develop CVD and the costs of caring for them. This American Heart Association presidential advisory on dietary fats and CVD reviews and discusses the scientific evidence, including the most recent studies, on the effects of dietary saturated fat intake and its replacement by other types of fats and carbohydrates on CVD. In summary, randomized controlled trials that lowered intake of dietary saturated fat and replaced it with polyunsaturated vegetable oil reduced CVD by ≈30%, similar to the reduction achieved by statin treatment. Prospective observational studies in many populations showed that lower intake of saturated fat coupled with higher intake of polyunsaturated and monounsaturated fat is associated with lower rates of CVD and of other major causes of death and all-cause mortality. In contrast, replacement of saturated fat with mostly refined carbohydrates and sugars is not associated with lower rates of CVD and did not reduce CVD in clinical trials. Replacement of saturated with unsaturated fats lowers low-density lipoprotein cholesterol, a cause of atherosclerosis, linking biological evidence with incidence of CVD in populations and in clinical trials. Taking into consideration the totality of the scientific evidence, satisfying rigorous criteria for causality, we conclude strongly that lowering intake of saturated fat and replacing it with unsaturated fats, especially polyunsaturated fats, will lower the incidence of CVD. This recommended shift from saturated to unsaturated fats should occur simultaneously in an overall healthful dietary pattern such as DASH (Dietary Approaches to Stop Hypertension) or the Mediterranean diet as emphasized by the 2013 American Heart Association/American College of Cardiology lifestyle guidelines and the 2015 to 2020 Dietary Guidelines for Americans.

KEYWORDS:

AHA Scientific Statements; blood cholesterol; cardiovascular diseases, atherosclerosis; cholesterol, LDL; dietary fats; fatty acids, saturated; fatty acids, unsaturated

 

Acute Effect of Metformin on Postprandial Hypertriglyceridemia through Delayed Gastric Emptying.

Sato D, Morino K, Nakagawa F, Murata K, Sekine O, Beppu F, Gotoh N, Ugi S, Maegawa H.

Int J Mol Sci. 2017 Jun 16;18(6). pii: E1282. doi: 10.3390/ijms18061282.

PMID: 28621714

Abstract

Postprandial hypertriglyceridemia is a potential target for cardiovascular disease prevention in patients with diabetic dyslipidemia. Metformin has been reported to reduce plasma triglyceride concentrations in the postprandial states. However, little is known about the mechanisms underlying the triglyceride-lowering effect of metformin. Here, we examined the effects of metformin on lipid metabolism after olive oil-loading in 129S mice fed a high fat diet for three weeks. Metformin administration (250 mg/kg) for one week decreased postprandial plasma triglycerides. Pre-administration (250 mg/kg) of metformin resulted in a stronger triglyceride-lowering effect (approximately 45% lower area under the curve) than post-administration. A single administration (250 mg/kg) of metformin lowered plasma postprandial triglycerides comparably to administration for one week, suggesting an acute effect of metformin on postprandial hypertriglyceridemia. To explore whole body lipid metabolism after fat-loading, stomach size, fat absorption in the intestine, and fat oxidation (13C/12C ratio in expired CO₂ after administration of glyceryl-1-13C tripalmitate) were measured with and without metformin (250 mg/kg) pre-treatment. In metformin-treated mice, larger stomach size, lower fat oxidation, and no change in lipid absorption were observed. In conclusion, metformin administration before fat loading reduced postprandial hypertriglyceridemia, most likely by delaying gastric emptying.

KEYWORDS:

Metformin; gastric emptying; postprandial hypertriglyceridemia

 

A randomized cross-over study of the acute effects of running 5 km on glucose, insulin, metabolic rate, cortisol and Troponin T.

Keselman B, Vergara M, Nyberg S, Nystrom FH.

PLoS One. 2017 Jun 16;12(6):e0179401. doi: 10.1371/journal.pone.0179401. eCollection 2017.

PMID: 28622349

Abstract

BACKGROUND:

We aimed to study the impact by running 5 km, at maximal speed, on the normal variations of metabolic variables related to glucose, insulin, insulin sensitivity, cortisol, glucagon, Troponin T and metabolic rate.

MATERIAL AND METHODS:

Five women and 12 men 25.7±5.2 years of age with a body-mass-index of 22.5±2.3 kg/m2 where recruited to run 5 km at individual maximal speed in the morning, and to a corresponding day of rest, followed by standardized breakfast and lunch meals. Blood sampling and measurement of indirect calorimetry were done before and after meals. The participants were randomized regarding the order of the two trial-days in this cross-over study.

RESULTS:

Insulin and cortisol levels were higher, and insulin sensitivity was lower, on the race-day compared with the day of rest (linear mixed model: p<0.0001 for all three analyses). However, glucose levels and metabolic rate did not differ between the two trial days (p = 0.29 and p = 0.53, respectively). When analyzing specific time-points we found that glucose increased from 5.01±0.37 mmol/l to 6.36 ± 1.3 mmol/l, p<0.0001, by running, while serum insulin concomitantly increased from 42±21 to 90±54 pmol/l, p<0.0001. In accordance, the QUICKI index of serum sensitivity, 1/(log10insulin+log10glucose), was lowered post-race, p<0.0001. Serum cortisol levels increased from 408±137 nmol/l to 644±171 nmol/l, p<0.0001, post-race while serum glucagon levels were unaffected. Troponin T was detectable in serum post-race in 12 out of the 17 participants and reached or surpassed the clinical reference level of 15 ng/l in three subjects. Post-race electrocardiograms displayed no pathologies.

CONCLUSIONS:

Relatively short running-races can apparently induce a reduction in insulin sensitivity that is not fully compensated by concomitantly increased insulin secretion intended to ensure euglycemia. Since also Troponin T was detected in plasma in a majority of the participants, our data suggest that it is possible to induce considerable metabolic stress by running merely 5 km, when striving for maximal speed.

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Towards ageing well: Use it or lose it: Exercise, epigenetics and cognition.

Rea IM.

Biogerontology. 2017 Jun 17. doi: 10.1007/s10522-017-9719-3. [Epub ahead of print]

PMID: 28624982

http://sci-hub.cc/10.1007/s10522-017-9719-3

Abstract

More and more people are living into the 90s or becoming centenarians. But, the gift of increased 'age span' seldom equates with an improved 'health-span'. Governments across the world are expressing concern about the epidemic of chronic disease, and have responded by initiating policies that make prevention, reduction and treatment of chronic disease, a public health priority. But understanding, how to age long and well, with the avoidance of chronic disease and later life complex disease morbidity is challenging. While inherited genes have an undoubted role to play in the chance of maintaining good health or conversely a predilection to developing disease and chronic ill health, there is increasing evidence that behavioural and environmental life-style choices may contribute up to 50% of the variability of human lifespan. Physical exercise is readily available to everyone, and is a simple cheap and effective form of life-style intervention. Exercise appears to help maintain good health and to reduce the risk of developing chronic disease and ill health. Evidence suggests that physical activity improves well-being across many health domains through out life, continues to offer important health benefits in older age groups and tracks with a 'healthy ageing' profile. Although many of the molecular pathways remain to be fully identified, here we discuss how physical activity and exercise is understood to produce changes in the human epigenome, which have the potential to enhance cognitive and psychological health, improve muscular fitness, and lead to better ageing with improved quality of life in older age.

KEYWORDS:

Brain-derived neurotrophic factor; Cognition; Epigenetics; Exercise; Exercise-induced stress response; Healthy ageing; Lifestyle; Mitochondrial biogenesis

 

The Scientist » The Nutshell

Mutation Linked to Longer Life Span in Men

A deletion in a growth hormone receptor gene is tied to an average of 10 extra years of life among men, but not women, according to a study.

By Jef Akst | June 19, 2017

http://www.the-scientist.com/?articles.view/articleNo/49698/title/Mutation-Linked-to-Longer-Life-Span-in-Men/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=53271917&_hsenc=p2ANqtz--pfspZknNNPx2bcJrrCc_JBPRTv4MT8QAG2tEU-XFMWB6Gi7Y-yvSD_Zx2MyylTNMIrHDQvlivMLRY1KdNYzZF51TNuA&_hsmi=53271917

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The GH receptor exon 3 deletion is a marker of male-specific exceptional longevity associated with increased GH sensitivity and taller stature

Danny Ben-Avraham1,2,3, Diddahally R. Govindaraju3,4, Temuri Budagov1,3, Delphine Fradin5, Peter Durda6, Bing Liu7, Sandy Ott8, Danielle Gutman9, Lital Sharvit9, Robert Kaplan10, Pierre Bougnères5,11, Alex Reiner12,13, Alan R. Shuldiner8,14, Pinchas Cohen7, Nir Barzilai1,2,3 and Gil Atzmon1,2,3,9,*

Science Advances 16 Jun 2017:

Vol. 3, no. 6, e1602025

DOI: 10.1126/sciadv.1602025

http://sci-hub.cc/10.1126/sciadv.1602025

Abstract

Although both growth hormone (GH) and insulin-like growth factor 1 (IGF-1) signaling were shown to regulate life span in lower organisms, the role of GH signaling in human longevity remains unclear. Because a GH receptor exon 3 deletion (d3-GHR) appears to modulate GH sensitivity in humans, we hypothesized that this polymorphism could play a role in human longevity. We report a linear increased prevalence of d3-GHR homozygosity with age in four independent cohorts of long-lived individuals: 841 participants [567 of the Longevity Genes Project (LGP) (8% increase; P = 0.01), 152 of the Old Order Amish (16% increase; P = 0.02), 61 of the Cardiovascular Health Study (14.2% increase; P = 0.14), and 61 of the French Long-Lived Study (23.5% increase; P = 0.02)]. In addition, mega analysis of males in all cohorts resulted in a significant positive trend with age (26% increase; P = 0.007), suggesting sexual dimorphism for GH action in longevity. Further, on average, LGP d3/d3 homozygotes were 1 inch taller than the wild-type (WT) allele carriers (P = 0.05) and also showed lower serum IGF-1 levels (P = 0.003). Multivariate regression analysis indicated that the presence of d3/d3 genotype adds approximately 10 years to life span. The LGP d3/d3-GHR transformed lymphocytes exhibited superior growth and extracellular signal–regulated kinase activation, to GH treatment relative to WT GHR lymphocytes (P < 0.01), indicating a GH dose response. The d3-GHR variant is a common genetic polymorphism that modulates GH responsiveness throughout the life span and positively affects male longevity.

Keywordsgrowth hormone receptorIGF-Ipositive pleiotropylongevityCentenariansd3-GHR

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[The effect of defatted cocoa powder on cholesterol-induced changes of serum lipids in rats].

Ahmad MN, Amr AM.

Nutr Hosp. 2017 Jun 5;34(3):680-687. doi: 10.20960/nh.1334. Spanish.

PMID: 28627207

Abstract

INTRODUCTION:

Cocoa has been known for many health benefits, but its lipid-lowering activity still remains unresolved.

OBJECTIVES:

To investigate effects of varying amounts of defatted cocoa on serum lipids in cholesterol-fed rats.

METHODS:

Forty-eight male Sprague-Dawley rats were randomly assigned into four cholesterol-free (control) and four cholesterol-supplemented (experimental) diets containing 0, 1, 2 or 3% defatted cocoa (DC) and given ad libitumto the rats for ten weeks. Serum total cholesterol (TC), low- and very low-density lipoprotein cholesterol (LDL-C and VLDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were quantified, atherogenic index (AI) was calculated, and other biological parameters were assessed.

RESULTS:

Food intake and body weight did not respond to DC. Compared to 0% DC, 3% DC had the most prominent effect on serum lipids inducing significant fall in LDL-C and TG, and rise in TC/TG in cholesterol-deprived rats, and increase in VLDL-C and AI, and decrease in HDL-C in cholesterol-fed rats. Compared to cholesterol-deprived rats, 3% DC caused significant rise in VLDL-C, AI and TC/TG, and fall in TG in cholesterol-fed rats. This lipid-modifying effect was markedly substantiated by corresponding linear trend responses to DC. Differences in lipid variables of rats fed on DC diets were less evident.

CONCLUSIONS:

Results suggest that, in contrast to cholesterol-free situations, defatted cocoa is seemingly incapable of counteracting the atherogenic effect of cholesterol in rats, perhaps in an interaction that is likely to have clinical implications in cardiometabolic conditions.

KEYWORDS:

Defatted cocoa. Cholesterol. Dyslipidemia. Cardiometabolic risks. Rats.

 

Mitophagy Transcriptome: Mechanistic Insights into Polyphenol-Mediated Mitophagy.

Tan S, Wong E.

Oxid Med Cell Longev. 2017;2017:9028435. doi: 10.1155/2017/9028435. Epub 2017 May 25. Review.

PMID: 28626500

Abstract

Mitochondria are important bioenergetic and signalling hubs critical for myriad cellular functions and homeostasis. Dysfunction in mitochondria is a central theme in aging and diseases. Mitophagy, a process whereby damaged mitochondria are selectively removed by autophagy, plays a key homeostatic role in mitochondrial quality control. Upregulation of mitophagy has shown to mitigate superfluous mitochondrial accumulation and toxicity to safeguard mitochondrial fitness. Hence, mitophagy is a viable target to promote longevity and prevent age-related pathologies. Current challenge in modulating mitophagy for cellular protection involves identification of physiological ways to activate the pathway. Till date, mitochondrial stress and toxins remain the most potent inducers of mitophagy. Polyphenols have recently been demonstrated to protect mitochondrial health by facilitating mitophagy, thus suggesting the exciting prospect of augmenting mitophagy through dietary intake. In this review, we will first discuss the different surveillance mechanisms responsible for the removal of damaged mitochondrial components, followed by highlighting the transcriptional regulatory mechanisms of mitophagy. Finally, we will review the functional connection between polyphenols and mitophagy and provide insight into the underlying mechanisms that potentially govern polyphenol-induced mitophagy.

 

Glycogen controls Caenorhabditis elegans lifespan and resistance to oxidative stress.

Gusarov I, Pani B, Gautier L, Smolentseva O, Eremina S, Shamovsky I, Katkova-Zhukotskaya O, Mironov A, Nudler E.

Nat Commun. 2017 Jun 19;8:15868. doi: 10.1038/ncomms15868.

PMID: 28627510

Abstract

A high-sugar diet has been associated with reduced lifespan in organisms ranging from worms to mammals. However, the mechanisms underlying the harmful effects of glucose are poorly understood. Here we establish a causative relationship between endogenous glucose storage in the form of glycogen, resistance to oxidative stress and organismal aging in Caenorhabditis elegans. We find that glycogen accumulated on high dietary glucose limits C. elegans longevity. Glucose released from glycogen and used for NADPH/glutathione reduction renders nematodes and human hepatocytes more resistant against oxidative stress. Exposure to low levels of oxidants or genetic inhibition of glycogen synthase depletes glycogen stores and extends the lifespan of animals fed a high glucose diet in an AMPK-dependent manner. Moreover, glycogen interferes with low insulin signalling and accelerates aging of long-lived daf-2 worms fed a high glucose diet. Considering its extensive evolutionary conservation, our results suggest that glycogen metabolism might also have a role in mammalian aging.

 

Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study.

Elovainio M, Hakulinen C, Pulkki-Råback L, Virtanen M, Josefsson K, Jokela M, Vahtera J, Kivimäki M.

Lancet Public Health. 2017 May 4;2(6):e260-e266. doi: 10.1016/S2468-2667(17)30075-0. eCollection 2017 Jun.

PMID: 28626828

Abstract

BACKGROUND:

The associations of social isolation and loneliness with premature mortality are well known, but the risk factors linking them remain unclear. We sought to identify risk factors that might explain the increased mortality in socially isolated and lonely individuals.

METHODS:

We used prospective follow-up data from the UK Biobank cohort study to assess self-reported isolation (a three-item scale) and loneliness (two questions). The main outcomes were all-cause and cause-specific mortality. We calculated the percentage of excess risk mediated by risk factors to assess the extent to which the associations of social isolation and loneliness with mortality were attributable to differences between isolated and lonely individuals and others in biological (body-mass index, systolic and diastolic blood pressure, and handgrip strength), behavioural (smoking, alcohol consumption, and physical activity), socioeconomic (education, neighbourhood deprivation, and household income), and psychological (depressive symptoms and cognitive capacity) risk factors.

FINDINGS:

466 901 men and women (mean age at baseline 56·5 years [sD 8·1]) were included in the analyses, with a mean follow-up of 6·5 years (SD 0·8). The hazard ratio for all-cause mortality for social isolation compared with no social isolation was 1·73 (95% CI 1·65-1·82) after adjustment for age, sex, ethnic origin, and chronic disease (ie, minimally adjusted), and was 1·26 (95% CI 1·20-1·33) after further adjustment for socioeconomic factors, health-related behaviours, depressive symptoms, biological factors, cognitive performance, and self-rated health (ie, fully adjusted). The minimally adjusted hazard ratio for mortality risk related to loneliness was 1·38 (95% CI 1·30-1·47), which reduced to 0·99 (95% CI 0·93-1·06) after full adjustment for baseline risks.

INTERPRETATION:

Isolated and lonely people are at increased risk of death. Health policies addressing risk factors such as adverse socioeconomic conditions, unhealthy lifestyle, and lower mental wellbeing might reduce excess mortality among the isolated and the lonely.

 

Breast-feeding duration for the prevention of excess body weight of mother-child pairs concurrently: a 2-year cohort study.

Mastroeni MF, Mastroeni SSBS, Czarnobay SA, Ekwaru JP, Loehr SA, Veugelers PJ.

Public Health Nutr. 2017 Jun 19:1-12. doi: 10.1017/S1368980017001239. [Epub ahead of print]

PMID: 28625232

Abstract

OBJECTIVE:

To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after delivery.

DESIGN:

Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight.

SETTING:

Brazilian public maternity hospital.

SUBJECTS:

Three hundred and five mother-child pairs.

RESULTS:

At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for <2 months were more likely to have excess body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for <2 months was also associated with a greater likelihood of maternal excess body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children.

CONCLUSIONS:

Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.

KEYWORDS:

Birth cohort; Breast-feeding; Childhood obesity; Maternal obesity; Overweight; Postpartum weight

 

Long-chain Polyunsaturated Fatty Acid Supplementation Improves Mood in Elderly Japanese Men.

Tokuda H, Sueyasu T, Kawashima H, Shibata H, Koga Y.

J Oleo Sci. 2017 Jun 13. doi: 10.5650/jos.ess17035. [Epub ahead of print]

PMID: 28626140

Abstract

Although several studies have reported the effects of long-chain polyunsaturated fatty acid (LCPUFA) supplementation on the mood in healthy adults, the effects of LCPUFA on elderly individuals remain unclear. Thus, we hypothesized that LCPUFA supplementation improves mood in the elderly. To address this hypothesis, 115 elderly Japanese men aged 55-64 years were assigned and randomly allocated to the LCPUFA or placebo group. Participants received 4 weeks of supplementation with LCPUFAcontaining oil (docosahexaenoic acid (DHA) 300 mg/day, eicosapentaenoic acid (EPA) 100 mg/day, arachidonic acid (ARA) 120 mg/day) or a placebo oil. Mood was assessed using the Profile of Mood States (POMS) before and after supplementation as the secondary outcome in a previously performed randomized controlled trial on cognitive function. A total of 113 participants completed the supplementation period. One hundred participants (LCPUFA, n = 51; placebo, n = 49) who were eligible for evaluation of mood were analyzed. Increases in vigor scores on POMS, reflecting a positive mood, were significantly larger in the LCPUFA group than in the placebo group (LCPUFA, +1.8; placebo, -0.5). No significant differences were observed in changes in other negative mood scores between groups. DHA and ARA content in plasma phospholipids were increased by 0.8% and 0.7%, respectively, in the LCPUFA group, and were significantly larger than those in the placebo group. Dietary DHA, EPA, and ARA intake was unchanged during the study. These results suggest that LCPUFA supplementation may improve vigor (positive mood) in elderly Japanese men.

KEYWORDS:

arachidonic acid; docosahexaenoic acid; eicosapentaenoic acid; emotions; randomized controlled trial

 

The Effects of Food Labelling on Postexercise Energy Intake in Sedentary Women.

Lafrenière J, McNeil J, Provencher V, Doucet É.

J Obes. 2017;2017:1048973. doi: 10.1155/2017/1048973. Epub 2017 May 25.

PMID: 28626589

Abstract

Food labelling has been previously reported to influence energy intake (EI). Whether food labels influence postexercise EI remains to be determined. We assessed how food labelling and exercise (Ex) interact to influence food perception and postexercise EI. In this randomized crossover design, 14 inactive women participated in 4 experimental conditions: Ex (300 kcal at 70% of VO2peak) and lunch labelled as low in fat (LF), Ex and lunch labelled as high in fat (HF), Rest and LF, and Rest and HF. The lunch was composed of a plate of pasta, yogurt, and oatmeal cookies, which had the same nutritional composition across the 4 experimental conditions. EI at lunch and for the 48-hour period covering the testing day and the following day was assessed. Furthermore, perceived healthiness of the meal and appetite ratings were evaluated. There were no effects of exercise and food labelling on EI. However, meals labelled as LF were perceived as heathier, and this label was associated with higher prospective food consumption. Initial beliefs about food items had a stronger effect on healthiness perception than the different food labels and explain the positive correlation with the amount of food consumed (ρ = 0.34, P < 0.001).

 

Consumption of sugar-sweetened beverages and type 2 diabetes incidence in Thai adults: results from an 8-year prospective study.

Papier K, D'Este C, Bain C, Banwell C, Seubsman S, Sleigh A, Jordan S.

Nutr Diabetes. 2017 Jun 19;7(6):e283. doi: 10.1038/nutd.2017.27.

PMID: 28628126

Abstract

BACKGROUND:

The global prevalence of type 2 diabetes mellitus (T2DM) is high and is increasing in countries undergoing rapid socio-economic development, including Thailand. Sugar-sweetened beverage (SSB) intake may contribute to the risk of developing T2DM. However, few studies have assessed this association in Asian populations, and the results have been inconsistent. We aimed to assess that association in a prospective study of Thai adults.

METHODS:

Data were from Thai Cohort Study participants surveyed in 2005, 2009 and 2013. The nation-wide sample included adult cohort members who were free of diabetes in 2005 and who were followed-up in 2013 (n=39 175). We used multivariable logistic regression to assess associations between SSB intake and eight-year T2DM incidence. We used a counterfactual mediation analysis to explore potential mediation of the SSB intake and T2DM-risk relationship.

RESULTS:

In women (but not men) consuming SSBs once or more per day (versus rarely) was associated with increased T2DM incidence at the 8-year follow-up (odds ratio (OR)=2.4, 95% confidence interval (CI) 1.5-3.9). Obesity in 2009 was found to mediate ~23% of the total association between SSB intake in 2005 and T2DM risk in 2013 (natural indirect effect 1.15, 95% CI (1.02, 1.31).

CONCLUSIONS:

Frequent SSB consumption associated with higher T2DM incidence in women but not men. We found that a moderate proportion of the SSB-T2DM relationship was mediated through body mass index (BMI). Our findings suggest that targeting SSB consumption can help prevent a national rise in the incidence of T2DM.

 

Effects of a Multispecies Probiotic Supplement on Bone Health in Osteopenic Postmenopausal Women: A Randomized, Double-blind, Controlled Trial.

Jafarnejad S, Djafarian K, Fazeli MR, Yekaninejad MS, Rostamian A, Keshavarz SA.

J Am Coll Nutr. 2017 Jun 19:1-10. doi: 10.1080/07315724.2017.1318724. [Epub ahead of print]

PMID: 28628374

Abstract

OBJECTIVE:

The development of alternative approaches to prevent and/or treat osteoporosis, as a chronic progressive bone disease, is being considered currently. Among dietary supplements, probiotics may have favorable effects on bone metabolism. Therefore, the aim of this study was to evaluate the effects of a multispecies probiotic supplementation on bone biomarkers and bone density in osteopenic postmenopausal women.

METHODS:

This randomized double-blind placebo-controlled clinical trial was performed on 50 patients with osteopenia aged 50-72 years. Participants were randomly assigned to take either a multispecies probiotic supplement (GeriLact; n = 25) or placebo (n = 25) for 6 months. GeriLact contains 7 probiotic bacteria species. Participants received 500 mg Ca plus 200 IU vitamin D daily. Bone mineral density (BMD) of lumbar spine and total hip and blood biomarkers including bone-specific alkaline phosphatase (BALP), osteocalcin (OC), collagen type 1 cross-linked C-telopeptide (CTX), deoxypyridinoline (DPD), parathyroid hormone (PTH), 25-OH vitamin D, and serum pro-inflammatory cytokines (tumor necrosis factor [TNF]-α and interleukin [iL]-1β) were assessed at baseline and at the end of the study.

RESULTS:

The multispecies probiotic significantly decreased BALP (p = 0.03) and CTX (p = 0.04) levels in comparison with the control group but had no effect on BMD of the spine and total hip. Moreover, there was a statistically significant decrease in serum PTH (p = 0.01) and TNF-α (p = 0.02) in the intervention group compared to the placebo group.

CONCLUSIONS:

These results may suggest the favorable effects of the multispecies probiotic supplementation for 6 months on bone health in postmenopausal women due to slowing down the rate of bone turnover.

KEYWORDS:

Probiotic; bone biomarkers; osteopenia; osteoporosis; postmenopausal women; pro-inflammatory cytokines

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International society of sports nutrition position stand: diets and body composition.

Aragon AA, Schoenfeld BJ, Wildman R, Kleiner S, VanDusseldorp T, Taylor L, Earnest CP, Arciero PJ, Wilborn C, Kalman DS, Stout JR, Willoughby DS, Campbell B, Arent SM, Bannock L, Smith-Ryan AE, Antonio J.

J Int Soc Sports Nutr. 2017 Jun 14;14:16. doi: 10.1186/s12970-017-0174-y. eCollection 2017. Review.

PMID: 28630601

Abstract

Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature regarding the effects of diet types (macronutrient composition; eating styles) and their influence on body composition. The ISSN has concluded the following. 1) There is a multitude of diet types and eating styles, whereby numerous subtypes fall under each major dietary archetype. 2) All body composition assessment methods have strengths and limitations. 3) Diets primarily focused on fat loss are driven by a sustained caloric deficit. The higher the baseline body fat level, the more aggressively the caloric deficit may be imposed. Slower rates of weight loss can better preserve lean mass (LM) in leaner subjects. 4) Diets focused primarily on accruing LM are driven by a sustained caloric surplus to facilitate anabolic processes and support increasing resistance-training demands. The composition and magnitude of the surplus, as well as training status of the subjects can influence the nature of the gains. 5) A wide range of dietary approaches (low-fat to low-carbohydrate/ketogenic, and all points between) can be similarly effective for improving body composition. 6) Increasing dietary protein to levels significantly beyond current recommendations for athletic populations may result in improved body composition. Higher protein intakes (2.3-3.1 g/kg FFM) may be required to maximize muscle retention in lean, resistance-trained subjects under hypocaloric conditions. Emerging research on very high protein intakes (>3 g/kg) has demonstrated that the known thermic, satiating, and LM-preserving effects of dietary protein might be amplified in resistance-training subjects. 7) The collective body of intermittent caloric restriction research demonstrates no significant advantage over daily caloric restriction for improving body composition. 8) The long-term success of a diet depends upon compliance and suppression or circumvention of mitigating factors such as adaptive thermogenesis. 9) There is a paucity of research on women and older populations, as well as a wide range of untapped permutations of feeding frequency and macronutrient distribution at various energetic balances combined with training. Behavioral and lifestyle modification strategies are still poorly researched areas of weight management.

 

Timing of food intake during simulated night shift impacts glucose metabolism: A controlled study.

Grant CL, Coates AM, Dorrian J, Kennaway DJ, Wittert GA, Heilbronn LK, Pajcin M, Della Vedova C, Gupta CC, Banks S.

Chronobiol Int. 2017 Jun 21:1-11. doi: 10.1080/07420528.2017.1335318. [Epub ahead of print]

PMID: 28635334

Abstract

Eating during the night may increase the risk for obesity and type 2 diabetes in shift workers. This study examined the impact of either eating or not eating a meal at night on glucose metabolism. Participants underwent four nights of simulated night work (SW1-4, 16:00-10:00 h, <50 lux) with a daytime sleep opportunity each day (10:00-16:00 h, <3 lux). Healthy males were assigned to an eating at night (NE; n = 4, meals; 07:00, 19:00 and 01:30 h) or not eating at night (NEN; n = 7, meals; 07:00 h, 09:30, 16:10 and 19:00 h) condition. Meal tolerance tests were conducted post breakfast on pre-night shift (PRE), SW4 and following return to day shift (RTDS), and glucose and insulin area under the curve (AUC) were calculated. Mixed-effects ANOVAs were used with fixed effects of condition and day, and their interactions, and a random effect of subject identifier on the intercept. Fasting glucose and insulin were not altered by day or condition. There were significant effects of day and condition × day (both p < 0.001) for glucose AUC, with increased glucose AUC observed solely in the NE condition from PRE to SW4 (p = 0.05) and PRE to RTDS (p < 0.001). There was also a significant effect of day (p = 0.007) but not condition × day (p = 0.825) for insulin AUC, with increased insulin from PRE to RTDS in both eating at night (p = 0.040) and not eating at night (p = 0.006) conditions. Results in this small, healthy sample suggest that not eating at night may limit the metabolic consequences of simulated night work. Further study is needed to explore whether matching food intake to the biological clock could reduce the burden of type 2 diabetes in shift workers.

KEYWORDS:

glucose; insulin; metabolism; night shift; sleep loss; sleep restriction

 

https://www.crsociety.org/topic/11801-als-papers-citations-and-possibly-links-and-excerpts-or-my-synopses/page-12?hl=stature&do=findComment&comment=22416

The GH receptor exon 3 deletion is a marker of male-specific exceptional longevity associated with increased GH sensitivity and taller stature.

Ben-Avraham D, Govindaraju DR, Budagov T, Fradin D, Durda P, Liu B, Ott S, Gutman D, Sharvit L, Kaplan R, Bougnères P, Reiner A, Shuldiner AR, Cohen P, Barzilai N, Atzmon G.

Sci Adv. 2017 Jun 16;3(6):e1602025. doi: 10.1126/sciadv.1602025. eCollection 2017 Jun.

PMID: 28630896

Abstract

Although both growth hormone (GH) and insulin-like growth factor 1 (IGF-1) signaling were shown to regulate life span in lower organisms, the role of GH signaling in human longevity remains unclear. Because a GH receptor exon 3 deletion (d3-GHR) appears to modulate GH sensitivity in humans, we hypothesized that this polymorphism could play a role in human longevity. We report a linear increased prevalence of d3-GHR homozygosity with age in four independent cohorts of long-lived individuals: 841 participants [567 of the Longevity Genes Project (LGP) (8% increase; P = 0.01), 152 of the Old Order Amish (16% increase; P = 0.02), 61 of the Cardiovascular Health Study (14.2% increase; P = 0.14), and 61 of the French Long-Lived Study (23.5% increase; P = 0.02)]. In addition, mega analysis of males in all cohorts resulted in a significant positive trend with age (26% increase; P = 0.007), suggesting sexual dimorphism for GH action in longevity. Further, on average, LGP d3/d3 homozygotes were 1 inch taller than the wild-type (WT) allele carriers (P = 0.05) and also showed lower serum IGF-1 levels (P = 0.003). Multivariate regression analysis indicated that the presence of d3/d3 genotype adds approximately 10 years to life span. The LGP d3/d3-GHR transformed lymphocytes exhibited superior growth and extracellular signal-regulated kinase activation, to GH treatment relative to WT GHR lymphocytes (P < 0.01), indicating a GH dose response. The d3-GHR variant is a common genetic polymorphism that modulates GH responsiveness throughout the life span and positively affects male longevity.

KEYWORDS:

Centenarians; IGF-I; d3-GHR; growth hormone receptor; longevity; positive pleiotropy

 

"cognitive changes in older adults may not

be driven by age-related changes but by their proximity to

death, proposed by the terminal decline hypothesis."

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Decline in Memory, Visuospatial Ability, and Crystalized Cognitive Abilities in Older Adults: Normative Aging or Terminal Decline?

Bendayan R, Piccinin AM, Hofer SM, Cadar D, Johansson B, Muniz-Terrera G.

J Aging Res. 2017;2017:6210105. doi: 10.1155/2017/6210105. Epub 2017 May 29.

PMID: 28634548

http://www.hindawi.com.ololo.sci-hub.cc/journals/jar/2017/6210105/

Abstract

The aim of this study is to explore the pattern of change in multiple measures of cognitive abilities in a sample of oldest-old adults, comparing two different time metrics (chronological age and time to death) and therefore examining both underlying conceptual assumptions (age-related change and terminal decline). Moreover, the association with individual characteristics as sex, education, and dementia diagnosis was also examined. Measures of cognitive status (Mini-Mental State Examination and the Swedish Clock Test) and tests of crystallized (knowledge and synonyms), memory (verbal memory, nonverbal long-term memory, recognition and correspondence, and short-term memory), and visuospatial ability were included. The sample consisted of 671 older Swedish adult participants of the OCTO Twin Study. Linear mixed models with random coefficients were used to analyse change patterns and BIC indexes were used to compare models. Results showed that the time to death model was the best option in analyses of change in all the cognitive measures considered (except for the Information Test). A significant cognitive decline over time was found for all variables. Individuals diagnosed with dementia had lower scores at the study entrance and a faster decline. More educated individuals performed better in all the measures of cognition at study entry than those with poorer education, but no differences were found in the rate of change. Differences were found in age, sex, or time to death at baseline across the different measures. These results support the terminal decline hypothesis when compared to models assuming that cognitive changes are driven by normative aging processes.

 

Sirtuin-2 Protects Neural Cells from Oxidative Stress and Is Elevated in Neurodegeneration.

Singh P, Hanson PS, Morris CM.

Parkinsons Dis. 2017;2017:2643587. doi: 10.1155/2017/2643587. Epub 2017 May 28.

PMID: 28634568

Abstract

Sirtuins are highly conserved lysine deacetylases involved in ageing, energy production, and lifespan extension. The mammalian SIRT2 has been implicated in Parkinson's disease (PD) where studies suggest SIRT2 promotes neurodegeneration. We therefore evaluated the effects of SIRT2 manipulation in toxin treated SH-SY5Y cells and determined the expression and activity of SIRT2 in postmortem brain tissue from patients with PD. SH-SY5Y viability in response to oxidative stress induced by diquat or rotenone was measured following SIRT2 overexpression or inhibition of deacetylase activity, along with α-synuclein aggregation. SIRT2 in human tissues was evaluated using Western blotting, immunohistochemistry, and fluorometric activity assays. In SH-SY5Y cells, elevated SIRT2 protected cells from rotenone or diquat induced cell death and enzymatic inhibition of SIRT2 enhanced cell death. SIRT2 protection was mediated, in part, through elevated SOD2 expression. SIRT2 reduced the formation of α-synuclein aggregates but showed minimal colocalisation with α-synuclein. In postmortem PD brain tissue, SIRT2 activity was elevated compared to controls but also elevated in other neurodegenerative disorders. Results from both in vitro work and brain tissue suggest that SIRT2 is necessary for protection against oxidative stress and higher SIRT2 activity in PD brain may be a compensatory mechanism to combat neuronal stress.

 

Dietary diversity decreases the risk of cognitive decline among elderly Japanese.

Otsuka R.

Geriatr Gerontol Int. 2017 Jun;17(6):1038-1039. doi: 10.1111/ggi.13005. No abstract available.

PMID: 28635109

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Dietary diversity decreases the risk of cognitive decline among Japanese older adults.

Otsuka R, Nishita Y, Tange C, Tomida M, Kato Y, Nakamoto M, Imai T, Ando F, Shimokata H.

Geriatr Gerontol Int. 2017 Jun;17(6):937-944. doi: 10.1111/ggi.12817. Epub 2016 Jul 5.

PMID: 27380888

http://sci-hub.cc/10.1111/ggi.12817

Abstract

AIM:

To clarify the effectiveness of dietary diversity, calculated by dietary records, on cognitive decline.

METHODS:

Data were derived from the National Institute for Longevity Sciences - Longitudinal Study of Aging. Participants comprised 298 men and 272 women aged 60-81 years at baseline (second wave) who participated in the follow-up study (third to seventh wave) at least once. Cognitive function was assessed with the Mini-Mental State Examination in all study waves. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on a 3-day dietary record in the second wave. Cumulative data among participants with a Mini-Mental State Examination score >27 in the second wave were analyzed using a generalized estimating equation. Multivariate adjusted odds ratios and 95% confidence intervals for Mini-Mental State Examination scores ≤27 in each study wave according to a 1 standard deviation (increase), or quartiles of the Quantitative Index for Dietary Diversity at baseline, were adjusted for sex, age, follow-up time, baseline Mini-Mental State Examination score, education, body mass index, annual household income, current smoking status, energy intake and disease history.

RESULTS:

Multivariate adjusted odds ratio for a decline in Mini-Mental State Examination score was 0.79 (95% CI 0.70-0.89; P < 0.001) with a 1 SD increase in dietary diversity score, or 1.00 (reference), 0.99 (95% CI 0.70-1.43), 0.68 (95% CI 0.46-0.99) and 0.56 (95% CI 0.38-0.83) according to the lowest through highest quartiles of dietary diversity score, respectively (trend P = 0.001).

CONCLUSIONS:

Daily intake of various kinds of food might be a protective factor against cognitive decline in community-dwelling Japanese older adults. Geriatr Gerontol Int 2017; 17: 937-944.

KEYWORDS:

Japanese; cognitive decline; diet; dietary diversity; elderly

 

Pulsed food resources, but not forest cover, determines lifetime reproductive success in a forest-dwelling rodent.

Hoset KS, Villers A, Wistbacka R, Selonen V.

J Anim Ecol. 2017 Jun 21. doi: 10.1111/1365-2656.12715. [Epub ahead of print]

PMID: 28636171

Abstract

1.The relative contributions of habitat and food availability on fitness may provide evidence for key habitat features needed to safeguard population persistence. However, defining habitat quality for a species can be a complex task, especially if knowledge on the relationship between individual performance and habitat quality is lacking. 2.Here, we determined the relative importance of availability of suitable forest habitat, body mass, and food from masting tree species on female lifetime reproductive success (LRS) of Siberian flying squirrels (Pteromys volans). 3.We calculated LRS of 500 female flying squirrels based on a 22 year-long longitudinal data set of two populations from western Finland. We assessed with generalised additive models the potential effects of availability of suitable habitat and cumulative lifetime availability of food from masting tree species on female LRS, longevity and fecundity. On a reduced dataset, we evaluated the importance of female winter body mass and conducted a piecewise path analysis to determine how variables were connected. 4.According to generalised additive models female longevity, fecundity and LRS were mainly determined by variation in cumulative lifetime availability of food from masting alder and birch. Instead, habitat and body mass had smaller role. The path analysis indicated that lifetime food availability had direct effect on longevity and fecundity, and these had equal effect on LRS at both study sites. 5.Our results on LRS shows that the occurrence of tree masting events during a flying squirrel female's lifetime have profoundly larger effect on lifetime reproductive success than the cover of suitable forest habitat. Furthermore, this study emphasises the importance of both fecundity and longevity, and the indirect effects of food availability via those components, as determinants of lifetime fitness of female flying squirrels.

KEYWORDS:

Pteromys volans ; Siberian flying squirrel; arboreal mammal; fecundity; forest-specialist; habitat availability; longevity; tree mast

 

Association of vitamin D intake and serum levels with fertility: results from the Lifestyle and Fertility Study.

Fung JL, Hartman TJ, Schleicher RL, Goldman MB.

Fertil Steril. 2017 Jun 16. pii: S0015-0282(17)30420-X. doi: 10.1016/j.fertnstert.2017.05.037. [Epub ahead of print]

PMID: 28629584

Abstract

OBJECTIVE:

To evaluate the role of vitamin D intake and serum levels on conception of clinical pregnancy and live birth.

DESIGN:

Prospective cohort study.

SETTING:

Academic medical centers.

PATIENT(S):

Healthy, nulliparous women, age 18-39 years, and their male partners.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Clinical pregnancy and live birth were compared between those who did or did not meet the vitamin D estimated average requirement (EAR) intake (10 μg/d) and with serum 25-hydroxyvitamin D (25(OH)D) considered at risk for inadequacy or deficiency (<50 nmol/L) or sufficient (≥50 nmol/L).

RESULT(S):

Among 132 women, 37.1% did not meet the vitamin D EAR and 13.9% had serum levels at risk for inadequacy or deficiency. Clinical pregnancies were significantly higher among women who met the vitamin D EAR (67.5% vs. 49.0%) and with sufficient serum 25(OH)D (64.3% vs. 38.9%) compared with those who did not. Live births were higher among those who met the vitamin D EAR (59.0% vs. 40.0%). The adjusted odds ratio (AOR) of conceiving a clinical pregnancy was significantly higher among those who met the EAR (AOR = 2.26; 95% confidence interval [CI], 1.05-4.86) and had sufficient serum 25(OH)D (AOR = 3.37; 95% CI, 1.06-10.70). The associations were not significant after controlling for selected nutrients and dietary quality.

CONCLUSION(S):

Women with vitamin D intake below EAR and serum 25(OH)D levels at risk for inadequacy or deficiency may be less likely to conceive and might benefit from increased vitamin D intake to achieve adequacy.

KEYWORDS:

Vitamin D; fertility; pregnancy; serum 25(OH)D

 

High adherence to a Mediterranean diet and lower risk of frailty among French older adults community-dwellers: Results from the Three-City-Bordeaux Study.

Rahi B, Ajana S, Tabue-Teguo M, Dartigues JF, Peres K, Feart C.

Clin Nutr. 2017 May 31. pii: S0261-5614(17)30194-2. doi: 10.1016/j.clnu.2017.05.020. [Epub ahead of print]

PMID: 28629899

Abstract

BACKGROUND & AIMS:

Mediterranean diet (MeDi) is considered as a key component for healthy aging, including prevention of age-related disability, while its association with frailty, independent of disability has never been assessed. Our objective was to investigate the relation between MeDi adherence and frailty incidence among persons aged ≥75 years participating at the prospective population-based French Three-City Study.

METHODS:

The study sample consisted of 560 initially non-frail participants of the Three-City-Bordeaux center, seen at the 2009-2010 follow-up, and re-examined two years later. Adherence to MeDi was computed from a food frequency questionnaire (scored as 0-9). Frailty was defined as having at least three out of the following five slightly modified Fried frailty criteria: involuntary weight loss, exhaustion, slowness, weakness and low physical activity. Logistic regression models adjusted for sociodemographic and clinical covariates, including cognitive performance and depressive symptomatology, were used to assess the association between MeDi score and subsequent frailty risk.

RESULTS:

Over the 2-year follow-up, 79 participants (14%) became frail. Older adults with the highest MeDi adherence (score 6-9) had a significantly 68% frailty risk reduction (95% CI: 28-86%, p = 0.006) compared to those in the lowest MeDi category (score 0-3). Regarding the frailty criterion separately, the highest MeDi adherence was associated with a significantly reduced risk of incident slowness (OR = 0.45; 95% CI: 0.20-0.99, p = 0.04), poor muscle strength (OR = 0.44; 95% CI: 0.20-0.98, p = 0.04) and low physical activity (OR = 0.39; 95% CI: 0.18-0.82, p = 0.01), compared to the lowest MeDi adherence.

CONCLUSION:

In addition to its well-documented beneficial effects on health, adherence to MeDi might contribute to prevent the onset of frailty, even at late stages of life.

KEYWORDS:

Frailty risk; Late life; Mediterranean-type Diet

 

BIOMARKER CALIBRATED SODIUM AND POTASSIUM INTAKE AND CARDIOVASCULAR DISEASE RISK AMONG POSTMENOPAUSAL WOMEN.

Prentice RL, Huang Y, Neuhouser ML, Manson JE, Mossavar-Rahmani Y, Thomas F, Tinker LF, Allison M, Johnson KC, Wassertheil-Smoller S, Seth A, Rossouw JE, Shikany J, Carbone LD, Martin LW, Stefanick ML, Haring B, Van Horn L.

Am J Epidemiol. 2017 Jun 14. doi: 10.1093/aje/kwx238. [Epub ahead of print]

PMID: 28633342

Abstract

Studies of sodium and potassium intake and cardiovascular disease incidence often rely on self-reported dietary data. Here self-reported intakes from postmenopausal women at 40 participating U.S. clinical centers are calibrated using 24-hour urinary excretion measures in Women's Health Initiative cohorts, with follow-up over 1993-2010. Hypertension incidence related positively to (calibrated) sodium intake and to the ratio of sodium-to-potassium. The sodium-to-potassium ratio was associated with cardiovascular disease incidence during a 12-year average follow-up period. The estimated hazard ratio (95% confidence intervals) for a 20% increment in the sodium-to-potassium ratio was 1.13 (1.04, 1.22) for coronary heart disease; 1.20 (1.01, 1.42) for heart failure; and 1.11 (1.04, 1.19) for a composite cardiovascular disease outcome. The association for total stroke was not significant, but was positive for ischemic stroke and inverse for hemorrhagic stroke. Aside from hemorrhagic stroke, corresponding cardiovascular disease associations with sodium and potassium jointly were positive for sodium and inverse for potassium, though some were not statistically significant. Specifically, coronary heart disease hazard ratios (95% confidence intervals) for 20% increments were 1.11 (0.95, 1.30) for sodium, and 0.85 (0.73, 0.99) for potassium; and corresponding heart failure values were 1.36 (1.02, 1.82) for sodium and 0.90 (0.69, 1.18) for potassium.

KEYWORDS:

bias (epidemiology); cardiovascular disease; energy consumption; hazard ratio; measurement error; odds ratio; potassium; regression calibration; sodium

 

The effect of flaxseed supplementation on body weight and body composition: a systematic review and meta-analysis of 45 randomized placebo-controlled trials.

Mohammadi-Sartang M, Mazloom Z, Raeisi-Dehkordi H, Barati-Boldaji R, Bellissimo N, Totosy de Zepetnek JO.

Obes Rev. 2017 Jun 21. doi: 10.1111/obr.12550. [Epub ahead of print] Review.

PMID: 28635182

Abstract

Flaxseed consumption may be inversely associated with obesity; however, findings of available randomized controlled trials (RCTs) are conflicting. The present study aimed to systematically review and analyse RCTs assessing the effects of flaxseed consumption on body weight and body composition. PubMed, Medline via Ovid, SCOPUS, EMBASE and ISI Web of Sciences databases were searched up to November 2016. Mean changes in body composition indices including body weight, body mass index (BMI) and waist circumference were extracted. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity between studies was assessed with the I2 test. Publication bias and subgroup analyses were also performed. The quality of articles was assessed via the Jadad scale. A total of 45 RCTs were included. Meta-analyses suggested a significant reduction in body weight (WMD: -0.99 kg, 95% CI: -1.67, -0.31, p = 0.004), BMI (WMD: -0.30 kg m-2 , 95% CI: -0.53, -0.08, p = 0.008) and waist circumference (WMD: -0.80 cm, 95% CI: -1.40, -0.20, p = 0.008) following flaxseed supplementation. Subgroup analyses showed that using whole flaxseed in doses ≥30 g d-1 , longer-term interventions (≥12 weeks) and studies including participants with higher BMI (≥ 27 kg m-2 ) had positive effects on body composition. Whole flaxseed is a good choice for weight management particularly for weight reduction in overweight and obese participants.

KEYWORDS:

Body mass index; body weight; flax; obesity

 

Physical activity and asthma: A longitudinal and multi-country study.

Russell MA, Janson C, Gómez Real F, Johannessen A, Waatevik M, Benediktsdóttir B, Holm M, Lindberg E, Schlünssen V, Raza W, Dharmage SC, Svanes C.

J Asthma. 2017 Feb 16:1-8. doi: 10.1080/02770903.2017.1281293. [Epub ahead of print]

PMID: 28635546

http://sci-hub.cc/10.1080/02770903.2017.1281293

Abstract

OBJECTIVE:

To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis.

METHODS:

The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (<20, 20-24.99, 25-29.99, 30+ kg/m2) and physical activity grouped by amount and frequency of lighter (no sweating/heavy breathing) and vigorous (sweating/heavy breathing) activity.

RESULTS:

In the Bergen longitudinal analysis, undertaking light activity 3+ times/week at baseline was associated with less follow-up asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories.

CONCLUSION:

These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

KEYWORDS:

Adult; RHINE; asthma; physical exercise

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Tolerance to increased supplemented dietary intakes of methionine in healthy older adults.

Deutz NE, Simbo SY, Ligthart-Melis GC, Cynober L, Smriga M, Engelen MP.

Am J Clin Nutr. 2017 Jun 21. pii: ajcn152520. doi: 10.3945/ajcn.117.152520. [Epub ahead of print]

PMID: 28637772

Abstract

Background: l-Methionine (Met) is an essential amino acid for humans and is important for protein synthesis and the formation of polyamines and is involved in the synthesis of many metabolites, including homocysteine. Free-Met supplements have been claimed to have multiple positive effects; however, it remains unclear what the exact tolerance level is. With aging, Met metabolism changes, and increased plasma homocysteine is more apparent. High plasma concentrations of homocysteine are assumed to be associated with a high risk of developing atherosclerosis.Objective: We estimated the no-observed-adverse-effect level (NOAEL) and the lowest-observed-adverse-effect level (LOAEL) of supplemented, oral, free Met in healthy older adults by examining the increase in plasma homocysteine as the primary determinant.Design: We provided capsules with free Met to 15 healthy older adult subjects for 4 wk at climbing dosages of, on average, 9.2, 22.5, 46.3 and 91 mg · kg body weight-1 · d-1 with washout periods of 2 wk between each intake. Before, at 2 and 4 wk during, and 2 wk after each dosage, we studied a complete panel of biochemical blood variables to detect possible intolerance to increased Met intake. Plasma homocysteine and body composition were measured, and tolerance, quality of life, and cognitive function were assessed via questionnaires.Results: Plasma homocysteine was elevated with the highest dose of supplemented Met. The estimated NOAEL of supplemented Met was set at 46.3 mg · kg body weight-1 · d-1, and the estimated LOAEL of supplemented Met was set at 91 mg · kg body weight-1 · d-1 (on the basis of the actual intakes) in subjects independent of sex. No signs of intolerance were observed via questionnaires or other blood variables at the LOAEL. There were no meaningful changes in body composition.Conclusions: On the basis of plasma homocysteine, the NOAEL of supplemented Met intake is 46.3 and the LOAEL is 91 mg · kg body weight-1 · d-1 in healthy older adults. Both the NOAEL and LOAEL are not associated with meaningful effects on health and wellbeing.

KEYWORDS:

Tolerable Upper Intake Level; dietary methionine; homocysteine; lowest-observed-adverse-effect level; older adults; tolerance

 

Favourable Changes in Mortality in People with Diabetes - U.S. NHANES 1999-2010.

Tsujimoto T, Kajio H, Sugiyama T.

Diabetes Obes Metab. 2017 Jun 22. doi: 10.1111/dom.13039. [Epub ahead of print]

PMID: 28640432

http://onlinelibrary.wiley.com.sci-hub.cc/doi/10.1111/dom.13039/abstract;jsessionid=2396184B27CE01CA31C78503A9AA3FF3.f04t04

Abstract

AIMS:

Diabetes-related complications have declined during the past two decades. We aimed to examine whether mortality in people with diabetes improved overtime in the 1999-2010 NHANES.

METHODS:

We conducted a prospective cohort study using 1999-2004 and 2005-2010 data from the National Health and Nutrition Examination Survey. For primary analyses, we compared the unadjusted, age-adjusted, and multivariable-adjusted hazard ratios (HR) for mortality outcomes (total, cardiovascular, cardiac, and cancer deaths) of the participants with diabetes with those without diabetes using Cox proportional hazard models.

RESULTS:

For each mortality outcome, HR (95% confidence interval) in diabetic participants in the years 2005-2010 was lower than that in the years 1999-2004 (all-cause death, 2.76 [1.87-4.08] vs. 4.23 [2.57-6.98]; cardiovascular death, 2.70 [1.20-6.04] vs. 8.82 [3.28-23.70]; cardiac death, 2.45 [0.98-6.09] vs. 15.55 [7.01-34.50]; cancer death, 2.33 [0.87-6.23] vs. 3.03 [1.20-7.65]). Compared with those in 1999-2004, greater declines in mortality in 2005-2010 were observed for cardiovascular (-54.0%) and cardiac deaths (-64.8%). In age-adjusted and multivariable-adjusted models, the cumulative event rates for total, cardiovascular, and cardiac death were not significantly different between participants with and without diabetes in 2005-2010; this was not the case in 1999-2004. The leading cause of death was malignant neoplasm in 2005-2010.

CONCLUSION:

Considerably improved outcomes for total, cardiovascular and cardiac death were observed for the 2005-2010 NHANES compared to the 1999-2004 NHANES.

KEYWORDS:

Diabetes mellitus; and cancer; cardiovascular disease; cardiovascular risk; mortality

 

Associations of obesity and lifestyle with the risk and mortality of bloodstream infection in a general population: a 15-year follow-up of 64 027 individuals in the HUNT Study.

Paulsen J, Askim Å, Mohus RM, Mehl A, Dewan A, Solligård E, Damås JK, Åsvold BO.

Int J Epidemiol. 2017 Jun 15. doi: 10.1093/ije/dyx091. [Epub ahead of print]

PMID: 28637260

Abstract

BACKGROUND:

Bloodstream infections (BSI) cause considerable morbidity and mortality, and primary prevention should be a priority. Lifestyle factors are of particular interest since they represent a modifiable target.

METHODS:

We conducted a prospective cohort study among participants in the population-based Norwegian HUNT2 Survey, where 64 027 participants were followed from 1995-97 through 2011 by linkage to prospectively recorded information on BSI at local and regional hospitals. The exposures were: baseline body mass index (BMI) measurements; and self-reported smoking habits, leisure time physical activity and alcohol intake. The outcomes were hazard ratios (HR) of BSI and BSI mortality.

RESULTS:

During 810 453 person-years and median follow-up of 14.8 years, 1844 (2.9%) participants experienced at least one BSI and 396 (0.62%) died from BSI. Compared with normal weight participants (BMI 18.5-24.9 kg/m 2 ), the age- and sex-adjusted risk of a first-time BSI was 31% [95% confidence interval (CI) 14-51%] higher at BMI 30.0-34.9 kg/m 2 , 87% (95% CI 50-135%) higher at BMI 35.0-39.9 kg/m 2 and 210% (95% CI 117-341%) higher at BMI ≥ 40.0 kg/m 2 . The risk of BSI mortality was similarly increased. Compared with never-smokers, current smokers had 51% (95% CI 34-70%) and 75% (95% CI 34-129%) higher risks of BSI and BSI mortality, respectively. Physically inactive participants had 71% (95% CI 42-107%) and 108% (95% CI 37-216%) higher risks of BSI and BSI mortality, respectively, compared with the most physically active.

CONCLUSIONS:

Obesity, smoking and physical inactivity carry increased risk of BSI and BSI mortality.

KEYWORDS:

Bacteraemia; alcohol drinking; exercise; obesity; sepsis; smoking

 

Long-Term Effects of High-Protein Diets on Renal Function.

Kamper AL, Strandgaard S.

Annu Rev Nutr. 2017 Jun 21. doi: 10.1146/annurev-nutr-071714-034426. [Epub ahead of print]

PMID: 28637384

Abstract

Chronic kidney disease (CKD) has a prevalence of approximately 13% and is most frequently caused by diabetes and hypertension. In population studies, CKD etiology is often uncertain. Some experimental and observational human studies have suggested that high-protein intake may increase CKD progression and even cause CKD in healthy people. The protein source may be important. Daily red meat consumption over years may increase CKD risk, whereas white meat and dairy proteins appear to have no such effect, and fruit and vegetable proteins may be renal protective. Few randomized trials exist with an observation time greater than 6 months, and most of these were conducted in patients with preexisting diseases that dispose to CKD. Results conflict and do not allow any conclusion about kidney-damaging effects of longterm, high-protein intake. Until additional data become available, present knowledge seems to substantiate a concern. Screening for CKD should be considered before and during long-term, high-protein intake.

 

Meta-analysis of Soy Consumption and Gastrointestinal Cancer Risk.

Lu D, Pan C, Ye C, Duan H, Xu F, Yin L, Tian W, Zhang S.

Sci Rep. 2017 Jun 22;7(1):4048. doi: 10.1038/s41598-017-03692-y.

PMID: 28642459

Abstract

Soy consumption has received considerable attention for its potential role in reducing cancer incidence and mortality. However, its effects on gastrointestinal (GI) cancer are controversial. Therefore, we performed a meta-analysis to evaluate the association between soy consumption and gastrointestinal cancer risk by searching for prospective studies in PubMed, Web of Science, EMBASE and the reference lists of the included articles. The study-specific odds ratio (OR), relative risk (RR) or hazard ratio (HR) estimates and 95% confidence intervals (CIs) were pooled using either a fixed-effect or random-effect model. Twenty-two independent prospective studies were eligible for our meta-analysis, including 21 cohort studies and one nested case-control study. Soy product consumption was inversely associated with the incidence of overall GI cancer (0.857; 95% CI: 0.766, 0.959) and the gastric cancer subgroup (0.847; 95% CI: 0.722, 0.994) but not the colorectal cancer subgroup. After stratifying the results according to gender, an inverse association was observed between soy product intake and the incidence of GI cancer for females (0.711; 95% CI: 0.506, 0.999) but not for males.

 

Blood fatty acid changes in healthy young Americans in response to a 10-week diet that increased n-3 and reduced n-6 fatty acid consumption: a randomised controlled trial.

Young AJ, Marriott BP, Champagne CM, Hawes MR, Montain SJ, Johannsen NM, Berry K, Hibbeln JR.

Br J Nutr. 2017 May;117(9):1257-1269. doi: 10.1017/S0007114517001003. Epub 2017 May 23.

PMID: 28534446

Abstract

Military personnel generally under-consume n-3 fatty acids and overconsume n-6 fatty acids. In a placebo-controlled, double-blinded study, we investigated whether a diet suitable for implementation in military dining facilities and civilian cafeterias could benefit n-3/n-6 fatty acid status of consumers. Three volunteer groups were provided different diets for 10 weeks. Control (CON) participants consumed meals from the US Military's Standard Garrison Dining Facility Menu. Experimental, moderate (EXP-Mod) and experimental-high (EXP-High) participants consumed the same meals, but high n-6 fatty acid and low n-3 fatty acid containing chicken, egg, oils and food ingredients were replaced with products having less n-6 fatty acids and more n-3 fatty acids. The EXP-High participants also consumed smoothies containing 1000 mg n-3 fatty acids per serving, whereas other participants received placebo smoothies. Plasma and erythrocyte EPA and DHA in CON group remained unchanged throughout, whereas EPA, DHA and Omega-3 Index increased in EXP-Mod and EXP-High groups, and were higher than in CON group after 5 weeks. After 10 weeks, Omega-3 Index in EXP-High group had increased further. No participants exhibited changes in fasting plasma TAG, total cholesterol, LDL, HDL, mood or emotional reactivity. Replacing high linoleic acid (LA) containing foods in dining facility menus with similar high oleic acid/low LA and high n-3 fatty acid foods can improve n-6/n-3 blood fatty acid status after 5 weeks. The diets were well accepted and suitable for implementation in group feeding settings like military dining facilities and civilian cafeterias.

KEYWORDS:

AA arachidonic acid; CON control; EXP-High experimental-high; EXP-Mod experimental moderate; HUFA highly unsaturated fatty acid; LA linoleic acid; SCD sudden cardiac death; Cafeterias; Diet interventions; Military personnel; n-3/n-6 Fatty acids

 

High-quality fish oil has a more favourable effect than oxidised fish oil on intermediate-density lipoprotein and LDL subclasses: a randomised controlled trial.

Rundblad A, Holven KB, Ottestad I, Myhrstad MC, Ulven SM.

Br J Nutr. 2017 May;117(9):1291-1298. doi: 10.1017/S0007114517001167. Epub 2017 May 31.

PMID: 28558855

http://sci-hub.cc/10.1017/S0007114517001167

Abstract

Fish oil (FO) supplementation reduces the risk of CVD. However, it is not known if FO of different qualities have different effects on lipoprotein subclasses in humans. We aimed at investigating the effects of oxidised FO and high-quality FO supplementation on lipoprotein subclasses and their lipid concentrations in healthy humans. In all, fifty-four subjects completed a double-blind randomised controlled intervention study. The subjects were randomly assigned to receive high-quality FO (n 17), oxidised FO (n 18) or high-oleic sunflower oil capsules (HOSO, n 19) for 7 weeks. The concentration of marine n-3 fatty acids was equal in high-quality FO and oxidised FO (1·6 g EPA+DHA/d). The peroxide value (PV) and anisidine value (AV) were 4 mEq/kg and 3 in high-quality FO and HOSO, whereas the PV and AV in the oxidised FO were 18 mEq/kg and 9. Blood samples were collected at baseline and end of study. NMR spectroscopy was applied for the analysis of lipoprotein subclasses and their lipid concentrations. High-quality FO reduced the concentration of intermediate-density lipoprotein (IDL) particles and large, medium and small LDL particles, as well as the concentrations of total lipids, phospholipids, total cholesterol, cholesteryl esters and free cholesterol in IDL and LDL subclasses compared with oxidised FO and HOSO. Hence, high-quality FO and oxidised FO differently affect lipid composition in lipoprotein subclasses, with a more favourable effect mediated by high-quality FO. In future trials, reporting the oxidation levels of FO would be useful.

KEYWORDS:

AV anisidine value; CETP cholesteryl ester transfer protein; E% percentage of energy; FO fish oil; HOSO high-oleic sunflower oil capsules; IDL intermediate-density lipoprotein; PBMC peripheral blood mononuclear cells; PV peroxide value; Fish oil; LDL; Lipoprotein subclasses; Oxidised fish oil

 

International Society of Sports Nutrition Position Stand: protein and exercise.

Jäger R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, Skwiat TM, Purpura M, Ziegenfuss TN, Ferrando AA, Arent SM, Smith-Ryan AE, Stout JR, Arciero PJ, Ormsbee MJ, Taylor LW, Wilborn CD, Kalman DS, Kreider RB, Willoughby DS, Hoffman JR, Krzykowski JL, Antonio J.

J Int Soc Sports Nutr. 2017 Jun 20;14:20. doi: 10.1186/s12970-017-0177-8. eCollection 2017. Review.

PMID: 28642676

International Society of Sports Nutrition Position Stand: protein and exercise.

Jäger R, Kerksick CM, Campbell BI, Cribb PJ, Wells SD, Skwiat TM, Purpura M, Ziegenfuss TN, Ferrando AA, Arent SM, Smith-Ryan AE, Stout JR, Arciero PJ, Ormsbee MJ, Taylor LW, Wilborn CD, Kalman DS, Kreider RB, Willoughby DS, Hoffman JR, Krzykowski JL, Antonio J.

J Int Soc Sports Nutr. 2017 Jun 20;14:20. doi: 10.1186/s12970-017-0177-8. eCollection 2017. Review.

PMID: 28642676

 

Differential Fasting Plasma Glucose and Ketone Body Levels in GHRKO versus 3xTg-AD Mice: A Potential Contributor to Aging-Related Cognitive Status?

Griffith CM, Macklin LN, Bartke A, Patrylo PR.

Int J Endocrinol. 2017;2017:9684061. doi: 10.1155/2017/9684061. Epub 2017 May 30.

PMID: 28638409

Abstract

Cognitive function declines with age and appears to correlate with decreased cerebral metabolic rate (CMR). Caloric restriction, an antiaging manipulation that extends life-span and can preserve cognitive function, is associated with decreased glucose uptake, decreased lactate levels, and increased ketone body (KB) levels in the brain. Since the majority of brain nutrients come from the periphery, this study examined whether the capacity to regulate peripheral glucose levels and KB production differs in animals with successful cognitive aging (growth hormone receptor knockouts, GHRKOs) versus unsuccessful cognitive aging (the 3xTg-AD mouse model of Alzheimer's disease). Animals were fasted for 5 hours with their plasma glucose and KB levels subsequently measured. Intriguingly, in GHRKO mice, compared to those in controls, fasting plasma glucose levels were significantly decreased while their KB levels were significantly increased. Conversely, 3xTg-AD mice, compared to controls, exhibited significantly elevated plasma glucose levels and significantly reduced plasma KB levels. Taken together, these results suggest that the capacity to provide the brain with KBs versus glucose throughout an animal's life could somehow help preserve cognitive function with age, potentially through minimizing overall brain exposure to reactive oxygen species and advanced glycation end products and improving mitochondrial function.

 

[On reading the methods used, they swithced from corn oil to the other oils.]

How canola and sunflower oils affect lipid profile and anthropometric parameters of participants with dyslipidemia.

Saedi S, Noroozi M, Khosrotabar N, Mazandarani S, Ghadrdoost B.

Med J Islam Repub Iran. 2017 Jan 15;31:5. doi: 10.18869/mjiri.31.5. eCollection 2017.

PMID: 28638812

http://mjiri.iums.ac.ir/article-1-3635-en.pdf

Abstract

Background: Restricted intakes of saturated and trans-fatty acids and replacement with poly or monounsaturated fatty acids are emphasized in healthy diets. This study evaluates the effects of a six-month consumption of canola oil compared to sunflower oil on lipid profile and anthropometric parameters of people affected by dyslipidemia. Methods: This randomized controlled trial was conducted on 96 patients with dyslipidemia, who were randomly assigned into canola oil or the sunflower oil groups. The participants were instructed to record the contents of their daily meals, beverages, fruits, and snacks a day before treatment, at the second clinic visit, in the third month, and at the end of study (i.e., six months). Lipid profile and anthropometric parameters were compared between the two groups. Student t-test or Mann Whitney U test was used for statistical comparisons of variables between groups. Multivariate analysis was performed to adjust the confounding factor effects. Results: Of the enrolled participants, 44 (45.8%) were on sunflower oil diet and 52 (54.2%) on canola oil diet. We observed no change in anthropometric parameters and thus no significant difference between the two groups (p>0.05). Significant reductions in LDL-C (p<0.001), total cholesterol (p<0.001) and triglyceride levels (p<0.001), and significant elevation in HDL-C (p=0.008) were observed in canola oil group, as well as those who used sunflower oil. Conclusion: Dietary fats in the form of canola oil or sunflower oil effectively lower the serum cholesterol, LDL-C and triglyceride concentrations. They also result in an increase in serum concentration of HDL-C. These oils, however, did not modify general anthropometric parameters.

KEYWORDS:

Anthropometric Parameters; Canola Oil; Dyslipidemia; Lipid Profile; Sunflower Oil

 

Hints of some steps that may boost brain health in old age

No proven way to stave off mental decline, but these 3 steps 'do no harm,' report says

The Associated Press Posted: Jun 22, 2017

http://www.cbc.ca/news/health/possible-steps-to-boost-brain-health-1.4173589

 

Alcohol responsible for more hospital admissions than heart attacks last year: report

Measurement could be 'an important indicator for monitoring public health'

By Sherry Noik, CBC News Posted: Jun 22, 2017

http://www.cbc.ca/news/health/alcohol-hospital-admissions-1.4172091

 

Bacterial pathogens: A spoonful of sugar could be the medicine.

Jung HJ, Pamer EG.

Nature. 2017 Jun 22;546(7659):479-480. doi: 10.1038/nature23084. Epub 2017 Jun 14. No abstract available.

PMID: 28614303

Pili are filamentous bacterial structures that promote adhesion to host cells. It emerges that a small molecule that inhibits this adhesion can prevent colonization of the mouse gut by a pathogenic bacterium. See Letter p.528

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Selective depletion of uropathogenic E. coli from the gut by a FimH antagonist.

Spaulding CN, Klein RD, Ruer S, Kau AL, Schreiber HL, Cusumano ZT, Dodson KW, Pinkner JS, Fremont DH, Janetka JW, Remaut H, Gordon JI, Hultgren SJ.

Nature. 2017 Jun 22;546(7659):528-532. doi: 10.1038/nature22972. Epub 2017 Jun 14.

PMID: 28614296

Both F17-like and type 1 pili promote intestinal colonization in mouse colonic crypts, and the high-affinity mannoside M4284 reduces intestinal colonization of uropathogenic Escherichia coli while simultaneously treating urinary tract infections without disrupting the composition of the gut microbiota.

Abstract

Urinary tract infections (UTIs) caused by uropathogenic Escherichia coli (UPEC) affect 150 million people annually. Despite effective antibiotic therapy, 30-50% of patients experience recurrent UTIs. In addition, the growing prevalence of UPEC that are resistant to last-line antibiotic treatments, and more recently to carbapenems and colistin, make UTI a prime example of the antibiotic-resistance crisis and emphasize the need for new approaches to treat and prevent bacterial infections. UPEC strains establish reservoirs in the gut from which they are shed in the faeces, and can colonize the periurethral area or vagina and subsequently ascend through the urethra to the urinary tract, where they cause UTIs. UPEC isolates encode up to 16 distinct chaperone-usher pathway pili, and each pilus type may enable colonization of a habitat in the host or environment. For example, the type 1 pilus adhesin FimH binds mannose on the bladder surface, and mediates colonization of the bladder. However, little is known about the mechanisms underlying UPEC persistence in the gut. Here, using a mouse model, we show that F17-like and type 1 pili promote intestinal colonization and show distinct binding to epithelial cells distributed along colonic crypts. Phylogenomic and structural analyses reveal that F17-like pili are closely related to pilus types carried by intestinal pathogens, but are restricted to extra-intestinal pathogenic E. coli. Moreover, we show that targeting FimH with M4284, a high-affinity inhibitory mannoside, reduces intestinal colonization of genetically diverse UPEC isolates, while simultaneously treating UTI, without notably disrupting the structural configuration of the gut microbiota. By selectively depleting intestinal UPEC reservoirs, mannosides could markedly reduce the rate of UTIs and recurrent UTIs.

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Use and Misuse of Aspirin in Primary Cardiovascular Prevention.

Coccheri S.

Clin Med Insights Cardiol. 2017 Apr 21;11:1179546817702149. doi: 10.1177/1179546817702149. eCollection 2017. Review.

PMID: 28469496 Free PMC Article

Abstract

The use of low-dose aspirin in primary prevention of cardiovascular (CV) events in healthy or apparently healthy people is a widely debated topic. Many arguments indicate that "primary prevention" is only a conventional definition and that the transition from primary to secondary prevention represents a continuum of increasing levels of CV risk. Although there are no direct proofs of a different efficacy of aspirin at different CV risk levels, in low-risk populations aspirin will appear to be less efficient. In fact, the lower number of events occurring in patients at low risk yields lower absolute numbers of events prevented. As many as 6 meta-analyses of trials of primary CV prevention with aspirin versus placebo, performed between 2009 and 2016, confirmed the above concepts and showed a concordant, significant reduction in nonfatal myocardial infarction, with no significant effects on stroke, as well as on CV and all-cause mortality. The recent demonstration of a moderate protective effect of aspirin on cancer (especially colorectal) confers, however, additional value to the use of aspirin, although unusually long durations of treatment and optimal daily compliance seem to be necessary. Because aspirin increases the bleeding risk, the evaluation of its net clinical benefit is an important point of debate. Thus, it is justified to search for a cutoff level of global CV risk above which the net clinical benefit of aspirin becomes evident. Such a threshold value has been calculated considering the data of 9 primary prevention trials, by the Thrombosis Group of the European Society of Cardiology, and has been indicated as a risk value of 2 or more major CV events per 100 persons per year. Also, in the recent 2016 US Guidelines, the main criterion adopted for the indication of aspirin is the level of global CV risk (suggested cutoff is 1 or more major CV events per 100 persons per year). Beyond the different values selected, it is seems very important to introduce to clinical practice and future trials a new criterion based on the level of global CV risk.

KEYWORDS:

Primary prevention; aspirin; cardiovascular risk

 

Oral Consumption of Vitamin K2 for 8 Weeks Associated With Increased Maximal Cardiac Output During Exercise.

McFarlin BK, Henning AL, Venable AS.

Altern Ther Health Med. 2017 Jul;23(4):26-32.

PMID: 28646812

Abstract

Background • Vitamin K1 and K2 are not typically common in a Western diet because they are found in a variety of fermented foods. Vitamin K2 in particular has been demonstrated to restore mitochondrial function and has a key role in production of mitochondrial adenosine triphosphate. Thus, it is reasonable to speculate that dietary supplementation with vitamin K2 could increase the function of muscle with high mitochondrial content (ie, skeletal and cardiac muscle). Objective • The purpose of this study was to determine if 8 wk of dietary supplementation with Vitamin K2 could alter cardiovascular responses to a graded cycle ergometer test. Design • The study was a randomized controlled trial. Setting • The study took place in the Applied Physiology Laboratory of the Department of Biological Sciences at the University of North Texas (Denton, TX, USA). Participants • Participants were aerobically trained males and female athletes (N = 26). Intervention • Participants were randomly assigned either to a control group that received a rice flour placebo or to an intervention group that received vitamin K2. For weeks 1 to 4, participants received 300 mg/d; for weeks 5 to 8, they received 150 mg/d. Subjects assigned to the control group received similar doses to mirror the intervention group. Subjects consumed the supplements during an 8-wk period while they maintained their typical exercise habits. Outcome Measures • At baseline and postintervention, participants completed a standard, graded exercise test on an electronically braked cycle ergometer. Before the test, participants were fitted with a mouth piece, and their oxygen consumption, carbon dioxide production, respiratory rate, and respiratory exchange ratio were measured. In addition, participants were fitted with skin-mounted electrodes that measured noninvasive cardiac output, stroke volume, and heart rate. To assess the cumulative exercise change, an area-under-the-curve (AUC) value was calculated separately for each outcome variable at each treatment time point. Results • Vitamin K2 supplementation was associated with a 12% increase in maximal cardiac output, with P = .031, with a trend toward an increase in heart-rate AUC, with P = .070. No significant changes occurred in stroke volume. Conclusions • Although vitamin K2 supplementation has previously been reported to improve cardiovascular function in diseased patients, to the research team's knowledge, the current study is the first to report its potential in active individuals. More research is needed to fully evaluate the potential effects of the observed effects.

 

Potential of Probiotics in Hypercholesterolemia: A Review of In Vitro and In Vivo Findings.

Sharma S, Puri S, Kurpad AV.

Altern Ther Health Med. 2017 Jun 23. pii: AT5479. [Epub ahead of print]

PMID: 28646806

Abstract

Context • Coronary heart disease (CHD) is a major public health problem in developing and developed countries. Elevated cholesterol levels, especially low-density lipoprotein (LDL) cholesterol, and the emergence of CHD, have been positively correlated in many clinical and epidemiological studies. The health benefits of probiotics have received a great deal of attention, including their blood cholesterol-lowering effects on humans. Objective • The research team intended to determine the current state of research examining the effects of various probiotic strains on lipid profiles, including measures in serum of total cholesterol, LDL cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol. Design • The review examined studies, in both animal and human models and focused on the potential of various probiotic strains to be dietary adjuncts in lowering levels of serum cholesterol with the aim of reducing the risk of cardiovascular disease (CVD) and CHD. Articles were reviewed systematically from Web search bases including PubMed and Cochrane Clinical Trial Registry. Articles meeting the inclusion search criteria were selected for further review and analysis. Only randomized controlled trials evaluating the effects of probiotics on lipid profiles in animals or humans were considered for inclusion in the review. Setting • The selection of articles and further inclusion in the review was performed in Institute of Home Economics, University of Delhi (New Delhi, India). Results • Some of the studies, in both animal and human models, have revealed that several strains were able to improve at least 1 lipid fraction. Although the results from animal studies have been fairly consistent, the findings from studies on humans have varied. Some strains when evaluated in human studies have shown insignificant effects on lipid fractions. Conclusions • Although several mechanisms for cholesterol removal by probiotics have been proposed, they need further investigation to be validated.

 

Does baseline hypotension predict incident depression in a cohort of community-dwelling older people? Data from The Irish Longitudinal Study on Ageing (TILDA).

Briggs R, Kenny RA, Kennelly SP.

Age Ageing. 2017 Mar 10:1-6. doi: 10.1093/ageing/afx033. [Epub ahead of print]

PMID: 28338875

Abstract

BACKGROUND:

hypotension is now recognised as a risk factor for syncope, cardiovascular events and mortality, but it may also represent a risk factor for late life depression (LLD). The aim of this study was to clarify the longitudinal relationship between hypotension and incident LLD.

METHODS:

this is a longitudinal study involving community-dwelling participants aged ≥50 years, using data from The Irish Longitudinal Study on Ageing. The Centre for Epidemiological Studies Depression Scale (CES-D) was administered at baseline and at follow-up 2 years later. Blood pressure (BP) was measured at baseline. Participants with a CES-D score ≥16 at baseline and those taking antidepressants were excluded and considered to have a current diagnosis of depression. A score of ≥16 at follow-up was used to define incident depression.

RESULTS:

about 4,525 participants were included and 200 participants had diagnosis of incident LLD. The incident depression group had lower systolic BP at baseline than the non-depressed group (132.8 ± 1.43 mm Hg vs. 136.0 ± 0.30 mm HG, P = 0.025). Logistic regression showed those with systolic BP <130 mm HG had an unadjusted odds ratio of 1.31 (1.01-1.68) for incident depression. This persisted after adjustment for confounding factors.

CONCLUSION:

systolic BP <130 mm Hg increased the likelihood of incident depression in a cohort of community-dwelling older adults. These findings are important because systolic hypotension may represent a potentially modifiable risk factor for LLD. They are also relevant in the context of BP treatment targets for older people.

KEYWORDS:

blood pressure; depression; hypotension; older people

 

Interaction of obstructive sleep apnoea and cognitive impairment with slow gait speed in middle-aged and older adults.

Lee S, Shin C.

Age Ageing. 2017 Jan 4. doi: 10.1093/ageing/afw228. [Epub ahead of print]

PMID: 28057621

http://sci-hub.cc/10.1093/ageing/afw228

Abstract

OBJECTIVE:

to investigate whether slow gait speed is associated with cognitive impairment and further whether the association is modified by obstructive sleep apnoea (OSA).

METHODS:

in total, 2,222 adults aged 49-80 years, free from dementia, stroke and head injury were asked to walk a 4-m course at fast and usual gait speeds. The time taken to walk was measured. All participants completed the Korean Mini-Mental State Examination, which was validated in the Korean language, to assess cognitive function. Additionally, the participants completed a polysomnography test to ascertain OSA (defined as an apnoea-hypopnoea index ≥15). Multivariable linear regression models were utilised to test the associations.

RESULTS:

time taken to walk 4 m showed significant inverse associations with cognitive scores (P value = 0.001 at fast gait speed and P = 0.002 at usual gait speed). Furthermore, a significant interaction according to OSA on the association between time to walk and cognitive impairment was found (P value for interaction = 0.003 at fast gait speed and P value for interaction = 0.007 at usual gait speed).

CONCLUSION:

we found that the inverse association between the time taken to walk 4 m and a cognitive score became significantly stronger, if an individual had OSA.

KEYWORDS:

cognition; gait; obstructive sleep apnoea; older people

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Chemical transformation of xenobiotics by the human gut microbiota.

Koppel N, Maini Rekdal V, Balskus EP.

Science. 2017 Jun 23;356(6344). pii: eaag2770. doi: 10.1126/science.aag2770. Review.

PMID: 28642381

http://science.sciencemag.org/content/356/6344/eaag2770.full

One person's meat is another's poison

The human gut is packed with actively metabolizing microorganisms. These have a transformative effect on what we ingest—whether food, drugs, or pollutants. Koppel et al. review the distinguishing features of microbial xenobiotic metabolism, its interaction with somatic metabolism, and interindividual variation. Depending on the functional composition of microorganisms in the gut, the subsequent products may have nutritionally beneficial effects, modify pharmaceuticals, or be toxic. All of these consequences of our companion microbes can have important impacts on human health and well-being.

Structured Abstract

BACKGROUND

Humans ingest a multitude of small molecules that are foreign to the body (xenobiotics), including dietary components, environmental chemicals, and pharmaceuticals. The trillions of microorganisms that inhabit our gastrointestinal tract (the human gut microbiota) can directly alter the chemical structures of such compounds, thus modifying their lifetimes, bioavailabilities, and biological effects. Our knowledge of how gut microbial transformations of xenobiotics affect human health is in its infancy, which is surprising given the importance of the gut microbiota. We currently lack an understanding of the extent to which this metabolism varies between individuals, the mechanisms by which these microbial activities influence human biology, and how we might rationally manipulate these reactions. This deficiency stems largely from the difficulty of connecting this microbial chemistry to specific organisms, genes, and enzymes.

ADVANCES

Over the past several decades, studies of gut microbiota–mediated modification of xenobiotics have revealed that these organisms collectively have a larger metabolic repertoire than human cells. The chemical differences between human and microbial transformations of ingested compounds arise not only from the increased diversity of enzymes present in this complex and variable community but also from the distinct selection pressures that have shaped these activities. For example, whereas host metabolism evolved to facilitate excretion of many xenobiotics from the body, microbial modifications of these compounds and their human metabolites often support microbial growth through provision of nutrients or production of energy. Notably, the chemistry of microbial transformations often opposes or reverses that of host metabolism, altering the pharmacokinetic and pharmacodynamic properties of xenobiotics and associated metabolites.

The range of xenobiotics subject to gut microbial metabolism is impressive and expanding. Gut microbes modify many classes of dietary compounds, including complex polysaccharides, lipids, proteins, and phytochemicals. These metabolic reactions are linked to a variety of health benefits, as well as disease susceptibilities. Gut microbes are also able to transform industrial chemicals and pollutants, altering their toxicities and lifetimes in the body. Similarly, microbial transformations of drugs can change their pharmacokinetic properties, be critical for prodrug activation, and lead to undesirable side effects or loss of efficacy. In the vast majority of cases, the individual microbes and enzymes that mediate these reactions are unknown.

Fueled by findings underscoring the relevance of microbial xenobiotic metabolism to human health, scientists are increasingly seeking to discover and manipulate the enzymatic chemistry involved in these transformations. Recent work exploring how gut microbes metabolize the drugs digoxin and irinotecan, as well as the dietary nutrient choline, provides guidance for such investigations. These studies, which combine traditional methods with modern approaches, illustrate how a molecular understanding of gut microbial xenobiotic metabolism can guide hypothesis-driven research into the roles these reactions play in both microbiota and host biology.

OUTLOOK

We still face a myriad of challenges in understanding the gut microbiota’s contribution to xenobiotic metabolism. It is imperative that we connect the many known microbial transformations with the genes and enzymes responsible for these activities, and knowledge of enzyme mechanism and biochemical logic will facilitate this objective. There also remains a great need to uncover currently unappreciated activities associated with this community. Revealing the full scope of microbially mediated transformations in the gut may give us new insights into the many variable and contradictory studies regarding the effects of diet, pollutants, and drugs on human health. Microbial genes and enzymes will provide both specific targets for manipulation and diagnostic markers that can be incorporated into clinical studies and practice. Ultimately, a molecular understanding of gut microbial xenobiotic metabolism will inform personalized nutrition, toxicology risk assessment, precision medicine, and drug development.

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image

Human gut microbes metabolize xenobiotics.

The microorganisms that inhabit the human gut alter the chemical structures of ingested compounds, including dietary components, industrial chemicals, and drugs. These changes affect xenobiotic toxicity, biological activity, and bioavailability. The gut microbial enzymes responsible for many of these transformations are poorly understood. Me, methyl.

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Abstract

The human gut microbiota makes key contributions to the metabolism of ingested compounds (xenobiotics), transforming hundreds of dietary components, industrial chemicals, and pharmaceuticals into metabolites with altered activities, toxicities, and lifetimes within the body. The chemistry of gut microbial xenobiotic metabolism is often distinct from that of host enzymes. Despite their important consequences for human biology, the gut microbes, genes, and enzymes involved in xenobiotic metabolism are poorly understood. Linking these microbial transformations to enzymes and elucidating their biological effects is undoubtedly challenging. However, recent studies demonstrate that integrating traditional and emerging technologies can enable progress toward this goal. Ultimately, a molecular understanding of gut microbial xenobiotic metabolism will guide personalized medicine and nutrition, inform toxicology risk assessment, and improve drug discovery and development.

 

One-Carbon Metabolism Biomarkers and Cognitive Decline in the Very Old: The Newcastle 85+ Study.

Mendonça N, Granic A, Mathers JC, Martin-Ruiz C, Wesnes KA, Seal CJ, Jagger C, Hill TR.

J Am Med Dir Assoc. 2017 Jun 21. pii: S1525-8610(17)30275-X. doi: 10.1016/j.jamda.2017.05.008. [Epub ahead of print]

PMID: 28647580

http://linkinghub.elsevier.com.sci-hub.cc/retrieve/pii/S152586101730275X

Abstract

OBJECTIVES:

Although the biological rationale for the association between folate, vitamin B12, and homocysteine with cognitive function seems plausible, conflicting results have been reported. This study aimed to determine the associations between 1-carbon (1-C) metabolism biomarkers (folate, vitamin B12, and homocysteine), and cognitive impairment at baseline and the rate of cognitive decline over 5 years in the very old.

DESIGN:

The Newcastle 85+ Study was a prospective longitudinal study of people 85 years old and followed over 5 years in Northeast England.

SETTING:

Community-dwelling and institutionalized.

PARTICIPANTS:

The analytical sample included 765 very old participants with 1-C metabolism biomarkers and cognitive measures.

MEASUREMENTS:

Global cognition was measured by the Standardized Mini-Mental State Examination (SMMSE) at baseline, and at 3 and 5 years of follow-up and, attention-specific cognition with the Cognitive Drug Research (CDR) System at baseline, and at 1.5 and 3.0 years of follow-up. Baseline red blood cell folate (RBC folate), plasma vitamin B12, and total homocysteine (tHcy) concentrations were determined by immunoassay. Linear mixed models were used to estimate the associations between quartiles of 1-C metabolism biomarkers and cognition over 3 (CDR) and 5 years (SMMSE).

RESULTS:

Compared with participants in the lowest quartile of RBC folate concentrations (<612 nmol/L), those in the highest quartile of RBC folate concentrations (>1280 nmol/L) had 1 more point on the SMMSE at baseline (β = +1.02, SE = 0.43, P = .02). Those in quartile 4 of tHcy (>21.4 μmol/L) had 1 point less in the SMMSE at baseline than those in the lowest quartile (<13.5 μmol/L) (β = -1.05, SE = 0.46, P = .02). Plasma vitamin B12 was not predictive of global or attention-specific cognition at baseline and at follow-up. None of the 1-C metabolism biomarkers except tHcy was associated with the rate of decline in attention scores over 3 years.

CONCLUSION:

RBC folate and tHcy, but not plasma vitamin B12, were associated with better global cognition in the very old at baseline but were not predictive of rate of decline over 5 years.

KEYWORDS:

B12; cognition; folate; homocysteine; ‘Aged, 80 and over’

 

Changes in the food environment over time: examining 40 years of data in the Framingham Heart Study.

James P, Seward MW, James O'Malley A, Subramanian SV, Block JP.

Int J Behav Nutr Phys Act. 2017 Jun 24;14(1):84. doi: 10.1186/s12966-017-0537-4.

PMID: 28646894

https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0537-4

https://ijbnpa.biomedcentral.com/track/pdf/10.1186/s12966-017-0537-4?site=ijbnpa.biomedcentral.com

Abstract

BACKGROUND:

Research has explored associations between diet, body weight, and the food environment; however, few studies have examined historical trends in food environments.

METHODS:

In the Framingham Heart Study Offspring (N = 3321) and Omni (N = 447) cohorts, we created food environment metrics in four Massachusetts towns utilizing geocoded residential, workplace, and food establishment addresses from 1971 to 2008. We created multilevel models adjusted for age, sex, education, and census tract poverty to examine trends in home, workplace, and commuting food environments.

RESULTS:

Proximity to and density of supermarkets, fast-food, full service restaurants, convenience stores, and bakeries increased over time for residential, workplace, and commuting environments; exposure to grocery stores decreased. The greatest increase in access was for supermarkets, with residential distance to the closest supermarket 1406 m closer (95% CI 1303 m, 1508 m) by 2005-2008 than in 1971-1975. Although poorer census tracts had higher access to fast-food restaurants consistently across follow-up, this disparity dissipated over time, due to larger increases in proximity to fast-food in wealthier neighborhoods.

CONCLUSIONS:

Access to most food establishment types increased over time, with similar trends across home, workplace, and commuter environments.

KEYWORDS:

Fast food; Food environment; Geographic information systems; Prospective cohort study; Supermarkets

 

The effects of amoxicillin and vancomycin on parameters reflecting cholesterol metabolism.

Baumgartner S, Reijnders D, Konings MCJM, Groen AK, Lütjohann D, Goossens GH, Blaak EE, Plat J.

Chem Phys Lipids. 2017 Jun 21. pii: S0009-3084(17)30105-6. doi: 10.1016/j.chemphyslip.2017.06.006. [Epub ahead of print]

PMID: 28647339

Abstract

BACKGROUND:

Changes in the microbiota composition have been implicated in the development of obesity and type 2 diabetes. However, not much is known on the involvement of gut microbiota in lipid and cholesterol metabolism. In addition, the gut microbiota might also be a potential source of plasma oxyphytosterol and oxycholesterol concentrations (oxidation products of plant sterols and cholesterol). Therefore, the aim of this study was to modulate the gut microbiota by antibiotic therapy to investigate effects on parameters reflecting cholesterol metabolism and oxyphytosterol concentrations.

DESIGN:

A randomized, double blind, placebo-controlled trial was performed in which 55 obese, pre-diabetic men received oral amoxicillin (broad-spectrum antibiotic), vancomycin (antibiotic directed against Gram-positive bacteria) or placebo (microcrystalline cellulose) capsules for 7days (1500mg/day). Plasma lipid and lipoprotein, non-cholesterol sterol, bile acid and oxy(phyto)sterol concentrations were determined at baseline and after 1-week intervention.

RESULTS:

Plasma secondary bile acids correlated negatively with cholestanol (marker for cholesterol absorption, r=-0.367; P <0.05) and positively with lathosterol concentrations (marker for cholesterol synthesis, r=0.430; P<0.05). Fasting plasma secondary bile acid concentrations were reduced after vancomycin treatment as compared to placebo treatment (-0.24±0.22μmol/L vs. -0.08±0.29μmol/L; P<0.01). Vancomycin and amoxicillin treatment did not affect markers for cholesterol metabolism, plasma TAG, total cholesterol, LDL-C or HDL-C concentrations as compared to placebo. In addition, both antibiotic treatments did not affect individual isoforms or total plasma oxyphytosterol or oxycholesterol concentrations.

CONCLUSION:

Despite strong correlations between plasma bile acid concentrations and cholesterol metabolism (synthesis and absorption), amoxicillin and vancomycin treatment for 7days did not affect plasma lipid and lipoprotein, plasma non-cholesterol sterol and oxy(phyto)sterol concentrations in obese, pre-diabetic men.

KEYWORDS:

Gut microbiota; antibiotics; bile acids; cholesterol metabolism; oxyphytosterols

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Retrospective cohort study and biobanking of patients treated for hemangioma in childhood - telomeres as biomarker of aging and radiation exposure.

Frenzel M, Ricoul M, Benadjaoud MA, Bellamy M, Lenain A, Haddy N, Diallo I, Mateus C, de Vathaire F, Sabatier L.

Int J Radiat Biol. 2017 Jun 26:1-14. doi: 10.1080/09553002.2017.1337278. [Epub ahead of print]

PMID: 28649877

Abstract

PURPOSE:

Cohorts allowing joint epidemiological and biological analyses are essential for radiation risk assessment. The French Hemangioma Cohort (FHC), studied within the European project EpiRadBio, is one of the rare cohorts suitable for studying the effect of low dose radiation exposure (<100 mGy at organs), with a long-term follow-up. This highly homogeneous cohort consists of healthy individuals belonging to a normal population, except for the presence of skin hemangioma (age at exposure: between 6 months and 3 years of age). Published epidemiological studies have demonstrated that the risk of developing cancer is three times higher in the exposed individuals than in the general population. Here, we present the biobanking of samples (nucleated blood cells, cytogenetic slides of T and B lymphocytes) from the FHC and a primary feasibility study of biomarker analysis focusing on mean telomere length (MTL). Telomeres act as an internal clock, regulating the lifetime of the cell by their shortening during cell division. MTL is thus a biomarker of age. Many in vitro studies have linked MTL and radiosensitivity. The FHC will make it possible to discriminate between the effects of aging and radiation on this biomarker.

CONCLUSION:

The establishment of a biobank of essentially healthy individuals (369 in total), exposed 40-70 years before, during their early childhood, is a logistical challenge. Even among those who previously participated to a self-questionnaire based study, the response rate was only 30%. The first biomarker to be studied was the MTL to discriminate age effects from those of radiation exposure. MTL showed significant variation within age groups (4-11 kb) in both the exposed and non-exposed groups. MTL within the limited age window (i.e. 40-73 year) examined, showed age-dependent changes of 46 bp/year, consistent with the age-dependent decline of 41 bp/year previously reported. We observed no significant changes in MTL according to the average active bone marrow dose. However, we were able to demonstrate that exposure to radiation causes the loss of cells with, on average, shorter telomeres, by applying a model in which both the heterogeneity of the individual dose received at the bone marrow and the heterogeneity of the intercellular distribution of MTL were taken into account.

KEYWORDS:

Molecular epidemiology; cohort study; hemangioma; ionising radiation; low dose effects; telomeres

 

https://en.wikipedia.org/wiki/Aminoglycoside

Systemic Aminoglycosides-Induced Vestibulotoxicity in Humans.

Van Hecke R, Van Rompaey V, Wuyts FL, Leyssens L, Maes L.

Ear Hear. 2017 Jun 23. doi: 10.1097/AUD.0000000000000458. [Epub ahead of print]

PMID: 28650850

Abstract

OBJECTIVES:

This systematic review aimed to investigate the prevalence and characteristics of vestibular adverse effects of aminoglycoside (AG) therapy in humans and to analyze objective vestibular tests for the detection of AG-induced vestibulotoxicity.

DESIGN:

PubMed, Cochrane Database, Web of Science, and reference lists of all included studies were screened by two independent researchers. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Studies were included according to preset inclusion criteria and reported outcomes of studies evaluating vestibular function using one or more objective vestibular function tests in adults and children after systemic AG administration. The methodological quality of each study was assessed using the quality assessment tool for quantitative studies. Interrater reliability was established using Cohen's Kappa.

RESULTS:

Twenty-seven studies were included, with the vast majority showing AG-induced vestibulotoxic side effects, ranging from 0 to 60%. Most studies reported AG-induced abnormalities by caloric and rotatory testing, whereas only a few studies reported using video Head Impulse test and vestibular evoked myogenic potential testing.

CONCLUSIONS:

Because type I hair cells (particularly of the semicircular canals) are more susceptible to ototoxicity, video Head Impulse test and vestibular evoked myogenic potential testing seem more promising for the early detection of vestibulotoxicity than caloric and rotatory testing. Prospective studies using an extensive vestibular test battery are needed to further characterize the impact of AGs on the different vestibular end organs and to identify the most sensitive vestibular technique for the early detection of vestibulotoxicity.

 

Risk of ESRD and Mortality Associated With Change in Filtration Markers.

Rebholz CM, Inker LA, Chen Y, Liang M, Foster MC, Eckfeldt JH, Kimmel PL, Vasan RS, Feldman HI, Sarnak MJ, Hsu CY, Levey AS, Coresh J; Chronic Kidney Disease Biomarkers Consortium.

Am J Kidney Dis. 2017 Jun 22. pii: S0272-6386(17)30733-3. doi: 10.1053/j.ajkd.2017.04.025. [Epub ahead of print]

PMID: 28648303

http://sci-hub.cc/10.1053/j.ajkd.2017.04.025

Abstract

BACKGROUND:

Using change in estimated glomerular filtration rate (eGFR) based on creatinine concentration as a surrogate outcome in clinical trials of chronic kidney disease has been proposed. Risk for end-stage renal disease (ESRD) and all-cause mortality associated with change in concentrations of other filtration markers has not been studied in chronic kidney disease populations.

STUDY DESIGN:

Observational analysis of 2 clinical trials.

SETTING & PARTICIPANTS:

Participants in the MDRD (Modification of Diet in Renal Disease; n=317) Study and AASK (African American Study of Kidney Disease and Hypertension; n=373).

PREDICTORS:

Creatinine, cystatin C, β-trace protein (BTP), and β2-microglobulin (B2M) were measured in serum samples collected at the 12- and 24-month follow-up visits, along with measured GFR (mGFR) at these time points.

OUTCOMES:

ESRD and all-cause mortality.

MEASUREMENTS:

Poisson regression was used to estimate incidence rate ratios and 95% CIs for ESRD and all-cause mortality during long-term follow-up (10-16 years) per 30% decline in mGFR or eGFR for each filtration marker and the average of all 4 markers.

RESULTS:

1-year decline in mGFR, eGFRcr, eGFRBTP, and the average of the 4 filtration markers was significantly associated with increased risk for incident ESRD in both studies (all P≤0.02). Compared to mGFR, only decline in eGFRBTP was statistically significantly more strongly associated with ESRD risk in both studies (both P≤0.03). Decline in eGFRcr, but not mGFR or the other filtration markers, was significantly associated with risk for all-cause mortality in AASK only (incidence rate ratio per 30% decline, 4.17; 95% CI, 1.78-9.74; P<0.001), but this association was not significantly different from decline in mGFR (P=0.2).

LIMITATIONS:

Small sample size.

CONCLUSIONS:

Declines in mGFR, eGFRcr, eGFRBTP, and the average of 4 filtration markers (creatinine, cystatin C, BTP, and B2M) were consistently associated with progression to ESRD.

KEYWORDS:

Beta-2-microglobulin (B2M); beta trace protein (BTP); creatinine; cystatin C; death; end-stage renal disease (ESRD); estimated GFR; filtration markers; glomerular filtration rate (GFR); incident ESRD; kidney function decline; measured GFR; mortality

 

[Aging and homeostasis. Biomedical Peculiarities of Semi-supercentenarians.]

Arai Y.

Clin Calcium. 2017;27(7):969-974. doi: CliCa1707969974. Japanese.

PMID: 28649103

Abstract

Semi-supercentenarians, or people who reach 105 years of age, are regarded as model cases for 'successful ageing'. Semi-supercentenarians maintain capability and cognition for longer than the centenarians who died between 100-104 years of age, together with postponed frailty or age-related diminution of multiple organ reserve. Understanding the biological factors determining extreme longevity and compression of morbidity might help to achieve extended healthy life span for the wider population.

 

Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease.

Guasch-Ferré M, Babio N, Martínez-González MA, Corella D, Ros E, Martín-Peláez S, Estruch R, Arós F, Gómez-Gracia E, Fiol M, Santos-Lozano JM, Serra-Majem L, Bulló M, Toledo E, Barragán R, Fitó M, Gea A, Salas-Salvadó J; PREDIMED Study Investigators.

Am J Clin Nutr. 2015 Dec;102(6):1563-73. doi: 10.3945/ajcn.115.116046. Epub 2015 Nov 11.

PMID: 26561617 Free Article

http://ajcn.nutrition.org/content/102/6/1563.long

http://ajcn.nutrition.org/content/102/6/1563.full.pdf+html

Abstract

BACKGROUND:

Dietary fat quality and fat replacement are more important for cardiovascular disease (CVD) prevention than is total dietary fat intake.

OBJECTIVE:

The aim was to evaluate the association between total fat intake and fat subtypes with the risk of CVD (myocardial infarction, stroke, or death from cardiovascular causes) and cardiovascular and all-cause death. We also examined the hypothetical effect of the isocaloric substitution of one macronutrient for another.

DESIGN:

We prospectively studied 7038 participants at high CVD risk from the PREvención con DIeta MEDiterránea (PREDIMED) study. The trial was conducted from 2003 to 2010, but the present analysis was based on an expanded follow-up until 2012. At baseline and yearly thereafter, total and specific fat subtypes were repeatedly measured by using validated food-frequency questionnaires. Time-dependent Cox proportional hazards models were used.

RESULTS:

After 6 y of follow-up, we documented 336 CVD cases and 414 total deaths. HRs (95% CIs) for CVD for those in the highest quintile of total fat, monounsaturated fatty acid (MUFA), and polyunsaturated fatty acid (PUFA) intake compared with those in the lowest quintile were 0.58 (0.39, 0.86), 0.50 (0.31, 0.81), and 0.68 (0.48, 0.96), respectively. In the comparison between extreme quintiles, higher saturated fatty acid (SFA) and trans-fat intakes were associated with 81% (HR: 1.81; 95% CI: 1.05, 3.13) and 67% (HR: 1.67; 95% CI: 1.09, 2.57) higher risk of CVD. Inverse associations with all-cause death were also observed for PUFA and MUFA intakes. Isocaloric replacements of SFAs with MUFAs and PUFAs or trans fat with MUFAs were associated with a lower risk of CVD. SFAs from pastries and processed foods were associated with a higher risk of CVD.

CONCLUSIONS:

Intakes of MUFAs and PUFAs were associated with a lower risk of CVD and death, whereas SFA and trans-fat intakes were associated with a higher risk of CVD. The replacement of SFAs with MUFAs and PUFAs or of trans fat with MUFAs was inversely associated with CVD. This trial was registered at www.controlled-trials.com as ISRCTN 35739639.

KEYWORDS:

PREDIMED study; all-cause death; cardiovascular disease; dietary fat; fat subtypes; saturated fat

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Serum 25-hydroxyvitamin D and Age-Related Cataract.

Park S, Choi NK.

Ophthalmic Epidemiol. 2017 Jun 28:1-6. doi: 10.1080/09286586.2017.1281427. [Epub ahead of print]

PMID: 28657409

Abstract

PURPOSE:

Cataract and insufficient vitamin D intake are both increasing worldwide concerns, yet little is known about the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and age-related cataract. We performed this study to determine the association between serum 25(OH)D levels and age-related cataract in adults.

METHODS:

Study participants comprised 16,086 adults aged 40 years or older who had never been diagnosed with or undergone surgery for cataract using Korean National Health and Nutrition Examination Survey data from 2008 to 2012. Participants were assessed to have cataract when diagnosed with cortical, nuclear, anterior subcapsular, posterior subcapsular, or mixed cataract. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the magnitude and significance of the association between serum 25(OH)D levels and cataract in multivariable logistic regression models.

RESULTS:

The OR for nuclear cataract with the highest quintile of serum 25(OH)D levels was 0.86 (95% CI 0.75-0.99) compared to the lowest quintile. A linear trend across quintiles was significant. Natural log-transformed serum 25(OH)D levels were also significantly associated with nuclear cataract (OR 0.84, 95% CI 0.75-0.95). The population-attributable fraction of nuclear cataract due to serum 25(OH)D insufficiency (<30 ng/mL) was 8.8% (p = 0.048).

CONCLUSIONS:

Serum 25(OH)D levels were inversely associated with the risk of nuclear cataract. Prospective studies investigating the effects of serum 25(OH)D levels on the development of nuclear cataract are needed to confirm our findings.

KEYWORDS:

25(OH)D; 25-hydroxyvitamin D; cataract; eye; vitamin D

 

 

The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review.

Aridi YS, Walker JL, Wright ORL.

Nutrients. 2017 Jun 28;9(7). pii: E674. doi: 10.3390/nu9070674. Review.

PMID: 28657600

Abstract

The ageing population is accompanied by increased rates of cognitive decline and dementia. Not only does cognitive decline have a profound impact on an individual's health and quality of life, but also on that of their caregivers. The Mediterranean diet (MD) has been known to aid in reducing the risk of cardiovascular diseases, cancer and diabetes. It has been recently linked to better cognitive function in the elderly population. The purpose of this review was to compile evidence based data that examined the effect of adherence to the MD on cognitive function and the risk of developing dementia or Alzheimer's disease. This review followed PRISMA guidelines and was conducted using four databases and resulted in 31 articles of interest. Cross-sectional studies and cohort studies in the non-Mediterranean region showed mixed results. However, cohort studies in the Mediterranean region and randomized controlled trials showed more cohesive outcomes of the beneficial effect of the MD on cognitive function. Although more standardized and in-depth studies are needed to strengthen the existing body of evidence, results from this review indicate that the Mediterranean diet could play a major role in cognitive health and risk of Alzheimer's disease and dementia.

KEYWORDS:

Alzheimer’s disease; Mediterranean; ageing; cognition; cognitive function; dementia; diet; nutrition

 

Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia.

Rolnik DL, Wright D, Poon LC, O'Gorman N, Syngelaki A, de Paco Matallana C, Akolekar R, Cicero S, Janga D, Singh M, Molina FS, Persico N, Jani JC, Plasencia W, Papaioannou G, Tenenbaum-Gavish K, Meiri H, Gizurarson S, Maclagan K, Nicolaides KH.

N Engl J Med. 2017 Jun 28. doi: 10.1056/NEJMoa1704559. [Epub ahead of print]

PMID: 28657417

Abstract

Background Preterm preeclampsia is an important cause of maternal and perinatal death and complications. It is uncertain whether the intake of low-dose aspirin during pregnancy reduces the risk of preterm preeclampsia. Methods In this multicenter, double-blind, placebo-controlled trial, we randomly assigned 1776 women with singleton pregnancies who were at high risk for preterm preeclampsia to receive aspirin, at a dose of 150 mg per day, or placebo from 11 to 14 weeks of gestation until 36 weeks of gestation. The primary outcome was delivery with preeclampsia before 37 weeks of gestation. The analysis was performed according to the intention-to-treat principle. Results A total of 152 women withdrew consent during the trial, and 4 were lost to follow up, which left 798 participants in the aspirin group and 822 in the placebo group. Preterm preeclampsia occurred in 13 participants (1.6%) in the aspirin group, as compared with 35 (4.3%) in the placebo group (odds ratio in the aspirin group, 0.38; 95% confidence interval, 0.20 to 0.74; P=0.004). Results were materially unchanged in a sensitivity analysis that took into account participants who had withdrawn or were lost to follow-up. Adherence was good, with a reported intake of 85% or more of the required number of tablets in 79.9% of the participants. There were no significant between-group differences in the incidence of neonatal adverse outcomes or other adverse events. Conclusions Treatment with low-dose aspirin in women at high risk for preterm preeclampsia resulted in a lower incidence of this diagnosis than placebo.

 

The Diuretic Action of Weak and Strong Alcoholic Beverages in Elderly Men: A Randomized Diet-Controlled Crossover Trial.

Polhuis KCMM, Wijnen AHC, Sierksma A, Calame W, Tieland M.

Nutrients. 2017 Jun 28;9(7). pii: E660. doi: 10.3390/nu9070660.

PMID: 28657601

Abstract

With ageing, there is a greater risk of dehydration. This study investigated the diuretic effect of alcoholic beverages varying in alcohol concentration in elderly men. Three alcoholic beverages (beer (AB), wine (AW), and spirits (S)) and their non-alcoholic counterparts (non-alcoholic beer (NAB), non-alcoholic wine (NAW), and water (W)) were tested in a diet-controlled randomized crossover trial. For the alcoholic beverages, alcohol intake equaled a moderate amount of 30 g. An equal volume of beverage was given for the non-alcoholic counterpart. After consumption, the urine output was collected every hour for 4 h and the total 24 h urine output was measured. AW and S resulted in a higher cumulative urine output compared to NAW and W during the first 4 h (effect size: 0.25 mL p < 0.003, effect size: 0.18 mL, p < 0.001, respectively), but not after the 24h urine collection (p > 0.40, p > 0.10). AB and NAB did not differ at any time point (effect size: -0.02 mL p > 0.70). For urine osmolality, and the sodium and potassium concentration, the findings were in line. In conclusion, only moderate amounts of stronger alcoholic beverages, such as wine and spirits, resulted in a short and small diuretic effect in elderly men.

KEYWORDS:

beer; dehydration; hydration; moderate alcohol consumption; spirits; wine

 

Carbohydrate intake and training efficacy - a randomized cross-over study.

Beaudouin F, Joerg F, Hilpert A, Meyer T, Hecksteden A.

J Sports Sci. 2017 Jun 28:1-7. doi: 10.1080/02640414.2017.1346276. [Epub ahead of print]

PMID: 28657863

Abstract

Carbohydrate (CHO) availability during endurance exercise seems to attenuate exercise-induced perturbations of cellular homeostasis and might consequently diminish the stimulus for training adaptation. Therefore, a negative effect of CHO intake on endurance training efficacy seems plausible. This study aimed to test the influence of carbohydrate intake on the efficacy of an endurance training program on previously untrained healthy adults. A randomized cross-over trial (8-week wash-out period) was conducted in 23 men and women with two 8-week training periods (with vs. without intake of 50g glucose before each training bout). Training intervention consisted of 4x45 min running/walking sessions/week at 70% of heart rate reserve. Exhaustive, ramp-shaped exercise tests with gas exchange measurements were conducted before and after each training period. Outcome measures were maximum oxygen uptake (VO2max) and ventilatory anaerobic threshold (VT). VO2max and VT increased after training regardless of CHO intake (VO2max: Non-CHO 2.6 ± 3.0 ml*min-1*kg-1 p = 0.004; CHO 1.4 ± 2.5 ml*min-1*kg-1 p = 0.049; VT: Non-CHO 4.2 ± 4.2 ml*min-1*kg-1 p < 0.001; CHO 3.0 ± 4.2 ml*min-1*kg-1 p = 0.003). The 95% confidence interval (CI) for the difference between conditions was between +0.1 and +2.1 ml*min-1*kg-1 for VO2max and between -1.2 and +3.1 for VT. It is concluded that carbohydrate intake could potentially impair the efficacy of an endurance training program.

KEYWORDS:

Glucose monohydrate; aerobic exercise; maximum oxygen uptake; physiological adaptation

 

Protein Supplementation to Augment the Effects of High Intensity Resistance Training in Untrained Middle-Aged Males: The Randomized Controlled PUSH Trial.

Wittke A, von Stengel S, Hettchen M, Fröhlich M, Giessing J, Lell M, Scharf M, Bebenek M, Kohl M, Kemmler W.

Biomed Res Int. 2017;2017:3619398. doi: 10.1155/2017/3619398. Epub 2017 Jun 1.

PMID: 28656141

Abstract

High intensity (resistance exercise) training (HIT) defined as a "single set resistance exercise to muscular failure" is an efficient exercise method that allows people with low time budgets to realize an adequate training stimulus. Although there is an ongoing discussion, recent meta-analysis suggests the significant superiority of multiple set (MST) methods for body composition and strength parameters. The aim of this study is to determine whether additional protein supplementation may increase the effect of a HIT-protocol on body composition and strength to an equal MST-level. One hundred and twenty untrained males 30-50 years old were randomly allocated to three groups: (a) HIT, (b) HIT and protein supplementation (HIT&P), and © waiting-control (CG) and (after cross-over) high volume/high-intensity-training (HVHIT). HIT was defined as "single set to failure protocol" while HVHIT consistently applied two equal sets. Protein supplementation provided an overall intake of 1.5-1.7 g/kg/d/body mass. Primary study endpoint was lean body mass (LBM). LBM significantly improved in all exercise groups (p ≤ 0.043); however only HIT&P and HVHIT differ significantly from control (p ≤ 0.002). HIT diverges significantly from HIT&P (p = 0.017) and nonsignificantly from HVHIT (p = 0.059), while no differences were observed for HIT&P versus HVHIT (p = 0.691). In conclusion, moderate to high protein supplementation significantly increases the effects of a HIT-protocol on LBM in middle-aged untrained males.

 

Use of a Single Baseline Versus Multi-Year 24-Hour Urine Collections for Estimation of Long-Term Sodium Intake and Associated Cardiovascular and Renal Risk.

Olde Engberink RHG, van den Hoek TC, van Noordenne ND, van den Born BH, Peters-Sengers H, Vogt L.

Circulation. 2017 Jun 27. pii: CIRCULATIONAHA.117.029028. doi: 10.1161/CIRCULATIONAHA.117.029028. [Epub ahead of print]

PMID: 28655835

http://sci-hub.cc/10.1161/CIRCULATIONAHA.117.029028

Abstract

Background -A decrease in sodium intake has been shown to lower blood pressure, but data from cohort studies on the association with cardiovascular and renal outcomes are inconsistent. In these studies sodium intake was often estimated using a single baseline measurements, which may be inaccurate considering day-to-day changes in sodium intake and sodium excretion. We compared the effects of single versus repetitive follow-up 24-hour urine samples on the relation between sodium intake and long-term cardiorenal outcomes. Methods -We selected adult subjects with an eGFR >60 mL/min, an outpatient 24-hour urine sample between 1998-1999 and at least 1 collection during a 17-year follow-up. Sodium intake was estimated using a single baseline collection and the average of samples that were collected during a 1, 5 and 15-year follow-up. We used Cox-regression analysis and the landmark approach to investigate the relation between sodium intake and cardiovascular (cardiovascular events or mortality) and renal outcome (end-stage renal disease (ESRD): dialysis, transplantation and >60% eGFR decline, or mortality). Results -We included 574 subjects with 9,776 24-hour urine samples. Average age was 47 years and 46% were male. Median follow-up was 16.2 years. Average 24-hour sodium excretion, ranging from 3.8- 3.9 gram (165-170 mmol), was equal among all methods (p=0.88). However, relative to a single baseline measurement, 50% of the subjects had a >0.8 gram sodium (>34 mmol) difference in sodium intake with long-term estimations. As a result, 45%, 49% and 50% of all subjects switched between tertiles of sodium intake when using 1, 5, or 15-year averages, respectively. Consequently, hazard ratios for cardiorenal outcome changed up to 85% when using sodium intake estimations from short-term (1-year) and long-term (5-year) follow-up, instead of baseline estimations. Conclusions -Relative to a single baseline 24-hour sodium measurement, the use of subsequent 24-hour urine samples resulted in different estimations of an individual's sodium intake, while population averages remained similar. This had significant consequences for the association between sodium intake and long-term cardiovascular and renal outcome.

KEYWORDS:

cardiovascular disease; epidemiology; renal disease; salt intake; sodium

 

Effects of Macronutrient Distribution on Weight and Related Cardiometabolic Profile in Healthy Non-Obese Chinese: A 6-month, Randomized Controlled-Feeding Trial.

Wan Y, Wang F, Yuan J, Li J, Jiang D, Zhang J, Huang T, Zheng J, Mann J, Li D.

EBioMedicine. 2017 Jun 20. pii: S2352-3964(17)30252-9. doi: 10.1016/j.ebiom.2017.06.017. [Epub ahead of print]

PMID: 28655596

http://www.ebiomedicine.com/article/S2352-3964(17)30252-9/fulltext

http://www.ebiomedicine.com/article/S2352-3964(17)30252-9/pdf

Abstract

BACKGROUND:

It has been suggested that the increase in carbohydrate at the expense of fat has contributed to the obesity epidemic in North America and some European countries. However, obesity rates in China have increased rapidly in parallel with a transition from the traditional low fat, high carbohydrate diet to a diet relatively high in fat and reduced in carbohydrate. Therefore, the current study aimed to determine whether the traditional Chinese diet was likely to be more effective than a diet with higher fat and lower carbohydrate - which is consumed in most Western societies, at weight control among a non-obese healthy population in China.

METHODS:

The 6-month, two-center, three-arm, randomized, parallel-group, controlled-feeding trial was conducted at People's Liberation Army General Hospital in north China and Zhejiang University in south China. We recruited healthy young adults (aged 18-35years, body mass index <28) who lived in the university campus or the hospital dormitory during the whole study intervention period. They were required to eat only the foods provided, and to avoid excessive or unusual strenuous exercise during the trial. Participants were simultaneously enrolled and randomized using a computer-generated number (stratified by clinic center, age, sex, and body mass index) by data manager to one of the three isocaloric diets (1:1:1): a lower fat, higher carbohydrate diet (fat 20%, carbohydrate 66% energy); a moderate fat, moderate carbohydrate diet (fat 30%, carbohydrate 56% energy); a higher fat, lower carbohydrate diet (fat 40%, carbohydrate 46% energy). Protein provided 14% energy in all diets. We provided all food and beverages throughout the 6-month intervention. Laboratory personnel were masked to treatment allocation. Body weight was the primary outcome and measured each month. Data were primarily analyzed according to an intention-to-treat approach, supplemented with per-protocol analysis. The study was approved by the Ethics Committee at Zhejiang University. Each participant provided written informed consent. The study was registered at Clinicaltrials.gov, number NCT02355795.

FINDINGS:

Between April 30, 2016, and October 30, 2016, 307 participants were randomly assigned to the lower fat diet (n=101), the moderate fat diet (n=105) and the higher fat diet (n=101), and 245 (79.8%) participants completed the study. Reduction in body weight was significantly greater in the lower fat, higher carbohydrate group throughout the intervention (P<0.001 for the interaction between diet group and time) than in the two other groups. Weight change at 6months was -1.6kg (95% CI -1.8 to -1.4) in the lower fat, higher carbohydrate group; -1.1kg (95% CI -1.3 to -0.9) in the moderate fat, moderate carbohydrate group, and -0.9kg (95% CI -1.1 to -0.6) in the higher fat, lower carbohydrate group. Reduction in waist circumference, total cholesterol, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol on the lower fat, higher carbohydrate group were greater than those observed on the other two diet groups.

INTERPRETATION:

A lower fat, relatively higher carbohydrate diet, similar in macronutrient composition to that traditionally eaten in China appears to be less likely to promote excessive weight gain and be associated with a lower cardiometabolic risk profile than a diet more typical of that eaten in Western countries in healthy non-obese Chinese. Findings from studies in European and North American populations suggesting possible benefits of carbohydrate restriction may not apply to people of other ethnicities.

KEYWORDS:

Body weight; Cardiometabolic profile; Diet; High fat; Low carbohydrate; Macronutrient composition

 

[so if most of the food fiber was not soluble and insoluble, then what was it?] [Also, note the comparison with the two diet types for restiction. It seemed to me they, in the Medicterranean country study, stacked the deck for the more Mediterranean type diet in their diet selection.]

Fruit Fiber Consumption Specifically Improves Liver Health Status in Obese Subjects under Energy Restriction.

Cantero I, Abete I, Monreal JI, Martinez JA, Zulet MA.

Nutrients. 2017 Jun 28;9(7). pii: E667. doi: 10.3390/nu9070667.

PMID: 28657604

http://www.mdpi.com/2072-6643/9/7/667/htm

Abstract

The prevalence of non-alcoholic-fatty-liver-disease (NAFLD) is associated with obesity, diabetes, and metabolic syndrome (MS). This study aimed to evaluate the influence of two energy-restricted diets on non-invasive markers and scores of liver damage in obese individuals with features of MS after six months of follow-up and to assess the role of fiber content in metabolic outcomes. Seventy obese individuals from the RESMENA (Reduction of Metabolic Syndrome in Navarra) study were evaluated at baseline and after six months of energy-restricted nutritional intervention (American Heart Association (AHA) and RESMENA dietary groups). Dietary records, anthropometrical data, body composition by dual energy X-ray absorptiometry (DXA), and routine laboratory measurements were analyzed by standardized methods. Regarding liver status, cytokeratin-18 fragments and several non-invasive scores of fatty liver were also assessed. The RESMENA strategy was a good and complementary alternative to AHA for the treatment of obesity-related comorbidities. Participants with higher insoluble fiber consumption (≥7.5 g/day) showed improvements in fatty liver index (FLI), hepatic steatosis index (HIS), and NAFLD liver fat score (NAFLD_LFS), while gamma-glutamyl transferase (GGT) and transaminases evidenced significant improvements as a result of fruit fiber consumption (≥8.8 g/day). Remarkably, a regression model evidenced a relationship between liver status and fiber from fruits. These results support the design of dietary patterns based on the consumption of insoluble fiber and fiber from fruits in the context of energy restriction for the management of obese patients suffering fatty liver disease.

KEYWORDS:

AHA; RESMENA; fatty liver disease; fiber; insoluble fiber; metabolic syndrome; obesity

 

[The below paper is pdf-availed.]

CENTENARIANS AS A 21st CENTURY HEALTHY AGING MODEL: A LEGACY OF HUMANITY AND THE NEED FOR A WORLD-WIDE CONSORTIUM (WWCC100+).

Franceschi C, Passarino G, Mari D, Monti D.

Mech Ageing Dev. 2017 Jun 23. pii: S0047-6374(17)30167-7. doi: 10.1016/j.mad.2017.06.002. [Epub ahead of print] No abstract available.

PMID: 28651996

This issue of Mechanisms of Aging and Development is dedicated to centenarians, i.e. people who have reached the remarkable age of 100 years. 100 is a sort of magic number with three digits, and centenarians have been and are considered “special people” who stimulate general curiosity because they are supposed to harbor the “secret” of life and are a paradigm of the uninterrupted quest for immortality. Sometimes, science starts from such generic/popular intuition and tries to put it into a robust scientific frame. This is what happened with centenarians. Until a few decades ago, they were considered a curiosity, and research data on them were mostly anecdotal. Starting from some seminal papers (Franceschi et al., 2000b; Motta, 1998 ; Motta et al., 2005), research on centenarians and their phenotypic as well as genetic characteristics has slowly developed; at present it has gained the limelight and allowed for a change of paradigm. Varying from the usual search for “risk” factors, the study of centenarians allows to identify protective factors, either genetic or environmental, against all major chronic age-related diseases. Moreover, the study of centenarians has shed light on some basic mechanisms of aging and longevity in humans. In fact, the importance of topics, central to aging and longevity such as immunosenescence (Franceschi et al., 1995), inflammation (Franceschi et al., 2000a), mtDNA genetics (De Benedictis et al., 1999) and gut microbiota (Biagi et al., 2010) (just to mention a few) have largely emerged from studies in humans, and particularly on centenarians, rather than in animal models (Franceschi et al., 2007). Last but not least, the study of centenarians has permitted the consideration of other variables that had been neglected and/or very difficult to study in animal models. Namely, the critical importance of demography (gender, date of birth, different cohorts) (Ostan et al., 2016; Yashin et al., 2000 ; Yashin et al., 1999), population genetics (related to hominid evolution and adaptation to quite different environments) and all the variables related to cultural habits, such as lifestyle and personality which are typical of humans and which are likely to play a major role in aging and longevity (Franceschi and Garagnani, 2016). It is important to stress that most of these non-biological factors, such as nutrition and education, have undergone profound changes since the beginning of the 20th Century.

Within this scenario, we thought it was worth to ask some of the most distinguished scholars on human longevity to write up-to-date mini-reviews on the topics that have emerged from the study of centenarians that they considered most relevant and most informative for all those scientists who, from different angles, are interested in the biology of aging, longevity and age-associated diseases.

The following is a brief summary of the major topics and major questions addressed in this special issue of Mechanisms of Aging and Development:

Centenarians’ demography and gender in the past and in the future

Centenarians are living 20-30 years longer than members of the same birth cohort, and their global number has strongly increased during the 20th century. A detailed analysis of demographic data is illustrated in Robine et al. and underlines how the global number of centenarians increases more and more rapidly over time. In 1990 the global number of centenarians was 96,000 while in 2100 they will reach more than 25 million. Moreover, the rate of increase in male centenarians will be higher than that of females during the period between 2015 and 2100, suggesting that the female current life span values are closer to the potential biological limit. Therefore, the forecasted sex ratio tends to decrease from 3.7 females for every one male centenarian in 2015 to 1.9 females for one male centenarian in 2100.

Although it has been known for a long time that aging has different effects in females and males (with the former living on average longer but in a worse condition), not much was known about the gender-specific factors of longevity. To this regard Montesanto et al. performed a demographic analysis of the geographic distribution of the Female/Male ratio of centenarians in Italy and reconstructed its historical changes. The authors suggested that the centenarian Female/Male ratio is likely to be related to environmental and social factors, which have a different effect on the two genders.

In the Okinawa Centenarian Study a high prevalence and a continuous increase of centenarians in this island emerges, in comparison to other relatively long-lived countries. In 1975 there were less than 30 centenarians while at present (2016) the number was close to 1000. According to the Authors, this phenomenon is due to an improvement of life expectancy advantage by generation, an increase that was most evident in women (in Okinawa 87% of centenarians are females) (Willcox et al.). The demographic aspects are also described in the paper dedicated to longevity in Japan (Arai et al.). In this paper, particular attention was devoted to summarizing the peculiar characteristics and phenotypes of semi-supercentenarians (105+) and supercentenarians (110+), while stressing their heterogeneity. These subjects, and particularly supercentenarians, are characterized by the marked postponement of age-related debilitation and the retention of physical independence for an extraordinarily long period. An important contribution to this topic emerges from the results of the Chinese Longitudinal Healthy Longevity Study presented by Yi et al. The reported data refers to the world’s largest study on centenarians, nonagenarians and octogenarians and describes the demographic and socio-economic characteristics, health phenotype, and genetic characteristics of Han Chinese centenarians. Socio-economic aspects are taken into account to analyse important variables such as schooling and institutionalization, and a clear distinction emerges between centenarians living in rural areas in comparison with those living in urban areas. The gender differences which emerged are particularly interesting. The percentage of female centenarians with no schooling was 88.6 in urban areas and 96.1 in rural areas, in sharp contrast to 48.9–64.0 for their male counterparts. Moreover, about 27.7% of the Chinese male centenarians were professionals, technicians, administrative managers or clerks before the age 60, but the corresponding figure was only 3.9% among Chinese female centenarians. These data clearly point out a lifelong much higher socioeconomic status of male centenarians compared to their female counterparts in China, a situation which has to be taken into account to adequately interpret the phenotypic data such as health and cognitive status.

Centenarians exhibit peculiar energy/metabolic characteristics which contribute to their longevity

The main characteristics of a centenarian phenotype are up-dated in several contributions which are deeply related to the fundamental pathways underpinning aging and longevity (Franceschi et al., 2017; Kennedy et al., 2014 ; Longo et al., 2015).

Garasto et al. reviewed and updated the literature regarding the hypothyroid state that characterizes the centenarians. A slightly lower thyroid function, and thus a lower basal metabolic rate and a reduction in oxidative stress, likely serves as an adaptive mechanism favouring longevity by preventing excessive catabolism in the oldest old. It is known that other endocrine parameters and related pathways [e.g. insulin, growth hormone (GH), Insulin-like Growth Factor-1 (IGF-1)] significantly affect aging and longevity. The review presented by Vitale et al. summarizes the current state of knowledge regarding the endocrine profile of centenarians, focusing on the GH/IGF-I/insulin system. In centenarians, a coherent set of data clearly show that glucose handling and insulin sensitivity are remarkably maintained, while data concerning GH/IGF-I axis are still controversial.

A detailed and up-to-date review on the role of mitochondria in longevity is proposed by Rose et al. The Authors start reviewing the critical importance of these organelles in many fundamental mechanisms concerning production of energy and oxidative stress, apoptosis and Ca++ homeostasis and then focus on recent findings supporting an additional mechanism for control of cellular and tissue function by mitochondria, i.e. the complex mitochondrial-nuclear communication mechanisms and the extracellular release of mitochondrial components that can act as signaling molecules. Counter intuitively, recent evidence suggests that a certain/slight level of mitochondrial impairment seems to be functional to attain longevity in animal models, as it effectively activates a stress response able to modulate a series of rescue mechanisms and to promote survival. Humans may benefit from this response in terms of delayed aging and longevity.

2. Omics approaches to the centenarians’ phenotype

The centenarian phenotype is highly complex and in this issue several papers accepted the challenge of reviewing available data resulting from the use of the new, high-dimensionality, omic technologies (genetics, epigenetics, metabolomics, metagenomics and glicomics) to disentangle such a complexity. All these omics studies, separately considered, allowed the identification of specific signatures that characterize the centenarians. The next step/challenge is to put together all these phenotypic/omics data in order to let a coherent set/combination of omics markers able to better grasp the complex molecular core of longevity emerge.

Systems Biology

This concept is outlined in detail and applied to the inflammaging, including glycomics, one of the most prevalent theories of ageing proposed by Franceschi and colleagues several years ago, and described and updated in the Monti et al. paper.

Genetics

The survival analysis of centenarians’ families, compared to the general population and the analysis of monozigotic and dizogotic twins, have suggested that the longevity phenotype has a genetic component accounting for 25% of the intra population phenotype variance. Such a genetic component has been largely analyzed among centenarians, and this has allowed to identify a number of genes, the variation of which is correlated with the individual chance of healthy ageing. In particular, genes correlated with the maintenance of cellular integrity, inflammation, response to oxidative stress, as well as the storage and the use of nutrients have indicated the most important pathways correlated with longevity, and suggesting interventions to slow ageing. However, the analysis of the genetic component of longevity in humans, which has been based on the comparison of the genetic variability between centenarians and younger controls from the same population, has dramatically highlighted the population specificity of the correlations between genetic variation and longevity. This has created a number of problems in the analysis of genetic data regarding centenarians, because such analyses require a careful selection of the control population, which needs to be sex and geographically matched with the centenarians. These problems grew when, thanks to the technological advances in the sequencing analysis, a huge amount of data on the genetic variability of centenarians have accumulated leading to meta-analysis. This problem is addressed in the paper by Sebastiani et al., where the authors alert on the possibility of false positive findings. The population specificity of the genetics of longevity is due partly to the population specificity of genetic variation but most of all to the interplay between genetic variation and environmental factors, which for humans means a number of social, cultural and behavioral factors. In the paper by Dato et al., the authors discuss the complex intricacy of genetic factors with life style and cultural factors which modulate the individual chance of longevity. A very important aspect of such interaction is the effect on the epigenetic profile which in turn, by modulating the gene expression, has important effects on the ageing phenotype.

Epigenetics

The emerging field of age-related epigenetic changes regarding the phenotype of elderly and centenarians is discussed in the paper by Bacalini et al., where the authors also show the ageing associated epigenetic modifications, consisting mainly in a progressive process of genome demethylation associated with a hypermethylation of gene-specific CpG dinucleotides. To understand how these epigenetic modifications are modulated, the identification of the genes which are affected by age specific modifications will represent an important boost for the research on ageing. Olivieri and co-Authors have focused their review on the potentiality of blood circulating microRNAs (c-miRs) as biomarkers of healthy and unhealthy ageing trajectories, including centenarians or super-centenarians as the extreme limit of human lifespan. Authors have clearly identified one of the most promising c-miRs, i.e. miR-21-5p, whose level is able to distinguish among type 2 diabetes or metabolic syndrome, cardiovascular disease patients, centenarians and healthy controls. On the other hand, specific technical problems related to the measurements of c-miRs in the blood and a final consensus of the scientific community are needed to clarify the potential role of c-miRs in terms of their predictive, and/or diagnostic power as a therapeutic monitoring biomarker.

Metabolomics

Martin et al. address the centenarians’ phenotype from a metabolomics perspective, looking for a possible functional fingerprint of these exceptional individuals. Metabolomics combined with metabolic network analysis was able to unravel how metabolites change with age and to identify a specific metabolomics signature of centenarians, shedding light on how metabolic interactions affect individual aging phenotype and function. Moreover, such comprehensive metabonomic network approach is key to understand the systemic decline and function failure with age.

Metagenomics

An additional aspect, which is correlated to the environmental factors but interplays with the individual genetic and the epigenetic background is the composition of the gut microbiome. In fact, the composition of the gut microbiome is influenced by the individual lifestyle and nutrition, and undergoes important changes in the elderly; such composition, in turn, affects the health of the host. In a co-evolutionary vision of the relationship between gut microbiota and ageing as an adaptive process of the human superorganism, long-living individuals who get to “successfully” age might be the ones whose microbiota manages to continuously re-establish a mutualistic relationship with the host, adapting to the progressive endogenous and environmental changes. In the paper by Biagi et al., the authors provide a state of the art study of the gut microbiota in ageing and longevity, with particular attention to the interaction between the microbiota and individual genetic, environmental, and cultural background.

Centenarians as super-controls for studies on age-related diseases

A major characteristic of centenarians is the fact that they avoided or postponed the onset of major age-related diseases, including dementia, and that some of them maintain a good cognitive status. Recently, Ismail and co-authors have validated data regarding the compression of morbidity and the delay of the onset of major age-related diseases for cancer, cardiovascular disease, diabetes mellitus, hypertension, and osteoporosis, in two large populations of exceptional long-living subjects (Ismail et al., 2016). Moreover, the authors demonstrated that this finding could be generalised to ethnically varied longevity cohorts. Recently, it was reported that centenarians belonging to a large cohort of predominantly male community-dwelling elderly veterans, showed slower incidence rates of chronic diseases, such as stroke, atrial fibrillation, heart failure, chronic obstructive pulmonary disease, malignancy diabetes mellitus than younger subjects (Kheirbek et al., 2017). Thus, centenarians can be assumed as the most informative human model of healthy ageing where the influence of diseases and comorbidities is minimized. This model allows the identification of the fundamental biological mechanisms involved in and responsible for human longevity and healthy ageing. Centenarians lived without major diseases until a very advanced age, when most of the members of the same demographic cohort underwent a major disease or died. In particular, those who still maintain unimpaired cognitive ability, offer the unique possibility to identify protective genetic and non-genetic factors towards severe cognitive decline and dementia and/or to assess whether the classical risk factors for dementia change sign and/or to continue to exert their role even at advanced/extreme age. An updated mini-review of Arosio et al. has been devoted to a critical revision of literature that seeks to ascertain whether dementia is not inevitable in the oldest old, as previously reported for other parameters such as physical activity and immune status. The emerged remarks highlight that often, the cognitive function in centenarians is underestimated because certain critical aspects that influence cognitive function are not taken into account. In conclusion, centenarians may be considered as a kind of super-controls in order to better identify the genetic risk factors for common age-disease as suggested by Giuliani et al. This review describes the relationship between the genetics of aging and age-related diseases with particular attention to the ecological perspective. Authors address the connections between genes that promote longevity and genes associated to age-related diseases, describing trade-off mechanisms and the antagonistic pleiotropy theory. This review also describes and motivates the use of centenarians as “super-controls” for the studies of the major age-related diseases because it allows the maximization of the phenotypic differences and the reduction of heterogeneity in the control group (centenarians are “real” controls as they have never developed or they have postponed the disease) in genetic association studies. Then, evolutionary and ecological considerations are described with the purpose of clarifying the relationship between healthy aging, longevity and age-related diseases. Giuliani and colleagues describe the importance of considering the population genetic variability and the evolutionary dynamics (such as migration, mutation, admixture and natural selection) in shaping the current genomic background of individuals and in association studies. In conclusion, they illustrate recent findings from whole genome sequencing of long-lived individuals.

Take home message of this special issue devoted to centenarians

From a worldwide perspective, the phenotype of centenarians’ appears to be a complex mixture of commonalities and peculiarities. The major commonality is that they largely avoided or postponed chronic age-related diseases, and that they remained physically and cognitively active until age 90 and above. The second commonality refers to the gender difference. Centenarian women outnumber centenarian men in all countries, but the quality of aging is better in centenarian men. The third commonality is the heterogeneity of centenarians’ health status, either physical or cognitive, likely resulting from the space/geography and time/birth cohort, and the consequent adaptation to different socio-economic and cultural/anthropological environments. Indeed, also the centenarians’ phenotype is the result of the interaction between genes and environment, and this lifelong adaptation is the basis of their specific peculiarities. The peculiarity of centenarians is that their overarching environment encompasses by definition more than a century – from the last years of 1800 until today – a period where enormous changes occurred worldwide, including lifestyle, nutrition, vaccination, antibiotics, type of work, house heating, to mention a few. Thus, the centenarians’ phenotype is highly dynamic. In this special issue it is clearly stated that the centenarians belonging to different birth cohorts are different and that the centenarians of the future will be different from those we are studying today. This difference/heterogeneity also suggests that the genes favoring longevity and the epigenetic changes related to longevity are also largely different among centenarians belonging to different populations, e.g. the Japanese, Chinese, Italian and USA centenarians considered in this issue. The same considerations apply to metagenomics, as diet and host genetics have impacted heavily on the composition of the gut microbiota of centenarians.

However, it is clear that we are far from understanding such a huge diversity of centenarians related to their different birth cohorts, ethnicity, and worldwide cultural habits (lifestyle, nutrition, socio-economic status). We are under the impression that we have scratched the surface and that the quest for understanding the reasons why centenarians are centenarians are still largely unknown. These considerations are particularly important regarding a large number of nations, including demographic giants like India, where the study of centenarians are scarce.

Thus, a global effort is urgently needed, and the Editors and all the scientists who authored the papers included in this special issue take this opportunity to launch the idea of a Worldwide Centenarian Consortium (whose acronym could be WWC100+) to adequately address the complexity of extreme longevity. We could all profit from the experience of ongoing initiatives such as the International Centenarian Consortium − dementia (ICC-dementia) to pave the way to a widespread approach to human longevity and healthy aging (Brodaty et al., 2016).

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Hematological parameters and all-cause mortality: a prospective study of older people.

Frąckiewicz J, Włodarek D, Brzozowska A, Wierzbicka E, Słowińska MA, Wądołowska L, Kałuża J.

Aging Clin Exp Res. 2017 Jun 29. doi: 10.1007/s40520-017-0791-y. [Epub ahead of print]

PMID: 28664457

https://link.springer.com/article/10.1007/s40520-017-0791-y/fulltext.html

https://link.springer.com/content/pdf/10.1007%2Fs40520-017-0791-y.pdf

Abstract

BACKGROUND:

The effect of low and high concentration of some hematological parameters in the blood can have a negative impact on health.

AIM:

Therefore, we investigated the associations between hematological parameters and all-cause mortality among older people living in Poland.

METHODS:

The study was carried out among 75-80-year-old participants (n = 403) from Warsaw and Olsztyn regions, Poland. Information on lifestyle factors and food consumption were obtained at baseline (June 1, 1999) using a self-administered questionnaire. Red blood cell, haemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC) were determined. The data on deaths from all-causes were collected from the baseline until October 31, 2006. During an average of 7.4 years of follow-up, we ascertained 154 cases of death from all-causes.

RESULTS:

Compared with men in the lowest tertile of MCV, MCH, and MCHC, the multivariable hazard ratios (HRs) of all-cause mortality in those in the highest tertile were 0.35 (95% CI, 0.17-0.73), 0.32 (95% CI, 0.16-0.67), and 0.44 (95% CI, 0.22-0.88), respectively. In contrast, among women after combining the second and the third tertiles of MCV, MCH, and MCHC, the HRs were 2.01 (95% CI, 1.01-3.99), 1.71 (95% CI, 0.85-3.43), and 1.09 (95% CI, 0.62-1.94), respectively.

DISCUSSION/CONCLUSION:

We observed inverse associations between some hematological parameters and all-cause mortality among men, but not among women. This may be explained by a difference in iron metabolism, iron status, hormone regulations, or the occurrence of some diseases.

KEYWORDS:

Gender; Hematological parameters; Mortality; Older people; Prospective study

 

AGE-RELATED MACULAR DEGENERATION AND THE RISK OF ALL-CAUSE AND CARDIOVASCULAR MORTALITY: A Meta-Analysis of Cohort Studies.

Xin X, Sun Y, Li S, Xu H, Zhang D.

Retina. 2017 Jun 29. doi: 10.1097/IAE.0000000000001741. [Epub ahead of print]

PMID: 28665868

Abstract

PURPOSE:

We evaluated the association between age-related macular degeneration (AMD) and the risk of all-cause and cardiovascular mortality by meta-analyses of data from prospective studies.

METHODS:

A literature search was performed in PubMed, Web of Science, Embase, Cocharne Library, and China National Knowledge Infrastructure for relevant articles published up to December 2016. We estimated hazard ratios with 95% confidence intervals with fixed-effect models and conducted meta-regression to explore the potential sources of heterogeneity. Small-study effect was estimated by Egger's test and funnel plot.

RESULTS:

We identified 13 population-based prospective cohort studies that examined the relationship between AMD and all-cause and cardiovascular mortality. Overall, the hazard ratios (95% confidence intervals) of all-cause mortality and cardiovascular mortality associated with any AMD were 1.15 (1.05-1.27) and 1.05 (95% confidence intervals: 0.87-1.26), respectively. The risk of all-cause mortality and cardiovascular mortality associated with early AMD were 1.08 (1.00-1.18) and 1.05 (0.89-1.24), and the associations with late AMD were 1.23 (1.11-1.36) and 1.28 (1.04-1.57), respectively. No evidence of small-study effect was found.

CONCLUSION:

This meta-analysis indicated that AMD, especially late AMD, was associated with increased risk of all-cause mortality and cardiovascular mortality based on comparisons with people who did not have AMD and who were of similar age and sex.

 

<i>Lactobacillus johnsonii</i> N6.2 Modulates the Host Immune Responses: A Double-Blind, Randomized Trial in Healthy Adults.

Marcial GE, Ford AL, Haller MJ, Gezan SA, Harrison NA, Cai D, Meyer JL, Perry DJ, Atkinson MA, Wasserfall CH, Garrett T, Gonzalez CF, Brusko TM, Dahl WJ, Lorca GL.

Front Immunol. 2017 Jun 12;8:655. doi: 10.3389/fimmu.2017.00655. eCollection 2017.

PMID: 28659913

Abstract

Lactobacillus johnsonii N6.2 mitigates the onset of type 1 diabetes (T1D) in biobreeding diabetes-prone rats, in part, through changes in kynurenine:tryptophan (K:T) ratios. The goal of this pilot study was to determine the safety, tolerance, and general immunological response of L. johnsonii N6.2 in healthy subjects. A double-blind, randomized clinical trial in 42 healthy individuals with no known risk factors for T1D was undertaken to evaluate subject responses to the consumption of L. johnsonii N6.2. Participants received 1 capsule/day containing 108 colony-forming units of L. johnsonii N6.2 or placebo for 8 weeks. Comprehensive metabolic panel (CMP), leukocyte subpopulations by complete blood count (CBC) and flow cytometry, serum cytokines, and relevant metabolites in the indoleamine-2,3-dioxygenase pathway were assessed. L. johnsonii N6.2 survival and intestinal microbiota was analyzed. Daily and weekly questionnaires were assessed for potential effects of probiotic treatment on general wellness. The administration of L. johnsonii N6.2 did not modify the CMP or CBC of participants suggesting general safety. In fact, L. johnsonii N6.2 administration significantly decreased the occurrence of abdominal pain, indigestion, and cephalic syndromes. As predicted, increased serum tryptophan levels increased resulting in a decreased K:T ratio was observed in the L. johnsonii N6.2 group. Interestingly, immunophenotyping assays revealed that monocytes and natural killer cell numbers were increased significantly after washout (12 weeks). Moreover, an increase of circulating effector Th1 cells (CD45RO+CD183+CD196-) and cytotoxic CD8+ T cells subset was observed in the L. johnsonii N6.2 group. Consumption of L. johnsonii N6.2 is well tolerated in adult control subjects, demonstrates systemic impacts on innate and adaptive immune populations, and results in a decreased K:T ratio. These data provide support for the safety and feasibility of using L. johnsonii N6.2 in prevention trials in subjects at risk for T1D.

KEYWORDS:

Lactobacillus johnsonii; T cell; diabetes type I; gastrointestinal symptom; immunological response; indoleamine-2,3-dioxygenase; microbiome; probiotic

 

Associations between quality of life and duration and frequency of physical activity and sedentary behaviour: Baseline findings from the WALK 2.0 randomised controlled trial.

Kolt GS, George ES, Rebar AL, Duncan MJ, Vandelanotte C, Caperchione CM, Maeder AJ, Tague R, Savage TN, Van Itallie A, Mawella NR, Hsu WW, Mummery WK, Rosenkranz RR.

PLoS One. 2017 Jun 29;12(6):e0180072. doi: 10.1371/journal.pone.0180072. eCollection 2017.

PMID: 28662137

Abstract

While physical and mental health benefits of regular physical activity are well known, increasing evidence suggests that limiting sedentary behaviour is also important for health. Evidence shows associations of physical activity and sedentary behaviour with health-related quality of life (HRQoL), however, these findings are based predominantly on duration measures of physical activity and sedentary behaviour (e.g., minutes/week), with less attention on frequency measures (e.g., number of bouts). We examined the association of HRQoL with physical activity and sedentary behaviour, using both continuous duration (average daily minutes) and frequency (average daily bouts≥10 min) measures. Baseline data from the WALK 2.0 trial were analysed. WALK 2.0 is a randomised controlled trial investigating the effects of Web 2.0 applications on engagement, retention, and subsequent physical activity change. Daily physical activity and sedentary behaviour (duration = average minutes, frequency = average number of bouts ≥10 minutes) were measured (ActiGraph GT3X) across one week, and HRQoL was assessed with the 'general health' subscale of the RAND 36-Item Health Survey. Structural equation modelling was used to evaluate associations. Participants (N = 504) were 50.8±13.1 (mean±SD) years old with a BMI of 29.3±6.0. The 465 participants with valid accelerometer data engaged in an average of 24.0±18.3 minutes and 0.64±0.74 bouts of moderate-vigorous physical activity per day, 535.2±83.8 minutes and 17.0±3.4 bouts of sedentary behaviour per day, and reported moderate-high general HRQoL (64.5±20.0). After adjusting for covariates, the duration measures of physical activity (path correlation = 0.294, p<0.05) and sedentary behaviour were related to general HRQoL (path coefficient = -0.217, p<0.05). The frequency measure of physical activity was also significant (path coefficient = -0.226, p<0.05) but the frequency of sedentary behaviour was not significantly associated with general HRQoL. Higher duration levels of physical activity in fewer bouts, and lower duration of sedentary behaviour are associated with better general HRQoL. Further prospective studies are required to investigate these associations in different population groups over time.

 

Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials.

Maghsoumi-Norouzabad L, Mansoori A, Abed R, Shishehbor F.

Nutr Neurosci. 2017 Jun 30:1-10. doi: 10.1080/1028415X.2017.1344371. [Epub ahead of print]

PMID: 28665211

Abstract

The present systematic review with meta-analysis of randomized controlled trials (RCTs) aimed to analyze the effectiveness of omega-3 fatty acids on the frequency, severity, and duration of migraine. This systematic review was performed by searching several databases for controlled clinical trials. Of the 13 trials, five, two, and three RCTs met the eligibility criteria to evaluate the efficacy of omega-3 on the frequency, duration, and severity of migraine attacks, respectively. The Jadad scale was used to evaluate the risk of bias analysis. Overall estimates of the intervention effect were obtained from random-effect meta-analysis. The studies' heterogeneity was evaluated using the chi-squared test (χ2) (Cochran's test (Q test)) and I2 Index. Potential sources of heterogeneity among the trials were investigated by meta-regression analyses. The results showed that omega-3 intake had no effect on frequency (WMD = -0.20; 95%CI -0.67, 0.27; P = 0.401, and I2 = 4.6%; P = 0.380) and severity (SMD = -0.59; 95%CI -1.85, 0.66; P = 0.35, and I2 = 88.8%; P = 0.000) of migraine but had a reduction effect on the duration of migraine attacks (WMD = -3.44; 95%CI -5.70, -1.19; P = 0.003, and I2 = 0.0%; P = 0.926). In conclusion, omega-3 intake leads to a significant reduction of approximately 3.44 hours in the duration of migraine. Further randomized controlled trials of high methodological quality with adequate sample sizes are required to confirm the results of the meta-analyses.

KEYWORDS:

Migraine; docosahexaenoic acid; eicosapentaenoic acid; fish oil; omega-3

 

Calcium Intake and the Risk of Ovarian Cancer: A Meta-Analysis.

Song X, Li Z, Ji X, Zhang D.

Nutrients. 2017 Jun 30;9(7). pii: E679. doi: 10.3390/nu9070679. Review.

PMID: 28665326

http://www.mdpi.com/2072-6643/9/7/679/htm

Abstract

Several epidemiological studies have evaluated the association between calcium intake and the risk of ovarian cancer. However, the results of these studies remain controversial. Thus, we performed a meta-analysis to explore the association between calcium intake and the risk of ovarian cancer. Pubmed, Embase and Web of Science were searched for eligible publications up to April 2017. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random-effects model. Small-study effect was estimated using Egger's test and the funnel plot. Among 15 epidemiological studies involving 493,415 participants and 7453 cases eligible for this meta-analysis, 13 studies were about dietary calcium intake, 4 studies about dairy calcium intake and 7 studies about dietary plus supplemental calcium intake. When comparing the highest with the lowest intake, the pooled RRs of ovarian cancer were 0.80 (95% CI 0.72-0.89) for dietary calcium, 0.80 (95% CI 0.66-0.98) for dairy calcium and 0.90 (95% CI 0.65-1.24) for dietary plus supplemental calcium, respectively. Dietary calcium was significantly associated with a reduced risk of ovarian cancer among cohort studies (RR = 0.86, 95% CI 0.74-0.99) and among case-control studies (RR = 0.75, 95% CI 0.64-0.89). In subgroup analysis by ovarian cancer subtypes, we found a statistically significant association between the dietary calcium (RR = 0.78, 95% CI 0.69-0.88) and the risk of epithelial ovarian cancer (EOC). This meta-analysis indicated that increased calcium intake might be inversely associated with the risk of ovarian cancer; this still needs to be confirmed by larger prospective cohort studies.

KEYWORDS:

calcium; intake; meta-analysis; ovarian cancer

 

Feeding the microbiota: transducer of nutrient signals for the host.

Shanahan F, van Sinderen D, O'Toole PW, Stanton C.

Gut. 2017 Jun 29. pii: gutjnl-2017-313872. doi: 10.1136/gutjnl-2017-313872. [Epub ahead of print] Review.

PMID: 28663354

Abstract

Advances in microbiome science cast light on traditional concepts on nutritional science, and are poised for clinical translation. Epidemiologic observations which linked lifestyle factors to risk of disease are being re-interpreted with mechanistic insight based on improved understanding of the microbiota. Examples include the role of dietary fibre in disease prevention, the deleterious effects of highly restricted diets, and the contribution of the microbiota to over- and undernutrition. While the microbiota transduces nutrient signals for the host, food and habitual diet shape the composition of the gut microbiota at every stage of life. The composition and diversity of food intake determines which microbes will colonise, flourish, persist, or become extinct. Disruption of the developing microbiota in infancy contributes to the risk of immune and metabolic disease in later life, whereas loss of microbes in the elderly due to monotonous diets has been linked with unhealthy ageing and frailty. This should influence modern dietary advice regarding prevention and management of chronic non-communicable inflammatory and metabolic disorders, and will inform the design of infant and future food formula. The microbiota profile is also emerging as a biomarker to predict responsiveness to dietary interventions and promises to make personalised nutrition a reality.

KEYWORDS:

food; microbiome; microbiota; nutrition

 

Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta‐Analysis of Prospective Studies

Yoriko Heianza, Wenjie Ma, JoAnn E. Manson, Kathryn M. Rexrode, Lu Qi

Journal of the American Heart Association. 2017;6:e004947, originally published June 29, 2017

https://doi.org/10.1161/JAHA.116.004947

http://jaha.ahajournals.org/content/6/7/e004947

Abstract

BACKGROUND:

Trimethylamine-N-oxide (TMAO), a metabolite derived from gut microbes and

dietary phosphatidylcholine, is linked to both coronary artery disease

pathogenesis and increased cardiovascular risks. The ability of plasma TMAO

to predict 5-year mortality risk in patients with stable coronary artery

disease has not been reported. This study examined the clinical prognostic

value of TMAO in patients with stable coronary artery disease who met

eligibility criteria for a patient cohort similar to that of the Clinical

Outcomes Utilizing Revascularization and Aggressive Drug Evaluation

(COURAGE) trial.

METHODS AND RESULTS:

We examined the relationship between fasting plasma TMAO and all-cause

mortality over 5-year follow-up in sequential patients with stable coronary

artery disease (n=2235) who underwent elective coronary angiography. We

identified the COURAGE-like patient cohort as patients who had evidence of

significant coronary artery stenosis and who were managed with optimal

medical treatment. Higher plasma TMAO levels were associated with a 4-fold

increased mortality risk. Following adjustments for traditional risk

factors, high-sensitivity C-reactive protein, and estimated glomerular

filtration rate, elevated TMAO levels remained predictive of 5-year

all-cause mortality risk (quartile 4 versus 1, adjusted hazard ratio 1.95,

95% CI 1.33-2.86; P=0.003). TMAO remained predictive of incident mortality

risk following cardiorenal and inflammatory biomarker adjustments to the

model (adjusted hazard ratio 1.71, 95% CI 1.11-2.61; P=0.0138) and provided

significant incremental prognostic value for all-cause mortality (net

reclassification index 42.37%, P<0.001; improvement in area under receiver

operator characteristic curve 70.6-73.76%, P<0.001).

CONCLUSIONS:

Elevated plasma TMAO levels portended higher long-term mortality risk among

patients with stable coronary artery disease managed with optimal medical

treatment.

KEYWORDS:

optimal medical treatment; prognosis; stable coronary artery disease;

trimethylamine N-oxide

 

Gut-Derived Serum Lipopolysaccharide is Associated With Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet.

Pastori D, Carnevale R, Nocella C, Novo M, Santulli M, Cammisotto V, Menichelli D, Pignatelli P, Violi F.

J Am Heart Assoc. 2017 Jun 5;6(6). pii: e005784. doi: 10.1161/JAHA.117.005784.

PMID: 28584074 Free Article

http://jaha.ahajournals.org/content/6/6/e005784.long

Abstract

BACKGROUND:

Gut microbiota is emerging as a novel risk factor for atherothrombosis, but the predictive role of gut-derived lipopolysaccharide (LPS) is unknown. We analyzed (1) the association between LPS and major adverse cardiovascular events (MACE) in atrial fibrillation (AF) and (2) its relationship with adherence to a Mediterranean diet (Med-diet).

METHODS AND RESULTS:

This was a prospective single-center study including 912 AF patients treated with vitamin K antagonists (3716 patient-years). The primary end point was a composite of MACE. Baseline serum LPS, adherence to Med-diet (n=704), and urinary excretion of 11-dehydro-thromboxane B2 (TxB2, n=852) were investigated. Mean age was 73.5 years; 42.9% were women. A total of 187 MACE (5.0% per year) occurred: 54, 59, and 74 in the first, second, and third tertile of LPS, respectively (log-rank test P=0.004). Log-LPS (hazard ratio 1.194, P=0.009), age (hazard ratio 1.083, P<0.001), and previous cerebrovascular (hazard ratio 1.634, P=0.004) and cardiac events (hazard ratio 1.822, P<0.001) were predictors of MACE. In the whole cohort, AF (versus sinus rhythm) (β 0.087, P=0.014) and low-density lipoprotein cholesterol (β 0.069, P=0.049) were associated with circulating LPS. Furthermore, Med-diet score (β -0.137, P<0.001) was predictive of log-LPS, with fruits (β -0.083, P=0.030) and legumes (β -0.120, P=0.002) negatively associated with log-LPS levels. Log-LPS and log-TxB2 were highly correlated (r=0.598, P<0.001). Log-LPS (β 0.574, P<0.001) and Med-diet score (β -0.218, P<0.001) were significantly associated with baseline urinary excretion of TxB2.

CONCLUSIONS:

In this cohort of AF patients, LPS levels were predictive of MACE and negatively affected by high adherence to Med-diet. LPS may contribute to MACE incidence in AF by increasing platelet activation.

KEYWORDS:

Mediterranean diet; atrial fibrillation; cardiovascular events; lipopolysaccharide; thromboxane

 

Associations of Abdominal Obesity and New-Onset Atrial Fibrillation in the General Population.

Baek YS, Yang PS, Kim TH, Uhm JS, Park J, Pak HN, Lee MH, Joung B.

J Am Heart Assoc. 2017 Jun 6;6(6). pii: e004705. doi: 10.1161/JAHA.116.004705.

PMID: 28588091 Free Article

Abstract

BACKGROUND:

Higher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.

METHODS AND RESULTS:

We studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow-up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01-1.45, P=0.043), 14% (95% confidence interval, 1.06-1.23, P<0.001), and 52% (95% confidence interval, 1.30-1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder-adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10-1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new-onset AF, particularly in participants without comorbidities.

CONCLUSIONS:

Abdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

KEYWORDS:

Asians; atrial fibrillation; incidence; nationwide cohort; obesity

 

Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study.

Johnson LSB, Salonen M, Kajantie E, Conen D, Healey JS, Osmond C, Eriksson JG.

J Am Heart Assoc. 2017 Jun 25;6(6). pii: e006036. doi: 10.1161/JAHA.117.006036.

PMID: 28649086 Free Article

http://jaha.ahajournals.org/content/6/6/e006036.long

Abstract

BACKGROUND:

Early life risk factors are associated with cardiometabolic disease, but have not been fully studied in atrial fibrillation (AF). There are discordant results from existing studies of birth weight and AF, and the impact of maternal body size, gestational age, placental size, and birth length is unknown.

METHODS AND RESULTS:

The Helsinki Birth Cohort Study includes 13 345 people born as singletons in Helsinki in the years 1934-1944. Follow-up was through national registries, and ended on December 31, 2013, with 907 incident cases. Cox regression analyses stratified on year of birth were constructed for perinatal variables and incident AF, adjusting for offspring sex, gestational age, and socioeconomic status at birth. There was a significant U-shaped association between birth weight and AF (P for quadratic term=0.01). The lowest risk of AF was found among those with a birth weight of 3.4 kg (3.8 kg for women [85th percentile] and 3.0 kg for men [17th percentile]). High maternal body mass index (≥30 kg/m2) predicted offspring AF; hazard ratio 1.36 (95% CI 1.07-1.74, P=0.01) compared with normal body mass index (<25 kg/m2). Maternal height was associated with early-onset AF (<65.3 years), hazard ratio 1.47 (95% CI 1.24-1.74, P<0.0001), but not with later onset AF. Results were independent of incident coronary artery disease, hypertension, or diabetes mellitus.

CONCLUSIONS:

High maternal body mass index during pregnancy and maternal height are previously undescribed predictors of offspring AF. Efforts to prevent maternal obesity might reduce later AF in offspring. Birth weight has a U-shaped relation to incident AF independent of other perinatal variables.

KEYWORDS:

atrial fibrillation; hypertension; population science; population studies; risk prediction

 

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women.

Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Du J, Yang J, Li S, Li L, Woodward M, Chen Z.

J Am Heart Assoc. 2017 Jun 21;6(6). pii: e006081. doi: 10.1161/JAHA.117.006081.

PMID: 28637778 Free Article

Abstract

BACKGROUND:

Breastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases (CVDs) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West.

METHODS AND RESULTS:

In 2004-2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow-up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD, with adjusted HRs of 0.91 (95% CI, 0.84-0.99) for coronary heart disease and 0.92 (95% CI, 0.85-0.99) for stroke. Women who had breastfed for ≥24 months had an 18% (HR, 0.82; 0.77-0.87) lower risk of coronary heart disease and a 17% (HR, 0.83; 0.79-0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94-0.98) for coronary heart disease and 0.97 (95% CI, 0.96-0.98) for stroke.

CONCLUSIONS:

Among Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

KEYWORDS:

China; breastfeeding; cardiovascular disease; epidemiology; risk factor; women

 

Overweight, Obesity, and Survival After Stroke in the Framingham Heart Study.

Aparicio HJ, Himali JJ, Beiser AS, Davis-Plourde KL, Vasan RS, Kase CS, Wolf PA, Seshadri S.

J Am Heart Assoc. 2017 Jun 24;6(6). pii: e004721. doi: 10.1161/JAHA.116.004721.

PMID: 28647687 Free Article

Abstract

BACKGROUND:

We investigated how body weight affects survival after stroke, leveraging the availability of multiple prestroke body mass index (BMI) measurements and using a nested case-control design in a community-based sample.

METHODS AND RESULTS:

We compared all-cause mortality in participants stratified by prestroke weight. Separate analyses were performed for ischemic stroke and all stroke and for age-, sex-, and BMI category-matched stroke-free controls. Participants were grouped into BMI categories and followed for up to 10 years. Differences in survival were tested for interaction by case status. In sensitivity analysis, to exclude those with prestroke weight loss, we restricted the reference group to participants with 2 consistently normal BMI measurements within 10 years before stroke/matching. There were 782 stroke cases (age 71±9, 51% female participants, 87% ischemic stroke) and 2346 controls (age 72±9, 51% female participants). Overweight participants with ischemic stroke had a lower mortality compared with those with normal weight (hazard ratio


=0.70, 95%CI 0.55-0.90, P=0.005). The association of reduced mortality with BMI ≥25, compared with normal-weight BMI 18.5 to <25, was pronounced among ischemic stroke cases but diminished with inclusion of hemorrhagic strokes (case-control interaction P=0.051 and P=0.130, respectively). Compared with participants with stable normal weight, moderately increased weight was protective after ischemic stroke (overweight HR=0.72, 95%CI 0.53-0.99, P=0.041).

CONCLUSIONS:

Overweight and mildly obese participants had better 10-year survival after ischemic stroke compared with normal-weight participants, even after excluding persons with recent prestroke weight loss. There may be unknown protective factors associated with a moderately increased body weight before stroke.

KEYWORDS:

body mass index; body weight; cerebrovascular disease; epidemiology; mortality; obesity; recurrent event; risk factor; secondary prevention; stroke

 

[it was recommended by my doctor for me to have the levothyroxine 'therapy'.

Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

David J. Stott, M.B., Ch.B., M.D., Nicolas Rodondi, M.D., Patricia M. Kearney, M.D., Ph.D., Ian Ford, Ph.D., Rudi G.J. Westendorp, M.D., Ph.D., Simon P. Mooijaart, M.D., Ph.D., Naveed Sattar, F.Med.Sci., Carole E. Aubert, M.D., Drahomir Aujesky, M.D., Douglas C. Bauer, M.D., Christine Baumgartner, M.D., Manuel R. Blum, M.D., John P. Browne, Ph.D., Stephen Byrne, Ph.D., Tinh-Hai Collet, M.D., Olaf M. Dekkers, M.D., Ph.D., Wendy P.J. den Elzen, Ph.D., Robert S. Du Puy, M.D., Graham Ellis, M.D., Martin Feller, M.D., Carmen Floriani, M.D., Kirsty Hendry, Ph.D., Caroline Hurley, M.P.H., J. Wouter Jukema, M.D., Ph.D., Sharon Kean, Maria Kelly, M.Pharm., Danielle Krebs, Ph.D., Peter Langhorne, M.D., Ph.D., Gemma McCarthy, M.P.H., Vera McCarthy, Ph.D., Alex McConnachie, Ph.D., Mairi McDade, B.Sc., R.G.N., Martina Messow, Ph.D., Annemarie O’Flynn, Ph.D., David O’Riordan, M.Pharm., Rosalinde K.E. Poortvliet, M.D., Ph.D., Terence J Quinn, M.D., Ph.D., Audrey Russell, M.M.Sc., Carol Sinnott, Ph.D., Jan W.A. Smit, M.D., Ph.D., H. Anette Van Dorland, Ph.D., Kieran A. Walsh, M.Pharm., Elaine K. Walsh, M.B., B.Ch., B.A.O., Torquil Watt, M.D., Robbie Wilson, M.Sc., and Jacobijn Gussekloo, M.D., Ph.D., for the TRUST Study Group*

N Engl J Med 2017; 376:2534-2544June 29, 2017DOI: 10.1056/NEJMoa1603825

BACKGROUND

The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition.

METHODS

We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment. The two primary outcomes were the change in the Hypothyroid Symptoms score and Tiredness score on a thyroid-related quality-of-life questionnaire at 1 year (range of each scale is 0 to 100, with higher scores indicating more symptoms or tiredness, respectively; minimum clinically important difference, 9 points).

RESULTS

The mean age of the patients was 74.4 years, and 396 patients (53.7%) were women. The mean (±SD) thyrotropin level was 6.40±2.01 mIU per liter at baseline; at 1 year, this level had decreased to 5.48 mIU per liter in the placebo group, as compared with 3.63 mIU per liter in the levothyroxine group (P<0.001), at a median dose of 50 μg. We found no differences in the mean change at 1 year in the Hypothyroid Symptoms score (0.2±15.3 in the placebo group and 0.2±14.4 in the levothyroxine group; between-group difference, 0.0; 95% confidence interval [CI], −2.0 to 2.1) or the Tiredness score (3.2±17.7 and 3.8±18.4, respectively; between-group difference, 0.4; 95% CI, −2.1 to 2.9). No beneficial effects of levothyroxine were seen on secondary-outcome measures. There was no significant excess of serious adverse events prespecified as being of special interest.

CONCLUSIONS

Levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism.

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CLINICAL PRACTICE

Subclinical Hypothyroidism

Robin P. Peeters, M.D., Ph.D.

N Engl J Med 2017; 376:2556-2565June 29, 2017DOI: 10.1056/NEJMcp1611144

http://sci-hub.cc/10.1056/NEJMcp1611144

The management of subclinical hypothyroidism (an elevated thyrotropin level with a normal free thyroxine level) should be guided by the degree of elevation of thyrotropin, the presence of symptoms, and other patient factors.

 

[interesting where all the bad air is.]

Air pollution limits in U.S. inadequate to prevent deaths

No 'safe level' of air pollution, according to study of more than 60 million health records

Thomson Reuters Posted: Jun 29, 2017

http://www.cbc.ca/news/health/air-pollution-us-premature-deaths-1.4183412

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Air Pollution and Mortality in the Medicare Population

Qian Di, M.S., Yan Wang, M.S., Antonella Zanobetti, Ph.D., Yun Wang, Ph.D., Petros Koutrakis, Ph.D., Christine Choirat, Ph.D., Francesca Dominici, Ph.D., and Joel D. Schwartz, Ph.D.

N Engl J Med 2017; 376:2513-2522 June 29, 2017 DOI: 10.1056/NEJMoa1702747

http://sci-hub.cc/10.1056/NEJMoa1702747

BACKGROUND

Studies have shown that long-term exposure to air pollution increases mortality. However, evidence is limited for air-pollution levels below the most recent National Ambient Air Quality Standards. Previous studies involved predominantly urban populations and did not have the statistical power to estimate the health effects in underrepresented groups.

METHODS

We constructed an open cohort of all Medicare beneficiaries (60,925,443 persons) in the continental United States from the years 2000 through 2012, with 460,310,521 person-years of follow-up. Annual averages of fine particulate matter (particles with a mass median aerodynamic diameter of less than 2.5 μm [PM2.5]) and ozone were estimated according to the ZIP Code of residence for each enrollee with the use of previously validated prediction models. We estimated the risk of death associated with exposure to increases of 10 μg per cubic meter for PM2.5 and 10 parts per billion (ppb) for ozone using a two-pollutant Cox proportional-hazards model that controlled for demographic characteristics, Medicaid eligibility, and area-level covariates.

RESULTS

Increases of 10 μg per cubic meter in PM2.5 and of 10 ppb in ozone were associated with increases in all-cause mortality of 7.3% (95% confidence interval [CI], 7.1 to 7.5) and 1.1% (95% CI, 1.0 to 1.2), respectively. When the analysis was restricted to person-years with exposure to PM2.5 of less than 12 μg per cubic meter and ozone of less than 50 ppb, the same increases in PM2.5 and ozone were associated with increases in the risk of death of 13.6% (95% CI, 13.1 to 14.1) and 1.0% (95% CI, 0.9 to 1.1), respectively. For PM2.5, the risk of death among men, blacks, and people with Medicaid eligibility was higher than that in the rest of the population.

CONCLUSIONS

In the entire Medicare population, there was significant evidence of adverse effects related to exposure to PM2.5 and ozone at concentrations below current national standards. This effect was most pronounced among self-identified racial minorities and people with low income.

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EDITORIALS

Air Pollution Still Kills

R.E. Berger, R. Ramaswami, C.G. Solomon, and J.M. Drazen

N Engl J Med 2017; 376:2591-2592June 29, 2017DOI: 10.1056/NEJMe1706865

This article has no abstract; the first 100 words appear below.

http://sci-hub.cc/10.1056/NEJMe1706865

In late October 1948, a dense smog descended over the town of Donora, Pennsylvania. The town was home to a zinc plant and a steel mill, both run by the United States Steel Corporation. Susan Gnora, a 62-year-old resident of Donora, started to gasp and cough as the smog descended.1 She died the next day. Dr. William Rongaus, a physician and a member of the board of health, went door to door, treating patients for their respiratory symptoms and encouraging them to leave town if they could. Many thousands were ill, and at least 20 people died in one of . . .

 

Perspective

Recognizing Sepsis as a Global Health Priority — A WHO Resolution

Konrad Reinhart, M.D., Ron Daniels, M.D., Niranjan Kissoon, M.D., Flavia R. Machado, M.D., Ph.D., Raymond D. Schachter, L.L.B., and Simon Finfer, M.D.

June 28, 2017DOI: 10.1056/NEJMp1707170

http://www.nejm.org/doi/full/10.1056/NEJMp1707170?query=TOC

 

The Scientist » News & Opinion » Daily News

Evidence for Human Lifespan Limit Contested

Five groups of scientists criticize a widely publicized Nature paper from 2016 suggesting that humans can only live up to 115 years.

By Diana Kwon | June 28, 2017

http://www.the-scientist.com/?articles.view/articleNo/49758/title/Evidence-for-Human-Lifespan-Limit-Contested/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=53720401&_hsenc=p2ANqtz-8FJczQ22fDLcuU1M6oVFZ3KWV_yGrV90SWdmldPPjab2dyG0Hof7-KZS-n1FrOGe2ujist6MX4YpC9jQVZVNOuy8fg-Q&_hsmi=53720401

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No limit to how long people can live: study

Canadian researchers say maximum lifespan could continue to climb 'far into the foreseeable future'

By Sherry Noik, CBC News Posted: Jun 28, 2017

http://www.cbc.ca/news/health/no-limit-on-lifespan-1.4181742

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Many possible maximum lifespan trajectories.

Hughes BG, Hekimi S.

Nature. 2017 Jun 28;546(7660):E8-E9. doi: 10.1038/nature22786. No abstract available.

PMID: 28658230

http://sci-hub.cc/10.1038/nature22786

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ARISING FROM:

Evidence for a limit to human lifespan.

Dong X, Milholland B, Vijg J.

Nature. 2016 Oct 13;538(7624):257-259. doi: 10.1038/nature19793. Epub 2016 Oct 5.

PMID: 27706136

http://sci-hub.cc/10.1038/nature19793

Abstract

Driven by technological progress, human life expectancy has increased greatly since the nineteenth century. Demographic evidence has revealed an ongoing reduction in old-age mortality and a rise of the maximum age at death, which may gradually extend human longevity. Together with observations that lifespan in various animal species is flexible and can be increased by genetic or pharmaceutical intervention, these results have led to suggestions that longevity may not be subject to strict, species-specific genetic constraints. Here, by analysing global demographic data, we show that improvements in survival with age tend to decline after age 100, and that the age at death of the world's oldest person has not increased since the 1990s. Our results strongly suggest that the maximum lifespan of humans is fixed and subject to natural constraints.

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The recent Letter by Dong et al.1 analysed demographic trends to claim that there is a biological limit to maximum human lifespan (approximately 115 years). Although this claim is not novel—Antero-Jacquemin et al. also identified a biological ‘barrier’…

Subject terms: Ageing Geriatrics

Contesting the evidence for limited human lifespan.

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Brown NJL, Albers CJ, Ritchie SJ.

Nature. 2017 Jun 28;546(7660):E6-E7. doi: 10.1038/nature22784. No abstract available.

PMID: 28658214

http://sci-hub.cc/10.1038/nature22784

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Is there evidence for a limit to human lifespan?

Rozing MP, Kirkwood TBL, Westendorp RGJ.

Nature. 2017 Jun 28;546(7660):E11-E12. doi: 10.1038/nature22788. No abstract available.

PMID: 28658235

http://sci-hub.cc/10.1038/nature22788

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Questionable evidence for a limit to human lifespan.

Lenart A, Vaupel JW.

Nature. 2017 Jun 28;546(7660):E13-E14. doi: 10.1038/nature22790. No abstract available.

PMID: 28658239

http://sci-hub.cc/10.1038/nature22790

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Maximum human lifespan may increase to 125 years.

de Beer J, Bardoutsos A, Janssen F.

Nature. 2017 Jun 28;546(7660):E16-E17. doi: 10.1038/nature22792. No abstract available.

PMID: 28658213

http://sci-hub.cc/10.1038/nature22792

>>>>>>>>>>>>>>>>>>>>>

Evidence for a limit to human lifespan.

Dong X, Milholland B, Vijg J.

Nature. 2016 Oct 13;538(7624):257-259. doi: 10.1038/nature19793. Epub 2016 Oct 5.

PMID: 27706136

http://sci-hub.cc/10.1038/nature19793

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Hematological parameters and all-cause mortality: a prospective study of older people.

Frąckiewicz J, Włodarek D, Brzozowska A, Wierzbicka E, Słowińska MA, Wądołowska L, Kałuża J.

Aging Clin Exp Res. 2017 Jun 29. doi: 10.1007/s40520-017-0791-y. [Epub ahead of print]

PMID: 28664457

https://link.springer.com/article/10.1007/s40520-017-0791-y/fulltext.html

https://link.springer.com/content/pdf/10.1007%2Fs40520-017-0791-y.pdf

Abstract

BACKGROUND:

The effect of low and high concentration of some hematological parameters in the blood can have a negative impact on health.

AIM:

Therefore, we investigated the associations between hematological parameters and all-cause mortality among older people living in Poland.

METHODS:

The study was carried out among 75-80-year-old participants (n = 403) from Warsaw and Olsztyn regions, Poland. Information on lifestyle factors and food consumption were obtained at baseline (June 1, 1999) using a self-administered questionnaire. Red blood cell, haemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), and mean corpuscular haemoglobin concentration (MCHC) were determined. The data on deaths from all-causes were collected from the baseline until October 31, 2006. During an average of 7.4 years of follow-up, we ascertained 154 cases of death from all-causes.

RESULTS:

Compared with men in the lowest tertile of MCV, MCH, and MCHC, the multivariable hazard ratios (HRs) of all-cause mortality in those in the highest tertile were 0.35 (95% CI, 0.17-0.73), 0.32 (95% CI, 0.16-0.67), and 0.44 (95% CI, 0.22-0.88), respectively. In contrast, among women after combining the second and the third tertiles of MCV, MCH, and MCHC, the HRs were 2.01 (95% CI, 1.01-3.99), 1.71 (95% CI, 0.85-3.43), and 1.09 (95% CI, 0.62-1.94), respectively.

DISCUSSION/CONCLUSION:

We observed inverse associations between some hematological parameters and all-cause mortality among men, but not among women. This may be explained by a difference in iron metabolism, iron status, hormone regulations, or the occurrence of some diseases.

KEYWORDS:

Gender; Hematological parameters; Mortality; Older people; Prospective study

 

AGE-RELATED MACULAR DEGENERATION AND THE RISK OF ALL-CAUSE AND CARDIOVASCULAR MORTALITY: A Meta-Analysis of Cohort Studies.

Xin X, Sun Y, Li S, Xu H, Zhang D.

Retina. 2017 Jun 29. doi: 10.1097/IAE.0000000000001741. [Epub ahead of print]

PMID: 28665868

Abstract

PURPOSE:

We evaluated the association between age-related macular degeneration (AMD) and the risk of all-cause and cardiovascular mortality by meta-analyses of data from prospective studies.

METHODS:

A literature search was performed in PubMed, Web of Science, Embase, Cocharne Library, and China National Knowledge Infrastructure for relevant articles published up to December 2016. We estimated hazard ratios with 95% confidence intervals with fixed-effect models and conducted meta-regression to explore the potential sources of heterogeneity. Small-study effect was estimated by Egger's test and funnel plot.

RESULTS:

We identified 13 population-based prospective cohort studies that examined the relationship between AMD and all-cause and cardiovascular mortality. Overall, the hazard ratios (95% confidence intervals) of all-cause mortality and cardiovascular mortality associated with any AMD were 1.15 (1.05-1.27) and 1.05 (95% confidence intervals: 0.87-1.26), respectively. The risk of all-cause mortality and cardiovascular mortality associated with early AMD were 1.08 (1.00-1.18) and 1.05 (0.89-1.24), and the associations with late AMD were 1.23 (1.11-1.36) and 1.28 (1.04-1.57), respectively. No evidence of small-study effect was found.

CONCLUSION:

This meta-analysis indicated that AMD, especially late AMD, was associated with increased risk of all-cause mortality and cardiovascular mortality based on comparisons with people who did not have AMD and who were of similar age and sex.

 

<i>Lactobacillus johnsonii</i> N6.2 Modulates the Host Immune Responses: A Double-Blind, Randomized Trial in Healthy Adults.

Marcial GE, Ford AL, Haller MJ, Gezan SA, Harrison NA, Cai D, Meyer JL, Perry DJ, Atkinson MA, Wasserfall CH, Garrett T, Gonzalez CF, Brusko TM, Dahl WJ, Lorca GL.

Front Immunol. 2017 Jun 12;8:655. doi: 10.3389/fimmu.2017.00655. eCollection 2017.

PMID: 28659913

Abstract

Lactobacillus johnsonii N6.2 mitigates the onset of type 1 diabetes (T1D) in biobreeding diabetes-prone rats, in part, through changes in kynurenine:tryptophan (K:T) ratios. The goal of this pilot study was to determine the safety, tolerance, and general immunological response of L. johnsonii N6.2 in healthy subjects. A double-blind, randomized clinical trial in 42 healthy individuals with no known risk factors for T1D was undertaken to evaluate subject responses to the consumption of L. johnsonii N6.2. Participants received 1 capsule/day containing 108 colony-forming units of L. johnsonii N6.2 or placebo for 8 weeks. Comprehensive metabolic panel (CMP), leukocyte subpopulations by complete blood count (CBC) and flow cytometry, serum cytokines, and relevant metabolites in the indoleamine-2,3-dioxygenase pathway were assessed. L. johnsonii N6.2 survival and intestinal microbiota was analyzed. Daily and weekly questionnaires were assessed for potential effects of probiotic treatment on general wellness. The administration of L. johnsonii N6.2 did not modify the CMP or CBC of participants suggesting general safety. In fact, L. johnsonii N6.2 administration significantly decreased the occurrence of abdominal pain, indigestion, and cephalic syndromes. As predicted, increased serum tryptophan levels increased resulting in a decreased K:T ratio was observed in the L. johnsonii N6.2 group. Interestingly, immunophenotyping assays revealed that monocytes and natural killer cell numbers were increased significantly after washout (12 weeks). Moreover, an increase of circulating effector Th1 cells (CD45RO+CD183+CD196-) and cytotoxic CD8+ T cells subset was observed in the L. johnsonii N6.2 group. Consumption of L. johnsonii N6.2 is well tolerated in adult control subjects, demonstrates systemic impacts on innate and adaptive immune populations, and results in a decreased K:T ratio. These data provide support for the safety and feasibility of using L. johnsonii N6.2 in prevention trials in subjects at risk for T1D.

KEYWORDS:

Lactobacillus johnsonii; T cell; diabetes type I; gastrointestinal symptom; immunological response; indoleamine-2,3-dioxygenase; microbiome; probiotic

 

Associations between quality of life and duration and frequency of physical activity and sedentary behaviour: Baseline findings from the WALK 2.0 randomised controlled trial.

Kolt GS, George ES, Rebar AL, Duncan MJ, Vandelanotte C, Caperchione CM, Maeder AJ, Tague R, Savage TN, Van Itallie A, Mawella NR, Hsu WW, Mummery WK, Rosenkranz RR.

PLoS One. 2017 Jun 29;12(6):e0180072. doi: 10.1371/journal.pone.0180072. eCollection 2017.

PMID: 28662137

Abstract

While physical and mental health benefits of regular physical activity are well known, increasing evidence suggests that limiting sedentary behaviour is also important for health. Evidence shows associations of physical activity and sedentary behaviour with health-related quality of life (HRQoL), however, these findings are based predominantly on duration measures of physical activity and sedentary behaviour (e.g., minutes/week), with less attention on frequency measures (e.g., number of bouts). We examined the association of HRQoL with physical activity and sedentary behaviour, using both continuous duration (average daily minutes) and frequency (average daily bouts≥10 min) measures. Baseline data from the WALK 2.0 trial were analysed. WALK 2.0 is a randomised controlled trial investigating the effects of Web 2.0 applications on engagement, retention, and subsequent physical activity change. Daily physical activity and sedentary behaviour (duration = average minutes, frequency = average number of bouts ≥10 minutes) were measured (ActiGraph GT3X) across one week, and HRQoL was assessed with the 'general health' subscale of the RAND 36-Item Health Survey. Structural equation modelling was used to evaluate associations. Participants (N = 504) were 50.8±13.1 (mean±SD) years old with a BMI of 29.3±6.0. The 465 participants with valid accelerometer data engaged in an average of 24.0±18.3 minutes and 0.64±0.74 bouts of moderate-vigorous physical activity per day, 535.2±83.8 minutes and 17.0±3.4 bouts of sedentary behaviour per day, and reported moderate-high general HRQoL (64.5±20.0). After adjusting for covariates, the duration measures of physical activity (path correlation = 0.294, p<0.05) and sedentary behaviour were related to general HRQoL (path coefficient = -0.217, p<0.05). The frequency measure of physical activity was also significant (path coefficient = -0.226, p<0.05) but the frequency of sedentary behaviour was not significantly associated with general HRQoL. Higher duration levels of physical activity in fewer bouts, and lower duration of sedentary behaviour are associated with better general HRQoL. Further prospective studies are required to investigate these associations in different population groups over time.

 

Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials.

Maghsoumi-Norouzabad L, Mansoori A, Abed R, Shishehbor F.

Nutr Neurosci. 2017 Jun 30:1-10. doi: 10.1080/1028415X.2017.1344371. [Epub ahead of print]

PMID: 28665211

Abstract

The present systematic review with meta-analysis of randomized controlled trials (RCTs) aimed to analyze the effectiveness of omega-3 fatty acids on the frequency, severity, and duration of migraine. This systematic review was performed by searching several databases for controlled clinical trials. Of the 13 trials, five, two, and three RCTs met the eligibility criteria to evaluate the efficacy of omega-3 on the frequency, duration, and severity of migraine attacks, respectively. The Jadad scale was used to evaluate the risk of bias analysis. Overall estimates of the intervention effect were obtained from random-effect meta-analysis. The studies' heterogeneity was evaluated using the chi-squared test (χ2) (Cochran's test (Q test)) and I2 Index. Potential sources of heterogeneity among the trials were investigated by meta-regression analyses. The results showed that omega-3 intake had no effect on frequency (WMD = -0.20; 95%CI -0.67, 0.27; P = 0.401, and I2 = 4.6%; P = 0.380) and severity (SMD = -0.59; 95%CI -1.85, 0.66; P = 0.35, and I2 = 88.8%; P = 0.000) of migraine but had a reduction effect on the duration of migraine attacks (WMD = -3.44; 95%CI -5.70, -1.19; P = 0.003, and I2 = 0.0%; P = 0.926). In conclusion, omega-3 intake leads to a significant reduction of approximately 3.44 hours in the duration of migraine. Further randomized controlled trials of high methodological quality with adequate sample sizes are required to confirm the results of the meta-analyses.

KEYWORDS:

Migraine; docosahexaenoic acid; eicosapentaenoic acid; fish oil; omega-3

 

Calcium Intake and the Risk of Ovarian Cancer: A Meta-Analysis.

Song X, Li Z, Ji X, Zhang D.

Nutrients. 2017 Jun 30;9(7). pii: E679. doi: 10.3390/nu9070679. Review.

PMID: 28665326

http://www.mdpi.com/2072-6643/9/7/679/htm

Abstract

Several epidemiological studies have evaluated the association between calcium intake and the risk of ovarian cancer. However, the results of these studies remain controversial. Thus, we performed a meta-analysis to explore the association between calcium intake and the risk of ovarian cancer. Pubmed, Embase and Web of Science were searched for eligible publications up to April 2017. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random-effects model. Small-study effect was estimated using Egger's test and the funnel plot. Among 15 epidemiological studies involving 493,415 participants and 7453 cases eligible for this meta-analysis, 13 studies were about dietary calcium intake, 4 studies about dairy calcium intake and 7 studies about dietary plus supplemental calcium intake. When comparing the highest with the lowest intake, the pooled RRs of ovarian cancer were 0.80 (95% CI 0.72-0.89) for dietary calcium, 0.80 (95% CI 0.66-0.98) for dairy calcium and 0.90 (95% CI 0.65-1.24) for dietary plus supplemental calcium, respectively. Dietary calcium was significantly associated with a reduced risk of ovarian cancer among cohort studies (RR = 0.86, 95% CI 0.74-0.99) and among case-control studies (RR = 0.75, 95% CI 0.64-0.89). In subgroup analysis by ovarian cancer subtypes, we found a statistically significant association between the dietary calcium (RR = 0.78, 95% CI 0.69-0.88) and the risk of epithelial ovarian cancer (EOC). This meta-analysis indicated that increased calcium intake might be inversely associated with the risk of ovarian cancer; this still needs to be confirmed by larger prospective cohort studies.

KEYWORDS:

calcium; intake; meta-analysis; ovarian cancer

 

Feeding the microbiota: transducer of nutrient signals for the host.

Shanahan F, van Sinderen D, O'Toole PW, Stanton C.

Gut. 2017 Jun 29. pii: gutjnl-2017-313872. doi: 10.1136/gutjnl-2017-313872. [Epub ahead of print] Review.

PMID: 28663354

Abstract

Advances in microbiome science cast light on traditional concepts on nutritional science, and are poised for clinical translation. Epidemiologic observations which linked lifestyle factors to risk of disease are being re-interpreted with mechanistic insight based on improved understanding of the microbiota. Examples include the role of dietary fibre in disease prevention, the deleterious effects of highly restricted diets, and the contribution of the microbiota to over- and undernutrition. While the microbiota transduces nutrient signals for the host, food and habitual diet shape the composition of the gut microbiota at every stage of life. The composition and diversity of food intake determines which microbes will colonise, flourish, persist, or become extinct. Disruption of the developing microbiota in infancy contributes to the risk of immune and metabolic disease in later life, whereas loss of microbes in the elderly due to monotonous diets has been linked with unhealthy ageing and frailty. This should influence modern dietary advice regarding prevention and management of chronic non-communicable inflammatory and metabolic disorders, and will inform the design of infant and future food formula. The microbiota profile is also emerging as a biomarker to predict responsiveness to dietary interventions and promises to make personalised nutrition a reality.

KEYWORDS:

food; microbiome; microbiota; nutrition

 

Gut Microbiota Metabolites and Risk of Major Adverse Cardiovascular Disease Events and Death: A Systematic Review and Meta‐Analysis of Prospective Studies

Yoriko Heianza, Wenjie Ma, JoAnn E. Manson, Kathryn M. Rexrode, Lu Qi

Journal of the American Heart Association. 2017;6:e004947, originally published June 29, 2017

https://doi.org/10.1161/JAHA.116.004947

http://jaha.ahajournals.org/content/6/7/e004947

Abstract

BACKGROUND:

Trimethylamine-N-oxide (TMAO), a metabolite derived from gut microbes and

dietary phosphatidylcholine, is linked to both coronary artery disease

pathogenesis and increased cardiovascular risks. The ability of plasma TMAO

to predict 5-year mortality risk in patients with stable coronary artery

disease has not been reported. This study examined the clinical prognostic

value of TMAO in patients with stable coronary artery disease who met

eligibility criteria for a patient cohort similar to that of the Clinical

Outcomes Utilizing Revascularization and Aggressive Drug Evaluation

(COURAGE) trial.

METHODS AND RESULTS:

We examined the relationship between fasting plasma TMAO and all-cause

mortality over 5-year follow-up in sequential patients with stable coronary

artery disease (n=2235) who underwent elective coronary angiography. We

identified the COURAGE-like patient cohort as patients who had evidence of

significant coronary artery stenosis and who were managed with optimal

medical treatment. Higher plasma TMAO levels were associated with a 4-fold

increased mortality risk. Following adjustments for traditional risk

factors, high-sensitivity C-reactive protein, and estimated glomerular

filtration rate, elevated TMAO levels remained predictive of 5-year

all-cause mortality risk (quartile 4 versus 1, adjusted hazard ratio 1.95,

95% CI 1.33-2.86; P=0.003). TMAO remained predictive of incident mortality

risk following cardiorenal and inflammatory biomarker adjustments to the

model (adjusted hazard ratio 1.71, 95% CI 1.11-2.61; P=0.0138) and provided

significant incremental prognostic value for all-cause mortality (net

reclassification index 42.37%, P<0.001; improvement in area under receiver

operator characteristic curve 70.6-73.76%, P<0.001).

CONCLUSIONS:

Elevated plasma TMAO levels portended higher long-term mortality risk among

patients with stable coronary artery disease managed with optimal medical

treatment.

KEYWORDS:

optimal medical treatment; prognosis; stable coronary artery disease;

trimethylamine N-oxide

 

Gut-Derived Serum Lipopolysaccharide is Associated With Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet.

Pastori D, Carnevale R, Nocella C, Novo M, Santulli M, Cammisotto V, Menichelli D, Pignatelli P, Violi F.

J Am Heart Assoc. 2017 Jun 5;6(6). pii: e005784. doi: 10.1161/JAHA.117.005784.

PMID: 28584074 Free Article

http://jaha.ahajournals.org/content/6/6/e005784.long

Abstract

BACKGROUND:

Gut microbiota is emerging as a novel risk factor for atherothrombosis, but the predictive role of gut-derived lipopolysaccharide (LPS) is unknown. We analyzed (1) the association between LPS and major adverse cardiovascular events (MACE) in atrial fibrillation (AF) and (2) its relationship with adherence to a Mediterranean diet (Med-diet).

METHODS AND RESULTS:

This was a prospective single-center study including 912 AF patients treated with vitamin K antagonists (3716 patient-years). The primary end point was a composite of MACE. Baseline serum LPS, adherence to Med-diet (n=704), and urinary excretion of 11-dehydro-thromboxane B2 (TxB2, n=852) were investigated. Mean age was 73.5 years; 42.9% were women. A total of 187 MACE (5.0% per year) occurred: 54, 59, and 74 in the first, second, and third tertile of LPS, respectively (log-rank test P=0.004). Log-LPS (hazard ratio 1.194, P=0.009), age (hazard ratio 1.083, P<0.001), and previous cerebrovascular (hazard ratio 1.634, P=0.004) and cardiac events (hazard ratio 1.822, P<0.001) were predictors of MACE. In the whole cohort, AF (versus sinus rhythm) (β 0.087, P=0.014) and low-density lipoprotein cholesterol (β 0.069, P=0.049) were associated with circulating LPS. Furthermore, Med-diet score (β -0.137, P<0.001) was predictive of log-LPS, with fruits (β -0.083, P=0.030) and legumes (β -0.120, P=0.002) negatively associated with log-LPS levels. Log-LPS and log-TxB2 were highly correlated (r=0.598, P<0.001). Log-LPS (β 0.574, P<0.001) and Med-diet score (β -0.218, P<0.001) were significantly associated with baseline urinary excretion of TxB2.

CONCLUSIONS:

In this cohort of AF patients, LPS levels were predictive of MACE and negatively affected by high adherence to Med-diet. LPS may contribute to MACE incidence in AF by increasing platelet activation.

KEYWORDS:

Mediterranean diet; atrial fibrillation; cardiovascular events; lipopolysaccharide; thromboxane

 

Associations of Abdominal Obesity and New-Onset Atrial Fibrillation in the General Population.

Baek YS, Yang PS, Kim TH, Uhm JS, Park J, Pak HN, Lee MH, Joung B.

J Am Heart Assoc. 2017 Jun 6;6(6). pii: e004705. doi: 10.1161/JAHA.116.004705.

PMID: 28588091 Free Article

Abstract

BACKGROUND:

Higher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.

METHODS AND RESULTS:

We studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow-up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01-1.45, P=0.043), 14% (95% confidence interval, 1.06-1.23, P<0.001), and 52% (95% confidence interval, 1.30-1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder-adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10-1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new-onset AF, particularly in participants without comorbidities.

CONCLUSIONS:

Abdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

KEYWORDS:

Asians; atrial fibrillation; incidence; nationwide cohort; obesity

 

Early Life Risk Factors for Incident Atrial Fibrillation in the Helsinki Birth Cohort Study.

Johnson LSB, Salonen M, Kajantie E, Conen D, Healey JS, Osmond C, Eriksson JG.

J Am Heart Assoc. 2017 Jun 25;6(6). pii: e006036. doi: 10.1161/JAHA.117.006036.

PMID: 28649086 Free Article

http://jaha.ahajournals.org/content/6/6/e006036.long

Abstract

BACKGROUND:

Early life risk factors are associated with cardiometabolic disease, but have not been fully studied in atrial fibrillation (AF). There are discordant results from existing studies of birth weight and AF, and the impact of maternal body size, gestational age, placental size, and birth length is unknown.

METHODS AND RESULTS:

The Helsinki Birth Cohort Study includes 13 345 people born as singletons in Helsinki in the years 1934-1944. Follow-up was through national registries, and ended on December 31, 2013, with 907 incident cases. Cox regression analyses stratified on year of birth were constructed for perinatal variables and incident AF, adjusting for offspring sex, gestational age, and socioeconomic status at birth. There was a significant U-shaped association between birth weight and AF (P for quadratic term=0.01). The lowest risk of AF was found among those with a birth weight of 3.4 kg (3.8 kg for women [85th percentile] and 3.0 kg for men [17th percentile]). High maternal body mass index (≥30 kg/m2) predicted offspring AF; hazard ratio 1.36 (95% CI 1.07-1.74, P=0.01) compared with normal body mass index (<25 kg/m2). Maternal height was associated with early-onset AF (<65.3 years), hazard ratio 1.47 (95% CI 1.24-1.74, P<0.0001), but not with later onset AF. Results were independent of incident coronary artery disease, hypertension, or diabetes mellitus.

CONCLUSIONS:

High maternal body mass index during pregnancy and maternal height are previously undescribed predictors of offspring AF. Efforts to prevent maternal obesity might reduce later AF in offspring. Birth weight has a U-shaped relation to incident AF independent of other perinatal variables.

KEYWORDS:

atrial fibrillation; hypertension; population science; population studies; risk prediction

 

Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women.

Peters SAE, Yang L, Guo Y, Chen Y, Bian Z, Du J, Yang J, Li S, Li L, Woodward M, Chen Z.

J Am Heart Assoc. 2017 Jun 21;6(6). pii: e006081. doi: 10.1161/JAHA.117.006081.

PMID: 28637778 Free Article

Abstract

BACKGROUND:

Breastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases (CVDs) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West.

METHODS AND RESULTS:

In 2004-2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow-up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD, with adjusted HRs of 0.91 (95% CI, 0.84-0.99) for coronary heart disease and 0.92 (95% CI, 0.85-0.99) for stroke. Women who had breastfed for ≥24 months had an 18% (HR, 0.82; 0.77-0.87) lower risk of coronary heart disease and a 17% (HR, 0.83; 0.79-0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94-0.98) for coronary heart disease and 0.97 (95% CI, 0.96-0.98) for stroke.

CONCLUSIONS:

Among Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

KEYWORDS:

China; breastfeeding; cardiovascular disease; epidemiology; risk factor; women

 

Overweight, Obesity, and Survival After Stroke in the Framingham Heart Study.

Aparicio HJ, Himali JJ, Beiser AS, Davis-Plourde KL, Vasan RS, Kase CS, Wolf PA, Seshadri S.

J Am Heart Assoc. 2017 Jun 24;6(6). pii: e004721. doi: 10.1161/JAHA.116.004721.

PMID: 28647687 Free Article

Abstract

BACKGROUND:

We investigated how body weight affects survival after stroke, leveraging the availability of multiple prestroke body mass index (BMI) measurements and using a nested case-control design in a community-based sample.

METHODS AND RESULTS:

We compared all-cause mortality in participants stratified by prestroke weight. Separate analyses were performed for ischemic stroke and all stroke and for age-, sex-, and BMI category-matched stroke-free controls. Participants were grouped into BMI categories and followed for up to 10 years. Differences in survival were tested for interaction by case status. In sensitivity analysis, to exclude those with prestroke weight loss, we restricted the reference group to participants with 2 consistently normal BMI measurements within 10 years before stroke/matching. There were 782 stroke cases (age 71±9, 51% female participants, 87% ischemic stroke) and 2346 controls (age 72±9, 51% female participants). Overweight participants with ischemic stroke had a lower mortality compared with those with normal weight (hazard ratio {HR}=0.70, 95%CI 0.55-0.90, P=0.005). The association of reduced mortality with BMI ≥25, compared with normal-weight BMI 18.5 to <25, was pronounced among ischemic stroke cases but diminished with inclusion of hemorrhagic strokes (case-control interaction P=0.051 and P=0.130, respectively). Compared with participants with stable normal weight, moderately increased weight was protective after ischemic stroke (overweight HR=0.72, 95%CI 0.53-0.99, P=0.041).

CONCLUSIONS:

Overweight and mildly obese participants had better 10-year survival after ischemic stroke compared with normal-weight participants, even after excluding persons with recent prestroke weight loss. There may be unknown protective factors associated with a moderately increased body weight before stroke.

KEYWORDS:

body mass index; body weight; cerebrovascular disease; epidemiology; mortality; obesity; recurrent event; risk factor; secondary prevention; stroke

 

[it was recommended by my doctor for me to have the levothyroxine 'therapy'.

Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

David J. Stott, M.B., Ch.B., M.D., Nicolas Rodondi, M.D., Patricia M. Kearney, M.D., Ph.D., Ian Ford, Ph.D., Rudi G.J. Westendorp, M.D., Ph.D., Simon P. Mooijaart, M.D., Ph.D., Naveed Sattar, F.Med.Sci., Carole E. Aubert, M.D., Drahomir Aujesky, M.D., Douglas C. Bauer, M.D., Christine Baumgartner, M.D., Manuel R. Blum, M.D., John P. Browne, Ph.D., Stephen Byrne, Ph.D., Tinh-Hai Collet, M.D., Olaf M. Dekkers, M.D., Ph.D., Wendy P.J. den Elzen, Ph.D., Robert S. Du Puy, M.D., Graham Ellis, M.D., Martin Feller, M.D., Carmen Floriani, M.D., Kirsty Hendry, Ph.D., Caroline Hurley, M.P.H., J. Wouter Jukema, M.D., Ph.D., Sharon Kean, Maria Kelly, M.Pharm., Danielle Krebs, Ph.D., Peter Langhorne, M.D., Ph.D., Gemma McCarthy, M.P.H., Vera McCarthy, Ph.D., Alex McConnachie, Ph.D., Mairi McDade, B.Sc., R.G.N., Martina Messow, Ph.D., Annemarie O’Flynn, Ph.D., David O’Riordan, M.Pharm., Rosalinde K.E. Poortvliet, M.D., Ph.D., Terence J Quinn, M.D., Ph.D., Audrey Russell, M.M.Sc., Carol Sinnott, Ph.D., Jan W.A. Smit, M.D., Ph.D., H. Anette Van Dorland, Ph.D., Kieran A. Walsh, M.Pharm., Elaine K. Walsh, M.B., B.Ch., B.A.O., Torquil Watt, M.D., Robbie Wilson, M.Sc., and Jacobijn Gussekloo, M.D., Ph.D., for the TRUST Study Group*

N Engl J Med 2017; 376:2534-2544June 29, 2017DOI: 10.1056/NEJMoa1603825

BACKGROUND

The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older persons with this condition.

METHODS

We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg if the body weight was <50 kg or the patient had coronary heart disease), with dose adjustment according to the thyrotropin level; 369 patients were assigned to receive placebo with mock dose adjustment. The two primary outcomes were the change in the Hypothyroid Symptoms score and Tiredness score on a thyroid-related quality-of-life questionnaire at 1 year (range of each scale is 0 to 100, with higher scores indicating more symptoms or tiredness, respectively; minimum clinically important difference, 9 points).

RESULTS

The mean age of the patients was 74.4 years, and 396 patients (53.7%) were women. The mean (±SD) thyrotropin level was 6.40±2.01 mIU per liter at baseline; at 1 year, this level had decreased to 5.48 mIU per liter in the placebo group, as compared with 3.63 mIU per liter in the levothyroxine group (P<0.001), at a median dose of 50 μg. We found no differences in the mean change at 1 year in the Hypothyroid Symptoms score (0.2±15.3 in the placebo group and 0.2±14.4 in the levothyroxine group; between-group difference, 0.0; 95% confidence interval [CI], −2.0 to 2.1) or the Tiredness score (3.2±17.7 and 3.8±18.4, respectively; between-group difference, 0.4; 95% CI, −2.1 to 2.9). No beneficial effects of levothyroxine were seen on secondary-outcome measures. There was no significant excess of serious adverse events prespecified as being of special interest.

CONCLUSIONS

Levothyroxine provided no apparent benefits in older persons with subclinical hypothyroidism.

>>>>>>>>>>>>>>>>>>>>>>>>>

CLINICAL PRACTICE

Subclinical Hypothyroidism

Robin P. Peeters, M.D., Ph.D.

N Engl J Med 2017; 376:2556-2565June 29, 2017DOI: 10.1056/NEJMcp1611144

http://sci-hub.cc/10.1056/NEJMcp1611144

The management of subclinical hypothyroidism (an elevated thyrotropin level with a normal free thyroxine level) should be guided by the degree of elevation of thyrotropin, the presence of symptoms, and other patient factors.

 

[interesting where all the bad air is.]

Air pollution limits in U.S. inadequate to prevent deaths

No 'safe level' of air pollution, according to study of more than 60 million health records

Thomson Reuters Posted: Jun 29, 2017

http://www.cbc.ca/news/health/air-pollution-us-premature-deaths-1.4183412

>>>>>>>>>>>>>>>>>>>>>>

Air Pollution and Mortality in the Medicare Population

Qian Di, M.S., Yan Wang, M.S., Antonella Zanobetti, Ph.D., Yun Wang, Ph.D., Petros Koutrakis, Ph.D., Christine Choirat, Ph.D., Francesca Dominici, Ph.D., and Joel D. Schwartz, Ph.D.

N Engl J Med 2017; 376:2513-2522 June 29, 2017 DOI: 10.1056/NEJMoa1702747

http://sci-hub.cc/10.1056/NEJMoa1702747

BACKGROUND

Studies have shown that long-term exposure to air pollution increases mortality. However, evidence is limited for air-pollution levels below the most recent National Ambient Air Quality Standards. Previous studies involved predominantly urban populations and did not have the statistical power to estimate the health effects in underrepresented groups.

METHODS

We constructed an open cohort of all Medicare beneficiaries (60,925,443 persons) in the continental United States from the years 2000 through 2012, with 460,310,521 person-years of follow-up. Annual averages of fine particulate matter (particles with a mass median aerodynamic diameter of less than 2.5 μm [PM2.5]) and ozone were estimated according to the ZIP Code of residence for each enrollee with the use of previously validated prediction models. We estimated the risk of death associated with exposure to increases of 10 μg per cubic meter for PM2.5 and 10 parts per billion (ppb) for ozone using a two-pollutant Cox proportional-hazards model that controlled for demographic characteristics, Medicaid eligibility, and area-level covariates.

RESULTS

Increases of 10 μg per cubic meter in PM2.5 and of 10 ppb in ozone were associated with increases in all-cause mortality of 7.3% (95% confidence interval [CI], 7.1 to 7.5) and 1.1% (95% CI, 1.0 to 1.2), respectively. When the analysis was restricted to person-years with exposure to PM2.5 of less than 12 μg per cubic meter and ozone of less than 50 ppb, the same increases in PM2.5 and ozone were associated with increases in the risk of death of 13.6% (95% CI, 13.1 to 14.1) and 1.0% (95% CI, 0.9 to 1.1), respectively. For PM2.5, the risk of death among men, blacks, and people with Medicaid eligibility was higher than that in the rest of the population.

CONCLUSIONS

In the entire Medicare population, there was significant evidence of adverse effects related to exposure to PM2.5 and ozone at concentrations below current national standards. This effect was most pronounced among self-identified racial minorities and people with low income.

>>>>>>>>>>>>

Air Pollution Still Kills.

Berger RE, Ramaswami R, Solomon CG, Drazen JM.

N Engl J Med. 2017 Jun 29;376(26):2591-2592. doi: 10.1056/NEJMe1706865. No abstract available.

PMID: 28657876

http://sci-hub.cc/10.1056/NEJMe1706865

In late October 1948, a dense smog descended over the town of Donora, Pennsylvania. The town was home to a zinc plant and a steel mill, both run by the United States Steel Corporation. Susan Gnora, a 62-year-old resident of Donora, started to gasp and cough as the smog descended.1 She died the next day. Dr. William Rongaus, a physician and a member of the board of health, went door to door, treating patients for their respiratory symptoms and encouraging them to leave town if they could. Many thousands were ill, and at least 20 people died in one of . . .

 

Recognizing Sepsis as a Global Health Priority - A WHO Resolution.

Reinhart K, Daniels R, Kissoon N, Machado FR, Schachter RD, Finfer S.

N Engl J Med. 2017 Jun 28. doi: 10.1056/NEJMp1707170. [Epub ahead of print] No abstract available.

PMID: 28658587 Free Article

http://www.nejm.org/doi/full/10.1056/NEJMp1707170?query=TOC

 

The Scientist » News & Opinion » Daily News

Evidence for Human Lifespan Limit Contested

Five groups of scientists criticize a widely publicized Nature paper from 2016 suggesting that humans can only live up to 115 years.

By Diana Kwon | June 28, 2017

http://www.the-scientist.com/?articles.view/articleNo/49758/title/Evidence-for-Human-Lifespan-Limit-Contested/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=53720401&_hsenc=p2ANqtz-8FJczQ22fDLcuU1M6oVFZ3KWV_yGrV90SWdmldPPjab2dyG0Hof7-KZS-n1FrOGe2ujist6MX4YpC9jQVZVNOuy8fg-Q&_hsmi=53720401

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

No limit to how long people can live: study

Canadian researchers say maximum lifespan could continue to climb 'far into the foreseeable future'

By Sherry Noik, CBC News Posted: Jun 28, 2017

http://www.cbc.ca/news/health/no-limit-on-lifespan-1.4181742

>>>>>>>>>>>>>>>>>>>

Many possible maximum lifespan trajectories.

Hughes BG, Hekimi S.

Nature. 2017 Jun 28;546(7660):E8-E9. doi: 10.1038/nature22786. No abstract available.

PMID: 28658230

http://sci-hub.cc/10.1038/nature22786

>>>>>>>>>>>>>>>>>>>>>>>

ARISING FROM:

Evidence for a limit to human lifespan.

Dong X, Milholland B, Vijg J.

Nature. 2016 Oct 13;538(7624):257-259. doi: 10.1038/nature19793. Epub 2016 Oct 5.

PMID: 27706136

http://sci-hub.cc/10.1038/nature19793

Abstract

Driven by technological progress, human life expectancy has increased greatly since the nineteenth century. Demographic evidence has revealed an ongoing reduction in old-age mortality and a rise of the maximum age at death, which may gradually extend human longevity. Together with observations that lifespan in various animal species is flexible and can be increased by genetic or pharmaceutical intervention, these results have led to suggestions that longevity may not be subject to strict, species-specific genetic constraints. Here, by analysing global demographic data, we show that improvements in survival with age tend to decline after age 100, and that the age at death of the world's oldest person has not increased since the 1990s. Our results strongly suggest that the maximum lifespan of humans is fixed and subject to natural constraints.

>>>>>>>>>>>>>>>>>>>>>>>>

The recent Letter by Dong et al.1 analysed demographic trends to claim that there is a biological limit to maximum human lifespan (approximately 115 years). Although this claim is not novel—Antero-Jacquemin et al. also identified a biological ‘barrier’…

Subject terms: Ageing Geriatrics

>>>>>>>>>>>>>>>>>>>>>>>>>

Contesting the evidence for limited human lifespan

Brown NJL, Albers CJ, Ritchie SJ.

Nature. 2017 Jun 28;546(7660):E6-E7. doi: 10.1038/nature22784. No abstract available.

PMID: 28658214

http://sci-hub.cc/10.1038/nature22784

>>>>>>>>>>>>>>>>>>>>>>>

Is there evidence for a limit to human lifespan?

Rozing MP, Kirkwood TBL, Westendorp RGJ.

Nature. 2017 Jun 28;546(7660):E11-E12. doi: 10.1038/nature22788. No abstract available.

PMID: 28658235

http://sci-hub.cc/10.1038/nature22788

>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Questionable evidence for a limit to human lifespan.

Lenart A, Vaupel JW.

Nature. 2017 Jun 28;546(7660):E13-E14. doi: 10.1038/nature22790. No abstract available.

PMID: 28658239

http://sci-hub.cc/10.1038/nature22790

>>>>>>>>>>>>>>>>>>>>>>>>

Maximum human lifespan may increase to 125 years.

de Beer J, Bardoutsos A, Janssen F.

Nature. 2017 Jun 28;546(7660):E16-E17. doi: 10.1038/nature22792. No abstract available.

PMID: 28658213

http://sci-hub.cc/10.1038/nature22792

Edited by AlPater

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[The below paper is pdf-availed.]

The association of mobility disability and weight status with risk of disability pension: A prospective cohort study.

Norrbäck M, de Munter J, Tynelius P, Ahlström G, Rasmussen F.

Scand J Public Health. 2017 Jun 1:1403494817707633. doi: 10.1177/1403494817707633. [Epub ahead of print]

PMID: 28666397

Abstract

BACKGROUND/AIMS:

Mobility disability (MD) and obesity are conditions which have been associated with weaker labour market attachment. This study investigates whether the combined burden of MD and obesity increase the risk of disability pension compared with having only one of these conditions (the reference group).

METHODS:

A nationwide cohort study, based on national surveys made between 1996 and 2011, was conducted including 50,015 individuals aged 19-64 years who were followed-up in a large database in terms of attainment of disability pension until 31 December 2012 (at the latest). Proportional hazards regression models were used to analyse the risk of all-cause and diagnosis-specific disability pension with six exposure groups, established by mobility and weight status (BMI) obtained through self-reports.

RESULTS:

A total of 2296 participants had received disability pension after a mean follow-up period of 7.2 years (SD 4.6). People with MD, regardless of weight, had 4-8 times higher risk of disability pension (for any reason) compared with the reference group (individuals with normal weight and no MD).

CONCLUSIONS:

No evidence of a double burden of MD and obesity with disability pension was observed in this study. MD seemed to contribute more to the risk of disability pension than weight status. In a long-term perspective, society and also people at risk of these disabling conditions would benefit from reallocation of resources from disability pensions to health-promoting and preventive policies, not least targeting MD.

KEYWORDS:

Mobility limitation; cohort study; disability; disability pension; obesity; work participation

>>>>>>>>>>>>>

Table II. Risk of all-cause disability pension estimated by proportional hazards regression for six groups according to weight status and

mobility disability in a cohort of 49,992 men and women followed-up 1997–2012.

----------------------------------------

Exposure groups Model 1 HR (95% CI) Model 2 HR (95% CI) Model 3 HR (95% CI)

-----------------------------------------

Normal weight without MD 1 (Ref.) 1 (Ref.) 1 (Ref.)

Overweight without MD 1.16 (1.06,1.28) 1.13 (1.02,1.24) 1.12 (1.02,1.24)

Obese without MD 1.97 (1.73,2.25) 1.75 (1.53,2.00) 1.76 (1.54,2.01)

Normal weight with MD 8.71 (7.14,10.64) 7.14 (5.84,8.72) 5.85 (4.77,7.18)

Overweight with MD 7.78 (6.46,9.36) 6.48 (5.38,7.81) 6.08 (5.04,7.33)

Obese with MD 7.35 (5.80,9.33) 5.33 (4.19,6.77) 5.17 (4.07,6.57)

------------------------------------------

Values are hazard ratios (HRs) and 95% confidence interval (95% CIs) estimated by a stratified proportional hazards model. Individuals

who did not receive disability pension before date of death, emigration or turned 65 years before end of follow-up 31 December 2012, were

censored.

Model 1: Unadjusted Hazard Ratios (HRs) with 95% Confidence Intervals (CIs).

Model 2: Model 1 adjusted for sex, year of birth, country of birth, and highest obtained education.

Model 3: Model 2 additionally adjusted for other disability benefits at baseline.

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Prognosis Impact of Frailty Assessed by the Edmonton Frail Scale in the Setting of Acute Coronary Syndrome in the Elderly.

Blanco S, Ferrières J, Bongard V, Toulza O, Sebai F, Billet S, Biendel C, Lairez O, Lhermusier T, Boudou N, Campelo-Parada F, Roncalli J, Galinier M, Carrié D, Elbaz M, Bouisset F.

Can J Cardiol. 2017 Jul;33(7):933-939. doi: 10.1016/j.cjca.2017.03.026. Epub 2017 Apr 8.

PMID: 28668143

Abstract

BACKGROUND:

Elderly patients represent a large proportion of patients admitted for acute coronary syndrome (ACS). Whether frailty-defined as a biological syndrome that reflects a state of decreased physiological reserve and vulnerability to stressors-may impact the clinical outcomes in this population remains unclear. We aimed to determine the prevalence of frailty and its impact on mortality in patients aged ≥ 80 years admitted for ACS.

METHODS:

This prospective observational study was conducted in patients aged 80 years or older admitted to a tertiary hospital for ACS. Frailty was assessed using the Edmonton Frail Scale (EFS), which provides a score ranging from 0 (not frail) to 17 (very frail). The population was divided into 3 classes: EFS score 0-3, EFS score 4-6; and EFS score >7.

RESULTS:

Two hundred thirty-six patients were included, with a mean follow-up duration of 470 days. The mean age was 85.9 years. Seventy-five patients died during the follow-up period. One hundred nineteen patients (50.4%) had an EFS score of 0-3, 68 patients (28.8%) had an EFS score of 4-6, and 49 patients (20.8%) had an EFS score ≥ 7. The all-cause mortality rate was 17.7% in the EFS 0-3 group, 35.3% in the EFS 4-6 group, and 61.2% in the EFS ≥ 7 group (P < 0.001). After multivariate analysis, frailty status remained associated with all-cause mortality: the hazard ratio (HR) was 1.53 (95% confidence interval [CI], 0.74-3.16) in the EFS 4-6 group, and the HR was 3.60 (95% CI, 1.70-7.63) in the EFS ≥ 7 group.

CONCLUSIONS:

Frailty is a strong and independent prognostic factor for midterm all-cause mortality in elderly patients presenting with ACS.

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[The below paper is pdf-availed.]

Successful Aging as a Predictor of Long-Term Care Among Oldest Old: The Vitality 90+ Study.

Nosraty L, Pulkki J, Raitanen J, Enroth L, Jylhä M.

J Appl Gerontol. 2017 Jun 1:733464817716968. doi: 10.1177/0733464817716968. [Epub ahead of print]

PMID: 28671023

Abstract

AIM:

The aim of the study was to investigate whether successful aging (SA) predicts entering long-term care (LTC) among nonagenarians.

METHODS:

Data originated from the linkage of the Vitality 90+ Study surveys with register data from Finnish Population Register and Care Registers. Altogether 1,966 community-dwelling individuals were followed for 2 years and 1,354 individuals for 5 years. Four models of SA were constructed by varying combinations of physical, psychological, and social components. Competing risk regression analysis was used.

FINDINGS:

The incidence rate for entering LTC was lower for successful agers. Three models of SA presented a significantly decreased risk for entering LTC in the whole group and in women. The impact of SA was attenuated when living alone, needing help, and the year of participation were adjusted for, but was still significant for Model 3.

CONCLUSION:

Nonagenarians who meet the multidimensional criteria of SA are less likely to enter LTC than those aging less successfully.

KEYWORDS:

cumulative incidence; good aging; institutionalization; mortality

 

Nutrition in the elderly: a recommendation for more (evenly distributed) protein?

Phillips SM.

Am J Clin Nutr. 2017 Jun 7. pii: ajcn159863. doi: 10.3945/ajcn.117.159863. [Epub ahead of print] No abstract available.

PMID: 28592608

http://ajcn.nutrition.org/content/early/2017/06/07/ajcn.117.159863.extract

>>>>>>>>>>>>>>>>>>>>>>>>>>>

Even mealtime distribution of protein intake is associated with greater muscle strength, but not with 3-y physical function decline, in free-living older adults: the Quebec longitudinal study on Nutrition as a Determinant of Successful Aging (NuAge study).

Farsijani S, Payette H, Morais JA, Shatenstein B, Gaudreau P, Chevalier S.

Am J Clin Nutr. 2017 May 17. pii: ajcn146555. doi: 10.3945/ajcn.116.146555. [Epub ahead of print]

PMID: 28515070

http://sci-hub.cc/10.3945/ajcn.116.146555

Abstract

Background: Functional status declines with aging, thus impeding autonomy. Recently, a more even mealtime distribution of dietary protein was positively associated with muscle mass, but the relation of this distribution to physical performance remains unknown.Objective: We examined the relation between mealtime protein-intake distribution and physical performance and its 3-y decline in community-dwelling older adults.Design: Three-year follow-up data from 827 men and 914 women (67-84 y) in the longitudinal study on nutrition and aging [Quebec longitudinal study on Nutrition as a Determinant of Successful Aging (NuAge study); Quebec, Canada] were analyzed. Physical performance, which was measured yearly, was grouped into the following 2 functional composite scores: muscle strength (handgrip, arm, and leg) and mobility (timed-up-and-go, chair stand, and walking speed). Dietary data were collected in 2 sets of three 24-h food recalls at baseline and year 2. The individual mealtime protein distribution was calculated as the CV (i.e., SD divided by the mean) of grams of protein per meal. A mixed model analysis was used to examine trajectories of muscle strength and mobility across time by sex as conditioned by the protein distribution and adjusted for potential covariates.Results: Physical performance deteriorated over 3 y with muscle strength declining more than the mobility score in men (-1.51 ± 1.68 compared with -0.66 ± 2.81) and women (-1.35 ± 1.77 compared with -0.78 ± 2.63) (means ± SD, P < 0.001). More-evenly distributed protein intake, independent of the total quantity, was associated with a higher muscle-strength score in both sexes throughout follow-up. It was also associated with a greater mobility score, but only in men and only before adjustment for covariates. Strength and mobility rates of decline were not affected by protein-intake distribution in either sex.Conclusions: In addition to the previously observed association with lean mass, an even distribution of daily protein intake across meals is independently associated with greater muscle strength, but not with the mobility score, in older adults. A longer-term investigation of the role of protein intake and its distribution on physical performance is warranted, as well as intervention studies, to support future recommendations.

KEYWORDS:

aging; diet; dietary protein; dynapenia; functional capacity; mobility; nutrition; physical performance; skewed protein intake

 

Is the whole not greater than the sum of its parts? The case of sarcopenic obesity.

Batsis JA, Cook SB.

Am J Clin Nutr. 2017 Jun 14. pii: ajcn159871. doi: 10.3945/ajcn.117.159871. [Epub ahead of print] No abstract available.

PMID: 28615264

http://ajcn.nutrition.org/content/early/2017/06/14/ajcn.117.159871.extract

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Sarcopenic obesity, weight loss, and mortality: the English Longitudinal Study of Ageing.

Hamer M, O'Donovan G.

Am J Clin Nutr. 2017 May 24. pii: ajcn152488. doi: 10.3945/ajcn.117.152488. [Epub ahead of print]

PMID: 28539380

http://sci-hub.cc/10.3945/ajcn.117.152488

Abstract

Background: Age-related sarcopenia describes the loss of muscle strength and often accompanies an increase in adiposity in the elderly.Objective: We examined the association of sarcopenic obesity and changes in muscle strength and weight with the risk of mortality.Design: Participants (n = 6864) were community-dwelling men and women (45.6% men; 54.4% women; mean ± SD age: 66.2 ± 9.5 y) from the English Longitudinal Study of Ageing. Handgrip strength and body mass index (BMI; in kg/m2) were measured at baseline and at a 4-y follow-up. Individual participant data were linked with death records from National Health Service registries. Sarcopenic obesity was defined as obese individuals (BMI ≥30) in the lowest tertile of sex-specific grip strength (<35.3 kg for men and <19.6 kg for women).Results: There were 906 deaths over a mean follow-up of 8 y. Compared with the reference group (normal BMI and highest handgrip tertile), the risk of all-cause mortality increased as grip strength reduced within each BMI category. For participants in the lowest handgrip tertile, there was little difference in the risk between normal BMI (HR: 3.25; 95% CI: 1.86, 5.65), overweight (HR: 2.50; 95% CI: 1.44, 4.35), and obesity (HR: 2.66; 95% CI: 1.86, 3.80) after adjusting for covariates. The risk of all-cause mortality was significantly greater in participants who experienced weight loss over 4 y (HR: 2.21; 95% CI: 1.32, 3.71) and/or reduced hand grip strength (HR: 1.53; 95% CI: 10.07, 2.17) than in those with stable weight and grip strength, with the highest risk in those with both weight loss and reduced strength (HR: 3.77; 95% CI: 2.54, 5.60).Conclusions: Sarcopenic obesity did not confer any greater risk than sarcopenia alone. Weight loss combined with sarcopenia presented the greatest risk of mortality.

KEYWORDS:

adiposity; aging; epidemiology; mortality; muscle strength

 

Central adiposity and the overweight risk paradox in aging: follow-up of 130,473 UK Biobank participants.

Bowman K, Atkins JL, Delgado J, Kos K, Kuchel GA, Ble A, Ferrucci L, Melzer D.

Am J Clin Nutr. 2017 May 31. pii: ajcn147157. doi: 10.3945/ajcn.116.147157. [Epub ahead of print]

PMID: 28566307 Free Article

http://ajcn.nutrition.org/content/106/1/130.long

http://ajcn.nutrition.org/content/106/1/130.full.pdf+html

Abstract

Background: For older groups, being overweight [body mass index (BMI; in kg/m2): 25 to <30] is reportedly associated with a lower or similar risk of mortality than being normal weight (BMI: 18.5 to <25). However, this "risk paradox" is partly explained by smoking and disease-associated weight loss. This paradox may also arise from BMI failing to measure fat redistribution to a centralized position in later life.Objective: This study aimed to estimate associations between combined measurements of BMI and waist-to-hip ratio (WHR) with mortality and incident coronary artery disease (CAD).Design: This study followed 130,473 UK Biobank participants aged 60-69 y (baseline 2006-2010) for ≤8.3 y (n = 2974 deaths). Current smokers and individuals with recent or disease-associated (e.g., from dementia, heart failure, or cancer) weight loss were excluded, yielding a "healthier agers" group. Survival models were adjusted for age, sex, alcohol intake, smoking history, and educational attainment. Population and sex-specific lower and higher WHR tertiles were <0.91 and ≥0.96 for men and <0.79 and ≥0.85 for women, respectively.Results: Ignoring WHR, the risk of mortality for overweight subjects was similar to that for normal-weight subjects (HR: 1.09; 95% CI: 0.99, 1.19; P = 0.066). However, among normal-weight subjects, mortality increased for those with a higher WHR (HR: 1.33; 95% CI: 1.08, 1.65) compared with a lower WHR. Being overweight with a higher WHR was associated with substantial excess mortality (HR: 1.41; 95% CI: 1.25, 1.61) and greatly increased CAD incidence (sub-HR: 1.64; 95% CI: 1.39, 1.93) compared with being normal weight with a lower WHR. There was no interaction between physical activity and BMI plus WHR groups with respect to mortality.Conclusions: For healthier agers (i.e., nonsmokers without disease-associated weight loss), having central adiposity and a BMI corresponding to normal weight or overweight is associated with substantial excess mortality. The claimed BMI-defined overweight risk paradox may result in part from failing to account for central adiposity, rather than reflecting a protective physiologic effect of higher body-fat content in later life.

KEYWORDS:

UK Biobank; adiposity; aging; body mass index; coronary artery disease; mortality; older persons; overweight; waist-hip ratio

 

ω-3 and ω-6 long-chain PUFAs and their enzymatic metabolites in neovascular eye diseases.

Gong Y, Fu Z, Liegl R, Chen J, Hellström A, Smith LE.

Am J Clin Nutr. 2017 May 17. pii: ajcn153825. doi: 10.3945/ajcn.117.153825. [Epub ahead of print] Review.

PMID: 28515072

http://sci-hub.cc/10.3945/ajcn.117.153825

Abstract

Neovascular eye diseases, including retinopathy of prematurity, diabetic retinopathy, and age-related macular degeneration, threaten the visual health of children and adults. Current treatment options, including anti-vascular endothelial growth factor therapy and laser retinal photocoagulation, have limitations and are associated with adverse effects; therefore, the identification of additional therapies is highly desirable. Both clinical and experimental studies show that dietary ω-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFAs) reduce retinal and choroidal angiogenesis. The ω-3 LC-PUFA metabolites from 2 groups of enzymes, cyclooxygenases and lipoxygenases, inhibit [and the ω-6 (n-6) LC-PUFA metabolites promote] inflammation and angiogenesis. However, both of the ω-3 and the ω-6 lipid products of cytochrome P450 oxidase 2C promote neovascularization in both the retina and choroid, which suggests that inhibition of this pathway might be beneficial. This review summarizes our current understanding of the roles of ω-3 and ω-6 LC-PUFAs and their enzymatic metabolites in neovascular eye diseases.

KEYWORDS:

age-related macular degeneration; diabetic retinopathy; lipid metabolism; long-chain polyunsaturated fatty acid; retinopathy of prematurity

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Cytochrome P450 Oxidase 2C Inhibition Adds to ω-3 Long-Chain Polyunsaturated Fatty Acids Protection Against Retinal and Choroidal Neovascularization.

Gong Y, Fu Z, Edin ML, Liu CH, Wang Z, Shao Z, Fredrick TW, Saba NJ, Morss PC, Burnim SB, Meng SS, Lih FB, Lee KS, Moran EP, SanGiovanni JP, Hellström A, Hammock BD, Zeldin DC, Smith LE.

Arterioscler Thromb Vasc Biol. 2016 Sep;36(9):1919-27. doi: 10.1161/ATVBAHA.116.307558. Epub 2016 Jul 14.

PMID: 27417579

http://atvb.ahajournals.org/content/36/9/1919.long

Abstract

OBJECTIVE:

Pathological ocular neovascularization is a major cause of blindness. Increased dietary intake of ω-3 long-chain polyunsaturated fatty acids (LCPUFA) reduces retinal neovascularization and choroidal neovascularization (CNV), but ω-3 LCPUFA metabolites of a major metabolizing pathway, cytochrome P450 oxidase (CYP) 2C, promote ocular pathological angiogenesis. We hypothesized that inhibition of CYP2C activity will add to the protective effects of ω-3 LCPUFA on neovascular eye diseases.

APPROACH AND RESULTS:

The mouse models of oxygen-induced retinopathy and laser-induced CNV were used to investigate pathological angiogenesis in the retina and choroid, respectively. The plasma levels of ω-3 LCPUFA metabolites of CYP2C were determined by mass spectroscopy. Aortic ring and choroidal explant sprouting assays were used to investigate the effects of CYP2C inhibition and ω-3 LCPUFA-derived CYP2C metabolic products on angiogenesis ex vivo. We found that inhibition of CYP2C activity by montelukast added to the protective effects of ω-3 LCPUFA on retinal neovascularization and CNV by 30% and 20%, respectively. In CYP2C8-overexpressing mice fed a ω-3 LCPUFA diet, montelukast suppressed retinal neovascularization and CNV by 36% and 39% and reduced the plasma levels of CYP2C8 products. Soluble epoxide hydrolase inhibition, which blocks breakdown and inactivation of CYP2C ω-3 LCPUFA-derived active metabolites, increased oxygen-induced retinopathy and CNV in vivo. Exposure to selected ω-3 LCPUFA metabolites of CYP2C significantly reversed the suppression of both angiogenesis ex vivo and endothelial cell functions in vitro by the CYP2C inhibitor montelukast.

CONCLUSIONS:

Inhibition of CYP2C activity adds to the protective effects of ω-3 LCPUFA on pathological retinal neovascularization and CNV.

KEYWORDS:

CYP2C inhibitor; arachidonic acid; choroidal neovascularization; diabetic retinopathy; docosahexaenoic acid

 

Low-fat dietary pattern and cardiovascular disease: results from the Women's Health Initiative randomized controlled trial.

Prentice RL, Aragaki AK, Van Horn L, Thomson CA, Beresford SA, Robinson J, Snetselaar L, Anderson GL, Manson JE, Allison MA, Rossouw JE, Howard BV.

Am J Clin Nutr. 2017 May 17. pii: ajcn153270. doi: 10.3945/ajcn.117.153270. [Epub ahead of print]

PMID: 28515068

http://sci-hub.cc/10.3945/ajcn.117.153270

Abstract

Background: The influence of a low-fat dietary pattern on the cardiovascular health of postmenopausal women continues to be of public health interest.Objective: This report evaluates low-fat dietary pattern influences on cardiovascular disease (CVD) incidence and mortality during the intervention and postintervention phases of the Women's Health Initiative Dietary Modification Trial.Design: Participants comprised 48,835 postmenopausal women aged 50-79 y; 40% were randomly assigned to a low-fat dietary pattern intervention (target of 20% of energy from fat), and 60% were randomly assigned to a usual diet comparison group. The 8.3-y intervention period ended in March 2005, after which >80% of surviving participants consented to additional active follow-up through September 2010; all participants were followed for mortality through 2013. Breast and colorectal cancer were the primary trial outcomes, and coronary heart disease (CHD) and overall CVD were additional designated outcomes.Results: Incidence rates for CHD and total CVD did not differ between the intervention and comparison groups in either the intervention or postintervention period. However, CHD HRs comparing these groups varied strongly with baseline CVD and hypertension status. Participants without prior CVD had an intervention period CHD HR of 0.70 (95% CI: 0.56, 0.87) or 1.04 (95% CI: 0.90, 1.19) if they were normotensive or hypertensive, respectively (P-interaction = 0.003). The CHD benefit among healthy normotensive women was partially offset by an increase in ischemic stroke risk. Corresponding HRs in the postintervention period were close to null. Participants with CVD at baseline (3.4%) had CHD HRs of 1.47 (95% CI: 1.12, 1.93) and 1.61 (95% CI: 1.02, 2.55) in the intervention and postintervention periods, respectively. However, various lines of evidence suggest that results in women with CVD or hypertension at baseline are confounded by postrandomization use of cholesterol-lowering medications.Conclusions: CVD risk in postmenopausal women appears to be sensitive to a change to a low-fat dietary pattern and, among healthy women, includes both CHD benefit and stroke risk.

KEYWORDS:

LDL cholesterol; cardiovascular disease; cholesterol-lowering medications; coronary heart disease; low-fat dietary pattern; nutritional behavioral intervention; postrandomization confounding; randomized controlled trial; stroke

 

Dietary acid load and mortality among Japanese men and women: the Japan Public Health Center-based Prospective Study.

Akter S, Nanri A, Mizoue T, Noda M, Sawada N, Sasazuki S, Tsugane S; Japan Public Health Center–based Prospective Study Group.

Am J Clin Nutr. 2017 May 24. pii: ajcn152876. doi: 10.3945/ajcn.117.152876. [Epub ahead of print]

PMID: 28539378

http://sci-hub.cc/10.3945/ajcn.117.152876

Abstract

Background: Diet-induced metabolic acidosis has been linked to cardiometabolic abnormalities including hypertension and type 2 diabetes. However, there are limited data on its association with other chronic diseases and mortality.Objective: The present study aimed to examine the association between dietary acid load and total and cause-specific mortality.Design: This study was a large-scale, population-based, prospective cohort study in Japan involving 42,736 men and 49,742 women, aged 45-75 y, who had no history of cancer, stroke, ischemic heart disease (IHD), or chronic liver disease at baseline. Dietary intake was assessed by using a validated 147-item food-frequency questionnaire. Potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were derived from nutrient intake. Death and cause of death were identified by using the residential registry and death certificates. Cox proportional hazards regression was used to estimate HRs and 95% CIs for total and cause-specific mortality with adjustment for potential confounding variables.Results: During a median follow-up of 16.9 y, 12,993 total deaths occurred. A higher PRAL score was associated with higher total mortality: the multivariable-adjusted HR for total mortality for the highest compared with the lowest quartiles of PRAL scores was 1.13 (95% CI: 1.07, 1.18; P-trend < 0.001). This score was positively associated with mortality from cardiovascular disease (CVD) and particularly from IHD; the HRs (95% CIs) for the highest compared with the lowest quartile of PRAL score were 1.16 (1.06, 1.28) and 1.16 (1.02, 1.33) for CVD and IHD mortality, respectively. There was no association between PRAL score and cancer mortality. Similar associations were observed between NEAP score and total and cause-specific mortality.Conclusion: A high dietary acid load score was associated with a higher risk of total mortality and mortality from CVD, particularly from IHD, in Japanese adults.

KEYWORDS:

Japanese; cancer; cardiovascular disease; dietary acid load; mortality; prospective

 

Fried potato consumption is associated with elevated mortality: an 8-y longitudinal cohort study.

Veronese N, Stubbs B, Noale M, Solmi M, Vaona A, Demurtas J, Nicetto D, Crepaldi G, Schofield P, Koyanagi A, Maggi S, Fontana L.

Am J Clin Nutr. 2017 Jun 7. pii: ajcn154872. doi: 10.3945/ajcn.117.154872. [Epub ahead of print]

PMID: 28592612

http://ajcn.nutrition.org.sci-hub.cc/lookup/doi/10.3945/ajcn.117.154872

Abstract

Background: Few studies have assessed the association between potato consumption and mortality.Objective: We investigated whether potato consumption (including fried and unfried potatoes) is associated with increased premature mortality risk in a North American cohort.Design: A longitudinal analysis included 4440 participants aged 45-79 y at baseline with an 8-y follow-up from the Osteoarthritis Initiative cohort study. Potato consumption (including fried and unfried potatoes) was analyzed by using a Block Brief 2000 food-frequency questionnaire and categorized as ≤1 time/mo, 2-3 times/mo, 1 time/wk, 2 times/wk, or ≥3 times/wk. Mortality was ascertained through validated cases of death. To investigate the association between potato consumption and mortality, Cox regression models were constructed to estimate HRs with 95% CIs, with adjustment for potential confounders.Results: Of the 4400 participants, 2551 (57.9%) were women with a mean ± SD age of 61.3 ± 9.2 y. During the 8-y follow-up, 236 participants died. After adjustment for 14 potential baseline confounders, and taking those with the lowest consumption of potatoes as the reference group, participants with the highest consumption of potatoes did not show an increased risk of overall mortality (HR: 1.11; 95% CI: 0.65, 1.91). However, subgroup analyses indicated that participants who consumed fried potatoes 2-3 times/wk (HR: 1.95; 95% CI: 1.11, 3.41) and ≥3 times/wk (HR: 2.26; 95% CI: 1.15, 4.47) were at an increased risk of mortality. The consumption of unfried potatoes was not associated with an increased mortality risk.Conclusions: The frequent consumption of fried potatoes appears to be associated with an increased mortality risk. Additional studies in larger sample sizes should be performed to confirm if overall potato consumption is associated with higher mortality risk.

KEYWORDS:

Osteoarthritis Initiative.; mortality; potato; risk factor

 

Association of dietary nitrate with atherosclerotic vascular disease mortality: a prospective cohort study of older adult women.

Blekkenhorst LC, Bondonno CP, Lewis JR, Devine A, Woodman RJ, Croft KD, Lim WH, Wong G, Beilin LJ, Prince RL, Hodgson JM.

Am J Clin Nutr. 2017 May 31. pii: ajcn146761. doi: 10.3945/ajcn.116.146761. [Epub ahead of print]

PMID: 28566306

http://ajcn.nutrition.org.sci-hub.cc/lookup/doi/10.3945/ajcn.116.146761

Abstract

Background: Nitrate-rich vegetables lower blood pressure and improve endothelial function in humans. It is not known, however, whether increased consumption of nitrate-rich vegetables translates to a lower risk of atherosclerotic vascular disease (ASVD) mortality.Objective: The objective was to investigate the association of nitrate intake from vegetables with ASVD mortality.Design: A total of 1226 Australian women aged 70-85 y without prevalent ASVD and/or diabetes were recruited in 1998 and were studied for 15 y. We assessed demographic and ASVD risk factors at baseline (1998), and we used a validated food-frequency questionnaire to evaluate dietary intake. Nitrate intake from vegetables was calculated by use of a newly developed comprehensive database. The primary outcome was any death attributed to ASVD ascertained by using linked data that were provided via the Western Australian Data Linkage system. We used Cox proportional hazards modeling to examine the association between nitrate intake and ASVD mortality before and after adjustment for lifestyle and cardiovascular disease risk factors.Results: During a follow-up period of 15,947 person-years, 238 of 1226 (19.4%) women died of ASVD-related causes. The mean ± SD vegetable nitrate intake was 67.0 ± 29.2 mg/d. Each SD higher vegetable nitrate intake was associated with a lower risk of ASVD mortality in both unadjusted [hr: 0.80 (95% CI: 0.70, 0.92), P = 0.002] and multivariable-adjusted [hr: 0.79 (95% CI: 0.68, 0.93), P = 0.004] analyses. This relation was attenuated after further adjustment for diet quality [hr: 0.85 (95% CI: 0.72, 1.01), P = 0.072]. Higher vegetable nitrate intake (per SD) also was associated with a lower risk of all-cause mortality [Multivariable-adjusted HR: 0.87 (95% CI: 0.78, 0.97), P = 0.011].Conclusions: Nitrate intake from vegetables was inversely associated with ASVD mortality independent of lifestyle and cardiovascular disease risk factors in this population of older adult women without prevalent ASVD or diabetes. These results support the concept that nitrate-rich vegetables may reduce the risk of age-related ASVD mortality.

KEYWORDS:

atherosclerosis; atherosclerotic vascular disease; cardiovascular diseases; mortality; nitrate; vegetables

 

The effect of oral iron with or without multiple micronutrients on hemoglobin concentration and hemoglobin response among nonpregnant Cambodian women of reproductive age: a 2 x 2 factorial, double-blind, randomized controlled supplementation trial.

Karakochuk CD, Barker MK, Whitfield KC, Barr SI, Vercauteren SM, Devlin AM, Hutcheon JA, Houghton LA, Prak S, Hou K, Chai TL, Stormer A, Ly S, Devenish R, Oberkanins C, Pühringer H, Harding KB, De-Regil LM, Kraemer K, Green TJ.

Am J Clin Nutr. 2017 May 10. pii: ajcn140996. doi: 10.3945/ajcn.116.140996. [Epub ahead of print]

PMID: 28490515

Abstract

Background: Despite a high prevalence of anemia among nonpregnant Cambodian women, current reports suggest that iron deficiency (ID) prevalence is low. If true, iron supplementation will not be an effective anemia reduction strategy.Objective: We measured the effect of daily oral iron with or without multiple micronutrients (MMNs) on hemoglobin concentration in nonpregnant Cambodian women screened as anemic.Design: In this 2 × 2 factorial, double-blind, randomized trial, nonpregnant women (aged 18-45 y) with hemoglobin concentrations ≤117 g/L (capillary blood) were recruited from 26 villages in Kampong Chhnang province and randomly assigned to receive 12 wk of iron (60 mg; Fe group), MMNs (14 other micronutrients; MMN group), iron plus MMNs (Fe+MMN group), or placebo capsules. A 2 × 2 factorial intention-to-treat analysis with the use of a generalized mixed-effects model was used to assess the effects of iron and MMNs and the interaction between these factors. Results: In July 2015, 809 women were recruited and 760 (94%) completed the trial. Baseline anemia prevalence was 58% (venous blood). Mean (95% CI) hemoglobin concentrations at 12 wk in the Fe, MMN, Fe+MMN, and placebo groups were 121 (120, 121), 116 (116, 117), 123 (122, 123), and 116 (116, 117) g/L, with no iron × MMN interaction (P = 0.66). Mean (95% CI) increases in hemoglobin were 5.6 g/L (3.8, 7.4 g/L) (P < 0.001) among women who received iron (n = 407) and 1.2 g/L (-0.6, 3.0 g/L) (P = 0.18) among women who received MMNs (n = 407). The predicted proportions (95% CIs) of women with a hemoglobin response (≥10 g/L at 12 wk) were 19% (14%, 24%), 9% (5%, 12%), 30% (24%, 35%), and 5% (2%, 9%) in the Fe, MMN, Fe+MMN, and placebo groups, respectively.Conclusions: Daily iron supplementation for 12 wk increased hemoglobin in nonpregnant Cambodian women; however, MMNs did not confer additional significant benefit. Overall, ∼24% of women who received iron responded after 12 wk; even fewer would be likely to respond in the wider population.

KEYWORDS:

Cambodia; anemia; hemoglobin; iron; micronutrient; supplementation; women

 

Shingles may up risk of heart attack, stroke

People who got shingles more likely to be female, have common heart-risk factors

Thomson Reuters Posted: Jul 03, 2017

http://www.cbc.ca/news/health/shingles-heart-attack-stroke-1.4188800

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Journal of the American College of Cardiology

Volume 70, Issue 2, July 2017

DOI: 10.1016/j.jacc.2017.05.015

Herpes Zoster Increases the Risk of Stroke and Myocardial Infarction

Min-Chul Kim, Sung-Cheol Yun, Han-Bin Lee, Pil Hyung Lee, Seung-Whan Lee, Sang-Ho Choi, Yang Soo Kim, Jun Hee Woo, Sung-Han Kim, Sun U. Kwon

http://sci-hub.cc/10.1016/j.jacc.2017.05.015

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Herpesvirus Infections and Risk of Frailty and Mortality in Older Women: Women's Health and Aging Studies.

Wang GC, Han C, Detrick B, Casolaro V, Levine DM, Fried LP, Walston JD.

J Am Geriatr Soc. 2016 May;64(5):998-1005. doi: 10.1111/jgs.14090. Epub 2016 Apr 30.

PMID: 27131018 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882224/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4882224/pdf/nihms756218.pdf

Abstract

OBJECTIVES:

To examine the relationship between herpesvirus infections and mortality and incident frailty risks in community-dwelling older women.

DESIGN:

Nested prospective cohort study.

SETTING:

Women's Health and Aging Studies I and II.

PARTICIPANTS:

Community-dwelling older women aged 70 to 79 (n = 633).

MEASUREMENTS:

Baseline serum antibody (immunoglobulin G) levels against four herpesviruses (herpes simplex virus types 1 (HSV-1) and 2 (HSV-2), varicella-zoster virus (VZV), 7 Epstein-Barr virus (EBV)), 3-year incident frailty rates, and 5-year mortality.

RESULTS:

Women seropositive for HSV-1 and HSV-2, but not VZV and EBV, had higher risk of 3-year incident frailty (HSV-1: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 0.96-3.74; HSV-2: HR = 2.10, 95% CI = 1.05-4.37) and 5-year mortality (HR = 1.73, 95% CI = 0.93-3.20; HR = 1.80, 95% CI = 0.94-3.44, respectively) than seronegative women. Incremental increases in serum HSV-1 and HSV-2 antibody levels were associated with incrementally higher risks of incident frailty and mortality. After adjustment for potential confounders, only higher serum HSV-2 antibody level was independently predictive of higher risk of mortality in older women (for each unit increase in antibody index, HR = 1.47, 95% CI = 1.05-2.07).

CONCLUSION:

HSV-1 and HSV-2 antibody levels are not independently associated with risk of incident frailty in older women. Only HSV-2 antibody level is independently predictive of 5-year mortality risk, with each incremental increase in the antibody level adding further risk.

KEYWORDS:

cytomegalovirus; frailty; herpes simplex virus; herpesvirus; mortality

 

Should we recommend reductions in saturated fat intake or in red/processed meat consumption? The SUN prospective cohort study.

Dominguez LJ, Bes-Rastrollo M, Basterra-Gortari FJ, Gea A, Barbagallo M, Martínez-González MA.

Clin Nutr. 2017 Jun 19. pii: S0261-5614(17)30224-8. doi: 10.1016/j.clnu.2017.06.013. [Epub ahead of print]

PMID: 28669669

http://sci-hub.cc/10.1016/j.clnu.2017.06.013

Abstract

BACKGROUND & AIMS:

While most studies have shown increased mortality associated with excessive red/processed meat consumption, the association of saturated fatty acids (SFA) intake with mortality is less homogeneous. We aimed to prospectively assess the association of both, meat consumption (red, processed, red + processed, and total) and SFA intake, with the risk of all-cause death.

METHODS:

We assessed 18,540 participants of the SUN (Seguimiento Universidad de Navarra) cohort, followed-up for a mean of 9.5 years. A validated 136-item FFQ was administered at baseline. We used Cox models adjusted for potential confounders.

RESULTS:

We observed 255 deaths during 176,916 person-years of follow-up. Age modified the association between meat consumption and all-cause mortality (p for interaction = 0.027, 0.075, and 0.013, for red, total, and processed meat, respectively). Among participants aged >45 years the fully-adjusted HRs (95% CIs) for one additional serving/d of red, total, and red + processed meat consumption were 1.47 (1.06, 2.04), 1.23 (1.05, 1.45), and 1.32 (1.05, 1.65), respectively, with significant linear trends (P for trend 0.022, 0.012, and 0.018, respectively). In these participants, SFA intake was non-significantly associated with mortality. However, isocaloric replacement of monounsaturated fat or carbohydrates by SFA resulted in significantly higher mortality risk. Likewise, replacing 100 g of vegetables, fruits & nuts or cereals by 100 g of red meat resulted in higher mortality risk. No association of meat consumption or SFA with all-cause mortality was observed in participants younger than 46 years.

CONCLUSIONS:

Among highly educated persons, aged >45 years, a high consumption of red, total, and red + processed meat was related to increased all-cause mortality, compared with those with low consumption, whereas no significant associations were found for SFA intake. Dietary guidelines should specifically limit meat consumption and not relying only in limiting SFA intake.

KEYWORDS:

Cohort; Diet; Mortality; Prospective; Red meat; Total meat

 

Dietary beetroot juice - effects on physical performance in COPD patients: a randomized controlled crossover trial.

Friis AL, Steenholt CB, Løkke A, Hansen M.

Int J Chron Obstruct Pulmon Dis. 2017 Jun 15;12:1765-1773. doi: 10.2147/COPD.S135752. eCollection 2017.

PMID: 28670117

Abstract

BACKGROUND AND OBJECTIVE:

Dietary beetroot juice (BR) supplementation has been shown to reduce the oxygen (O2) consumption of standardized exercise and reduce resting blood pressure (BP) in healthy individuals. However, the physiological response of BR in chronic obstructive pulmonary disease (COPD) remains controversial. The objective was to test exercise performance in COPD, supplementing with higher doses of BR for a longer duration compared to previous trials in this patient group.

METHODS:

Fifteen COPD patients consumed concentrated BR (2×70 mL twice daily, each containing 300 mg nitrate) or placebo (PL) (2×70 mL twice daily, nitrate-negligible) in a randomized order for 6 consecutive days. On day 7, participants consumed either BR or PL 150 min before testing. BP was measured before completing 6-minute walk test (6MWT) and two trials of submaximal cycling. The protocol was repeated after a minimum washout of 7 days.

RESULTS:

Plasma nitrite concentration was higher in the BR condition compared to PL (P<0.01). There was no difference between the BR and PL conditions regarding the covered distance during the 6MWT (mean ± standard error of the mean: 515±35 m (BR) vs 520±38 m (PL), P=0.46), O2 consumption of submaximal exercise (trial 1 P=0.31 vs trial 2 P=0.20), physical activity level (P>0.05), or systolic BP (P=0.80). However, diastolic BP (DBP) was reduced after BR ingestion compared to baseline (mean difference: 4.6, 95% CI: 0.1-9.1, P<0.05).

CONCLUSION:

Seven days of BR ingestion increased plasma nitrite concentrations and lowered DBP in COPD patients. However, BR did not increase functional walking capacity, O2 consumption during submaximal cycling, or physical activity level during the intervention period.

KEYWORDS:

beetroot juice; blood pressure; chronic obstructive pulmonary disease; exercise; nitrate; nitric oxide; nitrite

 

Chocolate Consumption and Risk of Coronary Heart Disease, Stroke, and Diabetes: A Meta-Analysis of Prospective Studies.

Yuan S, Li X, Jin Y, Lu J.

Nutrients. 2017 Jul 2;9(7). pii: E688. doi: 10.3390/nu9070688.

PMID: 28671591

http://www.mdpi.com/2072-6643/9/7/688/htm

Abstract

Although epidemiological studies have examined the role of chocolate in preventing cardiometabolic disease, the results remain inconsistent. Herein, we conducted a meta-analysis of prospective studies to determine the association between chocolate intake and risk of coronary heart disease (CHD), stroke, and diabetes. A systematical search in PubMed and Embase through March 2017, together with reference scrutiny of relevant literatures, was performed to identify eligible studies. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled using random effect models. Fourteen prospective studies of primary prevention with 508,705 participants were finally included, with follow-up durations ranging from 5 to 16 years. The summary RRs for the highest versus lowest chocolate consumption were 0.90 (95% CI: 0.82-0.97; n = 6) for CHD, 0.84 (95% CI: 0.78-0.90; n = 7) for stroke, and 0.82 (95% CI: 0.70-0.96; n = 5) for diabetes. Dose-response meta-analysis suggested a nonlinear association of chocolate consumption with all outcomes. For both CHD and stroke, there was little additional risk reduction when consuming chocolate ≥3 servings/week (one serving was defined as 30 g of chocolate). For diabetes, the peak protective effect of chocolate emerged at 2 servings/week (RR: 0.75, 95% CI: 0.63-0.89), with no benefit observed when increasing consumption above 6 servings/week. In conclusion, chocolate intake is associated with decreased risks of CHD, stroke, and diabetes. Consuming chocolate in moderation (≤6 servings/week) may be optimal for preventing these disorders.

KEYWORDS:

chocolate consumption; coronary heart disease; diabetes; meta-analysis; stroke

 

[i thought more adjustments in their multivariable adjustment should have been made, including for hepatitis virus.]

The ratio of serum eicosapentaenoic acid to arachidonic acid and risk of cancer death in a Japanese community: The Hisayama Study.

Nagata M, Hata J, Hirakawa Y, Mukai N, Yoshida D, Ohara T, Kishimoto H, Kawano H, Kitazono T, Kiyohara Y, Ninomiya T.

J Epidemiol. 2017 Jun 29. pii: S0917-5040(17)30143-0. doi: 10.1016/j.je.2017.01.004. [Epub ahead of print]

PMID: 28669629

http://linkinghub.elsevier.com.sci-hub.cc/retrieve/pii/S0917504017301430

Abstract

BACKGROUND:

Whether the intake of eicosapentaenoic acid (EPA) or arachidonic acid (AA) affects the risk of cancer remains unclear, and the association between the serum EPA:AA ratio and cancer risk has not been fully evaluated in general populations.

METHODS:

A total of 3098 community-dwelling subjects aged ≥40 years were followed up for 9.6 years (2002-2012). The levels of the serum EPA:AA ratio were categorized into quartiles (<0.29, 0.29-0.41, 0.42-0.60, and >0.60). The risk estimates were computed using a Cox proportional hazards model. The same analyses were conducted for the serum docosahexaenoic acid to arachidonic acid (DHA:AA) ratio and individual fatty acid concentrations.

RESULTS:

During the follow-up period, 121 subjects died of cancer. Age- and sex-adjusted cancer mortality increased with lower serum EPA:AA ratio levels (p trend<0.05). In the multivariable-adjusted analysis, the subjects in the first quartile of the serum EPA:AA ratio had a 1.93-fold (95% confidence interval, 1.15-3.22) greater risk of cancer death than those in the fourth quartile. Lower serum EPA concentrations were marginally associated with higher cancer mortality (p trend<0.11), but the serum DHA or AA concentrations and the serum DHA:AA ratio were not (all p trend>0.37). With regard to site-specific cancers, lower serum EPA:AA ratio was associated with a higher risk of death from liver cancer. However, no such associations were detected for deaths from other cancers.

CONCLUSIONS:

These findings suggest that decreased level of the serum EPA:AA ratio is a significant risk factor for cancer death in the general Japanese population.

KEYWORDS:

Arachidonic acid; Cohort studies; Eicosapentaenoic acid; Mortality; Neoplasms

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The Role of Leisure Activities in Mediating the Relationship between Physical Health and Well-Being: Differential Patterns in Old and Very Old Age.

Ihle A, Gouveia ÉR, Gouveia BR, van der Linden BWA, Sauter J, Gabriel R, Oris M, Fagot D, Kliegel M.

Gerontology. 2017 Jul 5. doi: 10.1159/000477628. [Epub ahead of print]

PMID: 28675907

Abstract

BACKGROUND:

Recently, Paggi et al. [Gerontology 2016;62:450-458] for the very first time showed in a cross-sectional sample of 259 adults aged 18-81 years that the relation of physical health to psychological well-being was mediated via frequency of leisure activity participation.

OBJECTIVE:

To extend this framework, we followed theories on successful aging and vulnerability to propose to add a differential perspective predicting that certain individuals may be more vulnerable than others and therefore may show differences in the mediation pattern. Specifically, we examined whether mediation patterns were differential in certain populations, such as in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities.

METHODS:

We analyzed data from 3,080 individuals on physical health (number of chronic diseases, subjective health status, and subjective evaluation of change in health over the last 10 years), frequency of participation in 18 leisure activities, and physical and psychological well-being using moderated mediation models with a path model approach that allowed the simultaneous estimation of all model paths, including their significance.

RESULTS:

We found that the relation of physical health to physical and psychological well-being was mediated via frequency of activity participation. For physical (but not for psychological) well-being, this mediation was more pronounced in old-old (compared to young-old) adults and in individuals who carried out a low (compared to those with a high) number of activities. These moderated mediations were attributable to differential relations of physical health to frequency of activity participation and to differential relations of frequency of activity participation to physical well-being between the investigated moderator levels.

CONCLUSION:

Present data suggest that participation in leisure activities may play a key role in mediating the relationship between physical health and well-being, particularly in very old age. Findings are discussed with respect to theories of successful aging and differences between physical and psychological well-being.

KEYWORDS:

Activity engagement; Health constraints; Physical well-being; Psychological well-being; Successful aging

 

Effect of soybean protein on blood pressure in postmenopausal women: a meta-analysis of randomized controlled trials.

Kou T, Wang Q, Cai J, Song J, Du B, Zhao K, Ma Y, Geng B, Zhang Y, Han X, Jiang M, Guo H, Hu B, Li Z, Zhai Y, Zhang C.

Food Funct. 2017 Jul 4. doi: 10.1039/c6fo01845a. [Epub ahead of print] Review.

PMID: 28675204

Abstract

The effect of soybean protein on blood pressure (BP) in postmenopausal women is controversial, so we aimed to conduct a systematic review and a meta-analysis of published randomized controlled trials (RCTs) to investigate whether supplementation with soy protein improves their blood pressure. PubMed and Embase were searched up to February 2016. Weighted mean differences were calculated for net changes in BP by using fixed-effect or random-effect models. Subgroup and meta-regression analyses were performed to clarify heterogeneity among the trials. A total of twelve trials (1551 postmenopausal women participants) were included in the present meta-analysis. The overall pooled estimates of the effect of soy protein indicated a significant effect on systolic blood pressure (SBP) (mean difference: -3.03 mmHg; 95% CI: -5.03, -1.02; P = 0.003) and diastolic blood pressure (DBP) (mean difference: -0.71 mmHg; 95% CI: -1.26, -0.16; P = 0.012). Subgroup analyses further demonstrated that soy protein intake ≥25 g d-1 significantly reduced BP, and the mean difference in SBP and DBP was -4.62 mmHg (95% CI: -8.42, -0.81; P = 0.04) and -1.63 mmHg (95% CI: -2.85, -0.41; P = 0.009), respectively. Soy isoflavone intake ≥100 mg d-1 had a better reduction effect both in SBP (-5.47 mmHg; 95% CI: -8.42, -2.51; P = 0.00) and DBP (-2.03 mmHg; 95% CI: -3.35, -0.72; P = 0.002). However, soy protein intake <25 g d-1 or soy isoflavone intake <100 mg d-1 had no such effects (P > 0.05). This meta-analysis suggests that ingestion of ≥25 g soy protein per day has BP-lowering effects, and the improvements in BP may be due to the isoflavones component of soy protein. More high-quality RCTs need to be carried out to confirm the present findings.

 

Vitamin D supplementation in primary allergy prevention: systematic review of randomized and non-randomized studies.

Yepes-Nuñez JJ, Brożek JL, Fiocchi A, Pawankar R, Cuello-García C, Zhang Y, Morgano GP, Agarwal A, Gandhi S, Terracciano L, Schünemann HJ.

Allergy. 2017 Jul 4. doi: 10.1111/all.13241. [Epub ahead of print] Review.

PMID: 28675776

Abstract

BACKGROUND:

To date, a systematic review of the evidence regarding the association between Vitamin D and allergic diseases development has not yet been undertaken.

OBJECTIVE:

To review the efficacy and safety of Vitamin D supplementation when compared to no supplementation in pregnant women, breastfeeding women, infants and children for the prevention of allergies.

METHODS:

Three databases were searched through 30 January 2016 including randomized (RCT) and non-randomized studies (NRS). Two reviewers independently extracted data and assessed the certainty in the body of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS:

Among the 1932 articles identified, one RCT and four NRS were eligible. Very low certainty in the body of evidence across examined studies suggests that Vitamin D supplementation for pregnant women, breastfeeding women and infants may not decrease the risk of developing allergic diseases such as atopic dermatitis (in pregnant women), allergic rhinitis (in pregnant women, and infants), asthma and/or wheezing (in pregnant women, breastfeeding women, and infants), or food allergies (in pregnant women). We found no studies of primary prevention of allergic diseases in children.

CONCLUSION:

Limited information is available addressing primary prevention of allergic diseases after Vitamin D supplementation and its potential impact remains uncertain. This article is protected by copyright. All rights reserved.

KEYWORDS:

GRADE ; Allergy; Prevention; Vitamin D; systematic review

 

Serum 25-hydroxyvitamin D level, chronic diseases and all-cause mortality in a population-based prospective cohort: the HUNT Study, Norway.

Sun YQ, Langhammer A, Skorpen F, Chen Y, Mai XM.

BMJ Open. 2017 Jul 3;7(6):e017256. doi: 10.1136/bmjopen-2017-017256.

PMID: 28674149 Free Article

http://bmjopen.bmj.com/content/7/6/e017256.long

http://bmjopen.bmj.com/content/bmjopen/7/6/e017256.full.pdf

Abstract

OBJECTIVE:

To investigate the association of vitamin D status with all-cause mortality in a Norwegian population and the potential influences of existing chronic diseases on the association.

DESIGN:

A population-based prospective cohort study.

SETTING:

Nord-Trøndelag County, Norway.

PARTICIPANTS:

A random sample (n=6613) of adults aged 20 years or older in a cohort.

METHODS:

Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in blood samples collected at baseline (n=6377). Mortality was ascertained from the Norwegian National Registry. Cox regression models were applied to estimate the HRs with 95% CIs for all-cause mortality in association with serum 25(OH)D levels after adjustment for a wide spectrum of confounding factors as well as chronic diseases at baseline.

RESULTS:

The median follow-up time was 18.5 years, during which 1539 subjects died. The HRs for all-cause mortality associated with the first quartile level of 25(OH)D (<34.5 nmol/L) as compared with the fourth quartile (≥58.1 nmol/L) before and after adjustment for chronic diseases at baseline were 1.30 (95% CI 1.11 to 1.51) and 1.27 (95% CI 1.09 to 1.48), respectively. In the subjects without chronic diseases at baseline and with further exclusion of the first 3 years of follow-up, the corresponding adjusted HR was 1.34 (95% CI 1.09 to 1.66).

CONCLUSIONS:

Low serum 25(OH)D level was associated with increased all-cause mortality in a general Norwegian population. The association was not notably influenced by existing chronic diseases.

KEYWORDS:

25-hydroxyvitamin D (25(OH)D); all-cause mortality; chronic diseases; prospective cohort study; vitamin D

 

3β-hydroxy-urs-12-en-28-oic acid modulates dietary restriction mediated longevity and ameliorates toxic protein aggregation in C. elegans.

Negi H, Saikia SK, Pandey R.

J Gerontol A Biol Sci Med Sci. 2017 Jun 30. doi: 10.1093/gerona/glx118. [Epub ahead of print]

PMID: 28673026

Abstract

Species from lower invertebrates to a spectrum of mammals show anti-aging health benefits of phytochemical(s). Here, we explored the pro-longevity effects of a natural triterpenoid, ursolic acid (3β-hydroxy-urs-12-en-28-oic acid; UA) in Caenorhabditis elegans with maximal lifespan being evident at 25µM UA. Similar to eat-2 mutants, UA uptake by worm results in reduced fat storage and attenuation of reactive oxygen species (ROS), independent of superoxide dismutase(s) activation. The genetic requirements for UA mediated longevity are quite similar to dietary restriction (DR) achieved through SKN-1/ NRF-2 exhibiting up regulation of downstream target genes gcs-1 and daf-9. Longevity mechanism was independent of PHA-4/FOXA and attributed to partial dependence on sir-2.1. Altogether, our study suggests differential use of UA elicited signalling cascades in nutrient sensing for longevity. Both the redox state and the proteostasis of an organism play critical role in aging and disease resistance. Interestingly, we observed a reduction of toxic protein aggregation in transgenic polyglutamine (polyQ) C. elegans model and UA mediated JNK-1 (c-Jun-NH2-terminal kinase) activation in wild-type animals. Thus, our study demonstrates a small extent of prevention against proteotoxic stress by UA coupled with positive aspects of DR mediated longevity.

KEYWORDS:

Healthy aging; Polyglutamine; ROS; Ursolic acid

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https://en.wikipedia.org/wiki/Ursolic_acid#Natural_occurrence

https://en.wikipedia.org/wiki/Ursolic_acid#Potential_biochemical_effects

Effect of Ursolic Acid on Metabolic Syndrome, Insulin Sensitivity, and Inflammation.

Ramírez-Rodríguez AM, González-Ortiz M, Martínez-Abundis E, Acuña Ortega N.

J Med Food. 2017 Jun 9. doi: 10.1089/jmf.2017.0003. [Epub ahead of print]

PMID: 28598231

Abstract

To evaluate the effect of ursolic acid on metabolic syndrome, insulin sensitivity, and inflammation. A randomized, double-blind, placebo-controlled clinical trial was carried out in 24 patients (30-60 years) with a diagnosis of metabolic syndrome without treatment. They were randomly assigned to two groups of 12 patients, each to receive orally 150 mg of ursolic acid or homologated placebo once a day for 12 weeks. Before and after the intervention, the components of metabolic syndrome, insulin sensitivity (Matsuda index), and inflammation profile (interleukin-6 and C-reactive protein) were evaluated. After ursolic acid administration, the remission of metabolic syndrome occurred in 50% of patients (P = .005) with significant differences in body weight (75.7 ± 11.5 vs. 71 ± 11 kg, P = .002), body mass index (BMI) (29.9 + 3.6 vs. 24.9 ± 1.2 kg/m2, P = .049), waist circumference (93 ± 8.9 vs. 83 + 8.6 cm, P = .008), fasting glucose (6.0 ± 0.5 vs. 4.7 ± 0.4 mmol/L, P = .002), and insulin sensitivity (3.1 ± 1.1 vs. 4.2 ± 1.2, P = .003). Ursolic acid administration leads to transient remission of metabolic syndrome, reducing body weight, BMI, waist circumference and fasting glucose, as well as increasing insulin sensitivity.

KEYWORDS:

inflammation; insulin sensitivity; metabolic syndrome; ursolic acid

 

Long-term heartburn medication use tied to higher risk of early death

In some cases, addressing the root cause of heartburn could reduce symptoms before jumping to medication

CBC News Posted: Jul 04, 2017

http://www.cbc.ca/news/health/heartburn-proton-pump-inhibitor-death-1.4189603

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Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans

Yan Xie1, Benjamin Bowe1, Tingting Li1,2, Hong Xian1,3, Yan Yan1,4, Ziyad Al-Aly1,2,5,6

BMJ Open 2017;7:e015735. doi:10.1136/bmjopen-2016-015735

http://bmjopen.bmj.com/content/7/6/e015735

http://bmjopen.bmj.com/content/bmjopen/7/6/e015735.full.pdf

Abstract

Objective Proton pump inhibitors (PPIs) are widely used, and their use is associated with increased risk of adverse events. However, whether PPI use is associated with excess risk of death is unknown. We aimed to examine the association between PPI use and risk of all-cause mortality.

Design Longitudinal observational cohort study.

Setting US Department of Veterans Affairs.

Participants Primary cohort of new users of PPI or histamine H2 receptor antagonists (H2 blockers) (n=349 312); additional cohorts included PPI versus no PPI (n=3 288 092) and PPI versus no PPI and no H2 blockers (n=2 887 030).

Main outcome measures Risk of death.

Results Over a median follow-up of 5.71 years (IQR 5.11–6.37), PPI use was associated with increased risk of death compared with H2 blockers use (HR 1.25, CI 1.23 to 1.28). Risk of death associated with PPI use was higher in analyses adjusted for high-dimensional propensity score (HR 1.16, CI 1.13 to 1.18), in two-stage residual inclusion estimation (HR 1.21, CI 1.16 to 1.26) and in 1:1 time-dependent propensity score-matched cohort (HR 1.34, CI 1.29 to 1.39). The risk of death was increased when considering PPI use versus no PPI (HR 1.15, CI 1.14 to 1.15), and PPI use versus no PPI and no H2 blockers (HR 1.23, CI 1.22 to 1.24). Risk of death associated with PPI use was increased among participants without gastrointestinal conditions: PPI versus H2 blockers (HR 1.24, CI 1.21 to 1.27), PPI use versus no PPI (HR 1.19, CI 1.18 to 1.20) and PPI use versus no PPI and no H2 blockers (HR 1.22, CI 1.21 to 1.23). Among new PPI users, there was a graded association between the duration of exposure and the risk of death.

Conclusions The results suggest excess risk of death among PPI users; risk is also increased among those without gastrointestinal conditions and with prolonged duration of use. Limiting PPI use and duration to instances where it is medically indicated may be warranted.

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Caloric restriction impacts plasma microRNAs in rhesus monkeys.

Schneider A, Dhahbi JM, Atamna H, Clark JP, Colman RJ, Anderson RM.

Aging Cell. 2017 Jul 5. doi: 10.1111/acel.12636. [Epub ahead of print]

PMID: 28677323

http://onlinelibrary.wiley.com/doi/10.1111/acel.12636/full

Abstract

Caloric restriction (CR) is one of the most robust interventions shown to delay aging in diverse species, including rhesus monkeys (Macaca mulatta). Identification of factors involved in CR brings a promise of translatability to human health and aging. Here, we show that CR induced a profound change in abundance of circulating microRNAs (miRNAs) linked to growth and insulin signaling pathway, suggesting that miRNAs are involved in CR's mechanisms of action in primates. Deep sequencing of plasma RNA extracts enriched for short species revealed a total of 243 unique species of miRNAs including 47 novel species. Approximately 70% of the plasma miRNAs detected were conserved between rhesus monkeys and humans. CR induced or repressed 24 known and 10 novel miRNA species. Regression analysis revealed correlations between bodyweight, adiposity, and insulin sensitivity for 10 of the CR-regulated known miRNAs. Sequence alignment and target identification for these 10 miRNAs identify a role in signaling downstream of the insulin receptor. The highly abundant miR-125a-5p correlated positively with adiposity and negatively with insulin sensitivity and was negatively regulated by CR. Putative target pathways of CR-associated miRNAs were highly enriched for growth and insulin signaling that have previously been implicated in delayed aging. Clustering analysis further pointed to CR-induced miRNA regulation of ribosomal, mitochondrial, and spliceosomal pathways. These data are consistent with a model where CR recruits miRNA-based homeostatic mechanisms to coordinate a program of delayed aging.

KEYWORDS:

aging; caloric restriction; miR-125a-5p; microRNA; rhesus monkeys

 

Anti-aging pharmacology in cutaneous wound healing: effects of metformin, resveratrol, and rapamycin by local application.

Zhao P, Sui BD, Liu N, Lv YJ, Zheng CX, Lu YB, Huang WT, Zhou CH, Chen J, Pang DL, Fei DD, Xuan K, Hu CH, Jin Y.

Aging Cell. 2017 Jul 5. doi: 10.1111/acel.12635. [Epub ahead of print]

PMID: 28677234

http://onlinelibrary.wiley.com/doi/10.1111/acel.12635/full

Abstract

Cutaneous wounds are among the most common soft tissue injuries and are particularly hard to heal in aging. Caloric restriction (CR) is well documented to extend longevity; pharmacologically, profound rejuvenative effects of CR mimetics have been uncovered, especially metformin (MET), resveratrol (RSV), and rapamycin (RAPA). However, locally applied impacts and functional differences of these agents on wound healing remain to be established. Here, we discovered that chronic topical administration of MET and RSV, but not RAPA, accelerated wound healing with improved epidermis, hair follicles, and collagen deposition in young rodents, and MET exerted more profound effects. Furthermore, locally applied MET and RSV improved vascularization of the wound beds, which were attributed to stimulation of adenosine monophosphate-activated protein kinase (AMPK) pathway, the key mediator of wound healing. Notably, in aged skin, AMPK pathway was inhibited, correlated with impaired vasculature and reduced healing ability. As therapeutic approaches, local treatments of MET and RSV prevented age-related AMPK suppression and angiogenic inhibition in wound beds. Moreover, in aged rats, rejuvenative effects of topically applied MET and RSV on cell viability of wound beds were confirmed, of which MET showed more prominent anti-aging effects. We further verified that only MET promoted wound healing and cutaneous integrity in aged skin. These findings clarified differential effects of CR-based anti-aging pharmacology in wound healing, identified critical angiogenic and rejuvenative mechanisms through AMPK pathway in both young and aged skin, and unraveled chronic local application of MET as the optimal and promising regenerative agent in treating cutaneous wound defects.

KEYWORDS:

AMPK pathway; aged skin; anti-aging pharmacology; metformin; vascularization; wound healing

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Association between handgrip strength, walking, age-related illnesses and cognitive status in a sample of Portuguese centenarians.

Vaz-Patto M, Bueno B, Ribeiro Ó, Teixeira L, Afonso RM.

Eur Rev Aging Phys Act. 2017 Jul 1;14:9. doi: 10.1186/s11556-017-0178-2. eCollection 2017.

PMID: 28680504

Abstract

BACKGROUND:

Centenarians are a growing population in Europe and present significant variability in motor and cognitive functions. The aim of our study was to characterize health status, as well as cognitive and motor functions in a group of Portuguese centenarians. In addition, our study also aimed at analyzing the relationship between cognitive functions and the burden of diseases affecting the elderly.

METHODS:

Fifty-two centenarians were evaluated using the Mini-Mental State Examination, short version. Walking-related parameters (velocity and time spent in the 3 m walk test), grip strength and number of age-related illnesses were also measured. The relationship between cognitive scores and time spent in the three metre walk test, velocity, grip strength and number of diseases was analysed.

RESULTS:

Cognitive scores showed a positive correlation with both handgrip strength and time spent in the three metre walk. In contrast, no association was found between cognitive scores and the presence/absence of disease, walking velocity or number of diseases present.

CONCLUSIONS:

These results suggest that in centenarians, cognitive functions may be related with motor functions.

KEYWORDS:

Centenarians; Cognitive status; Disease burden; Motor function

 

http://phenol-explorer.eu/contents/polyphenol/420

Antiosteoporotic activity of a syringic acid diet in ovariectomized mice.

Tanaka T, Kawaguchi N, Zaima N, Moriyama T, Fukuta Y, Shirasaka N.

J Nat Med. 2017 Jul 5. doi: 10.1007/s11418-017-1105-6. [Epub ahead of print]

PMID: 28681119

http://sci-hub.cc/10.1007/s11418-017-1105-6Abstract

In recent years, the number of patients with osteoporosis has risen with the increase in average longevity. Therefore, the chemoprevention of osteoporosis using food materials or food components has become an increasingly important target. Syringic acid (SA) is a phenolic compound present in the fruit of the açaí palm Euterpe oleracea and the mycelium of the shiitake mushroom Lentinula edodes. This compound has no affinity for estrogen receptors and is potentially useful for disease prevention. However, little is known about the effects of a SA diet on bone metabolism, particularly bone resorption in vivo. Here, we demonstrated the effects of a SA diet on bone loss and uterine weight loss in ovariectomized (OVX) mice. Ten-week-old OVX mice were fed SA-containing diets (100 mg/kg body weight/day) for 10 weeks. After 10 weeks of dietary SA, the body weight, food intake, and uterine weight of the OVX mice were unaffected; however, femoral bone mineral density (cortical bone density, cancellous bone density, and total bone density) was higher in the SA-fed groups than in the OVX-control group. Furthermore, histomorphometric analysis revealed that the number of osteoclasts and osteoblasts was decreased and increased, respectively, in the SA-fed groups. These results suggest that a SA diet suppresses bone loss by downregulating bone resorption and upregulating bone formation without affecting the uterus in OVX mice. Although further studies are needed, SA may be a compound that can be used to prevent or retard osteoporosis.

KEYWORDS:

Osteoblast; Osteoclast; Ovariectomized mice; Syringic acid

 

The association of dietary quality with colorectal cancer among normal weight, overweight and obese men and women: a prospective longitudinal study in the USA.

Torres Stone RA, Waring ME, Cutrona SL, Kiefe CI, Allison J, Doubeni CA.

BMJ Open. 2017 Jul 5;7(6):e015619. doi: 10.1136/bmjopen-2016-015619.

PMID: 28679675

http://bmjopen.bmj.com.sci-hub.cc/lookup/doi/10.1136/bmjopen-2016-015619

Abstract

OBJECTIVE:

Lower body mass index (BMI) and higher dietary quality reduce the risk of colorectal cancer (CRC). A full understanding of how these associations vary by sex and weight is lacking.

METHODS:

We used data from the National Institutes of Health - American Association of Retired Persons (NIH)-AARP) Diet and Health Study for 398 458 persons who were 50-71 years old in 1995-1996 and followed through 2006. Exposures were dietary quality as reflected by the Mediterranean Diet, the Healthy Eating Index-2010 and the Dietary Approaches to Stop Hypertension score, stratified by BMI category. The outcome was CRC diagnosis from cancer registry data. Cox regression models were adjusted for disease risk factors.

RESULTS:

Over a mean duration of 123 months of follow-up, there were 6515 new diagnoses of CRC (1953 among the normal weight, 2924 among the overweight and 1638 among the obese; 4483 among men and 2032 among women). For normal weight and overweight men, we found a strong dose-response pattern for the association of increasing quintile of dietary quality with decreasing risk of CRC; this pattern was observed for obese men as well, but less consistently across the three measures of dietary quality. The findings were of smaller magnitude and less consistent for women but still suggesting associations of similar direction.

CONCLUSION:

We observed that increased dietary quality was associated with lower risk of incident CRC up to 10 years later for men regardless of baseline weight category.

KEYWORDS:

and nutrition; body mass index; colorectal cancer; diet; food

 

Effects of a combined protein and antioxidant supplement on recovery of muscle function and soreness following eccentric exercise.

Ives SJ, Bloom S, Matias A, Morrow N, Martins N, Roh Y, Ebenstein D, O'Brien G, Escudero D, Brito K, Glickman L, Connelly S, Arciero PJ.

J Int Soc Sports Nutr. 2017 Jul 3;14:21. doi: 10.1186/s12970-017-0179-6. eCollection 2017.

PMID: 28680370

Abstract

BACKGROUND:

An acute bout of eccentric contractions (ECC) cause muscle fiber damage, inflammation, impaired muscle function (MF) and muscle soreness (MS). Individually, protein (PRO) and antioxidant (AO) supplementation may improve some aspects of recovery from ECC, though have yet to be combined. We sought to determine if combined PRO and AO supplementation (PRO + AO) improves MS and MF following damaging ECC over PRO alone.

METHODS:

Sixty sedentary college-aged males participated in a randomized, single-blind, parallel design study of peak isometric torque (PIMT), peak isokinetic torque (PIKT), thigh circumference (TC), and muscle soreness (MS) of knee extensor muscles measured at baseline, immediately after and 1, 2, 6, and 24 h after completion of 100 maximal ECC. Immediately, 6 h, and 22 h post-ECC, participants consumed either: carbohydrate control (CHO; n = 14), PRO (n = 16), or PRO + AO (n = 17).

RESULTS:

At baseline MS, TC, MF, macro- and micro-nutrient intakes, and total work during the ECC were not different between groups (p > 0.05). PIMT and PIKT (both -25%∆), TC (~1%∆) and MS (~35%∆) all changed with time (p < 0.05). We observed a group by time effect for PIKT (PRO + AO and PRO > CHO, p < 0.05). At 24 h post ECC, there was a trend towards improved relative PIMT (~11%) and PIKT (~17%) for PRO + AO (~17%) and PRO (~11%) compared to CHO. An interaction indicated PRO + AO had lowest MS over time (PRO + AO > PRO & CHO, p < 0.05).

CONCLUSIONS:

Our results suggest PRO facilitates recovery of muscle function within 24 h following ECC, and addition of AO ameliorates MS more than PRO or CHO alone.

KEYWORDS:

Antioxidant supplementation; Eccentric exercise; Free radicals; Muscle damage; Muscle function; Protein intake

 

Interaction between Nonsteroidal Anti-inflammatory Drugs and Low-fat Dietary Intervention on Colorectal Cancer Incidence; the Women's Health Initiative (WHI) Dietary Modification Trial.

Kato I, Lane D, Womack CR, Bock CH, Hou L, Lin JH, Wu C, Beebe Dimmer J, Simon MS.

J Am Coll Nutr. 2017 Jul 6:1-8. doi: 10.1080/07315724.2017.1321505. [Epub ahead of print]

PMID: 28682183

Abstract

BACKGROUND:

The Women's Health Initiative (WHI) Dietary Modification (DM) trial did not show that reductions in dietary fat accompanied by increases in vegetable and fruit consumption decrease the incidence of colorectal cancer. Secondary analyses suggested that aspirin use may modify the intervention effects of DM on colorectal cancer development, although a recent reanalysis including the postintervention period confirmed no main effect of the intervention on reducing colorectal cancer incidence Methods: We analyzed data from 48,834 postmenopausal women who were randomized into the low-fat DM (N = 19,540) or comparison (N = 29,294) group for an average 8.1 years and followed for an additional 9.4 years through August 31, 2014. Exposure to specific class(es) or strength(s) of nonsteroidal anti-inflammatory drugs (NSAIDs) was modeled at baseline and as time-dependent use through the 9-year clinic visit. A Cox proportional hazard model was employed to assess the association of the DM, medication use, and their interaction with colorectal cancer events.

RESULTS:

A total of 906 incident cases of colorectal cancer were identified during the intervention and postintervention periods. By both exposure models, we found that colorectal cancer incidence was not different in the DM from the comparison group among any type of NSAID users. None of the interactions with any category of NSAID use was statistically significant; however there was most modest evidence for an interaction (p = 0.07) with aspirin use at baseline (hazard ratio {HR} = 0.81, 95% confidence interval [CI], 0.60-1.11 for users; HR = 1.12, 95% CI, 0.97-1.30 for nonusers). Strength and duration of aspirin use at baseline did not alter the associations.

CONCLUSION:

Extended follow-up of women in the WHI DM trial did not confirm combined protective effects of aspirin and low-fat diet on colorectal cancer risk among the postmenopausal women.

KEYWORDS:

Low-fat diet; aspirin; clinical trial; colorectal cancer; nonsteroidal anti-inflammatory drugs

 

Statins intake and risk of liver cancer: A dose-response meta analysis of prospective cohort studies.

Yi C, Song Z, Wan M, Chen Y, Cheng X.

Medicine (Baltimore). 2017 Jul;96(27):e7435. doi: 10.1097/MD.0000000000007435.

PMID: 28682909

Abstract

Previous studies have indicated that statins intake was associated with liver cancer risk, but presented controversial results.Studies in PubMed and EMBASE were searched update to February 2017 to identify and quantify the potential dose-response association between statins intake and liver cancer.Six eligible studies involving a total of 11,8961 participants with 9530 incident cases were included in this meta-analysis. Statistically significant association was observed between increasing statins intake and liver cancer risk reduction (OR = 0.46, 95%CI: 0.24-0.68, P <.001). Furthermore, the summary relative risk of liver cancer for an increase of 50 cumulative defined daily dose per year was 0.86 (95%CI: 0.81-0.90, P <.001). Evidence of a nonlinear dose-response relationship between statins intake and liver cancer risk was found (P for nonlinearity <.01). Subgroups analysis indicated that statins intake was associated with a significantly risk of liver cancer risk reduction in Asia (OR = 0.44, 95%CI: 0.11-0.77, P <.001) and Caucasian (OR = 0.49, 95%CI: 0.36-0.61, P <.001). Subgroup meta-analyses in study design, study quality, number of participants, and number of cases showed consistency with the primary findings. Additional statins intake is associated with liver cancer risk reduction.

 

Dietary l-tryptophan leaves a lasting impression on the brain and the stress response.

Höglund E, Øverli Ø, Andersson MÅ, Silva P, Laursen DC, Moltesen MM, Krogdahl Å, Schjolden J, Winberg S, Vindas MA, Mayer I, Hillestad M.

Br J Nutr. 2017 May;117(10):1351-1357. doi: 10.1017/S0007114517001428. Epub 2017 Jun 19.

PMID: 28625179

Abstract

Comparative models suggest that effects of dietary tryptophan (Trp) on brain serotonin (5-hydroxytryptamine; 5-HT) neurochemistry and stress responsiveness are present throughout the vertebrate lineage. Moreover, hypothalamic 5-HT seems to play a central role in control of the neuroendocrine stress axis in all vertebrates. Still, recent fish studies suggest long-term effects of dietary Trp on stress responsiveness, which are independent of hypothalamic 5-HT. Here, we investigated if dietary Trp treatment may result in long-lasting effects on stress responsiveness, including changes in plasma cortisol levels and 5-HT neurochemistry in the telencephalon and hypothalamus of Atlantic salmon. Fish were fed diets containing one, two or three times the Trp content in normal feed for 1 week. Subsequently, fish were reintroduced to control feed and were exposed to acute crowding stress for 1 h, 8 and 21 d post Trp treatment. Generally, acute crowding resulted in lower plasma cortisol levels in fish treated with 3×Trp compared with 1×Trp- and 2×Trp-treated fish. The same general pattern was reflected in telencephalic 5-HTergic turnover, for which 3×Trp-treated fish showed decreased values compared with 2×Trp-treated fish. These long-term effects on post-stress plasma cortisol levels and concomitant 5-HT turnover in the telencephalon lends further support to the fact that the extrahypothalamic control of the neuroendocrine stress response is conserved within the vertebrate lineage. Moreover, they indicate that trophic/structural effects in the brain underlie the effects of dietary Trp treatment on stress reactivity.

KEYWORDS:

l-Tryptophan; 5-HIAA 5-hydroxyindoleacetic acid; 5-HT 5-hydroxytryptamine (serotonin); HPI hypothalamic–pituitary–interrenal; SSRI supplementation and serotonin reuptake inhibitors; Trp tryptophan; Long-term effects; Monoamines

 

Dietary calcium intake and rate of bone loss in men.

Bristow SM, Gamble GD, Horne AM, Reid IR.

Br J Nutr. 2017 May;117(10):1432-1438. doi: 10.1017/S0007114517001301. Epub 2017 Jun 13.

PMID: 28606219

Abstract

A high Ca intake has been recommended for osteoporosis prevention; however, little research has examined the relationship between dietary Ca and bone health in men. We examined associations between dietary Ca intake, bone mineral density (BMD) and change in BMD at the total body, hip and spine over 2 years in a cohort of men (mean age 57 years, BMI 26 kg/m2) from a trial. Data from the total cohort (n 323) were used in the analysis of Ca intake and BMD at baseline, and data from the placebo group (n 99) were used in the longitudinal analysis of Ca intake and change in BMD. Parathyroid hormone (PTH) and the markers of bone turnover serum total alkaline phosphatase activity, serum C-telopeptide and serum procollagen type-1 N-terminal propeptide were measured in a subset of participants at baseline (n 150), and associations with dietary Ca at baseline were examined. Mean Ca intake was 870 mg/d. Baseline BMD was not related to dietary Ca intake at any site, before or after adjustment for covariables. Similarly, bone loss over 2 years was not related to Ca intake at any site, before or after adjustment. Dietary Ca intake was inversely correlated with PTH at baseline (r -0·19, P=0·02), but was not associated with the markers of bone turnover. BMD and rates of bone loss were unrelated to Ca intake in these men. This suggests that strategies to increase Ca intake are unlikely to impact on the prevalence of and morbidity from male osteoporosis.

KEYWORDS:

25(OH)D 25-hydroxyvitamin D; BMD bone mineral density; PINP procollagen type-1 N-terminal propeptide; PTH parathyroid hormone; Bone density; Cross-sectional studies; Dietary calcium; Osteoporosis; Prospective studies

 

Carotenoid dietary intakes and plasma concentrations are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort.

Hayhoe RPG, Lentjes MAH, Mulligan AA, Luben RN, Khaw KT, Welch AA.

Br J Nutr. 2017 May;117(10):1439-1453. doi: 10.1017/S0007114517001180. Epub 2017 Jun 7.

PMID: 28587685

Abstract

Carotenoids are found in abundance in fruit and vegetables, and may be involved in the positive association of these foods with bone health. This study aimed to explore the associations of dietary carotenoid intakes and plasma concentrations with bone density status and osteoporotic fracture risk in a European population. Cross-sectional analyses (n 14 803) of bone density status, using calcaneal broadband ultrasound attenuation (BUA) and longitudinal analyses (n 25 439) of fracture cases were conducted on data from the prospective European Prospective Investigation into Cancer and Nutrition-Norfolk cohort of middle-aged and older men and women. Health and lifestyle questionnaires were completed, and dietary nutrient intakes were derived from 7-d food diaries. Multiple regression demonstrated significant positive trends in BUA for women across quintiles of dietary α-carotene intake (P=0·029), β-carotene intake (P=0·003), β-cryptoxanthin intake (P=0·031), combined lutein and zeaxanthin intake (P=0·010) and lycopene intake (P=0·005). No significant trends across plasma carotenoid concentration quintiles were apparent (n 4570). The Prentice-weighted Cox regression showed no trends in fracture risk across dietary carotenoid intake quintiles (mean follow-up time 12·5 years), except for a lower risk for wrist fracture in women with higher lutein and zeaxanthin intake (P=0·022); nevertheless, inter-quintile differences in fracture risk were found for both sexes. Analysis of plasma carotenoid data (mean follow-up time 11·9 years) showed lower hip fracture risk in men across higher plasma α-carotene (P=0·026) and β-carotene (P=0·027) quintiles. This study provides novel evidence that dietary carotenoid intake is relevant to bone health in men and women, demonstrating that associations with bone density status and fracture risk exist for dietary intake of specific carotenoids and their plasma concentrations.

KEYWORDS:

BUA broadband ultrasound attenuation; HRT hormone replacement therapy; Bone ultrasound; Carotenoids; Fractures; Nutrition; Osteoporosis

 

Commentary on 'dietary magnesium intake and fracture risk: data from a large prospective study'.

Hayhoe RPG.

Br J Nutr. 2017 May;117(10):1454-1455. doi: 10.1017/S0007114517001337. Epub 2017 Jun 13. No abstract available.

PMID: 28606204

http://sci-hub.cc/10.1017/S0007114517001337

 

Association of flavonoid-rich foods and flavonoids with risk of all-cause mortality.

Ivey KL, Jensen MK, Hodgson JM, Eliassen AH, Cassidy A, Rimm EB.

Br J Nutr. 2017 May;117(10):1470-1477. doi: 10.1017/S0007114517001325. Epub 2017 Jun 13.

PMID: 28606222

Abstract

Flavonoids are bioactive compounds found in foods such as tea, red wine, fruits and vegetables. Higher intakes of specific flavonoids, and flavonoid-rich foods, have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoid-rich foods, and flavonoids, in preventing all-cause mortality remains uncertain. As such, we examined the association of intake of flavonoid-rich foods and flavonoids with subsequent mortality among 93 145 young and middle-aged women in the Nurses' Health Study II. During 1 838 946 person-years of follow-up, 1808 participants died. When compared with non-consumers, frequent consumers of red wine, tea, peppers, blueberries and strawberries were at reduced risk of all-cause mortality (P<0·05), with the strongest associations observed for red wine and tea; multivariable-adjusted hazard ratios 0·60 (95 % CI 0·49, 0·74) and 0·73 (95 % CI 0·65, 0·83), respectively. Conversely, frequent grapefruit consumers were at increased risk of all-cause mortality, compared with their non-grapefruit consuming counterparts (P<0·05). When compared with those in the lowest consumption quintile, participants in the highest quintile of total-flavonoid intake were at reduced risk of all-cause mortality in the age-adjusted model; 0·81 (95 % CI 0·71, 0·93). However, this association was attenuated following multivariable adjustment; 0·92 (95 % CI 0·80, 1·06). Similar results were observed for consumption of flavan-3-ols, proanthocyanidins and anthocyanins. Flavonols, flavanones and flavones were not associated with all-cause mortality in any model. Despite null associations at the compound level and select foods, higher consumption of red wine, tea, peppers, blueberries and strawberries, was associated with reduced risk of total and cause-specific mortality. These findings support the rationale for making food-based dietary recommendations.

KEYWORDS:

ICD International Classification of Diseases; CVD; Cancer; Flavonoids; Mortality; Red wine; Tea

Edited by AlPater

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Dietary Protein Intake above the Current RDA and Bone Health: A Systematic Review and Meta-Analysis.

Wallace TC, Frankenfeld CL.

J Am Coll Nutr. 2017 Jul 7:1-16. doi: 10.1080/07315724.2017.1322924. [Epub ahead of print]

PMID: 28686536

Abstract

Dietary intake of protein is fundamental for optimal acquisition and maintenance of bone across all life stages; however, it has been hypothesized that intakes above the current recommended dietary allowance (RDA) might be beneficial for bone health. We utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines when preparing and reporting this systematic review and meta-analysis. A literature search strategy through April 11, 2017, was developed for the following 3 databases: PubMed, Ovid Medline, and Agricola. Included studies were those randomized controlled trials and prospective cohort studies among healthy adults ages 18 and older that examined the relationships between varying doses of protein intake at or above the current U.S. RDA (0.8 g/kg/d or 10%-15% of total caloric intake) from any source on fracture, bone mineral density (BMD)/bone mineral content (BMC), and/or markers of bone turnover. Twenty-nine articles were included for data extraction (16 randomized controlled trials [RCTs] and 13 prospective cohort studies). Meta-analysis of the prospective cohort studies showed high vs low protein intakes resulted in a statistically significant 16% decrease in hip fractures (standardized mean difference [sMD] = 0.84, 95% confidence interval [CI], 0.73, 0.95; I2 = 36.8%). Data from studies included in these analyses collectively lean toward the hypothesis that protein intake above the current RDA is beneficial to BMD at several sites. This systematic review supports that protein intakes above the current RDA may have some beneficial role in preventing hip fractures and BMD loss. There were no differences between animal or plant proteins, although data in this area were scarce. Larger, long-term, and more well-controlled clinical trials measuring fracture outcomes and BMD are needed to adequately assess whether protein intake above the current RDA is beneficial as a preventative measure and/or intervention strategy for osteoporosis. Key teaching points: • • Bone health is a multifactorial musculoskeletal issue, and optimal protein intakes are key in developing and maintaining bone throughout the life span. • • Dietary protein at levels above the current RDA may be beneficial in preventing hip fractures and BMD loss. • • Plant vs animal proteins do not seem to differ in their ability to prevent bone loss; however, data in this area are scarce. • • Larger, long-term RCTs using women not using hormone replacement therapy (HRT) are needed to adequately assess the magnitude of impact that protein intakes above the RDA have on preventing bone loss.

KEYWORDS:

Protein; bone; bone density; calcium; fractures

 

The PREDIMED trial, Mediterranean diet and health outcomes: How strong is the evidence?

Guasch-Ferré M, Salas-Salvadó J, Ros E, Estruch R, Corella D, Fitó M, Martínez-González MA; PREDIMED Investigators.

Nutr Metab Cardiovasc Dis. 2017 Jun 10. pii: S0939-4753(17)30098-4. doi: 10.1016/j.numecd.2017.05.004. [Epub ahead of print]

PMID: 28684083

Abstract

AIMS:

To address potential controversies on the health benefits of the Mediterranean diet (MedDiet) after PREDIMED, a randomized trial of MedDiet for primary cardiovascular prevention. We have focused on: a) the PREDIMED study design, b) analysis of PREDIMED data and c) interpretation of its results.

DATA SYNTHESIS:

Regarding the design of the trial, its early termination and between-group differences in the intensity of the intervention are potential causes of concern. The planned duration was 6 years but the trial was prematurely stopped when an interim analysis at 4.8-year provided sufficient evidence of benefit for the two MedDiets. In the MedDiet groups supplemented with extra-virgin olive oil or mixed-nuts, the primary composite endpoint (myocardial infarction, stroke, or cardiovascular death) was reduced by 30% and 28% respectively, as compared with the control group. Final results did not change after taking into account the different intensity of educational efforts during the trial. Other potential doubts related to data analysis (e.g., intention to treat versus a per-protocol approach, and consequences of dropouts) should not be causes of concern. Finally, we addressed alternative interpretations of the effect on all-cause mortality. The protocol-defined primary endpoint was a composite cardiovascular endpoint, not all-cause mortality. To analyze total mortality, we would have needed a much larger sample size and longer follow-up. Therefore, the PREDIMED results cannot be used to draw firm conclusions on MedDiets and all-cause mortality.

CONCLUSIONS:

The PREDIMED study was designed to overcome three major problems of previous nutritional research: a) residual confounding, addressed by using a randomized design; b) single-nutrient approaches, by randomizing an overall dietary pattern; and c) the limitations of assessing only intermediate risk markers, by using hard clinical end-points.

KEYWORDS:

Cardiovascular disease; Clinical trial; Mediterranean diet; PREDIMED

 

Association between Homocysteine Levels and All-cause Mortality: A Dose-Response Meta-Analysis of Prospective Studies.

Fan R, Zhang A, Zhong F.

Sci Rep. 2017 Jul 6;7(1):4769. doi: 10.1038/s41598-017-05205-3.

PMID: 28684797

Abstract

Plasma homocysteine (Hcy) levels may be associated with all-cause mortality risk. However, the results of this association are conflicting and the dose-response relationship between them has not been clearly defined. In this meta-analysis, we conducted a systematic literature search of the PubMed, Embase, Web of Science and Cochrane Library for the relevant articles dated up to February 2017. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated to evaluate the estimates, and the dose-response relationship was estimated using a restricted cubic spline model. Eleven prospective studies (4,110 deaths among 27,737 individuals) were included. The summary RR of all-cause mortality for the highest Hcy category vs. the lowest Hcy category was 1.80 (95% CI: 1.51, 2.14) with the random effects model. In dose-response meta-analysis, Hcy levels were significantly associated with all-cause mortality risk in a linear fashion (p nonlinearity = 0.255), and the risk of all-cause mortality increased by 33.6% for each 5 µmol/L increase in Hcy levels (RR = 1.336, 95% CI: 1.254-1.422, p < 0.001). Findings from this dose-response meta-analysis suggest that Hcy levels are linearly and positively associated with risk of all-cause mortality.

 

Contribution of dietary amino acids composition to incidence of cardiovascular outcomes: A prospective population-based study.

Mirmiran P, Bahadoran Z, Ghasemi A, Azizi F.

Nutr Metab Cardiovasc Dis. 2017 May 15. pii: S0939-4753(17)30097-2. doi: 10.1016/j.numecd.2017.05.003. [Epub ahead of print]

PMID: 28684082

http://sci-hub.cc/10.1016/j.numecd.2017.05.003

Abstract

BACKGROUND AND AIM:

Considering the limited data on the cardiovascular effects of dietary amino acid intakes, we assessed possible association of dietary amino acids with the risk of cardiovascular (CVD) events in a prospective population-based study.

METHODS:

Participants without CVD (n = 2369) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 6.7 years. Dietary protein and amino acid intakes were assessed at baseline (2006-2008); demographic, lifestyle and biochemical variables were evaluated at baseline and follow-up examination (2012-2014). Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary amino acids.

RESULTS:

Mean total protein intake was 76.9 ± 27.5 g/d, and dietary protein had no significant association with the risk of CVD (HR = 1.23, 95% CI = 0.65-2.31, and HR = 0.52, 95% CI = 0.19-1.41, in the second and third tertiles, respectively). After adjustment of potential confounders, the amino acid pattern with higher load of glycine, cysteine, arginine and tryptophan, was negatively associated with CVD (HR = 0.28, 95% CI = 0.09-0.88, P for trend = 0.08). Higher intake of sulfur-containing amino acids (cysteine and methionine), and potentially cardioprotective amino acids (arginine, cysteine, glutamic acid, glycine, histidine, leucine and tyrosine) corresponded to 73% (HR = 0.27, 95% CI = 0.09-0.86) and 74% (HR = 0.26, 95% CI = 0.09-0.78) decreased risk of CVD events. Higher intake of glutamic acid and proline (% of dietary total protein) increased the risk of CVD (HR = 1.30, 95% CI = 1.03-1.64, and HR = 1.33, 95% CI = 1.10-1.60, respectively).

CONCLUSION:

These novel data provide evidence to suggest that amino acid composition of diet may modify the risk of CVD events.

KEYWORDS:

Cardiovascular disease; Dietary amino acids; Dietary protein

 

Dietary nitrate supplementation increases acute mountain sickness severity and sense of effort during hypoxic exercise.

Rossetti GMK, Macdonald JH, Wylie LJ, Little SJ, Newton V, Wood B, Hawkins KA, Beddoe R, Davies HE, Oliver SJ.

J Appl Physiol (1985). 2017 Jul 6:jap.00293.2017. doi: 10.1152/japplphysiol.00293.2017. [Epub ahead of print]

PMID: 28684588

Abstract

Dietary nitrate supplementation enhances sea level performance and may ameliorate hypoxemia at high altitude. However, nitrate may exacerbate acute mountain sickness (AMS), specifically headache. This study investigated the effect of nitrate supplementation on AMS symptoms and exercise responses with 6h hypoxia. Twenty recreationally-active men (mean(SD): age 22(4) years, V̇O2max 51(6) mL·min-1·kg-1) completed this randomized double-blinded placebo-controlled crossover study. Twelve participants were classified as AMS- based on Environmental Symptom Questionnaire (AMS-C) score <0.7 in both trials, and five participants were classified as AMS+ based on AMS-C score ≥0.7 on placebo. Five days nitrate supplementation (70mL beetroot juice containing ~6.4mmol nitrate daily) increased plasma NO metabolites by 182µM compared to placebo but did not reduce AMS or improve exercise performance. After 4h hypoxia (FIO2=0.124) nitrate increased AMS-C and headache severity (visual analogue scale (VAS); whole sample ∆10[1,20] mm; p=0.03) compared to placebo. In addition, after 5h hypoxia, nitrate increased sense of effort during submaximal exercise (∆7[-1,14]; p=0.07). In AMS- nitrate did not alter headache or sense of effort. In contrast, in AMS+ nitrate increased headache severity (∆26[-3,56] mm; p=0.07), sense of effort (∆14[1,28]; p=0.04), oxygen consumption, ventilation, and mean arterial pressure during submaximal exercise. On the next day, in a separate acute hypoxic exercise test (FIO2=0.141), nitrate did not improve time to exhaustion at 80% hypoxic V̇O2max. In conclusion, dietary nitrate increases AMS and sense of effort during exercise, particularly in those who experienced AMS. Dietary nitrate is therefore not recommended as an AMS prophylactic or ergogenic aid non-acclimatized individuals at altitude.

KEYWORDS:

Altitude sickness; Beetroot; Headache; Nitric oxide; Rating of perceived exertion

 

[The below paper is not pdf-availed.]

Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men.

Franzon K, Byberg L, Sjögren P, Zethelius B, Cederholm T, Kilander L.

J Am Geriatr Soc. 2017 Jul 7. doi: 10.1111/jgs.14971. [Epub ahead of print]

PMID: 28685810

Abstract

OBJECTIVES:

To examine the longitudinal associations between aging with preserved functionality, i.e. independent aging and survival, and lifestyle variables, dietary pattern and cardiovascular risk factors.

DESIGN:

Cohort study.

SETTING:

Uppsala Longitudinal Study of Adult Men, Sweden.

PARTICIPANTS:

Swedish men (n = 1,104) at a mean age of 71 (range 69.4-74.1) were investigated, 369 of whom were evaluated for independent aging 16 years later, at a mean age of 87 (range 84.8-88.9).

MEASUREMENTS:

A questionnaire was used to obtain information on lifestyle, including education, living conditions, and physical activity. Adherence to a Mediterranean-like diet was assessed according to a modified Mediterranean Diet Score derived from 7-day food records. Cardiovascular risk factors were measured. Independent aging at a mean age of 87 was defined as lack of diagnosed dementia, a Mini-Mental State Examination score of 25 or greater, not institutionalized, independence in personal activities of daily living, and ability to walk outdoors alone. Complete survival data at age 85 were obtained from the Swedish Cause of Death Register.

RESULTS:

Fifty-seven percent of the men survived to age 85, and 75% of the participants at a mean age of 87 displayed independent aging. Independent aging was associated with never smoking (vs current) (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.05-4.60) and high (vs low) adherence to a Mediterranean-like diet (OR = 2.69, 95% CI = 1.14-6.80). Normal weight or overweight and waist circumference of 102 cm or less were also associated with independent aging. Similar associations were observed with survival.

CONCLUSION:

Lifestyle factors such as never smoking, maintaining a healthy diet, and not being obese at age 71 were associated with survival and independent aging at age 85 and older in men.

KEYWORDS:

Mediterranean diet; healthy aging; longitudinal; obesity; smoking

 

Dietary Choline and Betaine and Risk of CVD: A Systematic Review and Meta-Analysis of Prospective Studies.

Meyer KA, Shea JW.

Nutrients. 2017 Jul 7;9(7). pii: E711. doi: 10.3390/nu9070711. Review.

PMID: 28686188

Abstract

Studies implicate choline and betaine metabolite trimethylamine N-oxide (TMAO) in cardiovascular disease (CVD). We conducted a systematic review and random-effects meta-analysis to quantify a summary estimated effect of dietary choline and betaine on hard CVD outcomes (incidence and mortality). Eligible studies were prospective studies in adults with comprehensive diet assessment and follow-up for hard CVD endpoints. We identified six studies that met our criteria, comprising 18,076 incident CVD events, 5343 CVD deaths, and 184,010 total participants. In random effects meta-analysis, incident CVD was not associated with choline (relative risk (RR): 1.00; 95% CI: 0.98, 1.02) or betaine (RR: 0.99; 95% CI: 0.98, 1.01) intake. Results did not vary by study outcome (incident coronary heart disease, stroke, total CVD) and there was no evidence for heterogeneity among studies. Only two studies provided data on phosphatidylcholine and CVD mortality. Random effects meta-analysis did not support an association between choline and CVD mortality (RR: 1.09, 95% CI: 0.89, 1.35), but one study supported a positive association and there was significant heterogeneity (I² = 84%, p-value < 0.001). Our findings do not support an association between dietary choline/betaine with incident CVD, but call for further research into choline and CVD mortality.

KEYWORDS:

betaine; cardiovascular disease; choline; epidemiology; meta-analysis; systematic review

 

Non-skeletal health effects of vitamin D supplementation: A systematic review on findings from meta-analyses summarizing trial data.

Rejnmark L, Bislev LS, Cashman KD, Eiríksdottir G, Gaksch M, Grübler M, Grimnes G, Gudnason V, Lips P, Pilz S, van Schoor NM, Kiely M, Jorde R.

PLoS One. 2017 Jul 7;12(7):e0180512. doi: 10.1371/journal.pone.0180512. eCollection 2017.

PMID: 28686645

Abstract

BACKGROUND:

A large number of observational studies have reported harmful effects of low 25-hydroxyvitamin D (25OHD) levels on non-skeletal outcomes. We performed a systematic quantitative review on characteristics of randomized clinical trials (RCTs) included in meta-analyses (MAs) on non-skeletal effects of vitamin D supplementation.

METHODS AND FINDINGS:

We identified systematic reviews (SR) reporting summary data in terms of MAs of RCTs on selected non-skeletal outcomes. For each outcome, we summarized the results from available SRs and scrutinized included RCTs for a number of predefined characteristics. We identified 54 SRs including data from 210 RCTs. Most MAs as well as the individual RCTs reported null-findings on risk of cardiovascular diseases, type 2 diabetes, weight-loss, and malignant diseases. Beneficial effects of vitamin D supplementation was reported in 1 of 4 MAs on depression, 2 of 9 MAs on blood pressure, 3 of 7 MAs on respiratory tract infections, and 8 of 12 MAs on mortality. Most RCTs have primarily been performed to determine skeletal outcomes, whereas non-skeletal effects have been assessed as secondary outcomes. Only one-third of the RCTs had low level of 25OHD as a criterion for inclusion and a mean baseline 25OHD level below 50 nmol/L was only present in less than half of the analyses.

CONCLUSIONS:

Published RCTs have mostly been performed in populations without low 25OHD levels. The fact that most MAs on results from RCTs did not show a beneficial effect does not disprove the hypothesis suggested by observational findings on adverse health outcomes of low 25OHD levels.

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The Scientist » News & Opinion » Daily News

Olfaction Determines Weight in Mice

Animals lacking a sense of smell stayed thinner than their smelling counterparts, despite eating the same amount.

By Diana Kwon | July 5, 2017

http://www.the-scientist.com/?articles.view/articleNo/49798/title/Olfaction-Determines-Weight-in-Mice/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=53935012&_hsenc=p2ANqtz-9a9-rj9gtVSSuBxftbrtR2JEN3TJW00_sB1cKzjPT1xaZzvUh-zjzzvA9r2NLX-YB5acDzdmBKsNsjJMJwa_q9eLhG7g&_hsmi=53935012

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The Sense of Smell Impacts Metabolic Health and Obesity.

Riera CE, Tsaousidou E, Halloran J, Follett P, Hahn O, Pereira MMA, Ruud LE, Alber J, Tharp K, Anderson CM, Brönneke H, Hampel B, Filho CDM, Stahl A, Brüning JC, Dillin A.

Cell Metab. 2017 Jul 5;26(1):198-211.e5. doi: 10.1016/j.cmet.2017.06.015.

PMID: 28683287

http://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30357-1

Abstract

Olfactory inputs help coordinate food appreciation and selection, but their role in systemic physiology and energy balance is poorly understood. Here we demonstrate that mice upon conditional ablation of mature olfactory sensory neurons (OSNs) are resistant to diet-induced obesity accompanied by increased thermogenesis in brown and inguinal fat depots. Acute loss of smell perception after obesity onset not only abrogated further weight gain but also improved fat mass and insulin resistance. Reduced olfactory input stimulates sympathetic nerve activity, resulting in activation of β-adrenergic receptors on white and brown adipocytes to promote lipolysis. Conversely, conditional ablation of the IGF1 receptor in OSNs enhances olfactory performance in mice and leads to increased adiposity and insulin resistance. These findings unravel a new bidirectional function for the olfactory system in controlling energy homeostasis in response to sensory and hormonal signals.

KEYWORDS:

diet-induced obesity; energy balance; hyperosmia; hyposmia; insulin resistance; insulin-like growth factor 1 receptor; lipolysis; olfactory sensory neuron; thermogenesis

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Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study.

Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, Kaaks R, Kühn T, Boeing H, Aleksandrova K, Tjønneland A, Olsen A, Overvad K, Larsen SC, Redondo Cornejo ML, Agudo A, Sánchez Pérez MJ, Altzibar JM, Navarro C, Ardanaz E, Khaw KT, Butterworth A, Bradbury KE, Trichopoulou A, Lagiou P, Trichopoulos D, Palli D, Grioni S, Vineis P, Panico S, Tumino R, Bueno-de-Mesquita B, Siersema P, Leenders M, Beulens JWJ, Uiterwaal CU, Wallström P, Nilsson LM, Landberg R, Weiderpass E, Skeie G, Braaten T, Brennan P, Licaj I, Muller DC, Sinha R, Wareham N, Riboli E.

Ann Intern Med. 2017 Jul 11. doi: 10.7326/M16-2945. [Epub ahead of print]

PMID: 28693038

Abstract

BACKGROUND:

The relationship between coffee consumption and mortality in diverse European populations with variable coffee preparation methods is unclear.

OBJECTIVE:

To examine whether coffee consumption is associated with all-cause and cause-specific mortality.

DESIGN:

Prospective cohort study.

SETTING:

10 European countries.

PARTICIPANTS:

521 330 persons enrolled in EPIC (European Prospective Investigation into Cancer and Nutrition).

MEASUREMENTS:

Hazard ratios (HRs) and 95% CIs estimated using multivariable Cox proportional hazards models. The association of coffee consumption with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers subcohort (n = 14 800).

RESULTS:

During a mean follow-up of 16.4 years, 41 693 deaths occurred. Compared with nonconsumers, participants in the highest quartile of coffee consumption had statistically significantly lower all-cause mortality (men: HR, 0.88 [95% CI, 0.82 to 0.95]; P for trend < 0.001; women: HR, 0.93 [CI, 0.87 to 0.98]; P for trend = 0.009). Inverse associations were also observed for digestive disease mortality for men (HR, 0.41 [CI, 0.32 to 0.54]; P for trend < 0.001) and women (HR, 0.60 [CI, 0.46 to 0.78]; P for trend < 0.001). Among women, there was a statistically significant inverse association of coffee drinking with circulatory disease mortality (HR, 0.78 [CI, 0.68 to 0.90]; P for trend < 0.001) and cerebrovascular disease mortality (HR, 0.70 [CI, 0.55 to 0.90]; P for trend = 0.002) and a positive association with ovarian cancer mortality (HR, 1.31 [CI, 1.07 to 1.61]; P for trend = 0.015). In the EPIC Biomarkers subcohort, higher coffee consumption was associated with lower serum alkaline phosphatase; alanine aminotransferase; aspartate aminotransferase; γ-glutamyltransferase; and, in women, C-reactive protein, lipoprotein(a), and glycated hemoglobin levels.

LIMITATIONS:

Reverse causality may have biased the findings; however, results did not differ after exclusion of participants who died within 8 years of baseline. Coffee-drinking habits were assessed only once.

CONCLUSION:

Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country.

 

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, Salama JS, Vos T, Abate KH, Abbafati C, Ahmed MB, Al-Aly Z, Alkerwi A, Al-Raddadi R, Amare AT, Amberbir A, Amegah AK, Amini E, Amrock SM, Anjana RM, Ärnlöv J, Asayesh H, Banerjee A, Barac A, Baye E, Bennett DA, Beyene AS, Biadgilign S, Biryukov S, Bjertness E, Boneya DJ, Campos-Nonato I, Carrero JJ, Cecilio P, Cercy K, Ciobanu LG, Cornaby L, Damtew SA, Dandona L, Dandona R, Dharmaratne SD, Duncan BB, Eshrati B, Esteghamati A, Feigin VL, Fernandes JC, Fürst T, Gebrehiwot TT, Gold A, Gona PN, Goto A, Habtewold TD, Hadush KT, Hafezi-Nejad N, Hay SI, Horino M, Islami F, Kamal R, Kasaeian A, Katikireddi SV, Kengne AP, Kesavachandran CN, Khader YS, Khang YH, Khubchandani J, Kim D, Kim YJ, Kinfu Y, Kosen S, Ku T, Defo BK, Kumar GA, Larson HJ, Leinsalu M, Liang X, Lim SS, Liu P, Lopez AD, Lozano R, Majeed A, Malekzadeh R, Malta DC, Mazidi M, McAlinden C, McGarvey ST, Mengistu DT, Mensah GA, Mensink GBM, Mezgebe HB, Mirrakhimov EM, Mueller UO, Noubiap JJ, Obermeyer CM, Ogbo FA, Owolabi MO, Patton GC, Pourmalek F, Qorbani M, Rafay A, Rai RK, Ranabhat CL, Reinig N, Safiri S, Salomon JA, Sanabria JR, Santos IS, Sartorius B, Sawhney M, Schmidhuber J, Schutte AE, Schmidt MI, Sepanlou SG, Shamsizadeh M, Sheikhbahaei S, Shin MJ, Shiri R, Shiue I, Roba HS, Silva DAS, Silverberg JI, Singh JA, Stranges S, Swaminathan S, Tabarés-Seisdedos R, Tadese F, Tedla BA, Tegegne BS, Terkawi AS, Thakur JS, Tonelli M, Topor-Madry R, Tyrovolas S, Ukwaja KN, Uthman OA, Vaezghasemi M, Vasankari T, Vlassov VV, Vollset SE, Weiderpass E, Werdecker A, Wesana J, Westerman R, Yano Y, Yonemoto N, Yonga G, Zaidi Z, Zenebe ZM, Zipkin B, Murray CJL.

N Engl J Med. 2017 Jul 6;377(1):13-27. doi: 10.1056/NEJMoa1614362. Epub 2017 Jun 12.

PMID: 28604169 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5477817/

Abstract

BACKGROUND:

Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

METHODS:

We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

RESULTS:

In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

CONCLUSIONS:

The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.

>>>>>>>>>>>>>>>>>>>>>

Global Health Effects of Overweight and Obesity.

Gregg EW, Shaw JE.

N Engl J Med. 2017 Jul 6;377(1):80-81. doi: 10.1056/NEJMe1706095. Epub 2017 Jun 12. No abstract available.

PMID: 28604226 Free Article

http://www.nejm.org/doi/full/10.1056/NEJMe1706095

 

Declining Risk of Sudden Death in Heart Failure.

Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JGF, Dargie HJ, Granger CB, Kjekshus J, Køber L, Latini R, Maggioni AP, Packer M, Pitt B, Solomon SD, Swedberg K, Tavazzi L, Wikstrand J, Zannad F, Zile MR, McMurray JJV.

N Engl J Med. 2017 Jul 6;377(1):41-51. doi: 10.1056/NEJMoa1609758.

PMID: 28679089

Abstract

BACKGROUND:

The risk of sudden death has changed over time among patients with symptomatic heart failure and reduced ejection fraction with the sequential introduction of medications including angiotensin-converting-enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, and mineralocorticoid-receptor antagonists. We sought to examine this trend in detail.

METHODS:

We analyzed data from 40,195 patients who had heart failure with reduced ejection fraction and were enrolled in any of 12 clinical trials spanning the period from 1995 through 2014. Patients who had an implantable cardioverter-defibrillator at the time of trial enrollment were excluded. Weighted multivariable regression was used to examine trends in rates of sudden death over time. Adjusted hazard ratios for sudden death in each trial group were calculated with the use of Cox regression models. The cumulative incidence rates of sudden death were assessed at different time points after randomization and according to the length of time between the diagnosis of heart failure and randomization.

RESULTS:

Sudden death was reported in 3583 patients. Such patients were older and were more often male, with an ischemic cause of heart failure and worse cardiac function, than those in whom sudden death did not occur. There was a 44% decline in the rate of sudden death across the trials (P=0.03). The cumulative incidence of sudden death at 90 days after randomization was 2.4% in the earliest trial and 1.0% in the most recent trial. The rate of sudden death was not higher among patients with a recent diagnosis of heart failure than among those with a longer-standing diagnosis.

CONCLUSIONS:

Rates of sudden death declined substantially over time among ambulatory patients with heart failure with reduced ejection fraction who were enrolled in clinical trials, a finding that is consistent with a cumulative benefit of evidence-based medications on this cause of death.

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[The below paper is pdf-availed.]

Association Between Caffeine Intake and All-Cause and Cause-Specific Mortality: A Population-Based Prospective Cohort Study.

Tsujimoto T, Kajio H, Sugiyama T.

Mayo Clin Proc. 2017 Jul 8. pii: S0025-6196(17)30234-3. doi: 10.1016/j.mayocp.2017.03.010. [Epub ahead of print]

PMID: 28697850

Abstract

OBJECTIVE:

To assess whether caffeine intake is associated with all-cause and cause-specific mortality.

PATIENTS AND METHODS:

We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey 1999-2010. Cox proportional hazards models were used to compare the multivariate-adjusted hazard ratios (HRs) of participants with a caffeine intake of 10 to 99, 100 to 199, and 200 mg/d or more with those of participants with a caffeine intake of less than 10 mg/d.

RESULTS:

In total, 17,594 participants were included, and the mean ± SD and median (interquartile range) follow-up was 6.5±2.8 years and 6.4 (3.6-9.5) years, respectively; 17,568 participants (99.8%) completed the follow-up, and 1310 died. Compared with those who had a caffeine intake of less than 10 mg/d, HRs and 95% CIs for all-cause mortality were significantly lower in participants with a caffeine intake of 10 to 99 mg/d (HR, 0.81; 95% CI, 0.66-1.00; P=.05), 100 to 199 mg/d (HR, 0.63; 95% CI, 0.51-0.78; P<.001), and 200 or more mg/d (HR, 0.69; 95% CI, 0.58-0.83; P<.001). A similar association was observed in participants who consumed less than 1 cup of coffee per week, and the HR was lowest in those with a caffeine intake of 100 to 199 mg/d (HR, 0.46; 95% CI, 0.22-0.93). There was no association between caffeine intake and cardiovascular mortality, whereas the HRs for noncardiovascular mortality were significantly lower in those with a caffeine intake of 10 to 99 mg/d (HR, 0.74; 95% CI, 0.57-0.95; P=.01), 100 to 199 mg/d (HR, 0.60; 95% CI, 0.46-0.77; P<.001), and 200 or more mg/d (HR, 0.65; 95% CI, 0.53-0.80; P<.001).

CONCLUSION:

Moderate caffeine intake was associated with a decreased risk of all-cause mortality, regardless of the presence or absence of coffee consumption.

 

Occupational and leisure-time physical activity and risk of disability pension: prospective data from the HUNT Study, Norway.

Fimland MS, Vie G, Holtermann A, Krokstad S, Nilsen TIL.

Occup Environ Med. 2017 Jul 11. pii: oemed-2017-104320. doi: 10.1136/oemed-2017-104320. [Epub ahead of print]

PMID: 28698178

Abstract

OBJECTIVES:

To prospectively investigate the association between occupational physical activity (OPA) and disability pension due to musculoskeletal cause, mental cause or any cause. We also examined the combined association of OPA and leisure-time physical activity (LTPA) with disability pension.

METHODS:

A population-based cohort study in Norway on 32 362 persons aged 20-65 years with questionnaire data on OPA and LTPA that were followed up for incident disability pension through the National Insurance Database. We used Cox regression to estimate adjusted HRs with 95% CIs.

RESULTS:

During a follow-up of 9.3 years, 3837 (12%) received disability pension. Compared with people with mostly sedentary work, those who performed much walking, much walking and lifting, and heavy physical work had HRs of 1.26 (95% CI 1.16 to 1.38), 1.44 (95% CI 1.32 to 1.58) and 1.48 (95% CI 1.33 to 1.70), respectively. These associations were stronger for disability pension due to musculoskeletal disorders, whereas there was no clear association between OPA and risk of disability pension due to mental disorders. People with high OPA and low LTPA had a HR of 1.77 (95% CI 1.58 to 1.98) for overall disability pension and HR of 2.56 (95% CI 2.10 to 3.11) for disability pension due to musculoskeletal disorders, versus low OPA and high LTPA.

CONCLUSIONS:

We observed a positive association between OPA and risk of disability pension due to all causes and musculoskeletal disorders, but not for mental disorders. Physical activity during leisure time reduced some, but not all of the unfavourable effect of physically demanding work on risk of disability pension.

KEYWORDS:

Public health

 

Omega-6 polyunsaturated fatty acids, serum zinc, delta-5- and delta-6-desaturase activities and incident metabolic syndrome.

Yary T, Voutilainen S, Tuomainen TP, Ruusunen A, Nurmi T, Virtanen JK.

J Hum Nutr Diet. 2017 Aug;30(4):506-514. doi: 10.1111/jhn.12437. Epub 2016 Nov 7.

PMID: 28699199

Abstract

BACKGROUND:

The associations of n-6 polyunsaturated fatty acids (PUFA) with metabolic syndrome have been poorly explored. We investigated the associations of the serum n-6 PUFA and the activities of enzymes involved in the PUFA metabolism, delta-5-desaturase (D5D) and delta-6-desaturase (D6D) with risk of incident metabolic syndrome. We also investigated whether zinc, a cofactor for these enzymes, modifies these associations.

METHODS:

A prospective follow-up study was conducted on 661 men who were aged 42-60 years old at baseline in 1984-1989 and who were re-examined in 1998-2001.

RESULTS:

Men in the highest versus the lowest serum total omega-6 PUFA tertile had a 70% lower multivariate-adjusted risk of incident metabolic syndrome [odds ratio (OR) = 0.30; 95% confidence interval (CI) = 0.18-0.51, Ptrend < 0.001]. Inverse associations were also observed for linoleic acid, arachidonic acid and D5D activity. By contrast, men in the highest tertile of D6D activity had an 84% higher risk (OR = 1.84; 95% CI = 1.15-2.94, Ptrend = 0.008). Similar associations were observed with many of the metabolic syndrome components at the re-examinations. Most associations were attenuated after adjustment for body mass index. Finally, the associations of D6D and LA were stronger among those with a higher serum zinc concentration.

CONCLUSIONS:

Higher serum total n-6 PUFA, linoleic acid and arachidonic acid concentrations and D5D activity were associated with a lower risk of developing metabolic syndrome and higher D6D activity was associated with a higher risk. The role of zinc also needs to be investigated in other populations.

KEYWORDS:

delta-5-desaturase; delta-6-desaturase; metabolic syndrome; omega-6 polyunsaturated fatty acids; prospective study; zinc

 

Association of Changes in Diet Quality with Total and Cause-Specific Mortality.

Sotos-Prieto M, Bhupathiraju SN, Mattei J, Fung TT, Li Y, Pan A, Willett WC, Rimm EB, Hu FB.

N Engl J Med. 2017 Jul 13;377(2):143-153. doi: 10.1056/NEJMoa1613502.

PMID: 28700845

http://sci-hub.cc/10.1056/NEJMoa1613502

Abstract

Background Few studies have evaluated the relationship between changes in diet quality over time and the risk of death. Methods We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses' Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986-1998) were assessed with the use of the Alternate Healthy Eating Index-2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score. Results The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower - by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score - than the risk among participants with consistently low diet scores over time. Conclusions Improved diet quality over 12 years was consistently associated with a decreased risk of death.

 

Association of Changes in Diet Quality with Total and Cause-Specific Mortality

Mercedes Sotos-Prieto, Ph.D., Shilpa N. Bhupathiraju, Ph.D., Josiemer Mattei, Ph.D., M.P.H., Teresa T. Fung, Sc.D., Yanping Li, Ph.D., An Pan, Ph.D., Walter C. Willett, M.D., Dr.P.H., Eric B. Rimm, Sc.D., and Frank B. Hu, M.D., Ph.D.

N Engl J Med 2017; 377:143-153July 13, 2017DOI: 10.1056/NEJMoa1613502

Abstract

BACKGROUND

Few studies have evaluated the relationship between changes in diet quality over time and the risk of death.

METHODS

We used Cox proportional-hazards models to calculate adjusted hazard ratios for total and cause-specific mortality among 47,994 women in the Nurses’ Health Study and 25,745 men in the Health Professionals Follow-up Study from 1998 through 2010. Changes in diet quality over the preceding 12 years (1986–1998) were assessed with the use of the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score.

RESULTS

The pooled hazard ratios for all-cause mortality among participants who had the greatest improvement in diet quality (13 to 33% improvement), as compared with those who had a relatively stable diet quality (0 to 3% improvement), in the 12-year period were the following: 0.91 (95% confidence interval [CI], 0.85 to 0.97) according to changes in the Alternate Healthy Eating Index score, 0.84 (95 CI%, 0.78 to 0.91) according to changes in the Alternate Mediterranean Diet score, and 0.89 (95% CI, 0.84 to 0.95) according to changes in the DASH score. A 20-percentile increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17% with the use of the three diet indexes and a 7 to 15% reduction in the risk of death from cardiovascular disease with the use of the Alternate Healthy Eating Index and Alternate Mediterranean Diet. Among participants who maintained a high-quality diet over a 12-year period, the risk of death from any cause was significantly lower — by 14% (95% CI, 8 to 19) when assessed with the Alternate Healthy Eating Index score, 11% (95% CI, 5 to 18) when assessed with the Alternate Mediterranean Diet score, and 9% (95% CI, 2 to 15) when assessed with the DASH score — than the risk among participants with consistently low diet scores over time.

CONCLUSIONS

Improved diet quality over 12 years was consistently associated with a decreased risk of death.

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No independent association between pulse wave velocity and dementia: a population-based, prospective study.

Nilsson ED, Elmståhl S, Minthon L, Pihlsgård M, Nilsson PM, Hansson O, Nägga K.

J Hypertens. 2017 Jul 12. doi: 10.1097/HJH.0000000000001480. [Epub ahead of print]

PMID: 28704261

Abstract

OBJECTIVE:

Carotid-femoral pulse wave velocity (CFPWV), a marker of aortic stiffness, has been associated with cognitive test results and markers of cerebral small vessel disease, but its association with dementia has not been studied in detail. Our aim was to assess the association of CFPWV with prevalent and incident dementia in a large population-based study.

METHODS:

In total, CFPWV was measured in 3056 participants of the Malmö Diet and Cancer study 2007-2012 (age range 61-85 years). Individuals scoring below preset cut-offs on cognitive screening tests were thoroughly evaluated for prevalent dementia. Also, dementia diagnoses were retrieved from the Swedish National Patient Register up until 31 December 2014, and then validated through medical records and neuroimaging findings.

RESULTS:

We identified 159 cases of dementia, of which 57 were classified as prevalent, and 102 as incident during a median follow-up of 4.6 years. In fully adjusted logistic regressions, CFPWV was not associated with prevalent all-cause dementia (odds ratio 0.95 per 1 m/s increase in CFPWV, 95% confidence interval 0.83-1.08), and it did not predict incident all-cause dementia (odds ratio 1.00, 95% confidence interval 0.91-1.09). Neither was CFPWV associated with subtypes of dementia (Alzheimer's disease, vascular dementia, mixed dementia), although the number of cases in subgroups were low.

CONCLUSION:

No independent association was found between CFPWV and dementia. It remains a matter of debate why CFPWV repeatedly has been associated with cognitive test results and markers of cerebral small vessel disease, but not with dementia.

 

Does the ingestion of a 24 hour low glycaemic index Asian mixed meal diet improve glycaemic response and promote fat oxidation? A controlled, randomized cross-over study.

Camps SG, Kaur B, Quek RYC, Henry CJ.

Nutr J. 2017 Jul 12;16(1):43. doi: 10.1186/s12937-017-0258-1.

PMID: 28701162

https://nutritionj.biomedcentral.com/articles/10.1186/s12937-017-0258-1

https://nutritionj.biomedcentral.com/track/pdf/10.1186/s12937-017-0258-1?site=nutritionj.biomedcentral.com

Abstract

BACKGROUND:

The health benefits of consuming a low glycaemic index (GI) diet to reduce the risk of type 2 Diabetes are well recognized. In recent years the GI values of various foods have been determined. Their efficacy in constructing and consuming a low GI diet over 24 h in modulating glycaemic response has not been fully documented. The translation of using single-point GI values of foods to develop a 24 h mixed meal diet can provide valuable information to consumers, researchers and dietitians to optimize food choice for glycaemic control. By using GI values of foods to develop mixed meals, our study is the first to determine how both blood glucose and substrate oxidation may be modulated over 24 h.

METHODS:

The study included 11 Asian men with a BMI between 17-24 kg/m2 who followed both a 1-day low GI and 1-day high GI diet in a randomized, controlled cross-over design. Test meals included breakfast, lunch, snack and dinner. Glycaemic response was measured continuously for over 24 h and postprandial substrate oxidation for 10 h inside a whole body calorimeter.

RESULTS:

The low GI diet resulted in lower 24 h glucose iAUC (860 ± 440 vs 1329 ± 614 mmol/L.min; p = 0.014) with lower postprandial glucose iAUC after breakfast (p < 0.001), lunch (p = 0.009), snack (p = 0.012) and dinner (p = 0.003). Moreover, 24 h mean amplitude of glycaemic excursion was lower during the low GI vs high GI diet (1.44 ± 0.63 vs 2.33 ± 0.82 mmol/L; p < 0.001). Simultaneously, decrease in 10 h fat oxidation was less during the low vs high GI diet (-0.033 ± 0.021 vs -0.050 ± 0.017 g/min; p < 0.001), specifically after breakfast (p < 0.001) and lunch (p < 0.001).

CONCLUSIONS:

Our study corroborates that using low GI local foods to construct a 24 h low GI diet, is able to reduce glycaemic response and variability as recorded by continuous glucose monitoring. Our observations also confirm that a low GI diet promotes fat oxidation over carbohydrate oxidation when compared to a high GI diet. These observations provide public health support for the encouragement of healthier nutrition choices by consuming low GI foods.

KEYWORDS:

24 h diet; Continuous glucose monitoring; Glycaemic index; Glycaemic response; Indirect calorimetry; Mixed meals; Substrate oxidation; Whole body calorimeter

 

Lifestyle in progression from hypertensive disorders of pregnancy to chronic hypertension in Nurses' Health Study II: observational cohort study.

Timpka S, Stuart JJ, Tanz LJ, Rimm EB, Franks PW, Rich-Edwards JW.

BMJ. 2017 Jul 12;358:j3024. doi: 10.1136/bmj.j3024.

PMID: 28701338

Abstract

Objectives To study the association between lifestyle risk factors and chronic hypertension by history of hypertensive disorders of pregnancy (HDP: gestational hypertension and pre-eclampsia) and investigate the extent to which these risk factors modify the association between HDP and chronic hypertension.Design Prospective cohort study.Setting Nurses' Health Study II (1991-2013).Participants 54 588 parous women aged 32 to 59 years with data on reproductive history and without previous chronic hypertension, stroke, or myocardial infarction.Main outcome measure Chronic hypertension diagnosed by a physician and indicated through nurse participant self report. Multivariable Cox proportional hazards models were used to investigate the development of chronic hypertension contingent on history of HDP and four lifestyle risk factors: post-pregnancy body mass index, physical activity, adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, and dietary sodium/potassium intake. Potential effect modification (interaction) between each lifestyle factor and previous HDP was evaluated with the relative excess risk due to interaction.Results 10% (n=5520) of women had a history of HDP at baseline. 13 971 cases of chronic hypertension occurred during 689 988 person years of follow-up. Being overweight or obese was the only lifestyle factor consistently associated with higher risk of chronic hypertension. Higher body mass index, in particular, also increased the risk of chronic hypertension associated with history of HDP (relative excess risk due to interaction P<0.01 for all age strata). For example, in women aged 40-49 years with previous HDP and obesity class I (body mass index 30.0-34.9), 25% (95% confidence interval 12% to 37%) of the risk of chronic hypertension was attributable to a potential effect of obesity that was specific to women with previous HDP. There was no clear evidence of effect modification by physical activity, DASH diet, or sodium/potassium intake on the association between HDP and chronic hypertension.Conclusion This study suggests that the risk of chronic hypertension after HDP might be markedly reduced by adherence to a beneficial lifestyle. Compared with women without a history of HDP, keeping a healthy weight seems to be especially important with such a history.

 

Skipping breakfast and 5-year changes in body mass index and waist circumference in Japanese men and women.

Sakurai M, Yoshita K, Nakamura K, Miura K, Takamura T, Nagasawa SY, Morikawa Y, Kido T, Naruse Y, Nogawa K, Suwazono Y, Sasaki S, Ishizaki M, Nakagawa H.

Obes Sci Pract. 2017 Apr 3;3(2):162-170. doi: 10.1002/osp4.106. eCollection 2017 Jun.

PMID: 28702211

Abstract

OBJECTIVE:

This study investigated the relationship between frequency of skipping breakfast and annual changes in body mass index (BMI) and waist circumference (WC).

METHODS:

The participants were 4,430 factory employees. BMI and WC were measured repeatedly at annual medical examinations over a 5-year period. The association between frequency of skipping breakfast at the baseline examination and annual changes in anthropometric indices was evaluated using the generalized estimating equation method.

RESULTS:

The mean (standard deviation) BMI was 23.3 (3.0) kg m-2 for men and 21.9 (3.6) kg m-2 for women; and the mean WC was 82.6 (8.7) cm for men and 77.8 (9.8) cm for women. During the follow-up period, mean BMI increased by 0.2 kg m-2 for men and women, and mean WC increased by 1.1 cm for men and 1.0 cm for women. The annual change in the BMI of men who skipped breakfast four to six times per week was 0.061 kg m-2 higher, and that of those who skipped breakfast seven times per week was 0.046 kg m-2 higher, compared with those who did not skip breakfast. Annual changes in the WC of male participants who skipped breakfast seven times per week was 0.248 cm higher than that of those who did not skip breakfast. Skipping breakfast was not associated with changes in BMI or WC in women.

CONCLUSIONS:

Skipping breakfast was closely associated with annual changes in BMI and WC among men, and eating breakfast more than four times per week may prevent the excessive body weight gain associated with skipping breakfast.

KEYWORDS:

Body mass index; cohort study; skipping breakfast; waist circumference

 

Breast cancer risk prediction: an update to the Rosner-Colditz breast cancer incidence model.

Rice MS, Tworoger SS, Hankinson SE, Tamimi RM, Eliassen AH, Willett WC, Colditz G, Rosner B.

Breast Cancer Res Treat. 2017 Jul 12. doi: 10.1007/s10549-017-4391-5. [Epub ahead of print]

PMID: 28702896

Abstract

PURPOSE:

To update and expand the Rosner-Colditz breast cancer incidence model by evaluating the contributions of more recently identified risk factors as well as predicted percent mammographic density (MD) to breast cancer risk.

METHODS:

Using data from the Nurses' Health Study (NHS) and NHSII, we added adolescent somatotype (9 unit scale), vegetable intake (servings/day), breastfeeding (months), physical activity (MET-h/week), and predicted percent MD to the Rosner-Colditz model to determine whether these variables improved model discrimination. We evaluated all invasive as well as ER+/PR+, ER+/PR-, and ER-/PR- breast cancer.

RESULTS:

In the NHS/NHSII, we accrued over 5200 cases of invasive breast cancer over more than 20 years of follow-up with complete data on the risk factors. Adolescent somatotype and predicted percent MD significantly improved the original Rosner-Colditz model for all invasive breast cancer (change in age-adjusted AUC = 0.020, p < 0.001). The relative risk (RR) of invasive breast cancer for a 4-unit increase in adolescent somatotype was 0.62 (95% CI 0.56, 0.70), whereas the RR for a 20-unit increase in predicted percent MD was 1.32 (95% CI 1.28, 1.36). Adolescent somatotype and predicted percent MD also significantly improved the ER+/PR+model (change in age-adjusted AUC = 0.020, p < 0.001) as well as the ER+/PR- model (change in age-adjusted AUC = 0.012, p = 0.007). Adolescent somatotype, predicted percent MD, breastfeeding, and vegetable intake improved the ER-/PR- model (change in AUC = 0.031, p < 0.0001). The RR of ER-/PR- disease for 5 vegetable servings/day increase was 0.83 (95% CI 0.70, 0.99), while the RR for every 12 months of breastfeeding was 0.88 (95% CI 0.77, 1.01). Physical activity did not improve risk classification in any model.

CONCLUSION:

Adolescent somatotype and predicted percent MD significantly improved breast cancer risk classification using the Rosner-Colditz model. Further, risk factors specific to ER- disease, such as breastfeeding and vegetable intake, may also help improve risk prediction of this aggressive subtype.

KEYWORDS:

Breast cancer; Epidemiology; Risk prediction

 

Coffee Consumption and Heart Rate Variability: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Cohort Study.

de Oliveira RAM, Araújo LF, de Figueiredo RC, Goulart AC, Schmidt MI, Barreto SM, Ribeiro ALP.

Nutrients. 2017 Jul 13;9(7). pii: E741. doi: 10.3390/nu9070741.

PMID: 28703735

Abstract

Studies have shown that acute coffee ingestion can affect cardiovascular autonomic activity, although the chronic effects on heart rate variability (HRV) remain controversial.

METHOD:

A cross-sectional study with baseline data (2008-2010) from ELSA-Brasil cohort of 15,105 (aged 35-74), based in six Brazilian states. Coffee consumption in the previous 12 months was measured using the semi-quantitative food frequency questionnaire, and HRV was obtained through electrocardiographic tracings during 10 min at rest. Independent association between the frequency of coffee consumption "never or almost never", "≤1 cup/day", "2-3 cups/day", "≥3 cups/day", and HRV was estimated using generalized linear regression, adjusting for socio-demographic characteristics, health-related behavior, markers of abnormal metabolism, and the presence of coronary artery disease. Further, we applied Bonferroni correction in the full models.

RESULTS:

The mean age was 52 years (standard deviation (SD) = 9.1), and 52% was female; 9.5% never/almost never consumed coffee. In univariate analysis, coffee consumers had reduced values of HRV indexes, but after full adjustments and correction for multiple comparisons, these associations disappeared. A trend of reduction in HRV vagal indexes was observed in those that consumed ≥3 cups of coffee/day.

CONCLUSION:

Most of the effects attributed to the chronic use of coffee on the HRV indexes is related to the higher prevalence of unhealthy habits in coffee users, such as smoking and alcohol use. Adjustment for confounding factors weaken this association, making it non-significant. The effect of higher daily doses of coffee on the autonomic system should be evaluated in further studies.

KEYWORDS:

coffee consumption; coronary artery disease; heart rate variability

 

Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015

GBD 2015 Healthcare Access and Quality Collaborators

Lancet Jul 15, 2017, Volume 390, Number 10091 P 231-266

Open Access

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/fulltext

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30818-8.pdf

Summary

Background

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015.

Methods

We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time.

Findings

Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015.

Interpretation

This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world.

 

Are incident gallstones associated to sex-dependent changes with age? A cohort study.

Shabanzadeh DM, Holmboe SA, Sørensen LT, Linneberg A, Andersson AM, Jørgensen T.

Andrology. 2017 Jul 13. doi: 10.1111/andr.12391. [Epub ahead of print]

PMID: 28704597

Abstract

Age and female sex have repeatedly been identified as gallstone determinants but the underlying mechanisms are not clarified. The objectives of this study were to determine if changes with age in physiology, lifestyle, or reproductive hormones were associated with incident gallstones. A cohort study of a general population random sample (N = 2366) aged 30-60 years was performed. Participants were ultrasound screened for gallstones in 1982-84 and again in 1993-94. Lifestyle data and blood samples were obtained and re-analyzed in 2004. Changes with age in physiology (body mass index, blood pressure, blood lipids, self-rated health), lifestyle (smoking, alcohol and coffee consumption, dietary habits, physical activity level), and indices of reproductive function (number of births, oral contraceptive use, hormone replacement therapy, male reproductive hormones) were explored in females and males separately. Adjusted logistic regression analyses were performed. Incident gallstones (gallstones and cholecystectomy) at ultrasound examination in participants initially free of gallstones at baseline occurred in 9.9% of the study population. In females, increasing alcohol consumption (odds ratio (OR) 0.94, 95% confidence interval (CI) [0.90; 0.98]) and the cessation of hormone replacement therapy (OR 0.29, 95% CI [0.10; 0.83]) inversely determined incident gallstones. In males, increasing levels of SHBG (OR 0.97, 95% CI [0.94; 0.998]) inversely determined incident gallstones. Other changes with age in physiology, lifestyle, or reproductive hormones were not associated. High baseline free testosterone determined incident gallstones in males (OR 1.15, 95% CI [1.02; 1.30]). To conclude, changes with age in alcohol consumption in females and in reproductive hormones determined incident gallstones. Male reproductive hormones seem to have an impact on incident gallstones. Sex differences should be explored further in future studies.

KEYWORDS:

aging; cholelithiasis; gallbladder diseases; gonadal steroid hormones; longitudinal studies; ultrasonography

 

Role of ketogenic metabolic therapy in malignant glioma: A systematic review.

Winter SF, Loebel F, Dietrich J.

Crit Rev Oncol Hematol. 2017 Apr;112:41-58. doi: 10.1016/j.critrevonc.2017.02.016. Epub 2017 Feb 20. Review.

PMID: 28325264

Abstract

BACKGROUND:

Coined as the "Warburg effect" and a recognized hallmark of cancer, energy metabolism is aberrantly geared towards aerobic glycolysis in most human cancers, including malignant glioma. Ketogenic metabolic therapy (KMT), i.e. nutritional intervention with ketogenic or low-glycemic diets, has been proposed as an anti-neoplastic strategy in glioma patients.

MATERIALS AND METHODS:

We here review the rationale and existing data investigating KMT in management of patients with malignant glioma and discuss the promise and potential challenges of this novel strategy. Results from published clinical studies and ongoing clinical trials on the topic are systematically reviewed, including 6 published original articles and 10 ongoing clinical trials. Search criteria for this review entailed the databases MEDLINE, EMBASE, Cochrane CENTRAL, and Google Scholar, as well as ICTRP (WHO) and ClinicalTrials.gov (NIH) registries.

RESULTS:

A substantial amount of preclinical literature demonstrates KMT efficacy and safety in model systems of malignant glioma. Clinical literature indicates KMT safety and feasibility; 2 clinical studies suggest KMT-associated anti-neoplastic efficacy and clinical benefit. Ongoing clinical trials address KMT safety and metabolic impact, patient compliance, and patient clinical/survival benefit.

CONCLUSIONS:

While clinical evidence is still limited in this evolving field, increasing numbers of ongoing clinical trials suggest that KMT is emerging as a potential therapeutic option and might be combinable with existing anti-neoplastic treatments for malignant glioma. Emerging clinical data will help answer questions concerning safety and efficacy of KMT, and are aiming to identify the most promising KMT regimen, compatibility with other anti-cancer treatments, ethical aspects, and impact on quality of life of cancer patients.

KEYWORDS:

Adjunctive cancer therapy; Cancer metabolism; Glioblastoma multiforme; Ketogenic diet; Low glycemic diet; Malignant glioma; Metabolic therapy

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Perspective: A Definition for Whole-Grain Food Products—Recommendations from the Healthgrain Forum

Alastair B Ross, Jan-Willem van der Kamp, Roberto King, Kim-Anne Lê, Heddie Mejborn, Chris J Seal, Frank Thielecke

Adv Nutr 2017; 8:525-531 doi:10.3945/an.116.014001 OPEN ACCESS ARTICLE

http://advances.nutrition.org/content/8/4/525.full

http://advances.nutrition.org/content/8/4/525.full.pdf+html

Abstract

Whole grains are a key component of a healthy diet, and enabling consumers to easily choose foods with a high whole-grain content is an important step for better prevention of chronic disease. Several definitions exist for whole-grain foods, yet these do not account for the diversity of food products that contain cereals. With the goal of creating a relatively simple whole-grain food definition that aligns with whole-grain intake recommendations and can be applied across all product categories, the Healthgrain Forum, a not-for-profit consortium of academics and industry working with cereal foods, established a working group to gather input from academics and industry to develop guidance on labeling the whole-grain content of foods. The Healthgrain Forum recommends that a food may be labeled as “whole grain” if it contains ≥30% whole-grain ingredients in the overall product and contains more whole grain than refined grain ingredients, both on a dry-weight basis. For the purposes of calculation, added bran and germ are not considered refined-grain ingredients. Additional recommendations are also made on labeling whole-grain content in mixed-cereal foods, such as pizza and ready meals, and a need to meet healthy nutrition criteria. This definition allows easy comparison across product categories because it is based on dry weight and strongly encourages a move from generic whole-grain labels to reporting the actual percentage of whole grain in a product. Although this definition is for guidance only, we hope that it will encourage more countries to adopt regulation around the labeling of whole grains and stimulate greater awareness and consumption of whole grains in the general population.

Keywords:

whole grains cereal food regulation food guidelines food labelling dietary guidelines dietary intake public policy

 

Perspective: Neuroregenerative Nutrition

Dennis A Steindler and Brent A Reynolds

Adv Nutr 2017; 8:546-557 doi:10.3945/an.117.015388

http://sci-hub.cc/10.3945/an.117.015388

Abstract

Good health while aging depends upon optimal cellular and organ functioning that contribute to the regenerative ability of the body during the lifespan, especially when injuries and diseases occur. Although diet may help in the maintenance of cellular fitness during periods of stability or modest decline in the regenerative function of an organ, this approach is inadequate in an aged system, in which the ability to maintain homeostasis is further challenged by aging and the ensuing suboptimal functioning of the regenerative unit, tissue-specific stem cells. Focused nutritional approaches can be used as an intervention to reduce decline in the body’s regenerative capacity. This article brings together nutrition-associated therapeutic approaches with the fields of aging, immunology, neurodegenerative disease, and cancer to propose ways in which diet and nutrition can work with standard-of-care and integrated medicine to help improve the brain’s function as it ages. The field of regenerative medicine has exploded during the past 2 decades as a result of the discovery of stem cells in nearly every organ system of the body, including the brain, where neural stem cells persist in discrete areas throughout life. This fact, and the uncovering of the genetic basis of plasticity in somatic cells and cancer stem cells, open a door to a world where maintenance and regeneration of organ systems maintain health and extend life expectancy beyond its present limits. An area that has received little attention in regenerative medicine is the influence on regulatory mechanisms and therapeutic potential of nutrition. We propose that a strong relation exists between brain regenerative medicine and nutrition and that nutritional intervention at key times of life could be used to not only maintain optimal functioning of regenerative units as humans age but also play a primary role in therapeutic treatments to combat injury and diseases (in particular, those that occur in the latter one-third of the lifespan).

Keywords:

age- and disease-related inflammation avatar models combination nutrient therapies nutrition regenerative medicine stem cells

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Intake of dairy foods and risk of Parkinson disease.

Hughes KC, Gao X, Kim IY, Wang M, Weisskopf MG, Schwarzschild MA, Ascherio A.

Neurology. 2017 Jul 4;89(1):46-52. doi: 10.1212/WNL.0000000000004057. Epub 2017 Jun 8.

PMID: 28596209

Abstract

OBJECTIVE:

To prospectively examine the association between commonly consumed dairy products and the risk of Parkinson disease (PD) in women and men.

METHODS:

Analyses were based on data from 2 large prospective cohort studies, the Nurses' Health Study (n = 80,736) and the Health Professionals Follow-up Study (n = 48,610), with a total of 26 and 24 years of follow-up, respectively. Both US-based studies were conducted via mailed biennial questionnaires. Dietary intake was assessed with food frequency questionnaires administered repeatedly over the follow-up period. Incident cases of PD (n = 1,036) were identified via questionnaires and subsequently confirmed by reviewing medical records. We also conducted a meta-analysis to combine our study with 3 previously published prospective studies on total milk intake and PD risk and 1 study on total dairy intake and PD risk.

RESULTS:

While total dairy intake was not significantly associated with PD risk in our cohorts, intake of low-fat dairy foods was associated with PD risk. The pooled, multivariable-adjusted hazard ratio (HR) comparing people who consumed at least 3 servings of low-fat dairy per day to those who consumed none was 1.34 (95% confidence interval [CI] 1.01-1.79, p trend = 0.04). This association appeared to be driven by an increased risk of PD associated with skim and low-fat milk (HR 1.39, 95% CI 1.12-1.73, p trend <0.01). Results were similar in women and men (p for heterogeneity >0.05). In the meta-analysis, the pooled relative risk comparing extreme categories of total milk intake was 1.56 (95% CI 1.30-1.88), and the association between total dairy and PD became significant (HR 1.27, 95% CI 1.04-1.55).

CONCLUSIONS:

Frequent consumption of dairy products appears to be associated with a modest increased risk of PD in women and men.

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A cohort study on diet and the risk of Parkinson's disease: the role of food groups and diet quality.

Sääksjärvi K, Knekt P, Lundqvist A, Männistö S, Heliövaara M, Rissanen H, Järvinen R.

Br J Nutr. 2013 Jan 28;109(2):329-37. doi: 10.1017/S0007114512000955. Epub 2012 Apr 13.

PMID: 22716925

http://sci-hub.cc/10.1017/S0007114512000955

Abstract

Previous studies on individual foods and nutrients and Parkinson's disease (PD) risk have been inconsistent. Furthermore, only one study has examined the association between the quality of diet and PD. We investigated the prediction of food groups and diet quality on PD in the Finnish Mobile Clinic Survey (1966-72). The population comprised 4524 individuals, aged 40-79 years and free from PD at baseline. Data collection included health examinations, a questionnaire and a 1-year dietary history interview. A modified Alternate Healthy Eating Index was formed to assess diet quality. Statistical analyses were based on Cox's model. During a 41-year follow-up, eighty-five incident cases of PD occurred. No statistically significant associations were found between PD incidence and most of the food groups examined. A few exceptions were fruits and berries in men and milk in women, which showed positive associations. An inverse association between the intake of meat products and PD was found in women. The diet quality index did not predict PD, the adjusted relative risk between the highest and lowest quartiles being 1.83 (95 % CI 0.65, 5.18) in men and 0.97 (95 % CI 0.38, 2.48) in women. The present study suggests that since most of the single food groups or the quality of diet did not predict PD occurrence, the role of diet is apparently rather modest.

 

[see: http://advances.nutrition.org/content/8/4/532/F1.expansion.htmland http://advances.nutrition.org/content/8/4/532/F2.expansion.html ]

Perspective: Improving Nutritional Guidelines for Sustainable Health Policies: Current Status and Perspectives

Paolo Magni, Dennis M Bier, Sergio Pecorelli, Carlo Agostoni, Arne Astrup, Furio Brighenti, Robert Cook, Emanuela Folco, Luigi Fontana, Robert A Gibson, Ranieri Guerra, Gordon H Guyatt, John PA Ioannidis, Ann S Jackson, David M Klurfeld, Maria Makrides, Basil Mathioudakis, Alessandro Monaco, Chirag J Patel, Giorgio Racagni, Holger J Schünemann, Raanan Shamir, Niv Zmora, and Andrea Peracino

Adv Nutr 2017; 8:532-545 doi:10.3945/an.116.014738 OPEN ACCESS ARTICLE

http://advances.nutrition.org/content/8/4/532.full

http://advances.nutrition.org/content/8/4/532.full.pdf+html

Abstract

A large body of evidence supports the notion that incorrect or insufficient nutrition contributes to disease development. A pivotal goal is thus to understand what exactly is appropriate and what is inappropriate in food ingestion and the consequent nutritional status and health. The effective application of these concepts requires the translation of scientific information into practical approaches that have a tangible and measurable impact at both individual and population levels. The agenda for the future is expected to support available methodology in nutrition research to personalize guideline recommendations, properly grading the quality of the available evidence, promoting adherence to the well-established evidence hierarchy in nutrition, and enhancing strategies for appropriate vetting and transparent reporting that will solidify the recommendations for health promotion. The final goal is to build a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic biomarkers, food quality and intake frequency, lifestyle variables such as physical activity, and environmental variables including one’s microbiome profile. There is a strong and urgent need to develop a successful commitment among all the stakeholders to define novel and sustainable approaches toward the management of the health value of nutrition at individual and population levels. Moving forward requires adherence to well-established principles of evidence evaluation as well as identification of effective tools to obtain better quality evidence. Much remains to be done in the near future.

Keywords:

food genetics microbiome nutritional status personalized nutrition

 

Mortality from Amyotrophic Lateral Sclerosis and Parkinson's Disease Among Different Occupation Groups - United States, 1985-2011.

Beard JD, Steege AL, Ju J, Lu J, Luckhaupt SE, Schubauer-Berigan MK.

MMWR Morb Mortal Wkly Rep. 2017 Jul 14;66(27):718-722. doi: 10.15585/mmwr.mm6627a2.

PMID: 28704346 Free Article

https://www.cdc.gov/mmwr/volumes/66/wr/mm6627a2.htm

https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6627a2.pdf

Abstract

Amyotrophic lateral sclerosis (ALS) and Parkinson's disease, both progressive neurodegenerative diseases, affect >1 million Americans (1,2). Consistently reported risk factors for ALS include increasing age, male sex, and cigarette smoking (1); risk factors for Parkinson's disease include increasing age, male sex, and pesticide exposure, whereas cigarette smoking and caffeine consumption are inversely associated (2). Relative to cancer or respiratory diseases, the role of occupation in neurologic diseases is much less studied and less well understood (3). CDC evaluated associations between usual occupation and ALS and Parkinson's disease mortality using data from CDC's National Institute for Occupational Safety and Health (NIOSH) National Occupational Mortality Surveillance (NOMS), a population-based surveillance system that includes approximately 12.1 million deaths from 30 U.S. states.* Associations were estimated using proportionate mortality ratios (PMRs), standardizing indirectly by age, sex, race, and calendar year to the standard population of all NOMS deaths with occupation information. Occupations associated with higher socioeconomic status (SES) had elevated ALS and Parkinson's disease mortality. The shifts in the U.S. workforce toward older ages and higher SES occupations† highlight the importance of understanding this finding, which will require studies with designs that provide evidence for causality, detailed exposure assessment, and adjustment for additional potential confounders.

 

Cardiovascular diseases

The cholesterol and calorie hypotheses are both dead — it is time to focus on the real culprit: insulin resistance

The Pharmaceutical Journal 14 JUL 2017

By Maryanne Demasi, Robert H Lustig, Aseem Malhotra

http://www.pharmaceutical-journal.com/opinion/insight/the-cholesterol-and-calorie-hypotheses-are-both-dead-it-is-time-to-focus-on-the-real-culprit-insulin-resistance/20203046.article

Illustration showing diabetes and heart disease

Emerging evidence shows that insulin resistance is the most important predictor of cardiovascular disease and type 2

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Non-ketogenic combination of nutritional strategies provides robust protection against seizures.

Dallérac G, Moulard J, Benoist JF, Rouach S, Auvin S, Guilbot A, Lenoir L, Rouach N.

Sci Rep. 2017 Jul 14;7(1):5496. doi: 10.1038/s41598-017-05542-3.

PMID: 28710408

https://www.nature.com/articles/s41598-017-05542-3

https://pdf.nature.com/redirect-nature?ddsId=art:10.1038/s41598-017-05542-3&originUrl=https://www.nature.com/articles/s41598-017-05542-3&contentType=pdf

Abstract

Epilepsy is a neurological condition that affects 1% of the world population. Conventional treatments of epilepsy use drugs targeting neuronal excitability, inhibitory or excitatory transmission. Yet, one third of patients presents an intractable form of epilepsy and fails to respond to pharmacological anti-epileptic strategies. The ketogenic diet is a well-established non-pharmacological treatment that has been proven to be effective in reducing seizure frequency in the pharmaco-resistant patients. This dietary solution is however extremely restrictive and can be associated with complications caused by the high [fat]:[carbohydrate + protein] ratio. Recent advances suggest that the traditional 4:1 ratio of the ketogenic diet is not a requisite for its therapeutic effect. We show here that combining nutritional strategies targeting specific amino-acids, carbohydrates and fatty acids with a low [fat]:[proteins + carbohydrates] ratio also reduces excitatory drive and protects against seizures to the same extent as the ketogenic diet. Similarly, the morphological and molecular correlates of temporal lobe seizures were reduced in animals fed with the combined diet. These results provide evidence that low-fat dietary strategies more palatable than the ketogenic diet could be useful in epilepsy.

 

Potential Mediating Biomarkers underlying the Association of Body Mass Index or Waist Circumference with Blood Pressure: Results from Three Population-based Studies.

Wu X, Yang X, Shan R, Li T, Zi T, Li Y, Na L, Sun C.

Sci Rep. 2017 Jul 14;7(1):5364. doi: 10.1038/s41598-017-05677-3.

PMID: 28710353

Abstract

We conducted a comprehensive and in-depth assessment of body mass index (BMI) or waist circumference (WC) related to blood pressure (BP) and determined whether the association is mediated by the possible potential mediators in the cross-sectional survey of the Harbin Cohort Study on Diet, Nutrition and Chronic Non-communicable Diseases of 7094 participants aged 20-74 years, and validated the significant findings in the US National Health and Nutrition Examination Survey four cross-sectional cohorts (2005-2006, 2007-2008, 2009-2010, and 2011-2012) and the cohort data of the Harbin People's Health Study (a median of 4.2 follow-up years). We observed that BMI or WC was positively associated with BP (all P-values < 0.0001). Mediation analyses consistently indicated that these associations were mediated mainly by insulin resistance (IR) as measured by the homeostasis model (HOMA-IR), followed by triglyceride (TG) and total cholesterol (TC), and fasting glucose (FG) in the three studies. The proportions via the mediation of insulin/HOMA-IR were 25~40%, TG and TC were 15~20%, and FG was 2~8%, respectively. These findings suggest that the mediators, insulin/insulin resistance, TG, TC, and FG, could be targeted for preventing hypertension among populations who were overweight or obesity.

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