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The interaction between individualism and wellbeing in predicting mortality: Survey of Health Ageing and Retirement in Europe.
Okely JA, Weiss A, Gale CR.
J Behav Med. 2017 Jul 15. doi: 10.1007/s10865-017-9871-x. [Epub ahead of print]
PMID: 2871201
https://link.springer.com/content/pdf/10.1007%2Fs10865-017-9871-x.pdf
Abstract
The link between greater wellbeing and longevity is well documented. The aim of the current study was to test whether this association is consistent across individualistic and collectivistic cultures. The sample consisted of 13,596 participants from 11 European countries, each of which was assigned an individualism score according to Hofstede et al.'s (Cultures and organizations: software of the mind, McGraw Hill, New York, 2010) cultural dimension of individualism. We tested whether individualism moderated the cross-sectional association between wellbeing and self-rated health or the longitudinal association between wellbeing and mortality risk. Our analysis revealed a significant interaction between individualism and wellbeing such that the association between wellbeing and self-rated health or risk of mortality from cardiovascular disease was stronger in more individualistic countries. However, the interaction between wellbeing and individualism was not significant in analysis predicting all-cause mortality. Further prospective studies are needed to confirm our finding and to explore the factors responsible for this culturally dependent effect.
KEYWORDS:
Cultural dimensions; Individualism; Longevity; Self-rated health; Wellbeing

Association of carbohydrate and fat intake with metabolic syndrome.
Kwon YJ, Lee HS, Lee JW.
Clin Nutr. 2017 Jul 4. pii: S0261-5614(17)30233-9. doi: 10.1016/j.clnu.2017.06.022. [Epub ahead of print]
PMID: 28711416
Abstract
BACKGROUND & AIMS:
In Asia, dietary pattern has been changed with increased intake of refined carbohydrates, sugar, and saturated fat, while the prevalence of metabolic syndrome (MetS) is on the rise. However, it remains unclear whether a high-carbohydrate or a high-fat diet is more metabolically harmful, and the optimal amount of carbohydrates and fat has not been determined. The aim of our study was to examine the role of carbohydrate and fat intake in MetS in a Korean population.
METHODS:
Data were obtained from a large, population-based, cross-sectional study (6737 males and 8845 females). The subjects were divided into nine groups based on carbohydrate and fat proportion, and multiple logistic regression analysis was performed after adjusting for confounding variables.
RESULTS:
Regardless of fat intake, the risk of MetS significantly increased in males with higher carbohydrate proportions (of total energy intake). In females, the risk of MetS was significantly elevated only in those with both the highest carbohydrate proportion and lowest fat proportion.
CONCLUSION:
A high carbohydrate proportion was associated with a higher prevalence of MetS in males, and a high carbohydrate proportion combined with a low fat proportion was associated with MetS in females. Our results indicate that reduction of excessive carbohydrate intake paired with an adequate fat intake, taking into consideration optimal types of fat, is useful for MetS prevention. Longitudinal studies are needed to clarify the optimal types and amounts of carbohydrate and fat proportions as well as the mechanism underlying these relationships.
KEYWORDS:
Carbohydrate; Diet; Fat; Korean population; Metabolic syndrome

[The pdf of the first below paper is not availed.]
Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review.
van Dronkelaar C, van Velzen A, Abdelrazek M, van der Steen A, Weijs PJM, Tieland M.
J Am Med Dir Assoc. 2017 Jul 12. pii: S1525-8610(17)30305-5. doi: 10.1016/j.jamda.2017.05.026. [Epub ahead of print] Review.
PMID: 28711425
Abstract
INTRODUCTION:
Minerals may contribute to prevent and treat sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance. So far, there is no comprehensive review on the impact of minerals on sarcopenia outcomes. The aim of this systematic review is to evaluate the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults.
METHODS:
A systematic search was conducted between March 2016 and July 2016, in the PubMed database using predefined search terms. Articles on the role of dietary mineral intake or mineral serum concentrations on muscle mass, muscle strength, physical performance, and/or the prevalence of sarcopenia in healthy or frail older adults (average age ≥ 65 years) were selected. Only original research publications were included. The search and data extraction were conducted in duplicate by 2 independent researchers. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed in constructing this systematic review. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of the selected articles.
RESULTS:
From the 3346 articles found, a total of 10 studies met the inclusion criteria. Observational studies showed that serum selenium (n = 1) and calcium intake (n = 1) were significantly associated with muscle mass, and magnesium (n = 1), selenium (n = 1), iron (n = 1), and zinc (n = 1) intake were significantly and positively associated with physical performance in older adults. Furthermore, magnesium (n = 2), selenium (n = 2), calcium (n = 2), and phosphorus (n = 1) intake were associated with the prevalence of sarcopenia. Magnesium supplementation improved physical performance based on one randomized controlled trial. No studies on the role of sodium or potassium on muscle mass, muscle strength, or physical performance were found.
CONCLUSION:
Minerals may be important nutrients to prevent and/or treat sarcopenia. Particularly, magnesium, selenium, and calcium seem to be most promising. Most of the included studies, however, were observational studies. Therefore, more randomized controlled trials are needed to elucidate the potential benefits of mineral intake to prevent and/or treat sarcopenia and support healthy aging.
KEYWORDS:
Aging; dietary intake; elderly; muscle; nutrition; sarcopenic

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Guest AlPater

The Effects of Fasting During Ramadan on the Concentration of Serotonin, Dopamine, Brain-Derived Neurotrophic Factor and Nerve Growth Factor.
Bastani A, Rajabi S, Kianimarkani F.
Neurol Int. 2017 Jun 23;9(2):7043. doi: 10.4081/ni.2017.7043. eCollection 2017 Jun 23.
PMID: 28713531
Abstract
Neurotransmitters and neurotrophic factors are signaling molecules that play a crucial role in cell proliferation, differentiation, survival and functions of neurons. It is believed that caloric restriction could help the health of the nervous system by affecting the synthesis of neurotrophins and neurotransmitter and oxygen radical metabolism. The objective was to investigate the plasma levels of serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in 29 healthy fasted subjects (22 women and 7 men) during the month of fasting in Ramadan. The levels of these factors were measured (using ELISA method) three times, 2 days before the fasting month as a control, on the 14th and 29th day of Ramadan as test groups. In addition, these factors were investigated in the group of women only. According to our investigation, the plasma levels of serotonin, BDNF and NGF were significantly increased during fasting month of Ramadan. In detail, the levels of these factors were increased in 14th and 29th day test groups compared to controls (P<0.05). Moreover, these levels were significantly increased on the 29th day compared to the 14th day test groups, but there were no differences between dopamine levels in all groups. Furthermore, the results obtained in women's groups were the same as those obtained in previous groups. Our findings suggest that plasma levels of serotonin, BDNF and NGF were significantly increased during fasting month of Ramadan.
KEYWORDS:
BDNF; Caloric restriction; Dopamine; NGF; Serotonin

Analysis of Physical Activity Among Free-Living Nonagenarians From a Sardinian Longevous Population.
Pes GM, Dore MP, Errigo A, Poulain M.
J Aging Phys Act. 2017 Jul 17:1-18. doi: 10.1123/japa.2017-0088. [Epub ahead of print]
PMID: 28714795
Abstract
Physical activity was identified as a major determinant of longevity. Using wearable accelerometers, we evaluated energy expenditure (EE), including resting- (REE) and total-energy expenditure, (TEE), physical activity level (PAL), percentage of PAL ≥ 3 metabolic equivalent tasks (METs), number of steps, resting index (RI%) and sleeping patterns in 44 free-living nonagenarians (27 men) residing in a Sardinian village famous for its longevous population. The average REE and TEE recorded were: men 1278 ± 161 kcal/day and 957 ± 110, and women: 2286 ± 541kcal/day and 1811 ± 308 in the women, respectively. The average PAL was 1.8, and percentage of physical activity > 3 METs was above 40%. A significant negative correlation (p<0.05) between disability and PAL was found among women. This study provides evidence that nonagenarians from the longevous population of Sardinia show excellent physical functionality indexes. Their longevity might result, at least partly, from the capability to keep themselves physically fit during aging.
KEYWORDS:
Villagrande Strisaili; longevity; longevity Blue Zone; physical activity

The Impact of Aerobic Exercise on Fronto-Parietal Network Connectivity and Its Relation to Mobility: An Exploratory Analysis of a 6-Month Randomized Controlled Trial.
Hsu CL, Best JR, Wang S, Voss MW, Hsiung RGY, Munkacsy M, Cheung W, Handy TC, Liu-Ambrose T.
Front Hum Neurosci. 2017 Jun 30;11:344. doi: 10.3389/fnhum.2017.00344. eCollection 2017.
PMID: 28713255
Abstract
Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)-and exercise-induced changes in FPN connectivity would correlate with changes in mobility. We focused on the FPN as it is involved in top-down attentional control as well as motor planning and motor execution. Participants were randomized either to usual-care (CON), which included monthly educational materials about VCI and healthy diet; or thrice-weekly aerobic training (AT), which was walking outdoors with progressive intensity. Functional magnetic resonance imaging was acquired at baseline and trial completion, where the participants were instructed to perform bilateral finger tapping task. At trial completion, compared with AT, CON showed significantly increased FPN connectivity strength during right finger tapping (p < 0.05). Across the participants, reduced FPN connectivity was associated with greater cardiovascular capacity (p = 0.05). In the AT group, reduced FPN connectivity was significantly associated with improved mobility performance, as measured by the Timed-Up-and-Go test (r = 0.67, p = 0.02). These results suggest progressive AT may improve mobility in older adults with SIVCI via maintaining intra-network connectivity of the FPN.
KEYWORDS:
aging; fMRI; fronto-parietal network; functional connectivity; impaired mobility; vascular cognitive impairment

Walnut consumption increases activation of the insula to highly desirable food cues: A randomized, double-blind, placebo-controlled, cross-over fMRI study.
Farr OM, Tuccinardi D, Upadhyay J, Oussaada SM, Mantzoros CS.
Diabetes Obes Metab. 2017 Jul 17. doi: 10.1111/dom.13060. [Epub ahead of print]
PMID: 28715141
Abstract
AIMS:
The use of walnuts is recommended for obesity and type 2 diabetes, although the mechanisms through which walnuts may improve appetite and/or glycemic control remain largely unknown.
MATERIALS AND METHODS:
To determine whether short-term walnut consumption could alter the neural control of appetite using functional magnetic resonance imaging, we performed a randomized, placebo-controlled, double-blind, cross-over trial of 10 patients who received, while living in the controlled environment of a clinical research center, either walnuts or placebo (using a validated smoothie delivery system) for 5 days each, separated by a wash-out period of one month.
RESULTS:
Walnut consumption decreased feelings of hunger and appetite assessed using visual analog scales and increased the activation of the right insula to highly desirable food cues.
CONCLUSIONS:
These findings suggest that walnut consumption may increase salience and cognitive control processing of highly desirable food cues, leading to the beneficial metabolic effects observed.

Application of a Lifestyle-Based Tool to Estimate Premature Cardiovascular Disease Events in Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
Gooding HC, Ning H, Gillman MW, Shay C, Allen N, Goff DC Jr, Lloyd-Jones D, Chiuve S.
JAMA Intern Med. 2017 Jul 17. doi: 10.1001/jamainternmed.2017.2922. [Epub ahead of print]
PMID: 28715555
Abstract
IMPORTANCE:
Few tools exist for assessing the risk for early atherosclerotic cardiovascular disease (ASCVD) events in young adults.
OBJECTIVE:
To assess the performance of the Healthy Heart Score (HHS), a lifestyle-based tool that estimates ASCVD events in older adults, for ASCVD events occurring before 55 years of age.
DESIGN, SETTING, AND PARTICIPANTS:
This prospective cohort study included 4893 US adults aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants underwent measurement of lifestyle factors from March 25, 1985, through June 7, 1986, and were followed up for a median of 27.1 years (interquartile range, 26.9-27.2 years). Data for this study were analyzed from February 24 through December 12, 2016.
EXPOSURES:
The HHS includes age, smoking status, body mass index, alcohol intake, exercise, and a diet score composed of self-reported daily intake of cereal fiber, fruits and/or vegetables, nuts, sugar-sweetened beverages, and red and/or processed meats. The HHS in the CARDIA study was calculated using sex-specific equations produced by its derivation cohorts.
MAIN OUTCOMES AND MEASURES:
The ability of the HHS to assess the 25-year risk for ASCVD (death from coronary heart disease, nonfatal myocardial infarction, and fatal or nonfatal ischemic stroke) in the total sample, in race- and sex-specific subgroups, and in those with and without clinical ASCVD risk factors at baseline. Model discrimination was assessed with the Harrell C statistic; model calibration, with Greenwood-Nam-D'Agostino statistics.
RESULTS:
The study population of 4893 participants included 2205 men (45.1%) and 2688 women (54.9%) with a mean (SD) age at baseline of 24.8 (3.6) years; 2483 (50.7%) were black; and 427 (8.7%) had at least 1 clinical ASCVD risk factor (hypertension, hyperlipidemia, or diabetes types 1 and 2). Among these participants, 64 premature ASCVD events occurred in women and 99 in men. The HHS showed moderate discrimination for ASCVD risk assessment in this diverse population of mostly healthy young adults (C statistic, 0.71; 95% CI, 0.66-0.76); it performed better in men (C statistic, 0.74; 95% CI, 0.68-0.79) than in women (C statistic, 0.69; 95% CI, 0.62-0.75); in white (C statistic, 0.77; 95% CI, 0.71-0.84) than in black (C statistic, 0.66; 95% CI, 0.60-0.72) participants; and in those without (C statistic, 0.71; 95% CI, 0.66-0.76) vs with (C statistic, 0.64; 95% CI, 0.55-0.73) clinical risk factors at baseline. The HHS was adequately calibrated overall and within each subgroup.
CONCLUSIONS AND RELEVANCE:
The HHS, when measured in younger persons without ASCVD risk factors, performs moderately well in assessing risk for ASCVD events by early middle age. Its reliance on self-reported, modifiable lifestyle factors makes it an attractive tool for risk assessment and counseling for early ASCVD prevention.

[Fig. 2(E) alarmed me.]
Why caution may be warranted when consuming artificial sweeteners
More than 40% of adults say they use artificial sweeteners, but routine intake may be risky
CBC News Posted: Jul 17, 2017
http://www.cbc.ca/news/health/artificial-sweeteners-1.4206772
>>>>>>>>>>>>>>>>>>>>>>>>>>
Meghan B. Azad, Ahmed M. Abou-Setta, Bhupendrasinh F. Chauhan, Rasheda Rabbani, Justin Lys, Leslie Copstein, Amrinder Mann, Maya M. Jeyaraman, Ashleigh E. Reid, Michelle Fiander, Dylan S. MacKay, Jon McGavock, Brandy Wicklow, and Ryan Zarychanski
Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies
CMAJ July 17, 2017 189:E929-E939; doi:10.1503/cmaj.161390
http://www.cmaj.ca/content/189/28/E929.full
http://www.cmaj.ca/content/189/28/E929.full.pdf+html
Abstract
BACKGROUND Nonnutritive sweeteners, such as aspartame, sucralose and stevioside, are widely consumed, yet their long-term health impact is uncertain. We synthesized evidence from prospective studies to determine whether routine consumption of non-nutritive sweeteners was associated with long-term adverse cardiometabolic effects.
METHODS We searched MEDLINE, Embase and Cochrane Library (inception to January 2016) for randomized controlled trials (RCTs) that evaluated interventions for nonnutritive sweeteners and prospective cohort studies that reported on consumption of non-nutritive sweeteners among adults and adolescents. The primary outcome was body mass index (BMI). Secondary outcomes included weight, obesity and other cardiometabolic end points.
RESULTS From 11 774 citations, we included 7 trials (1003 participants; median follow-up 6 mo) and 30 cohort studies (405 907 participants; median follow-up 10 yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference −0.37 kg/m2; 95% confidence interval [CI] −1.10 to 0.36; I2 9%; 242 participants). In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I2 0%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome.
INTERPRETATION Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk. Further research is needed to fully characterize the long-term risks and benefits of nonnutritive sweeteners.

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Analysis of Physical Activity Among Free-Living Nonagenarians From a Sardinian Longevous Population.

Pes GM, Dore MP, Errigo A, Poulain M.

J Aging Phys Act. 2017 Jul 17:1-18. doi: 10.1123/japa.2017-0088. [Epub ahead of print]

PMID: 28714795

Abstract

Physical activity was identified as a major determinant of longevity. Using wearable accelerometers, we evaluated energy expenditure (EE), including resting- (REE) and total-energy expenditure, (TEE), physical activity level (PAL), percentage of PAL ≥ 3 metabolic equivalent tasks (METs), number of steps, resting index (RI%) and sleeping patterns in 44 free-living nonagenarians (27 men) residing in a Sardinian village famous for its longevous population. The average REE and TEE recorded were: men 1278 ± 161 kcal/day and 957 ± 110, and women: 2286 ± 541kcal/day and 1811 ± 308 in the women, respectively. The average PAL was 1.8, and percentage of physical activity > 3 METs was above 40%. A significant negative correlation (p<0.05) between disability and PAL was found among women. This study provides evidence that nonagenarians from the longevous population of Sardinia show excellent physical functionality indexes. Their longevity might result, at least partly, from the capability to keep themselves physically fit during aging.

KEYWORDS:

Villagrande Strisaili; longevity; longevity Blue Zone; physical activity

 

The Impact of Aerobic Exercise on Fronto-Parietal Network Connectivity and Its Relation to Mobility: An Exploratory Analysis of a 6-Month Randomized Controlled Trial.

Hsu CL, Best JR, Wang S, Voss MW, Hsiung RGY, Munkacsy M, Cheung W, Handy TC, Liu-Ambrose T.

Front Hum Neurosci. 2017 Jun 30;11:344. doi: 10.3389/fnhum.2017.00344. eCollection 2017.

PMID: 28713255

Abstract

Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)-and exercise-induced changes in FPN connectivity would correlate with changes in mobility. We focused on the FPN as it is involved in top-down attentional control as well as motor planning and motor execution. Participants were randomized either to usual-care (CON), which included monthly educational materials about VCI and healthy diet; or thrice-weekly aerobic training (AT), which was walking outdoors with progressive intensity. Functional magnetic resonance imaging was acquired at baseline and trial completion, where the participants were instructed to perform bilateral finger tapping task. At trial completion, compared with AT, CON showed significantly increased FPN connectivity strength during right finger tapping (p < 0.05). Across the participants, reduced FPN connectivity was associated with greater cardiovascular capacity (p = 0.05). In the AT group, reduced FPN connectivity was significantly associated with improved mobility performance, as measured by the Timed-Up-and-Go test (r = 0.67, p = 0.02). These results suggest progressive AT may improve mobility in older adults with SIVCI via maintaining intra-network connectivity of the FPN.

KEYWORDS:

aging; fMRI; fronto-parietal network; functional connectivity; impaired mobility; vascular cognitive impairment

 

Walnut consumption increases activation of the insula to highly desirable food cues: A randomized, double-blind, placebo-controlled, cross-over fMRI study.

Farr OM, Tuccinardi D, Upadhyay J, Oussaada SM, Mantzoros CS.

Diabetes Obes Metab. 2017 Jul 17. doi: 10.1111/dom.13060. [Epub ahead of print]

PMID: 28715141

Abstract

AIMS:

The use of walnuts is recommended for obesity and type 2 diabetes, although the mechanisms through which walnuts may improve appetite and/or glycemic control remain largely unknown.

MATERIALS AND METHODS:

To determine whether short-term walnut consumption could alter the neural control of appetite using functional magnetic resonance imaging, we performed a randomized, placebo-controlled, double-blind, cross-over trial of 10 patients who received, while living in the controlled environment of a clinical research center, either walnuts or placebo (using a validated smoothie delivery system) for 5 days each, separated by a wash-out period of one month.

RESULTS:

Walnut consumption decreased feelings of hunger and appetite assessed using visual analog scales and increased the activation of the right insula to highly desirable food cues.

CONCLUSIONS:

These findings suggest that walnut consumption may increase salience and cognitive control processing of highly desirable food cues, leading to the beneficial metabolic effects observed.

 

Application of a Lifestyle-Based Tool to Estimate Premature Cardiovascular Disease Events in Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Gooding HC, Ning H, Gillman MW, Shay C, Allen N, Goff DC Jr, Lloyd-Jones D, Chiuve S.

JAMA Intern Med. 2017 Jul 17. doi: 10.1001/jamainternmed.2017.2922. [Epub ahead of print]

PMID: 28715555

Abstract

IMPORTANCE:

Few tools exist for assessing the risk for early atherosclerotic cardiovascular disease (ASCVD) events in young adults.

OBJECTIVE:

To assess the performance of the Healthy Heart Score (HHS), a lifestyle-based tool that estimates ASCVD events in older adults, for ASCVD events occurring before 55 years of age.

DESIGN, SETTING, AND PARTICIPANTS:

This prospective cohort study included 4893 US adults aged 18 to 30 years from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants underwent measurement of lifestyle factors from March 25, 1985, through June 7, 1986, and were followed up for a median of 27.1 years (interquartile range, 26.9-27.2 years). Data for this study were analyzed from February 24 through December 12, 2016.

EXPOSURES:

The HHS includes age, smoking status, body mass index, alcohol intake, exercise, and a diet score composed of self-reported daily intake of cereal fiber, fruits and/or vegetables, nuts, sugar-sweetened beverages, and red and/or processed meats. The HHS in the CARDIA study was calculated using sex-specific equations produced by its derivation cohorts.

MAIN OUTCOMES AND MEASURES:

The ability of the HHS to assess the 25-year risk for ASCVD (death from coronary heart disease, nonfatal myocardial infarction, and fatal or nonfatal ischemic stroke) in the total sample, in race- and sex-specific subgroups, and in those with and without clinical ASCVD risk factors at baseline. Model discrimination was assessed with the Harrell C statistic; model calibration, with Greenwood-Nam-D'Agostino statistics.

RESULTS:

The study population of 4893 participants included 2205 men (45.1%) and 2688 women (54.9%) with a mean (SD) age at baseline of 24.8 (3.6) years; 2483 (50.7%) were black; and 427 (8.7%) had at least 1 clinical ASCVD risk factor (hypertension, hyperlipidemia, or diabetes types 1 and 2). Among these participants, 64 premature ASCVD events occurred in women and 99 in men. The HHS showed moderate discrimination for ASCVD risk assessment in this diverse population of mostly healthy young adults (C statistic, 0.71; 95% CI, 0.66-0.76); it performed better in men (C statistic, 0.74; 95% CI, 0.68-0.79) than in women (C statistic, 0.69; 95% CI, 0.62-0.75); in white (C statistic, 0.77; 95% CI, 0.71-0.84) than in black (C statistic, 0.66; 95% CI, 0.60-0.72) participants; and in those without (C statistic, 0.71; 95% CI, 0.66-0.76) vs with (C statistic, 0.64; 95% CI, 0.55-0.73) clinical risk factors at baseline. The HHS was adequately calibrated overall and within each subgroup.

CONCLUSIONS AND RELEVANCE:

The HHS, when measured in younger persons without ASCVD risk factors, performs moderately well in assessing risk for ASCVD events by early middle age. Its reliance on self-reported, modifiable lifestyle factors makes it an attractive tool for risk assessment and counseling for early ASCVD prevention.

 

[Fig. 2(E) alarmed me.]

Why caution may be warranted when consuming artificial sweeteners

More than 40% of adults say they use artificial sweeteners, but routine intake may be risky

CBC News Posted: Jul 17, 2017

http://www.cbc.ca/news/health/artificial-sweeteners-1.4206772

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

Meghan B. Azad, Ahmed M. Abou-Setta, Bhupendrasinh F. Chauhan, Rasheda Rabbani, Justin Lys, Leslie Copstein, Amrinder Mann, Maya M. Jeyaraman, Ashleigh E. Reid, Michelle Fiander, Dylan S. MacKay, Jon McGavock, Brandy Wicklow, and Ryan Zarychanski

Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies

CMAJ July 17, 2017 189:E929-E939; doi:10.1503/cmaj.161390

http://www.cmaj.ca/content/189/28/E929.full

http://www.cmaj.ca/content/189/28/E929.full.pdf+html

Abstract

BACKGROUND Nonnutritive sweeteners, such as aspartame, sucralose and stevioside, are widely consumed, yet their long-term health impact is uncertain. We synthesized evidence from prospective studies to determine whether routine consumption of non-nutritive sweeteners was associated with long-term adverse cardiometabolic effects.

METHODS We searched MEDLINE, Embase and Cochrane Library (inception to January 2016) for randomized controlled trials (RCTs) that evaluated interventions for nonnutritive sweeteners and prospective cohort studies that reported on consumption of non-nutritive sweeteners among adults and adolescents. The primary outcome was body mass index (BMI). Secondary outcomes included weight, obesity and other cardiometabolic end points.

RESULTS From 11 774 citations, we included 7 trials (1003 participants; median follow-up 6 mo) and 30 cohort studies (405 907 participants; median follow-up 10 yr). In the included RCTs, nonnutritive sweeteners had no significant effect on BMI (mean difference −0.37 kg/m2; 95% confidence interval [CI] −1.10 to 0.36; I2 9%; 242 participants). In the included cohort studies, consumption of nonnutritive sweeteners was associated with a modest increase in BMI (mean correlation 0.05, 95% CI 0.03 to 0.06; I2 0%; 21 256 participants). Data from RCTs showed no consistent effects of nonnutritive sweeteners on other measures of body composition and reported no further secondary outcomes. In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events. Publication bias was indicated for studies with diabetes as an outcome.

INTERPRETATION Evidence from RCTs does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk. Further research is needed to fully characterize the long-term risks and benefits of nonnutritive sweeteners.

 

The interaction between individualism and wellbeing in predicting mortality: Survey of Health Ageing and Retirement in Europe.

Okely JA, Weiss A, Gale CR.

J Behav Med. 2017 Jul 15. doi: 10.1007/s10865-017-9871-x. [Epub ahead of print]

PMID: 2871201

https://link.springer.com/content/pdf/10.1007%2Fs10865-017-9871-x.pdf

Abstract

The link between greater wellbeing and longevity is well documented. The aim of the current study was to test whether this association is consistent across individualistic and collectivistic cultures. The sample consisted of 13,596 participants from 11 European countries, each of which was assigned an individualism score according to Hofstede et al.'s (Cultures and organizations: software of the mind, McGraw Hill, New York, 2010) cultural dimension of individualism. We tested whether individualism moderated the cross-sectional association between wellbeing and self-rated health or the longitudinal association between wellbeing and mortality risk. Our analysis revealed a significant interaction between individualism and wellbeing such that the association between wellbeing and self-rated health or risk of mortality from cardiovascular disease was stronger in more individualistic countries. However, the interaction between wellbeing and individualism was not significant in analysis predicting all-cause mortality. Further prospective studies are needed to confirm our finding and to explore the factors responsible for this culturally dependent effect.

KEYWORDS:

Cultural dimensions; Individualism; Longevity; Self-rated health; Wellbeing

 

Association of carbohydrate and fat intake with metabolic syndrome.

Kwon YJ, Lee HS, Lee JW.

Clin Nutr. 2017 Jul 4. pii: S0261-5614(17)30233-9. doi: 10.1016/j.clnu.2017.06.022. [Epub ahead of print]

PMID: 28711416

Abstract

BACKGROUND & AIMS:

In Asia, dietary pattern has been changed with increased intake of refined carbohydrates, sugar, and saturated fat, while the prevalence of metabolic syndrome (MetS) is on the rise. However, it remains unclear whether a high-carbohydrate or a high-fat diet is more metabolically harmful, and the optimal amount of carbohydrates and fat has not been determined. The aim of our study was to examine the role of carbohydrate and fat intake in MetS in a Korean population.

METHODS:

Data were obtained from a large, population-based, cross-sectional study (6737 males and 8845 females). The subjects were divided into nine groups based on carbohydrate and fat proportion, and multiple logistic regression analysis was performed after adjusting for confounding variables.

RESULTS:

Regardless of fat intake, the risk of MetS significantly increased in males with higher carbohydrate proportions (of total energy intake). In females, the risk of MetS was significantly elevated only in those with both the highest carbohydrate proportion and lowest fat proportion.

CONCLUSION:

A high carbohydrate proportion was associated with a higher prevalence of MetS in males, and a high carbohydrate proportion combined with a low fat proportion was associated with MetS in females. Our results indicate that reduction of excessive carbohydrate intake paired with an adequate fat intake, taking into consideration optimal types of fat, is useful for MetS prevention. Longitudinal studies are needed to clarify the optimal types and amounts of carbohydrate and fat proportions as well as the mechanism underlying these relationships.

KEYWORDS:

Carbohydrate; Diet; Fat; Korean population; Metabolic syndrome

 

[The pdf of the first below paper is not availed.]

Minerals and Sarcopenia; The Role of Calcium, Iron, Magnesium, Phosphorus, Potassium, Selenium, Sodium, and Zinc on Muscle Mass, Muscle Strength, and Physical Performance in Older Adults: A Systematic Review.

van Dronkelaar C, van Velzen A, Abdelrazek M, van der Steen A, Weijs PJM, Tieland M.

J Am Med Dir Assoc. 2017 Jul 12. pii: S1525-8610(17)30305-5. doi: 10.1016/j.jamda.2017.05.026. [Epub ahead of print] Review.

PMID: 28711425

Abstract

INTRODUCTION:

Minerals may contribute to prevent and treat sarcopenia, the age-related loss of muscle mass, muscle strength, and physical performance. So far, there is no comprehensive review on the impact of minerals on sarcopenia outcomes. The aim of this systematic review is to evaluate the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults.

METHODS:

A systematic search was conducted between March 2016 and July 2016, in the PubMed database using predefined search terms. Articles on the role of dietary mineral intake or mineral serum concentrations on muscle mass, muscle strength, physical performance, and/or the prevalence of sarcopenia in healthy or frail older adults (average age ≥ 65 years) were selected. Only original research publications were included. The search and data extraction were conducted in duplicate by 2 independent researchers. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement was followed in constructing this systematic review. The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies was used to evaluate the quality of the selected articles.

RESULTS:

From the 3346 articles found, a total of 10 studies met the inclusion criteria. Observational studies showed that serum selenium (n = 1) and calcium intake (n = 1) were significantly associated with muscle mass, and magnesium (n = 1), selenium (n = 1), iron (n = 1), and zinc (n = 1) intake were significantly and positively associated with physical performance in older adults. Furthermore, magnesium (n = 2), selenium (n = 2), calcium (n = 2), and phosphorus (n = 1) intake were associated with the prevalence of sarcopenia. Magnesium supplementation improved physical performance based on one randomized controlled trial. No studies on the role of sodium or potassium on muscle mass, muscle strength, or physical performance were found.

CONCLUSION:

Minerals may be important nutrients to prevent and/or treat sarcopenia. Particularly, magnesium, selenium, and calcium seem to be most promising. Most of the included studies, however, were observational studies. Therefore, more randomized controlled trials are needed to elucidate the potential benefits of mineral intake to prevent and/or treat sarcopenia and support healthy aging.

KEYWORDS:

Aging; dietary intake; elderly; muscle; nutrition; sarcopenic

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Association between Meeting Physical Activity Guidelines and Mortality in Korean Adults: An 8-year Prospective Study.

Kim J.

J Exerc Nutrition Biochem. 2017 Jun 30;21(2):23-29. doi: 10.20463/jenb.2016.0054.

PMID: 28715883

Abstract

PURPOSE:

Although previous studies have investigated the association between physical activity and various health outcomes, limited information is available on the effect of meeting new governmental guidelines for physical activity on the risk of mortality in Korean adults. This study aimed to examine the prospective association between meeting these guidelines and all-cause mortality during an 8-year follow-up using a large nationwide sample of middle-aged and older adults in Korea.

METHODS:

This prospective study was conducted based on the Korean Longitudinal Study of Ageing. The study participants included 9,177 adults aged 45 years or older at baseline, and all participants were monitored in a 2-year cycle during an 8-year period (70,873 person-years). The risk of mortality was analyzed by determining physical activity levels using the Cox proportional hazard models, and the hazard ratio (HR) and 95% confidence interval (CI) were estimated using Cox models.

RESULTS:

A statistically significant effect of physical activity on the reduced risk of mortality was observed in cases in which the participants met the guidelines compared to the inactive group (HR: 0.68, 95% CI: 0.58-0.81 vs. the inactive group). A strong association between meeting the recommended physical activity levels and the reduced risk of mortality was also found for non-smokers (HR: 0.62; 95% CI: 0.51-0.76 vs. the inactive group), but not for current smokers (HR: 0.93; 95% CI: 0.67-1.29 vs. the inactive group).

CONCLUSION:

Meeting physical activity guidelines was associated with a decreased risk of all-cause mortality for Korean adults. Our results also suggest that smoking reduces the protective effect of physical activity on the risk of mortality.

KEYWORDS:

Guidelines; Mortality; Physical activity

 

Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program.

LaStayo P, Marcus R, Dibble L, Wong B, Pepper G.

BMC Geriatr. 2017 Jul 17;17(1):149. doi: 10.1186/s12877-017-0539-8.

PMID: 28716003

Abstract

BACKGROUND:

Addressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period.

METHODS:

Randomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis.

RESULTS:

The MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up <50% had experienced a fall or near fall.

CONCLUSIONS:

There were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival.

KEYWORDS:

Aging; Eccentric; Exercise; Falls; Prevention

 

Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study.

Lechien JR, Finck C, Huet K, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S.

Eur Arch Otorhinolaryngol. 2017 Jul 17. doi: 10.1007/s00405-017-4671-z. [Epub ahead of print]

PMID: 28717979

Abstract

The objective is to assess the differences in the severity of symptoms, signs, voice quality, and quality of life before and after treatment according to age in suspected laryngopharyngeal reflux (LPR) patients. The design used in this paper is prospective multi-center study. Eighty clinically diagnosed LPR patients with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were treated with pantoprazole and diet recommendations for 3 months. Patients were subdivided into three groups according their age: group 1 (18-39 years, N = 21), group 2 (40-59 years, N = 31), and group 3 (≥60 years, N = 28). RSI, RFS, Voice Handicap Index (VHI), Short Form 36 questionnaire (SF36), aerodynamic, and acoustic measurements were evaluated at baseline and after treatment. The response to the empiric treatment was also assessed. Significant improvements in RSI, RFS, and VHI were found in all patient groups. The elderly patients showed a significantly lower RSI score than younger subjects (p = 0.035) without RFS difference among groups. At baseline, the SF36 score was better in group 3 with respect to social functioning (p = 0.049). At the 3-month follow-up, we found significant improvement of acoustic parameters only in the younger age groups (group 1 and group 2). The rate of resistant patients to the empiric treatment was higher in the younger group than in the elderly patient group (42.9 versus 28.6%). Age appears to reduce the subjective LPR symptom perception, leading to a lower rate of uncured patients. The utilization of acoustic parameters as an indicator of treatment effectiveness seems less useful for elderly subjects, probably due to an overlap between an aging voice and LPR.

KEYWORDS:

Laryngitis; Laryngopharyngeal; Reflux; Voice

 

Energy Expenditure of Standing Compared to Sitting While Conducting Office Tasks.

Burns J, Forde C, Dockrell S.

Hum Factors. 2017 Jul 1:18720817719167. doi: 10.1177/0018720817719167. [Epub ahead of print]

PMID: 28719766

Abstract

Objectives This study aimed to investigate the energy expenditure of common office-based tasks. The objectives were to: (a) test the classification of tasks as sedentary or light-intensity physical activity and (b) compare the energy expenditure of tasks under two postural conditions (sitting and standing). Background The sedentary nature of office work has been highlighted as a health risk, and strategies to reduce sedentary behavior at work have been developed. However, there is limited evidence to guide the utilization of sit-stand workstations in the workplace for metabolic health benefits. Method A repeated measures laboratory-based study compared the energy expenditure of common office tasks in sitting and standing using indirect calorimetry ( n = 22). Four standardized tasks (sitting/standing quietly, reading, typing, sorting paper) under two postural conditions (sitting, standing) were performed in a randomized order. Results The mean energy expenditure for all tasks in sitting and standing was <1.5 METs. There were no significant differences in the energy expenditure of doing the same task in sitting compared to standing. In a repeated measures ANOVA, task ( p < .001) had a greater influence on METs expended than posture ( p = .030). Conclusion The study confirmed that the difference in energy expenditure of tasks carried out in sitting compared to standing is negligible. Application The ubiquitous use and utility of sit-stand workstations in the workplace needs to be reviewed. Notwithstanding the potential benefits of movement that may occur naturally, this study confirmed that standing as opposed to sitting does not produce a clinically important increase in energy expenditure.

KEYWORDS:

energy expenditure; occupational; sit-stand workstation; sitting; standing

 

Effect of diet and exercise intervention in Chinese pregnant women on gestational weight gain and perinatal outcomes: A quasi-experimental study.

Liu YQ, Liu Y, Hua Y, Chen XL.

Appl Nurs Res. 2017 Aug;36:50-56. doi: 10.1016/j.apnr.2017.05.001. Epub 2017 May 24.

PMID: 28720239

Abstract

Aim To determine the effect of a diet and exercise intervention in pregnant women on total gestational weight gain, weekly weight gain, 42-days postpartum weight retention, mode of delivery, and infant birth weight.

METHODS:

One hundred and one eligible Chinese pregnant women whose pre-pregnancy body mass index ranged from 18.5 to 24.9 were recruited between June 2013 and June 2014 from a tertiary hospital. Ninety participants, 45 in each group, completed the study. Intervention women received three face-to-face interventions and three follow-up phone calls which were developed based on the Transtheoretical Model. Gestational weight was measured at each prenatal check. Mode of delivery and infant birth weight were collected from the medical record. The 42-days postpartum weight was measured during the postpartum visits.

RESULTS:

(1) The total gestational weight gain and mean weight gain per week in the intervention group were significantly less than the control group (P=0.045 and P=0.008 respectively). (2) Infant birth weight was significantly lower in the intervention group (P=0.012). (3) Postpartum weight retention was significantly less in the intervention group (P=0.001). 4) There were not significant differences in mode of delivery. 5) Infant birth weight was significantly less than the control group (P=0.012).

CONCLUSIONS:

The lifestyle intervention significantly reduced gestational weight gain, optimized infant weight and lowered postpartum weight retention. Promotion of gestational weight management is needed and cultural health beliefs about pregnancy and postpartum practices should be considered when developing the intervention plan.

KEYWORDS:

Lifestyle intervention; Obesity; Physical activity; Pregnant women

 

Ischemic preconditioning does not alter muscle sympathetic responses to static handgrip and metaboreflex activation in young healthy men.

Incognito AV, Doherty CJ, Lee JB, Burns MJ, Millar PJ.

Physiol Rep. 2017 Jul;5(14). pii: e13342. doi: 10.14814/phy2.13342.

PMID: 28720715

Abstract

Ischemic preconditioning (IPC) has been hypothesized to elicit ergogenic effects by reducing feedback from metabolically sensitive group III/IV muscle afferents during exercise. If so, reflex efferent neural outflow should be attenuated. We investigated the effects of IPC on muscle sympathetic nerve activity (MSNA) during static handgrip (SHG) and used post-exercise circulatory occlusion (PECO) to isolate for the muscle metaboreflex. Thirty-seven healthy men (age: 24 ± 5 years [mean ± SD]) were randomized to receive sham (n = 16) or IPC (n = 21) interventions. Blood pressure, heart rate, and MSNA (microneurography; sham n = 11 and IPC n = 18) were collected at rest and during 2 min of SHG (30% maximal voluntary contraction) and 3 min of PECO before (PRE) and after (POST) sham or IPC treatment (3 × 5 min 20 mmHg or 200 mmHg unilateral upper arm cuff inflation). Resting mean arterial pressure was higher following sham (79 ± 7 vs. 83 ± 6 mmHg, P < 0.01) but not IPC (81 ± 6 vs. 82 ± 6 mmHg, P > 0.05), while resting MSNA burst frequency was unchanged (P > 0.05) with sham (18 ± 7 vs. 19 ± 9 bursts/min) or IPC (17 ± 7 vs. 19 ± 7 bursts/min). Mean arterial pressure, heart rate, stroke volume, cardiac output, and total vascular conductance responses during SHG and PECO were comparable PRE and POST following sham and IPC (All P > 0.05). Similarly, MSNA burst frequency, burst incidence, and total MSNA responses during SHG and PECO were comparable PRE and POST with sham and IPC (All P > 0.05). These findings demonstrate that IPC does not reduce hemodynamic responses or central sympathetic outflow directed toward the skeletal muscle during activation of the muscle metaboreflex using static exercise or subsequent PECO.

KEYWORDS:

Blood pressure; ischemic preconditioning; isometric exercise; sympathetic nervous system

PMID: 28720715 DOI: 10.14814/phy2.13342

 

Frequency of frailty and its association with cognitive status and survival in older Chileans.

Albala C, Lera L, Sanchez H, Angel B, Márquez C, Arroyo P, Fuentes P.

Clin Interv Aging. 2017 Jun 26;12:995-1001. doi: 10.2147/CIA.S136906. eCollection 2017.

PMID: 28721027

Abstract

BACKGROUND:

Age-associated brain physiologic decline and reduced mobility are key elements of increased age-associated vulnerability.

OBJECTIVE:

To study the frequency of frailty phenotype and its association with mental health and survival in older Chileans.

METHODS:

Follow-up of ALEXANDROS cohorts designed to study disability associated with obesity in community-dwelling people 60 years and older living in Santiago, Chile. At baseline, 2,098 (67% women) of 2,372 participants were identified as having the frailty phenotype: weak handgrip dynamometry, unintentional weight loss, fatigue/exhaustion, five chair-stands/slow walking speed and difficulty walking (low physical activity). After 10-15 years, 1,298 people were evaluated and 373 had died. Information regarding deaths was available for the whole sample.

RESULTS:

The prevalence of frailty at baseline (≥3 criteria) in the whole sample was 13.9% (women 16.4%; men 8.7%) and the pre-frailty prevalence (1-2 criteria) was 63.8% (65.0% vs 61.4%), respectively. Frailty was associated with cognitive impairment (frail 48.1%; pre-frail 21.7%; nonfrail 20.5%, P<0.001) and depression (frail 55.1%; pre-frail 27.3%; nonfrail 18.8%, P<0.001). Logistic regression models for frailty adjusted for sex and age showed a strong association between frailty and mild cognitive impairment (MCI) (odds ratio [OR] =3.93; 95% CI: 1.41-10.92). Furthermore, an important association was found for depression and frailty (OR =2.36; 95% CI 1.82-3.06). Age- and sex-adjusted hazard ratios (HRs) for death showed an increased risk with increasing frailty: pre-frail HR =1.56 (95% CI: 1.07-2.29), frail HR =1.91 (95% CI: 1.15-3.19); after adjustment by age and sex, a higher risk of death was observed for people identified as frail (HR =1.56, P=0.014) and pre-frail (HR =1.30, P=0.065). MCI and dementia were also risk factors for death (MCI: HR =1.69, P<0.027; dementia: HR =1.66, P=0.016).

CONCLUSION:

Frailty is highly prevalent and strongly associated with cognitive impairment and depression in older Chileans. The risk for death was higher for frail people, but underlying cognitive impairment is a key component of the lower survival rate.

KEYWORDS:

Chile; aging; cognitive impairment; depression; frailty

 

Alcohol consumption and risk of urothelial cell bladder cancer in the European Prospective Investigation into Cancer and Nutrition cohort.

Botteri E, Ferrari P, Roswall N, Tjønneland A, Hjartåker A, Huerta JM, Fortner RT, Trichopoulou A, Karakatsani A, La Vecchia C, Pala V, Perez-Cornago A, Sonestedt E, Liedberg F, Overvad K, Sánchez MJ, Gram IT, Stepien M, Trijsburg L, Börje L, Johansson M, Kühn T, Panico S, Tumino R, Bueno-de-Mesquita HB, Weiderpass E.

Int J Cancer. 2017 Jul 19. doi: 10.1002/ijc.30894. [Epub ahead of print]

PMID: 28722206

Abstract

Findings on the association between alcohol consumption and bladder cancer are inconsistent. We investigated that association in the European Prospective Investigation into Cancer and Nutrition cohort. We included 476,160 individuals mostly aged 35-70 years, enrolled in ten countries and followed for 13.9 years on average. Hazard ratios (HR) for developing urothelial cell carcinoma (UCC; 1,802 incident cases) were calculated using Cox proportional hazards models. Alcohol consumption at baseline and over the life course was analyzed, as well as different types of beverages (beer, wine, spirits). Baseline alcohol intake was associated with a statistically non-significant increased risk of UCC (HR 1.03; 95% confidence interval (CI) 1.00-1.06 for each additional 12 grams/day). HR in smokers was 1.04 (95% CI 1.01-1.07). Men reporting high baseline intakes of alcohol (>96 grams/day) had an increased risk of UCC (HR 1.57; 95% CI 1.03-2.40) compared to those reporting moderate intakes (<6 grams/day), but no dose-response relationship emerged. In men, an increased risk of aggressive forms of UCC was observed even at lower doses (>6 to 24 grams/day). Average lifelong alcohol intake was not associated with the risk of UCC, however intakes of spirits > 24 grams/day were associated with an increased risk of UCC in men (1.38; 95% CI 1.01-1.91) and smokers (1.39; 95% CI 1.01-1.92), compared to moderate intakes. We found no association between alcohol and UCC in women and never smokers. In conclusion, we observed some associations between alcohol and UCC in men and in smokers, possibly due to residual confounding by tobacco smoking.

 

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PERSPECTIVE

Active Surveillance for Low-Risk Cancers — A Viable Solution to Overtreatment?

Megan R. Haymart, M.D., David C. Miller, M.D., and Sarah T. Hawley, Ph.D.

N Engl J Med 2017; 377:203-206July 20, 2017DOI: 10.1056/NEJMp1703787

http://sci-hub.cc/10.1056/NEJMp1703787

The excellent prognosis associated with most low-risk cancers combined with the potential for avoiding treatment side effects make active surveillance a promising alternative to more intensive approaches. But achieving widespread adoption will require further work.

 

The Ability of a Single BMD and Fracture History Assessment to Predict Fracture Over 25 Years in Postmenopausal Women: The Study of Osteoporotic Fractures.

Black DM, Cauley JA, Wagman R, Ensrud K, Fink HA, Hillier TA, Lui LY, Cummings SR, Schousboe JT, Napoli N.

J Bone Miner Res. 2017 Jul 18. doi: 10.1002/jbmr.3194. [Epub ahead of print]

PMID: 28719727

Abstract

The ability of bone mineral density (BMD) and other risk factors to predict fracture risk is well-established for as long as 5 to 10 years. However, their value to predict risk over a longer term has not been directly studied. We investigated whether a single assessment of femoral neck BMD and fracture history can predict fracture risk over 20 to 25 years. We used data from the Study of Osteoporotic Fractures (SOF) that assessed BMD and risk factors in 7959 women age ≥67 (mean = 73.4) in 1988-1990. Follow-up for fractures continued for 25 years for hip fracture, and for 20 years for any nonvertebral fracture. Using age-adjusted proportional hazards models, we analyzed the relationships between a single baseline assessment of femoral neck BMD, fracture history and age, and 20-25-year fracture incidence. The 25-year cumulative incidence of hip fracture was 17.9%; 20-year incidence of any nonvertebral fracture was 46.2%. The 25-year hip fracture incidence was highest in those ≥80 years old (22.6%) compared to 13.9% in women aged <70 years. A single femoral neck BMD measurement strongly predicted long-term hip fracture risk to 25 years: 29.6% risk in the lowest BMD quartile versus 7.6% with the highest relative hazard (RH) = 4.9 (95% CI, 4.1 to 6.0). Femoral neck BMD predicted hip fracture with little degradation over time from RH/SD = 2.6 (2.2 to 3.0) for 0 to 5 years to RH/SD = 1.8 (1.4 to 2.4) for 20 to 25 years. Lifetime hip fracture risk was similar (∼30%) regardless of age from 67 to >80 years. History of hip fracture predicted hip fractures only slightly better than history of nonvertebral fracture (RH = 1.6 [95% CI, 1.1 to 2.2] versus RH = 1.4 [95% CI, 1.2 to 1.5], respectively). Fracture history remained strongly predictive up to 25 years. We conclude that a single BMD and fracture history assessment can predict fracture risk over 20 to 25 years. Long-term risk of hip fracture remains extremely high in the oldest age groups, supporting risk assessment and consideration of treatment even in the oldest, highest-risk women.

KEYWORDS:

AGE; BMD; FRACTURE; HISTORY OF FRACTURE

 

The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis.

Bhindi B, Wallis CJD, Nayan M, Farrell AM, Trost LW, Hamilton RJ, Kulkarni GS, Finelli A, Fleshner NE, Boorjian SA, Karnes RJ.

JAMA Intern Med. 2017 Jul 17. doi: 10.1001/jamainternmed.2017.2791. [Epub ahead of print]

PMID: 28715534

Abstract

IMPORTANCE:

Despite 3 decades of study, there remains ongoing debate regarding whether vasectomy is associated with prostate cancer.

OBJECTIVE:

To determine if vasectomy is associated with prostate cancer.

DATA SOURCES:

The MEDLINE, EMBASE, Web of Science, and Scopus databases were searched for studies indexed from database inception to March 21, 2017, without language restriction.

STUDY SELECTION:

Cohort, case-control, and cross-sectional studies reporting relative effect estimates for the association between vasectomy and prostate cancer were included.

DATA EXTRACTION AND SYNTHESIS:

Two investigators performed study selection independently. Data were pooled separately by study design type using random-effects models. The Newcastle-Ottawa Scale was used to assess risk of bias.

MAIN OUTCOMES AND MEASURES:

The primary outcome was any diagnosis of prostate cancer. Secondary outcomes were high-grade, advanced, and fatal prostate cancer.

RESULTS:

Fifty-three studies (16 cohort studies including 2 563 519 participants, 33 case-control studies including 44 536 participants, and 4 cross-sectional studies including 12 098 221 participants) were included. Of these, 7 cohort studies (44%), 26 case-control studies (79%), and all 4 cross-sectional studies were deemed to have a moderate to high risk of bias. Among studies deemed to have a low risk of bias, a weak association was found among cohort studies (7 studies; adjusted rate ratio, 1.05; 95% CI, 1.02-1.09; P < .001; I2 = 9%) and a similar but nonsignificant association was found among case-control studies (6 studies; adjusted odds ratio, 1.06; 95% CI, 0.88-1.29; P = .54; I2 = 37%). Effect estimates were further from the null when studies with a moderate to high risk of bias were included. Associations between vasectomy and high-grade prostate cancer (6 studies; adjusted rate ratio, 1.03; 95% CI 0.89-1.21; P = .67; I2 = 55%), advanced prostate cancer (6 studies; adjusted rate ratio, 1.08; 95% CI, 0.98-1.20; P = .11; I2 = 18%), and fatal prostate cancer (5 studies; adjusted rate ratio, 1.02; 95% CI, 0.92-1.14; P = .68; I2 = 26%) were not significant (all cohort studies). Based on these data, a 0.6% (95% CI 0.3%-1.2%) absolute increase in lifetime risk of prostate cancer associated with vasectomy and a population-attributable fraction of 0.5% (95% CI 0.2%-0.9%) were calculated.

CONCLUSIONS AND RELEVANCE:

This review found no association between vasectomy and high-grade, advanced-stage, or fatal prostate cancer. There was a weak association between vasectomy and any prostate cancer that was closer to the null with increasingly robust study design. This association is unlikely to be causal and should not preclude the use of vasectomy as a long-term contraceptive option.

 

Association of Ozone Exposure With Cardiorespiratory Pathophysiologic Mechanisms in Healthy Adults.

Day DB, Xiang J, Mo J, Li F, Chung M, Gong J, Weschler CJ, Ohman-Strickland PA, Sundell J, Weng W, Zhang Y, Zhang JJ.

JAMA Intern Med. 2017 Jul 17. doi: 10.1001/jamainternmed.2017.2842. [Epub ahead of print]

PMID: 28715576

Abstract

IMPORTANCE:

Exposure to ozone has been associated with cardiovascular mortality, but the underlying biological mechanisms are not yet understood.

OBJECTIVE:

To examine the association between ozone exposure and cardiopulmonary pathophysiologic mechanisms.

DESIGN, SETTING, AND PARTICIPANTS:

A longitudinal study involving 89 healthy adult participants living on a work campus in Changsha City, China, was conducted from December 1, 2014, to January 31, 2015. This unique quasiexperimental setting allowed for better characterization of air pollutant exposure effects because the participants spent most of their time in controlled indoor environments. Concentrations of indoor and outdoor ozone, along with the copollutants particulate matter, nitrogen dioxide, and sulfur dioxide, were monitored throughout the study period and then combined with time-activity information and filtration conditions of each residence and office to estimate 24-hour and 2-week combined indoor and outdoor mean exposure concentrations. Associations between each exposure measure and outcome measure were analyzed using single-pollutant and 2-pollutant linear mixed models controlling for ambient temperature, secondhand smoke exposure, and personal-level time-varying covariates.

MAIN OUTCOMES AND MEASURES:

Biomarkers indicative of inflammation and oxidative stress, arterial stiffness, blood pressure, thrombotic factors, and spirometry were measured at 4 sessions.

RESULTS:

Of the 89 participants, 25 (28%) were women and the mean (SD) age was 31.5 (7.6) years. The 24-hour ozone exposure concentrations ranged from 1.4 to 19.4 parts per billion (ppb), corresponding to outdoor concentrations ranging from 4.3 to 47.9 ppb. Within this range, in models controlling for a second copollutant and other potential confounders, a 10-ppb increase in 24-hour ozone was associated with mean increases of 36.3% (95% CI, 29.9%-43.0%) in the level of platelet activation marker soluble P-selectin, 2.8% (95% CI, 0.6%-5.1%) in diastolic blood pressure, 18.1% (95% CI, 4.5%-33.5%) in pulmonary inflammation markers fractional exhaled nitric oxide, and 31.0% (95% CI, 0.2%-71.1%) in exhaled breath condensate nitrite and nitrate as well as a -9.5% (95% CI, -17.7% to -1.4%) decrease in arterial stiffness marker augmentation index. A 10-ppb increase in 2-week ozone was associated with increases of 61.1% (95% CI, 37.8%-88.2%) in soluble P-selectin level and 126.2% (95% CI, 12.1%-356.2%) in exhaled breath condensate nitrite and nitrate level. Other measured biomarkers, including spirometry, showed no significant associations with either 24-hour ozone or 2-week ozone exposures.

CONCLUSIONS AND RELEVANCE:

Short-term ozone exposure at levels not associated with lung function changes was associated with platelet activation and blood pressure increases, suggesting a possible mechanism by which ozone may affect cardiovascular health.

 

Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Risk Factors: Is Behavioral Counselling Necessary?

Capewell S, Dowrick C.

JAMA Intern Med. 2017 Jul 11. doi: 10.1001/jamainternmed.2017.1979. [Epub ahead of print] No abstract available.

PMID: 28697229

http://sci-hub.cc/10.1001/jamainternmed.2017.1979

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Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement.

US Preventive Services Task Force, Grossman DC, Bibbins-Domingo K, Curry SJ, Barry MJ, Davidson KW, Doubeni CA, Epling JW Jr, Kemper AR, Krist AH, Kurth AE, Landefeld CS, Mangione CM, Phipps MG, Silverstein M, Simon MA, Tseng CW.

JAMA. 2017 Jul 11;318(2):167-174. doi: 10.1001/jama.2017.7171.

PMID: 28697260

Abstract

IMPORTANCE:

Adults who adhere to national guidelines for a healthful diet and physical activity have lower rates of cardiovascular morbidity and mortality than those who do not. All persons, regardless of their risk status for cardiovascular disease (CVD), can gain health benefits from healthy eating behaviors and appropriate physical activity.

OBJECTIVE:

To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on behavioral counseling to promote a healthful diet and physical activity for cardiovascular disease prevention among adults without obesity who do not have cardiovascular risk factors (hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes).

EVIDENCE REVIEW:

The USPSTF reviewed the evidence on whether primary care-relevant counseling interventions to promote a healthful diet, physical activity, or both improve health outcomes, intermediate outcomes associated with CVD, or dietary or physical activity behaviors in adults; interventions to reduce sedentary behaviors; and the harms of behavioral counseling interventions.

FINDINGS:

Counseling interventions result in improvements in healthful behaviors and small but potentially important improvements in intermediate outcomes, including reductions in blood pressure and low-density lipoprotein cholesterol levels and improvements in measures of adiposity. The overall magnitude of benefit related to these interventions is positive but small. The potential harms are at most small, leading the USPSTF to conclude that these interventions have a small net benefit for adults without obesity who do not have CVD risk factors.

CONCLUSIONS AND RECOMMENDATION:

The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity. Existing evidence indicates a positive but small benefit of behavioral counseling for the prevention of CVD in this population. Persons who are interested and ready to make behavioral changes may be most likely to benefit from behavioral counseling. (C recommendation).

 

[it surprises me.]

Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults: The ALLHAT-LLT Randomized Clinical Trial.

Han BH, Sutin D, Williamson JD, Davis BR, Piller LB, Pervin H, Pressel SL, Blaum CS; ALLHAT Collaborative Research Group.

JAMA Intern Med. 2017 Jul 1;177(7):955-965. doi: 10.1001/jamainternmed.2017.1442.

PMID: 28531241

Abstract

IMPORTANCE:

While statin therapy for primary cardiovascular prevention has been associated with reductions in cardiovascular morbidity, the effect on all-cause mortality has been variable. There is little evidence to guide the use of statins for primary prevention in adults 75 years and older.

OBJECTIVES:

To examine statin treatment among adults aged 65 to 74 years and 75 years and older when used for primary prevention in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT).

DESIGN, SETTING, AND PARTICIPANTS:

Post hoc secondary data analyses were conducted of participants 65 years and older without evidence of atherosclerotic cardiovascular disease; 2867 ambulatory adults with hypertension and without baseline atherosclerotic cardiovascular disease were included. The ALLHAT-LLT was conducted from February 1994 to March 2002 at 513 clinical sites.

INTERVENTIONS:

Pravastatin sodium (40 mg/d) vs usual care (UC).

MAIN OUTCOMES AND MEASURES:

The primary outcome in the ALLHAT-LLT was all-cause mortality. Secondary outcomes included cause-specific mortality and nonfatal myocardial infarction or fatal coronary heart disease combined (coronary heart disease events).

RESULTS:

There were 1467 participants (mean [sD] age, 71.3 [5.2] years) in the pravastatin group (48.0% [n = 704] female) and 1400 participants (mean [sD] age, 71.2 [5.2] years) in the UC group (50.8% [n = 711] female). The baseline mean (SD) low-density lipoprotein cholesterol levels were 147.7 (19.8) mg/dL in the pravastatin group and 147.6 (19.4) mg/dL in the UC group; by year 6, the mean (SD) low-density lipoprotein cholesterol levels were 109.1 (35.4) mg/dL in the pravastatin group and 128.8 (27.5) mg/dL in the UC group. At year 6, of the participants assigned to pravastatin, 42 of 253 (16.6%) were not taking any statin; 71.0% in the UC group were not taking any statin. The hazard ratios for all-cause mortality in the pravastatin group vs the UC group were 1.18 (95% CI, 0.97-1.42; P = .09) for all adults 65 years and older, 1.08 (95% CI, 0.85-1.37; P = .55) for adults aged 65 to 74 years, and 1.34 (95% CI, 0.98-1.84; P = .07) for adults 75 years and older. Coronary heart disease event rates were not significantly different among the groups. In multivariable regression, the results remained nonsignificant, and there was no significant interaction between treatment group and age.

CONCLUSIONS AND RELEVANCE:

No benefit was found when pravastatin was given for primary prevention to older adults with moderate hyperlipidemia and hypertension, and a nonsignificant direction toward increased all-cause mortality with pravastatin was observed among adults 75 years and older.

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Risks of Statin Therapy in Older Adults.

Curfman G.

JAMA Intern Med. 2017 Jul 1;177(7):966. doi: 10.1001/jamainternmed.2017.1457. No abstract available.

PMID: 28531249

http://sci-hub.cc/10.1001/jamainternmed.2017.1457

 

Progress on Decreasing Salt Consumption.

Katz MH.

JAMA Intern Med. 2017 Jul 1;177(7):995. doi: 10.1001/jamainternmed.2017.1416. No abstract available.

PMID: 28586921

http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2629445

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Sodium Reduction in US Households' Packaged Food and Beverage Purchases, 2000 to 2014.

Poti JM, Dunford EK, Popkin BM.

JAMA Intern Med. 2017 Jul 1;177(7):986-994. doi: 10.1001/jamainternmed.2017.1407.

PMID: 28586820

Abstract

IMPORTANCE:

Initiatives to reduce sodium in packaged foods have been launched in the United States, yet corresponding changes in the amount of sodium that US households obtain from packaged foods have not been evaluated, to our knowledge.

OBJECTIVE:

To assess 15-year changes in the amount of sodium that US households acquire from packaged food purchases, the sodium content of purchases, and the proportion of households that have purchases with optimal sodium density.

DESIGN, SETTING, AND PARTICIPANTS:

Longitudinal study of US households in the 2000 to 2014 Nielsen Homescan Consumer Panel, a population-based sample of households that used barcode scanners to record all packaged foods purchased throughout the year. Time-varying brand- and product-specific nutrition information was used for 1 490 141 products.

MAIN OUTCOMES AND MEASURES:

Sociodemographic-adjusted changes in mean sodium per capita (mg/d) and sodium content (mg/100 g), overall and for top food group sources of sodium, and the proportion of households that have total purchases with sodium density of 1.1 mg/kcal or less.

RESULTS:

In a nationwide sample of 172 042 US households (754 608 year-level observations), the amount of sodium that households acquired from packaged food and beverage purchases decreased significantly between 2000 and 2014 by 396 mg/d (95% CI, -407 to -385 mg/d) per capita. The sodium content of households' packaged food purchases decreased significantly during this 15-year period by 49 mg/100 g (95% CI, -50 to -48 mg/100 g), a 12.0% decline; decreases began in 2005 and continued through 2014. Moreover, the sodium content of households' purchases decreased significantly for all top food sources of sodium between 2000 and 2014, including declines of more than 100 mg/100 g for condiments, sauces, and dips (-114 mg/100 g; 95% CI, -117 to -111 mg/100 g) and salty snacks (-142 mg/100 g; 95% CI, -144 to -141 mg/100 g). However, in all years, less than 2% of US households had packaged food and beverage purchases with sodium density of 1.1 mg/kcal or less.

CONCLUSIONS AND RELEVANCE:

In this nationwide study, significant reductions in sodium from packaged food purchases were achieved in the past 15 years. Nonetheless, most US households had food and beverage purchases with excessive sodium density. Findings suggest that more concerted sodium reduction efforts are needed in the United States.

 

Recent Patterns of Prostate-Specific Antigen Testing for Prostate Cancer Screening in the United States.

Fedewa SA, Ward EM, Brawley O, Jemal A.

JAMA Intern Med. 2017 Jul 1;177(7):1040-1042. doi: 10.1001/jamainternmed.2017.0340. No abstract available.

PMID: 28437537

http://sci-hub.cc/10.1001/jamainternmed.2017.0340

 

Association of Statin Use With Risk of Back Disorder Diagnoses.

Makris UE, Alvarez CA, Wei W, Mortensen EM, Mansi IA.

JAMA Intern Med. 2017 Jul 1;177(7):1044-1046. doi: 10.1001/jamainternmed.2017.1068. No abstract available.

PMID: 28459971

http://sci-hub.cc/10.1001/jamainternmed.2017.1068

 

Whole dietary patterns to optimize cognitive function for military mission-readiness: a systematic review and recommendations for the field

Lynn Teo Cindy Crawford Rachel Yehuda Danny Jaghab John J. Bingham Matthew D. Gallon Meghan L. O’Connell Holly K. Chittum Sonya M. Arzola Kevin Berry

Nutr Rev (2017) 75 (suppl_2): 73-88. DOI: https://doi.org/10.1093/nutrit/nux009

Published: 15 June 2017

https://academic.oup.com/nutritionreviews/article/75/suppl_2/73/3868863/Whole-dietary-patterns-to-optimize-cognitive

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/nutritionreviews/75/suppl_2/10.1093_nutrit_nux009/1/nux009.pdf?Expires=1500590296&Signature=X9Ocg8HvOXLZo5A5zKHd1yi1z9N0k-sNBvOds-VKoXOKDrYjJnn2XMMhRfITQCRM0dLErET2RSZFVEvfx5t~vewYMm070F0hzdUw4ApaeXScsCPi2jw~GN4VbLspP7pTesyP2lKGu-VKUWNThZ~FQRQg~Hl7819AOG0O7v~T23LJjpq58Oj2M~65Aiic~zMAQAVIZjgFXhSJ3vZhEKieT8BWns8OoH59oQyhBnk7bUYx2SSOICW-iIo2JpNLTu4-FBlRYlZ7GLAAIuVSUALPY1CQlDiSjKYF~BDrhXmUMH~5DnvgH8N3Fwbyh5TY0-kp5Ogbjx9SBUw15MJ4tB7l2Q__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

Context:Optimizing cognitive performance, particularly during times of high stress, is a prerequisite to mission-readiness among military personnel. It has been of interest to determine whether such performance could be enhanced through diet. Objective: This systematic review assesses the quality of the evidence for whole dietary patterns across various outcomes related to cognitive function in healthy adult populations to develop research recommendations for the military. Data Sources:PubMed, CINAHL, Embase, PsycInfo, and the Cochrane Library were searched. Study Selection: Peer-reviewed randomized controlled trials published in the English language were eligible. Data Extraction:Fifteen included trials were assessed for methodological quality, and descriptive data were extracted. Data Synthesis: Of the 6 acceptable-quality studies, 1 demonstrated statistically nonsignificant results, whereas the other 5 showed conflicting results across the cognitive outcomes assessed.Conclusions:Due to the heterogeneity across the included studies, no recommendations could be reached concerning whether certain whole dietary patterns have an effect on cognitive outcomes in healthy populations. Specific recommendations for future research are offered.

Keywords: cognitive brain function, diet, healthy, military, mission-readiness, systematic review

Topic: diet mental processes military personnel cognitive ability

 

Inequalities in Life Expectancy Among US Counties, 1980 to 2014: Temporal Trends and Key Drivers.

Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Mackenbach JP, van Lenthe FJ, Mokdad AH, Murray CJL.

JAMA Intern Med. 2017 Jul 1;177(7):1003-1011. doi: 10.1001/jamainternmed.2017.0918.

PMID: 28492829

http://sci-hub.cc/10.1001/jamainternmed.2017.0918

Abstract

IMPORTANCE:

Examining life expectancy by county allows for tracking geographic disparities over time and assessing factors related to these disparities. This information is potentially useful for policy makers, clinicians, and researchers seeking to reduce disparities and increase longevity.

OBJECTIVE:

To estimate annual life tables by county from 1980 to 2014; describe trends in geographic inequalities in life expectancy and age-specific risk of death; and assess the proportion of variation in life expectancy explained by variation in socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.

DESIGN, SETTING, AND PARTICIPANTS:

Annual county-level life tables were constructed using small area estimation methods from deidentified death records from the National Center for Health Statistics (NCHS), and population counts from the US Census Bureau, NCHS, and the Human Mortality Database. Measures of geographic inequality in life expectancy and age-specific mortality risk were calculated. Principal component analysis and ordinary least squares regression were used to examine the county-level association between life expectancy and socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors.

EXPOSURES:

County of residence.

MAIN OUTCOMES AND MEASURES:

Life expectancy at birth and age-specific mortality risk.

RESULTS:

Counties were combined as needed to create stable units of analysis over the period 1980 to 2014, reducing the number of areas analyzed from 3142 to 3110. In 2014, life expectancy at birth for both sexes combined was 79.1 (95% uncertainty interval [uI], 79.0-79.1) years overall, but differed by 20.1 (95% UI, 19.1-21.3) years between the counties with the lowest and highest life expectancy. Absolute geographic inequality in life expectancy increased between 1980 and 2014. Over the same period, absolute geographic inequality in the risk of death decreased among children and adolescents, but increased among older adults. Socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors explained 60%, 74%, and 27% of county-level variation in life expectancy, respectively. Combined, these factors explained 74% of this variation. Most of the association between socioeconomic and race/ethnicity factors and life expectancy was mediated through behavioral and metabolic risk factors.

CONCLUSIONS AND RELEVANCE:

Geographic disparities in life expectancy among US counties are large and increasing. Much of the variation in life expectancy among counties can be explained by a combination of socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors. Policy action targeting socioeconomic factors and behavioral and metabolic risk factors may help reverse the trend of increasing disparities in life expectancy in the United States.

 

Large-scale physical activity data reveal worldwide activity inequality.

Althoff T, Sosič R, Hicks JL, King AC, Delp SL, Leskovec J.

Nature. 2017 Jul 10. doi: 10.1038/nature23018. [Epub ahead of print]

PMID: 28693034

http://sci-hub.cc/10.1038/nature23018

Abstract

To be able to curb the global pandemic of physical inactivity1, 2, 3, 4, 5, 6, 7 and the associated 5.3 million deaths per year2, we need to understand the basic principles that govern physical activity. However, there is a lack of large-scale measurements of physical activity patterns across free-living populations worldwide1, 6. Here we leverage the wide usage of smartphones with built-in accelerometry to measure physical activity at the global scale. We study a dataset consisting of 68 million days of physical activity for 717,527 people, giving us a window into activity in 111 countries across the globe. We find inequality in how activity is distributed within countries and that this inequality is a better predictor of obesity prevalence in the population than average activity volume. Reduced activity in females contributes to a large portion of the observed activity inequality. Aspects of the built environment, such as the walkability of a city, are associated with a smaller gender gap in activity and lower activity inequality. In more walkable cities, activity is greater throughout the day and throughout the week, across age, gender, and body mass index (BMI) groups, with the greatest increases in activity found for females. Our findings have implications for global public health policy and urban planning and highlight the role of activity inequality and the built environment in improving physical activity and health.

Subject terms: Epidemiology

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Perceived Physical Activity and Mortality: Evidence From Three Nationally Representative U.S. Samples.

Zahrt OH, Crum AJ.

Health Psychol. 2017 Jul 20. doi: 10.1037/hea0000531. [Epub ahead of print]

PMID: 28726475

Abstract

OBJECTIVE:

This research sought to examine the relationship of individuals' perceptions about their level of physical activity with mortality outcomes at the population level.

METHOD:

This study used 3 nationally representative samples with a total sample size of 61,141 U.S. adults (weighted N = 476 million). Data from the 1990 National Health Interview Survey (NHIS) and the 1999-2002/2003-2006 National Health and Nutrition Examination Survey (NHANES) were linked to prospective National Death Index mortality data through 2011, yielding follow-up periods of up to 21 years. Cox proportional hazards models were used to determine the association between respondents' perceptions of their relative level of physical activity (compared with other people their age) and all-cause mortality, adjusting for actual levels of physical activity, health status and behavior, and sociodemographic variables.

RESULTS:

Perceived physical activity relative to peers was associated with mortality risk. Individuals who perceived themselves as less active than others were up to 71% more likely to die in the follow-up period than those who perceived themselves as more active. This finding held across 3 samples and after adjusting for actual levels of physical activity and other covariates.

CONCLUSIONS:

Individuals' perceptions about their level of physical activity strongly predicted mortality, even after accounting for the effects of actual physical activity and other known determinants of mortality. This suggests that perceptions about health behaviors may play an important role in shaping health outcomes.

 

Dietary Antioxidants and Longitudinal Changes in Lower Urinary Tract Symptoms in Elderly Men: The Osteoporotic Fractures in Men Study.

Holton KF, Marshall LM, Shannon J, Lapidus JA, Shikany JM, Bauer DC, Barrett-Connor E, Parsons JK; Osteoporotic Fractures in Men Study Group.

Eur Urol Focus. 2016 Aug;2(3):310-318. doi: 10.1016/j.euf.2015.09.006. Epub 2015 Sep 26.

PMID: 28723378

Abstract

BACKGROUND:

Antioxidants can potentially alter the progression of lower urinary tract symptoms (LUTS) through anti-inflammatory mechanisms.

OBJECTIVE:

To determine if dietary antioxidants are associated with reduced likelihood of LUTS progression or increased likelihood of LUTS remission in untreated elderly men.

DESIGN, SETTING, AND PARTICIPANTS:

A prospective cohort study of 1670 US men aged 65-100 yr.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:

Baseline variables included the American Urological Association Symptom Index, dietary intake assessed via a 69-item Block food frequency questionnaire (FFQ), demographics, lifestyle characteristics, quality of life (SF-12), and medication use. LUTS was assessed at four time points over a mean ± standard deviation period of 6.9±0.4 yr. Group-based trajectory modeling was performed for men without prostate cancer who did not undergo LUTS treatment with medication or surgery during follow-up (n=1670). Analyses were stratified by LUTS symptoms at baseline. For men with mild baseline LUTS, we examined the likelihood of LUTS progression relative to LUTS stability. For men with moderate baseline LUTS, we analyzed the likelihood of both LUTS progression relative to LUTS stability and LUTS remission relative to progression. Odds ratios and 95% confidence intervals were estimated for quartiles of daily antioxidant intake using multivariable logistic regression.

RESULTS AND LIMITATIONS:

None of the dietary antioxidants (vitamin C, vitamin E, β-carotene, α-carotene, β-cryptoxanthin, lycopene, lutein/zeaxanthin) was associated with a lower probability of LUTS progression or LUTS remission. The study was limited by use of the brief Block FFQ, which contains only 69 food items and may have biased results toward the null hypothesis because of nondifferential misclassification.

CONCLUSIONS:

In this large cohort of US men, there were no significant associations between multiple dietary antioxidants and LUTS progression or remission over 7 yr.

PATIENT SUMMARY:

In a large cohort of elderly men, there were no significant longitudinal associations between multiple dietary antioxidants and lower urinary tract symptoms (LUTS). Our data suggest that dietary antioxidant consumption may not influence the natural history of LUTS in older men.

KEYWORDS:

Benign prostatic hyperplasia; Bladder outlet obstruction; Elderly; Epidemiology; Fall; Fracture; Lower urinary tract symptoms; Risk factor

 

Patterns of alcohol consumption and risk of falls in older adults: a prospective cohort study.

Ortolá R, García-Esquinas E, Galán I, Guallar-Castillón P, López-García E, Banegas JR, Rodríguez-Artalejo F.

Osteoporos Int. 2017 Jul 19. doi: 10.1007/s00198-017-4157-2. [Epub ahead of print]

PMID: 28725986

Abstract

Falls are a major health problem in older adults, but their relationship with alcohol consumption in this population remains unclear. In a cohort with 2170 older adults followed up for 3.3 years, both moderate drinking and the Mediterranean drinking pattern were associated with a lower risk of falls and injurious falls.

INTRODUCTION:

This study aims to examine the association between certain patterns of alcohol consumption, including the Mediterranean drinking pattern (MDP), and the risk of falls in older adults.

METHODS:

A prospective cohort with 2170 community-dwelling individuals aged ≥60 years was recruited in Spain in 2008-2010 and followed up through 2012. At baseline, participants reported alcohol consumption and, at the end of follow-up, their falls during the previous year. The MDP was defined as moderate alcohol consumption (threshold between moderate and heavy intake was 40 g/day for men and 24 g/day for women) with preference for wine and drinking only with meals. Analyses were conducted with negative binomial or logistic regression, as appropriate, and adjusted for the main confounders.

RESULTS:

Compared with never drinkers, the number of falls was lower in moderate drinkers (incidence rate ratio (95% confidence interval), 0.79 (0.63-0.99)) and drinkers with MDP (0.73 (0.56-0.96)). Also, moderate drinkers and those with MDP showed a lower risk of ≥2 falls (odds ratio (95% confidence interval), 0.58 (0.38-0.88) and 0.56 (0.34-0.93), respectively) and of falls requiring medical care (0.67 (0.46-0.96) and 0.61 (0.39-0.96), respectively).

CONCLUSION:

Both moderate drinking and the MDP were associated with a lower risk of falls and injurious falls in older adults. However, sound advice on alcohol consumption should balance risks and benefits.

KEYWORDS:

Alcohol; Cohort study; Falls; Older adults

 

Dietary acrylamide exposure was associated with increased cancer mortality in Chinese elderly men and women: a 11-year prospective study of Mr. and Ms. OS Hong Kong.

Liu ZM, Tse LA, Ho SC, Wu S, Chen B, Chan D, Wong SY.

J Cancer Res Clin Oncol. 2017 Jul 19. doi: 10.1007/s00432-017-2477-4. [Epub ahead of print]

PMID: 28726047

Abstract

AIM:

Our study aims to investigate the association between dietary acrylamide exposure and cancer mortality among Chinese elderly.

METHODS:

A prospective cohort of 4000 elderly men and women aged 65 years and above (Mr. and Ms. OS Hong Kong study) was recruited from local communities from 2001 to 2003. Dietary exposure to acrylamide was evaluated at baseline based on a validated food frequency questionnaire and an acrylamide database from the 1st Hong Kong Total Diet Study. Data on mortality statistics through March 2014 were obtained from the Death Registry of the Department of Health of Hong Kong with a median follow-up of 11.1 years. Cox proportional hazards models were used to examine the association between the acrylamide exposure and cancer mortality. Sex hormones were assessed in men.

RESULTS:

During a median follow-up of 11.1 years (39,271 person-years), we ascertained 330 cancer deaths. Vegetables (43.7%) and cereals (28.9%) products were the major contributors to dietary acrylamide. Compared with the lowest quartile of acrylamide intake (<9.9 µg/day), the multivariable hazard ratios for the highest quartile (>17.1 µg/day) were 1.9 (95% CI 1.3-2.8; P trend < 0.01), 1.9 (95% CI 1.0-3.6; P trend = 0.05), and 2.0 (95% CI 1.0-4.0; P trend = 0.06) for the cancer mortality from overall, digestive and respiratory system, respectively. The associations were attenuated to null after further adjustment for circulating free estradiol in men. No statistically significant interactions were observed between acrylamide exposure and sex, obesity and overall lifestyle pattern scores.

CONCLUSIONS:

The longitudinal data provided evidence that dietary acrylamide, in amounts that Chinese elderly are typically exposed to, was associated with increased cancer mortality. Circulating free estradiol may mediate the association in men.

KEYWORDS:

Acrylamide; Cancer mortality; Chinese elderly; Dietary exposure

 

Serum Vitamin D and Risk of Breast Cancer within Five Years.

O'Brien KM, Sandler DP, Taylor JA, Weinberg CR.

Environ Health Perspect. 2017 Jul 6;125(7):077004. doi: 10.1289/EHP943.

PMID: 28728134

https://ehp.niehs.nih.gov/EHP943/

https://ehp.niehs.nih.gov/wp-content/uploads/2017/07/EHP943.alt_.pdf

Abstract

BACKGROUND:

Vitamin D is an environmental and dietary agent with known anticarcinogenic effects, but protection against breast cancer has not been established.

OBJECTIVE:

We evaluated the association between baseline serum 25-hydroxyvitamin D [25(OH)D] levels, supplemental vitamin D use, and breast cancer incidence over the subsequent 5 y of follow-up.

METHODS:

From 2003-2009, the Sister Study enrolled 50,884 U.S. women 35-74 y old who had a sister with breast cancer but had never had breast cancer themselves. Using liquid chromatography-mass spectrometry, we measured 25(OH)D in serum samples from 1,611 women who later developed breast cancer and from 1,843 randomly selected cohort participants. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of developing breast cancer using Cox proportional hazards models.

RESULTS:

We found that 25(OH)D levels were associated with a 21% lower breast cancer hazard (highest versus lowest quartile: adjusted ; CI: 0.63, 0.98). Analysis of the first 5 y of follow-up for all 50,884 Sister Study participants showed that self-reported vitamin D supplementation was associated with an 11% lower hazard [ (CI: 0.81, 0.99)]. These associations were particularly strong among postmenopausal women [ (CI: 0.57, 0.93) and (CI: 0.74, 0.93), respectively].

CONCLUSIONS:

In this cohort of women with elevated risk, high serum 25(OH)D levels and regular vitamin D supplement use were associated with lower rates of incident, postmenopausal breast cancer over 5 y of follow-up. These results may help to establish clinical benchmarks for 25(OH)D levels; in addition, they support the hypothesis that vitamin D supplementation is useful in breast cancer prevention.

 

The risks of biomarker-based epidemiology: Associations of circulating calcium levels with age, mortality, and frailty vary substantially across populations.

Cohen AA, Legault V, Fuellen G, Fülöp T, Fried LP, Ferrucci L.

Exp Gerontol. 2017 Jul 16. pii: S0531-5565(17)30414-X. doi: 10.1016/j.exger.2017.07.011. [Epub ahead of print] Review.

PMID: 28723411

http://linkinghub.elsevier.com.sci-hub.cc/retrieve/pii/S053155651730414X

Abstract

Recent studies have shown contradictory associations between calcium levels and health outcomes. We suspected these conflicting results were the consequence of more general issues with how biomarkers are analyzed in epidemiological studies, particularly in the context of aging. To demonstrate the risks of typical analyses, we used three longitudinal aging cohort studies and their demographic subsets to analyze how calcium levels change with age and predict risk of mortality and frailty. We show that calcium levels either increase or decrease with age depending on the population, and positively or negatively predict frailty depending on the population; both age and frailty results showed substantial heterogeneity. Mortality analyses revealed few significant associations but were likely underpowered. Variation in population composition (demographics, diseases, diet, etc.) leads to contradictory findings in the literature for calcium and likely for other biomarkers. Epidemiological studies of biomarkers are particularly sensitive to population composition both because biomarkers generally have non-linear and often non-monotonic relationships with other key variables, notably age and health outcomes, and because there is strong interdependence among biomarkers, which are integrated into complex regulatory networks. Consequently, most biomarkers have multiple physiological roles and are implicated in multiple pathologies. We argue that epidemiological studies of aging using biomarkers must account for these factors, and suggest methods to do this.

KEYWORDS:

Aging biomarkers; Calcium; Frailty; Physiological complexity; Population composition

 

1 in 3 dementia cases are potentially preventable, report says

Improving health, education and lifestyle before old age emphasized: 'Move a muscle, the brain will follow'

CBC News Posted: Jul 20, 2017

http://www.cbc.ca/news/health/dementia-prevention-1.4213239

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Commissions from the Lancet journals

Dementia prevention, intervention, and care

Published: July 20, 2017

http://www.thelancet.com/commissions/dementia2017

Executive Summary

Dementia is the greatest global challenge for health and social care in the 21st century: around 50 million people worldwide have dementia and this number is predicted to triple by 2050. The Lancet Commission on dementia aims to review the best available evidence and produce recommendations on how to best manage, or even prevent, the dementia epidemic.

Dementia is not an inevitable consequence of ageing and the Commission identifies nine potentially modifiable health and lifestyle factors from different phases of life that, if eliminated, might prevent dementia. Although therapies are currently not available to modify the underlying disease process, the Commission outlines pharmacological and social interventions that are able to help manage the manifestations of dementia.

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Comments

Prevention and management of dementia: a priority for public health

Helen Frankish, Richard Horton

The Lancet

Published: July 19, 2017

http://sci-hub.cc/10.1016/S0140-6736(17)31756-7

Summary

Today, nearly 50 million people worldwide have dementia, with this figure projected to increase to 75 million by 2030 and to 132 million by 2050,1 largely driven by population ageing. Dementia causes not only disability and dependency for individuals affected by the disorder, but can also have a profoundly detrimental effect on family and other carers, who are at high risk of developing depression and anxiety disorders.2 The cost of caring for people with dementia is more than US$800 billion per year globally, rising to $2 trillion by 2030.

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Progress on dementia—leaving no one behind

Martin Prince

The Lancet

Published: July 19, 2017

http://sci-hub.cc/10.1016/S0140-6736(17)31757-9

Summary

The Lancet Commission Dementia Prevention, Intervention, and Care1 makes a timely evidence-driven contribution to global efforts to improve the lives of people with dementia and their carers, and limit the future impact on societies. The Commission proposes ambitious prevention targets, treatment of cognitive symptoms in people with Alzheimer's disease or dementia with Lewy bodies, individualised dementia care, provision of care for carers, planning for the future for patients and families, risk protection balanced with respect for autonomy, management of neuropsychiatric symptoms, consideration of dementia in end of life care, and use of technological innovations to improve care but not replace social contact.

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Profile

Gill Livingston: transforming dementia prevention and care

Rachael Davies

The Lancet

Published: July 19, 2017

http://sci-hub.cc/10.1016/S0140-6736(17)31913-X

Summary

It was during a placement as a junior doctor in the 1980s at Friern Barnet, one of the largest psychiatric hospitals in Europe, that Gill Livingston first witnessed the real human impact of dementia. “People were living in old Victorian wards of 24 people with little privacy. It seemed a terrible way to live”, she recalls. The experience sparked a lifelong interest and a passion to improve the lives of people with dementia and their carers. But for Livingston it also became a personal concern when dementia affected her own family.

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Commission

Dementia prevention, intervention, and care

Gill Livingston, Andrew Sommerlad, Vasiliki Orgeta, Sergi G Costafreda, Jonathan Huntley, David Ames, Clive Ballard, Sube Banerjee, Alistair Burns, Jiska Cohen-Mansfield, Claudia Cooper, Nick Fox, Laura N Gitlin, Robert Howard, Helen C Kales, Eric B Larson, Karen Ritchie, Kenneth Rockwood, Elizabeth L Sampson, Quincy Samus, Lon S Schneider, Geir Selbæk, Linda Teri, Naaheed Mukadam

The Lancet

http://sci-hub.cc/10.1016/S0140-6736(17)31363-6

Summary

Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society.

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Healthful and Unhealthful Plant-Based Diets and the Risk of Coronary Heart Disease in U.S. Adults.

Satija A, Bhupathiraju SN, Spiegelman D, Chiuve SE, Manson JE, Willett W, Rexrode KM, Rimm EB, Hu FB.

J Am Coll Cardiol. 2017 Jul 25;70(4):411-422. doi: 10.1016/j.jacc.2017.05.047.

PMID: 28728684

Abstract

BACKGROUND:

Plant-based diets are recommended for coronary heart disease (CHD) prevention. However, not all plant foods are necessarily beneficial for health.

OBJECTIVES:

This study sought to examine associations between plant-based diet indices and CHD incidence.

METHODS:

We included 73,710 women in NHS (Nurses' Health Study) (1984 to 2012), 92,329 women in NHS2 (1991 to 2013), and 43,259 men in Health Professionals Follow-up Study (1986 to 2012), free of chronic diseases at baseline. We created an overall plant-based diet index (PDI) from repeated semiquantitative food-frequency questionnaire data, by assigning positive scores to plant foods and reverse scores to animal foods. We also created a healthful plant-based diet index (hPDI) where healthy plant foods (whole grains, fruits/vegetables, nuts/legumes, oils, tea/coffee) received positive scores, whereas less-healthy plant foods (juices/sweetened beverages, refined grains, potatoes/fries, sweets) and animal foods received reverse scores. To create an unhealthful PDI (uPDI), we gave positive scores to less-healthy plant foods and reverse scores to animal and healthy plant foods.

RESULTS:

Over 4,833,042 person-years of follow-up, we documented 8,631 incident CHD cases. In pooled multivariable analysis, higher adherence to PDI was independently inversely associated with CHD (hazard ratio {HR} comparing extreme deciles: 0.92; 95% confidence interval [CI]: 0.83 to 1.01; p trend = 0.003). This inverse association was stronger for hDPI (HR: 0.75; 95% CI: 0.68 to 0.83; p trend <0.001). Conversely, uPDI was positively associated with CHD (HR: 1.32; 95% CI: 1.20 to 1.46; p trend <0.001).

CONCLUSIONS:

Higher intake of a plant-based diet index rich in healthier plant foods is associated with substantially lower CHD risk, whereas a plant-based diet index that emphasizes less-healthy plant foods is associated with higher CHD risk.

KEYWORDS:

coronary heart disease; diet; dietary pattern; epidemiology; nutrition; prospective cohort study

 

Efficacy and safety of sugarcane policosanol on dyslipidemia: A meta-analysis of randomized controlled trials.

Gong J, Qin X, Yuan F, Hu M, Chen G, Fang K, Wang D, Jiang S, Li J, Zhao Y, Huang Z, Dong H, Lu F.

Mol Nutr Food Res. 2017 Jul 20. doi: 10.1002/mnfr.201700280. [Epub ahead of print]

PMID: 28730734

Abstract

SCOPE:

This study aimed to systematically investigate whether sugarcane policosanol was effective and safe on dyslipidemia.

METHODS AND RESULTS:

A total of 11 databases including the PubMed, Web of science, Embase, Scopus, the Cochrane library and SinoMed databases were searched for available studies investigating the effects of policosanol on dyslipidemia. A total of 22 studies including 1886 subjects were included in the analysis. The pooled results showed that compared with placebo, sugarcane policosanol could significantly reduce total cholesterol (TC, 95% CI: -0.87 to -0.30 mmol/L) and low density lipoprotein cholesterol (LDL-c, 95% CI: -1.02 to -0.40mmol/L) and increase high density lipoprotein cholesterol; however, no significant effects were observed on triglyceride (TG) and body weight. Subgroup analysis suggested the studies from Cuba obtained more effective data than those outside this country, and the effects were not proportional to the dose. The adverse effects analysis demonstrated that sugarcane policosanol was safer than the control agents.

CONCLUSIONS:

The pooled results supported the lipid-lowering effects and safety of policosanol. Because of the high heterogeneity, the better treatment effects observed in the Cuban studies and the inconsistent dose-response relationship, more clinical trials are needed to further confirm the efficacy of policosanol on dyslipidemia.

KEYWORDS:

Cholesterol; Dyslipidemia; Meta-analysis; Sugarcane policosanol; Triglyceride

 

Association of glycaemic index and glycaemic load with metabolic syndrome in an Iranian adult population: Isfahan Healthy Heart Program.

Mohammadifard N, Mansourian M, Sajjadi F, Maghroun M, Pourmoghaddas A, Yazdekhasti N, Sarrafzadegan N.

Nutr Diet. 2017 Feb;74(1):61-66. doi: 10.1111/1747-0080.12288. Epub 2016 Jul 12.

PMID: 28731561

Abstract

AIM:

There is controversy around the clinical effects of the dietary glycaemic index (GI) and glycaemic load (GL) on cardiovascular diseases risk factors such as metabolic syndrome (MetS). So, the present study was performed to evaluate the relationship between GI or GL and metabolic syndrome in an Iranian adult population in 2007.

METHODS:

The study was based on data from a sub-sample of the Isfahan Healthy Heart Program (IHHP), collected across three cities in central Iran, in the year 2007. This was a cross-sectional survey of 1618 randomly selected adults aged ≥19 years. Nutritional assessment was conducted by a single 24-hour recall questionnaire. Fasting serum lipids, anthropometric indicators and blood pressure were measured by standard methods. Analysis of covariance was used to compare metabolic syndrome components according to energy-adjusted GI and GL levels. To expose the effect of potential confounders, hierarchical logistic regression models were utilised to determine adjusted odds ratios (OR) and 95% CI.

RESULTS:

After adjustment for age, gender, body mass index and energy intake, high GI was found to be significantly associated with MetS (OR 95% CI) (1.46 (1.01-2.12)). This was attenuated marginally by excluding the confounding effects of dietary fibre intake (1.29 (1.01-1.74)). All hierarchical models illustrated no significant association between energy-adjusted GL and the risk of MetS adjusted for confounders.

CONCLUSIONS:

There is a positive relationship between dietary GI, but not GL, and the presence of MetS after adjustment for potential confounders. However, studies with long duration of follow up and experimental studies are still required to confirm this relationship.

KEYWORDS:

glycaemic index; glycaemic load; metabolic syndrome; risk factor

 

Meta-analysis of the association between the inflammatory potential of diet and colorectal cancer risk.

Fan Y, Jin X, Man C, Gao Z, Wang X.

Oncotarget. 2017 Jul 14. doi: 10.18632/oncotarget.19233. [Epub ahead of print]

PMID: 28732363

Abstract

OBJECTIVES:

The inflammatory potential of diet has been inconsistently linked to colorectal cancer (CRC) risk. This meta-analysis aimed to evaluate the association of the inflammatory potential of diet, as estimated by the dietary inflammatory index (DII) score, with CRC risk.

MATERIALS AND METHODS:

The PubMed and Embase databases were searched for relevant studies from inception to February 2017. All cohort and case-control studies investigating the association of the DII score with CRC risk were selected.

RESULTS:

Four prospective cohorts and four case-control studies, which enrolled a total of 880,380 participants, were included. The pooled adjusted risk ratio (RR) of CRC for the highest DII score versus the lowest category was 1.43 (95% confidence interval [CI]: 1.26-1.62). When stratified by study design, the RRs for the case-control and cohort studies were 1.27 (95% CI: 1.16-1.38) and 1.81 (95% CI: 1.48-2.22), respectively. Subgroup analysis showed that individuals with the highest category of DII score were independently associated with CRC risk in men (RR=1.51; 95% CI: 1.29-1.76), women (RR=1.25; 95% CI: 1.10-1.41), colon cancer (RR=1.39; 95% CI: 1.19-1.62), and rectal cancer (RR=1.32; 95% CI: 1.01-1.74). However, the pooled RR was 1.07 (95% CI: 0.87-1.31) for rectal cancer among the prospective cohort studies.

CONCLUSIONS:

As estimated by a high DII score, pro-inflammatory diet is independently associated with increased CRC risk. This finding confirms that low inflammatory potential diet may reduce CRC risk. However, the gender- and cancer site-specific associations of the DII score with CRC risk need to be further investigated.

KEYWORDS:

colorectal cancer; dietary inflammatory index; meta-analysis; systematic review

 

Molecular mechanisms of renal aging.

Schmitt R, Melk A.

Kidney Int. 2017 Jul 17. pii: S0085-2538(17)30306-X. doi: 10.1016/j.kint.2017.02.036. [Epub ahead of print] Review.

PMID: 28729036

Abstract

Epidemiologic, clinical, and molecular evidence suggest that aging is a major contributor to the increasing incidence of acute kidney injury and chronic kidney disease. The aging kidney undergoes complex changes that predispose to renal pathology. The underlying molecular mechanisms could be the target of therapeutic strategies in the future. Here, we summarize recent insight into cellular and molecular processes that have been shown to contribute to the renal aging phenotype.The main clinical finding of renal aging is the decrease in glomerular filtration rate, and its structural correlate is the loss of functioning nephrons. Mechanistically, this has been linked to different processes, such as podocyte hypertrophy, glomerulosclerosis, tubular atrophy, and gradual microvascular rarefaction. Renal functional recovery after an episode of acute kidney injury is significantly worse in elderly patients. This decreased regenerative potential, which is a hallmark of the aging process, may be caused by cellular senescence. Accumulation of senescent cells could explain insufficient repair and functional loss, a view that has been strengthened by recent studies showing that removal of senescent cells results in attenuation of renal aging. Other potential mechanisms are alterations in autophagy as an important component of a disturbed renal stress response and functional differences in the inflammatory system. Promising therapeutic measures to counteract these age-related problems include mimetics of caloric restriction, pharmacologic renin-angiotensin-aldosterone system inhibition, and novel strategies of senotherapy with the goal of reducing the number of senescent cells to decrease aging-related disease in the kidney.

KEYWORDS:

acute kidney injury; cell survival; chronic kidney disease; geriatric nephrology

 

Senotherapy: growing old and staying young?

Schmitt R.

Pflugers Arch. 2017 Apr 7. doi: 10.1007/s00424-017-1972-4. [Epub ahead of print] Review.

PMID: 28389776

Abstract

Cellular senescence, which has been linked to age-related diseases, occurs during normal aging or as a result of pathological cell stress. Due to their incapacity to proliferate, senescent cells cannot contribute to normal tissue maintenance and tissue repair. Instead, senescent cells disturb the microenvironment by secreting a plethora of bioactive factors that may lead to inflammation, regenerative dysfunction and tumor progression. Recent understanding of stimuli and pathways that induce and maintain cellular senescence offers the possibility to selectively eliminate senescent cells. This novel strategy, which so far has not been tested in humans, has been coined senotherapy or senolysis. In mice, senotherapy proofed to be effective in models of accelerated aging and also during normal chronological aging. Senotherapy prolonged lifespan, rejuvenated the function of bone marrow, muscle and skin progenitor cells, improved vasomotor function and slowed down atherosclerosis progression. While initial studies used genetic approaches for the killing of senescent cells, recent approaches showed similar effects with senolytic drugs. These observations open up exciting possibilities with a great potential for clinical development. However, before the integration of senotherapy into patient care can be considered, we need further research to improve our insight into the safety and efficacy of this strategy during short- and long-term use.

KEYWORDS:

Aging; BH-3 mimetics; Cellular senescence; Rejuvenation; Senescence; Senolysis; Senotherapy; p16INK4a

 

Implementation of longevity-promoting supplements and medications in public health practice: achievements, challenges and future perspectives.

Vaiserman A, Lushchak O.

J Transl Med. 2017 Jul 20;15(1):160. doi: 10.1186/s12967-017-1259-8. Review.

PMID: 28728596

Abstract

BACKGROUND:

Most modern societies undergo rapid population aging. The rise in life expectancy, nevertheless, is not accompanied, to date, by the same increment of healthspan. Efforts to increase healthspan by means of supplements and pharmaceuticals targeting aging-related pathologies are presently in spotlight of a new branch in geriatric medicine, geroscience, postulating that aging could be manipulated in such a way that will in parallel allow delay the onset of all age-associated chronic disorders.

DISCUSSION:

Currently, the concept of the "longevity dividend" has been developed pointed out that the extension of healthspan by slowing the rate of aging is the most efficient way to combat various aging-related chronic illnesses and disabling conditions than combating them one by one, what is the present-day approach in a generally accepted disease-based paradigm. The further elaboration of pharmaceuticals specifically targeted at age-associated disorders (commonly referred to as 'anti-aging drugs') is currently one of the most extensively developed fields in modern biogerontology. Some classes of chemically synthesized compounds and nutraceuticals such as calorie restriction mimetics, autophagy inductors, senolytics and others have been identified as having potential for anti-aging intervention through their possible effects on basic processes underlying aging. In modern pharmaceutical industry, development of new classes of anti-aging medicines is apparently one of the most hopeful directions since potential target group may include each adult individual. Implementation of the geroscience-based approaches into healthcare policy and practice would increase the ratio of healthy to unhealthy population due to delaying the onset of age-associated chronic pathologies. That might result in decreasing the biological age and increasing the age of disability, thus increasing the age of retirement and enhancing income without raising taxes. Economic, social and ethical aspects of applying the healthspan- and lifespan-promoting interventions, however, have to be comprehensively debated prior to their implementation in public health practice.

KEYWORDS:

Aging; Anti-aging drugs; Geroscience; Healthspan; Life extension; Longevity dividend

Edited by AlPater

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Biogerontology. 2017 Aug;18(4), Pages 429-721

Special Issue: 10th European Congress of Biogerontology and 6th Biogerontological Meeting: The Future of Ageing

https://link.springer.com/journal/volumesAndIssues/10522

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The Future of Ageing: not more of the same.

Sikora E, Rattan SIS.

Biogerontology. 2017 Aug;18(4):429-432. doi: 10.1007/s10522-017-9720-x. Epub 2017 Jul 5. No abstract available.

PMID: 28681276

https://link.springer.com/article/10.1007/s10522-017-9720-x/fulltext.html?wt_mc=alerts.TOCjournals

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Aging, frailty and complex networks.

Mitnitski AB, Rutenberg AD, Farrell S, Rockwood K.

Biogerontology. 2017 Aug;18(4):433-446. doi: 10.1007/s10522-017-9684-x. Epub 2017 Mar 2. Review.

PMID: 28255823

Abstract

When people age their mortality rate increases exponentially, following Gompertz's law. Even so, individuals do not die from old age. Instead, they accumulate age-related illnesses and conditions and so become increasingly vulnerable to death from various external and internal stressors. As a measure of such vulnerability, frailty can be quantified using the frailty index (FI). Larger values of the FI are strongly associated with mortality and other adverse health outcomes. This association, and the insensitivity of the FI to the particular health variables that are included in its construction, makes it a powerful, convenient, and increasingly popular integrative health measure. Still, little is known about why the FI works so well. Our group has recently developed a theoretical network model of health deficits to better understand how changes in health are captured by the FI. In our model, health-related variables are represented by the nodes of a complex network. The network has a scale-free shape or "topology": a few nodes have many connections with other nodes, whereas most nodes have few connections. These nodes can be in two states, either damaged or undamaged. Transitions between damaged and non-damaged states are governed by the stochastic environment of individual nodes. Changes in the degree of damage of connected nodes change the local environment and make further damage more likely. Our model shows how age-dependent acceleration of the FI and of mortality emerges, even without specifying an age-damage relationship or any other time-dependent parameter. We have also used our model to assess how informative individual deficits are with respect to mortality. We find that the information is larger for nodes that are well connected than for nodes that are not. The model supports the idea that aging occurs as an emergent phenomenon, and not as a result of age-specific programming. Instead, aging reflects how damage propagates through a complex network of interconnected elements.

KEYWORDS:

Aging; Complex networks; Frailty; Frailty index; Frailty maximum; Information theory; Mathematical modeling; Mortality

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Physical activity improves cognition: possible explanations.

Koščak Tivadar B.

Biogerontology. 2017 Aug;18(4):477-483. doi: 10.1007/s10522-017-9708-6. Epub 2017 May 10. Review.

PMID: 28492999

Abstract

Good cognitive abilities (CA) enable autonomy, improve social inclusion and act preventively. Regular physical activity (PA) reduces the risk of developing Alzheimer's disease (AD) and, at the same time, it reduces the decline of CA and stimulates neurogenesis. So PA in connection with cognitive training, nutrition and social interaction has a positive effect on general CA and the central nervous system, the central executor, memory and attention, and reduces the likelihood of developing dementia. Our objective was to examine which sort and intensity of PA is preferred. We did a review, restricted only to human studies, of transparent scientific articles and sample surveys carried out and published in the period between 2001 and 2016 based on the keywords: age, aging, physical activity, physical abilities, cognitive abilities, memory and Alzheimer's disease. According to results CA and PA interact, as an increasing PA of only 10% reduces the risk of dementia and AD significantly. However, there is a question of appropriate intensity of exercise. Low-intensity aerobic exercise has a positive effect on the visual spatial perception and attention, whereas moderate PA has a positive impact on general CA, working memory and attention, verbal memory and attention and vice versa. While the majority of experts recommends vigorous or moderate exercise, many of them warn that higher intensity requires more attention to PA and less to cognitive processes, particularly in terms of reducing reactions, selective attention and flexibility to tasks. There is also a further question what PA should be like. Although some experts believe that the best combination is aerobic PA and exercises against resistance, it is not entirely clear whether the improvement in CA is a result of cardiac vascular fitness. On the other hand, for most elderly it is more suitable to perform an alternative form (not anaerobic) of PA due to comorbidity and actual fragility. We can conclude that PA has a positive effect on CA, but an appropriate intensity and the type of exercise remain unsolved. For the relevant findings it is absolutely necessary to have an interdisciplinary approach.

KEYWORDS:

Cognition; Memory; Physical activity

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Changes in pro-inflammatory markers and leucine concentrations in response to Nordic Walking training combined with vitamin D supplementation in elderly women.

Gmiat A, Mieszkowski J, Prusik K, Prusik K, Kortas J, Kochanowicz A, Radulska A, Lipiński M, Tomczyk M, Jaworska J, Antosiewicz J, Ziemann E.

Biogerontology. 2017 Aug;18(4):535-548. doi: 10.1007/s10522-017-9694-8. Epub 2017 Mar 18.

PMID: 28316011

http://sci-hub.cc/10.1007/s10522-017-9694-8

Abstract

Mechanisms underpinning age-related decreases in muscle strength and muscle mass relate to chronic inflammation. Physical activity induces an anti-inflammatory effect, but it is modulated by additional factors. We hypothesized that vitamin D, which has also anti-inflammatory activity will modify adaptation to exercise and reduce inflammation in elderly women. Twenty-seven women aged 67 ± 8 years were included and divided into groups with baseline vitamin D concentration more than 20 ng mL-1 (MVD) and less than 20 ng mL-1 (LVD). Both groups performed 1 h Nordic Walking (NW) training combined with vitamin D supplementation for 12 weeks. Serum concentrations of inflammation markers, branched amino acids, vitamin D, muscle strength and balance were assessed at the baseline and three days after intervention. The training caused the significant decrease in concentration of pro-inflammatory proteins HMGB1 (30 ± 156%; 90% CI) and IL-6 (-10 ± 66%; 90% CI) in MVD group. This effects in group MVD were moderate, indicating vitamin D as one of the modifiers of these exercise-induced changes. Rise of myokine irisin induced by exercise correlated inversely with HMGB1 and the correlation was more pronounced at the baseline as well as after training among MVD participants. Although the intervention caused the leucine level to rise, a comparison of the recorded response between groups and the adjusted effect indicated that the effect was 20% lower in the LVD group. Overall the applied training program was effective in reducing HMGB1 concentration. This drop was accompanied by the rise of myokine irisin and better uptake of leucine among women with higher baseline vitamin D.

KEYWORDS:

Aging; Branched chain amino acids; High-Mobility Group Box 1 (HMGB1)

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[They did not seem to account for confounders such as smoking.]

Alcohol use disorders and associated chronic disease - a national retrospective cohort study from France.

Schwarzinger M, Thiébaut SP, Baillot S, Mallet V, Rehm J.

BMC Public Health. 2017 Jul 21;18(1):43. doi: 10.1186/s12889-017-4587-y.

PMID: 28732487

https://link.springer.com/article/10.1186/s12889-017-4587-y/fulltext.html

https://link.springer.com/content/pdf/10.1186%2Fs12889-017-4587-y.pdf

Abstract

BACKGROUND:

Evidence on diseases caused by or associated with alcohol use disorders (AUDs) has been based on two meta-analyses including rather dated studies. The objective of this contribution was to estimate the risks of all-cause mortality and alcohol-attributable disease categories depending on a diagnosis of AUDs in a national sample for France.

METHODS:

In a national retrospective cohort study on all inpatient acute and rehabilitation care patients in Metropolitan France 2008-2012 (N = 26,356,361), AUDs and other disease categories were identified from all discharge diagnoses according to standard definitions, and we relied on in-hospital death for mortality (57.4% of all deaths).

RESULTS:

704,803 (2.7%) patients identified with AUDs had a threefold higher risk of death (HR = 2.98; 95% CI: 2.96-3.00) and died on average 12.2 years younger (men: 10.4, 95% CI: 10.3-10.5; women: 13.7, 95% CI: 13.6-13.9). AUDs were associated with significantly higher risks of hospital admission for all alcohol-attributable disease categories: digestive diseases, cancers (exception: breast cancer), cardiovascular diseases, dementia, infectious diseases, and injuries. Elevated risks were highest for liver diseases that were associated with about two-third of deaths in patients with AUDs (men: 64.3%; women: 71.1%).

CONCLUSIONS:

AUDs were associated with marked premature mortality and higher risks of alcohol-attributable disease categories. Our results support the urgent need of measures to reduce the burden of AUDs.

KEYWORDS:

Alcohol use disorders; Burden of disease; Mortality; Non-communicable disease; Risk factor

 

An Overview of Herbal Products and Secondary Metabolites Used for Management of Type Two Diabetes.

Ota A, Ulrih NP.

Front Pharmacol. 2017 Jul 6;8:436. doi: 10.3389/fphar.2017.00436. eCollection 2017. Review.

PMID: 28729836 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499308/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5499308/pdf/fphar-08-00436.pdf

Abstract

Diabetes mellitus is a common effect of uncontrolled high blood sugar and it is associated with long-term damage, dysfunction, and failure of various organs. In the adult population, the global prevalence of diabetes has nearly doubled since 1980. Without effective prevention and management programs, the continuing significant rise in diabetes will have grave consequences on the health and lifespan of the world population, and also on the world economy. Supplements can be used to correct nutritional deficiencies or to maintain an adequate intake of certain nutrients. These are often used as treatments for diabetes, sometimes because they have lower costs, or are more accessible or "natural" compared to prescribed medications. Several vitamins, minerals, botanicals, and secondary metabolites have been reported to elicit beneficial effects in hypoglycemic actions in vivo and in vitro; however, the data remain conflicting. Many pharmaceuticals commonly used today are structurally derived from natural compounds from traditional medicinal plants. Botanicals that are most frequently used to help manage blood glucose include: bitter melon (Momordica charantia), fenugreek (Trigonella foenum graecum), gurmar (Gymnema sylvestre), ivy gourd (Coccinia indica), nopal (Opuntia spp.), ginseng, Russian tarragon (Artemisia dracunculus), cinnamon (Cinnamomum cassia), psyllium (Plantago ovata), and garlic (Allium sativum). In majority of the herbal products and secondary metabolites used in treating diabetes, the mechanisms of action involve regulation of insulin signaling pathways, translocation of GLUT-4 receptor and/or activation the PPARγ. Several flavonoids inhibit glucose absorption by inhibiting intestinal α-amylase and α-glucosidase. In-depth studies to validate the efficacies and safeties of extracts of these traditional medicinal plants are needed, and large, well designed, clinical studies need to be carried out before the use of such preparations can be recommended for treatment and/or prevention of diabetes. The main focus of this review is to describe what we know to date of the active compounds in these, along with their glucose-lowering mechanisms, which are either through insulin-mimicking activity or enhanced glucose uptake.

KEYWORDS:

antidiabetic activity; herbal products; mechanisms of action; phenolic compounds; type 2 diabetes mellitus

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The glycaemic outcomes of Cinnamon, a review of the experimental evidence and clinical trials.

Medagama AB.

Nutr J. 2015 Oct 16;14:108. doi: 10.1186/s12937-015-0098-9. Review.

PMID: 26475130 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609100/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609100/pdf/12937_2015_Article_98.pdf

Abstract

INTRODUCTION:

Cinnamon is currently marketed as a remedy for obesity, glucose intolerance, diabetes mellitus and dyslipidaemia. Integrative medicine is a new concept that combines conventional treatment with evidence-based complementary therapies.

AIM:

The aim of this review is to critically evaluate the experimental evidence available for cinnamon in improving glycaemic targets in animal models and humans.

RESULTS:

Insulin receptor auto-phosphorlylation and de-phosphorylation, glucose transporter 4 (GLUT-4 ) receptor synthesis and translocation, modulation of hepatic glucose metabolism through changes in Pyruvate kinase (PK) and Phosphenol Pyruvate Carboxikinase (PEPCK), altering the expression of PPAR (γ) and inhibition of intestinal glucosidases are some of the mechanisms responsible for improving glycaemic control with cinnamon therapy. We reviewed 8 clinical trials that used Cinnamomum cassia in aqueous or powder form in doses ranging from 500 mg to 6 g per day for a duration lasting from 40 days to 4 months as well as 2 clinical trials that used cinnamon on treatment naïve patients with pre-diabetes. An improvement in glycaemic control was seen in patients who received Cinnamon as the sole therapy for diabetes, those with pre-diabetes (IFG or IGT) and in those with high pre-treatment HbA1c. In animal models, cinnamon reduced fasting and postprandial plasma glucose and HbA1c.

CONCLUSION:

Cinnamon has the potential to be a useful add-on therapy in the discipline of integrative medicine in managing type 2 diabetes. At present the evidence is inconclusive and long-term trials aiming to establish the efficacy and safety of cinnamon is needed. However, high coumarin content of Cinnamomum cassia is a concern, but Cinnamomum zeylanicum with its low coumarin content would be a safer alternate.

 

[The below paper is pdf-availed.]

Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysis.

Macfarlane GJ, Barnish MS, Jones GT.

Ann Rheum Dis. 2017 Jul 21. pii: annrheumdis-2017-211476. doi: 10.1136/annrheumdis-2017-211476. [Epub ahead of print]

PMID: 28733474

Abstract

OBJECTIVE:

It is uncertain whether persons with chronic widespread pain (CWP) experience premature mortality. Using the largest study conducted, we determine whether such a relationship exists, estimate its magnitude and establish what factors mediate any relationship.

METHODS:

UK Biobank, a cohort study of 0.5 million people aged 40-69 years, recruited throughout Great Britain in 2006-2010. Participants reporting 'pain all over the body' for >3 months were compared with persons without chronic pain. Information on death (with cause) was available until mid-2015. We incorporated these results in a meta-analysis with other published reports to calculate a pooled estimate of excess risk.

RESULTS:

7130 participants reported CWP and they experienced excess mortality (mortality risk ratio 2.43, 95%CI 2.17 to 2.72). Specific causes of death in excess were cancer (1.73adjusted age and sex, 95% CI 1.46 to 2.05), cardiovascular (3.24adjusted age and sex, 95% CI 2.55 to 4.11), respiratory (5.66adjusted age and sex, 95% CI 4.00 to 8.03) and other disease-related causes (4.04adjusted age and sex, 95% CI 3.05 to 5.34). Excess risk was substantially reduced after adjustment for low levels of physical activity, high body mass index, poor quality diet and smoking. In meta-analysis, all studies showed significant excess all-cause (combined estimate 1.59 (95% CI 1.05 to 2.42)), cardiovascular and cancer mortality.

CONCLUSIONS:

Evidence is now clear that persons with CWP experience excess mortality. UK Biobank results considerably reduce uncertainty around the magnitude of excess risk and are consistent with the excess being explained by adverse lifestyle factors, which could be targeted in the management of such patients.

KEYWORDS:

epidemiology; fibromyalgis/Pain syndromes; outcomes research

 

Meta-Analysis of 29 Experiments Evaluating the Effects of Rapamycin on Life Span in the Laboratory Mouse.

Swindell WR.

J Gerontol A Biol Sci Med Sci. 2016 Aug 12. pii: glw153. [Epub ahead of print]

PMID: 27519886

Abstract

Rapamycin has favorable effects on aging in mice and may eventually be applied to encourage "healthy aging" in humans. This study analyzed raw data from 29 survival studies of rapamycin- and control-treated mice, with the goals of estimating summary statistics and identifying factors associated with effect size heterogeneity. Meta-analysis demonstrated significant heterogeneity across studies, with hazard ratio (HR) estimates ranging from 0.22 (95% confidence interval [CI]: 0.06-0.82) to 0.92 (95% CI: 0.65-1.28). Sex was the major factor accounting for effect size variation, and mortality was decreased more in females (HR = 0.41; 95% CI: 0.35-0.48) as compared with males (HR = 0.63; 95% CI: 0.55-0.71). Rapamycin effects were also genotype dependent, however, with stronger survivorship increases in hybrid mice (14.4%; 95% CI: 12.5-16.3%) relative to pure inbred strains (8.8%; 95% CI: 6.2-11.6%). Number needed to treat was applied as an effect size metric, which consistently identified early senescence as the age of peak treatment benefit. These results provide synthesis of existing data to support the potential translation of findings from mouse to primate species. Because rapamycin's effect on survival depends on sex and genotype, further work is justified to understand how these factors shape treatment response.

KEYWORDS:

AFT model; Longevity; NNT; Proportional hazard; mTOR

 

Association of Polymorphisms in Connective Tissue Growth Factor and Epidermal Growth Factor Receptor Genes With Human Longevity.

Donlon TA, Morris BJ, He Q, Chen R, Masaki KH, Allsopp RC, Willcox DC, Tranah GJ, Parimi N, Evans DS, Flachsbart F, Nebel A, Kim DH, Park J, Willcox BJ.

J Gerontol A Biol Sci Med Sci. 2016 Jun 30. pii: glw116. [Epub ahead of print]

PMID: 27365368

Abstract

Growth pathways play key roles in longevity. The present study tested single-nucleotide polymorphisms (SNPs) in the connective tissue growth factor gene (CTGF) and the epidermal growth factor receptor gene (EGFR) for association with longevity. Comparison of allele and genotype frequencies of 12 CTGF SNPs and 41 EGFR SNPs between 440 American men of Japanese ancestry aged ≥95 years and 374 men of average life span revealed association with longevity at the p < .05 level for 2 SNPs in CTGF and 7 in EGFR Two in CTGF and two in EGFR remained significant after Bonferroni correction. The SNPs of both CTGF and EGFR were in a haplotype block in each respective gene. Haplotype analysis confirmed the suggestive association found by χ2 analysis. We noted an excess of heterozygotes among the longevity cases, consistent with heterozygote advantage in living to extreme old age. No associations of the most significant SNPs were observed in whites or Koreans. In conclusion, the present findings indicate that genetic variation in CTGF and EGFR may contribute to the attainment of extreme old age in Japanese. More research is needed to confirm that genetic variation in CTGF and EGFR contributes to the attainment of extreme old age across human populations.

KEYWORDS:

Case–control study; Connective tissue growth factor; Epidermal growth factor; Longevity; Molecular genetics

 

A Long-lived Mouse Lacking Both Growth Hormone and Growth Hormone Receptor: A New Animal Model for Aging Studies.

Gesing A, Wiesenborn D, Do A, Menon V, Schneider A, Victoria B, Stout MB, Kopchick JJ, Bartke A, Masternak MM.

J Gerontol A Biol Sci Med Sci. 2016 Sep 29. pii: glw193. [Epub ahead of print]

PMID: 27688483

http://sci-hub.cc/10.1093/gerona/glw193

Abstract

Disruption of the growth hormone (GH) signaling pathway promotes insulin sensitivity and is associated with both delayed aging and extended longevity. Two kinds of long-lived mice-Ames dwarfs (df/df) and GH receptor gene-disrupted knockouts (GHRKO) are characterized by a suppressed GH axis with a significant reduction of body size and decreased plasma insulin-like growth factor-1 (IGF-1) and insulin levels. Ames dwarf mice are deficient in GH, prolactin, and thyrotropin, whereas GHRKOs are GH resistant and are dwarf with decreased circulating IGF-1 and increased GH. Crossing Ames dwarfs and GHRKOs produced a new mouse line (df/KO), lacking both GH and GH receptor. These mice are characterized by improved glucose tolerance and increased adiponectin level, which could imply that these mice should be also characterized by additional life-span extension when comparing with GHRKOs and Ames dwarfs. Importantly, our longevity experiments showed that df/KO mice maintain extended longevity when comparing with N control mice; however, they do not live longer than GHRKO and Ames df/df mice. These important findings indicate that silencing GH signal is important to extend the life span; however, further decrease of body size in mice with already inhibited GH signal does not extend the life span regardless of improved some health-span markers.

KEYWORDS:

Ames dwarf mice; Dwarfism; GHRKO mice; Insulin signaling; Longevity

 

Dynapenic Abdominal Obesity as a Predictor of Worsening Disability, Hospitalization, and Mortality in Older Adults: Results From the InCHIANTI Study.

Rossi AP, Bianchi L, Volpato S, Bandinelli S, Guralnik J, Zamboni M, Ferrucci L.

J Gerontol A Biol Sci Med Sci. 2017 Mar 8. doi: 10.1093/gerona/glw203. [Epub ahead of print]

PMID: 28329134

Abstract

BACKGROUND:

There are relatively few prospective studies evaluating the combined effect of abdominal obesity and low muscle strength on mortality, hospitalization, and incident disability. The aim of this study was to prospectively evaluate the prognostic value of dynapenic abdominal obesity on incident disability, hospitalization, and mortality in the population of the InCHIANTI study.

METHODS:

In 370 men and 476 women aged between 65 and 95 years, handgrip strength, waist circumference (WC), body mass index, interleukin-6, C-reactive protein, education, medications, smoking status, and comorbidities were evaluated at the baseline. Difficulties in performing basic activities of daily living were assessed at baseline and at 3-, 6-, and 9-year follow-ups, using a standardized questionnaire. Hospitalization and mortality rates were evaluated during an 11-year follow-up. The study population was categorized as nondynapenic nonabdominal obese (ND/NAO, reference group), dynapenic nonabdominal obese (D/NAO), nondynapenic abdominal obese (ND/AO), and dynapenic abdominal obese (D/AO), according to handgrip strength/WC tertiles.

RESULTS:

D/AO participants presented more than a twofold increase in risk of worsening disability (odds ratio = 2.10; 95% confidence interval [CI]: 1.14-3.88) and significantly higher risk of hospitalization (1.36; 95% CI: 1.04-1.78) compared with ND/NAO participants. After adjustment for potential confounders, the relative risk of death was 1.47 (95% CI: 1.09-1.97) for D/NAO compared with the ND/NAO group.

CONCLUSIONS:

Dynapenic abdominal obese participants are at higher risk of worsening disability and hospitalization than ND/NAO participants. Mortality risk was higher in participants with dynapenia without central fat distribution compared with the reference group.

KEYWORDS:

Disability; Dynapenia; Mortality; Muscle strength; Sarcopenic obesity

 

The Importance of Mid-to-Late-Life Body Mass Index Trajectories on Late-Life Gait Speed.

Windham BG, Griswold ME, Wang W, Kucharska-Newton A, Demerath EW, Gabriel KP, Pompeii LA, Butler K, Wagenknecht L, Kritchevsky S, Mosley TH Jr.

J Gerontol A Biol Sci Med Sci. 2016 Nov 3. pii: glw200. [Epub ahead of print]

PMID: 27811156

Abstract

BACKGROUND:

Prior studies suggest being overweight may be protective against poor functional outcomes in older adults.

METHODS:

Body mass index (BMI, kg/m2) was measured over 25 years across five visits (1987-2011) among Atherosclerosis Risk in Communities Study participants (baseline Visit 1 n = 15,720, aged 45-64 years). Gait speed was measured at Visit 5 ("late-life", aged ≥65 years, n = 6,229). BMI trajectories were examined using clinical cutpoints and continuous mixed models to estimate effects of patterns of BMI change on gait speed, adjusting for demographics and comorbidities.

RESULTS:

Mid-life BMI (baseline visit; 55% women; 27% black) was associated with late-life gait speed 25 years later; gait speeds were 94.3, 89.6, and 82.1 cm/s for participants with baseline normal BMI (<25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30) (p < .001). In longitudinal analyses, late-life gait speeds were 96.9, 88.8, and 81.3 cm/s for participants who maintained normal, overweight, and obese weight status, respectively, across 25 years (p < .01). Increasing BMI over 25 years was associated with poorer late-life gait speeds; a 1%/year BMI increase for a participant with a baseline BMI of 22.5 (final BMI 28.5) was associated with a 4.6-cm/s (95% confidence interval: -7.0, -1.8) slower late-life gait speed than a participant who maintained a baseline BMI of 22.5.

CONCLUSION:

Being overweight in older age was not protective of mobility function. Maintaining a normal BMI in mid- and late-life may help preserve late-life mobility.

KEYWORDS:

Longitudinal; Mobility; Overweight

 

Zinc Deficiency Is associated With Depressive Symptoms-Results From the Berlin Aging Study II.

Jung A, Spira D, Steinhagen-Thiessen E, Demuth I, Norman K.

J Gerontol A Biol Sci Med Sci. 2016 Oct 27. pii: glw218. [Epub ahead of print]

PMID: 27789618

Abstract

BACKGROUND:

Zinc plays an important role for behavioral and mental function, maintaining the correct functions of intracellular signal transduction, cellular and trans-membrane transport, protein synthesis, and antioxidant system. We investigated both dietary zinc intake and plasma zinc levels and the correlation with depressive symptoms in a large sample of community-dwelling old.

DESIGN:

One thousand five hundred fourteen older people (aged 60-84 years, 772 women) from the Berlin Aging Study II were included. Zinc intake was assessed by the EPIC Food Frequency Questionnaire. Plasma zinc levels were assessed with atomic-absorption spectrophotometry. Depressive symptoms were assessed with the "Center for Epidemiological Studies Depression Scale" and the "Geriatric Depression Scale."

RESULTS:

Zinc deficiency in blood plasma was found in 18.7% of participants, and depressive symptoms in 15.7%. Participants with depressive symptoms had lower energy-adjusted zinc intake (median 11.1 vs 11.6 µmol/L; p = .048) and lower plasma zinc levels (median 12.2 vs12.3 mg/dL; p = .037). Even after adjustment for known predictors of depression, plasma zinc deficiency remained significantly associated with depressive symptoms (odds ratio: 1.490, 95% confidence interval: 1.027-2.164; p = .036). In the multiple logistic regression model stratified by sex, we found that plasma zinc deficiency was strongly associated with a higher risk for depressive symptoms in women (odds ratio: 1.739, 95% confidence interval: 1.068-2.833; p = .026).

CONCLUSIONS:

Plasma zinc deficiency was common in our old study population. An increase in dietary zinc and higher plasma zinc levels may reduce the risk of depressive symptoms. A screening for reduced dietary zinc intake or plasma zinc deficiency might be beneficial in older people at risk of depressive symptoms.

KEYWORDS:

Depressive disorders; Plasma zinc; Zinc intake

 

[The below paper is not pdf-availed.]

BMI Is a Risk Factor for Colorectal Cancer Mortality.

Shaukat A, Dostal A, Menk J, Church TR.

Dig Dis Sci. 2017 Jul 21. doi: 10.1007/s10620-017-4682-z. [Epub ahead of print]

PMID: 28733869

Abstract

BACKGROUND:

The relationship between dietary and lifestyle risk factors and long-term mortality from colorectal cancer is poorly understood. Several factors, such as obesity, intakes of red meat, and use of aspirin, have been reported to be associated with risk of colorectal cancer mortality, though these findings have not been replicated in all studies to date.

METHODS:

In the Minnesota Colon Cancer Control Study, 46,551 participants 50-80 years old were randomly assigned to usual care (control) or annual or biennial screening by fecal occult blood testing. Colon cancer mortality was assessed after 30 years of follow-up. Dietary intake and lifestyle risk factors were assessed by questionnaire at baseline.

RESULTS:

Age [hazard ratio (HR) 1.09; 95% CI 1.07, -1.11], male sex (HR 1.25; 95% CI 1.01, 1.57), and higher body mass index (BMI) (HR 1.03; 95% CI 1.00-1.05) increased the risk of CRC mortality, while undergoing screening for CRC was associated with a reduced risk of colorectal cancer mortality (HR 0.76; 95% CI 0.61-0.94 and 0.67; 95% CI 0.53-0.83 for biennial and annual screening, respectively). Intakes of grains, meats, proteins, coffee, alcohol, aspirin, fiber, fruits, and vegetables were not associated with colorectal cancer mortality.

CONCLUSIONS:

Our study confirms the relationship between BMI and long-term colorectal cancer mortality. Modulation of BMI may reduce risk of CRC mortality.

KEYWORDS:

Body mass index; Colon cancer mortality; Diet lifestyle

 

Chewing gum decreases energy intake at lunch following a controlled breakfast.

Melanson KJ, Kresge DL.

Appetite. 2017 Jul 18. pii: S0195-6663(17)30746-8. doi: 10.1016/j.appet.2017.07.015. [Epub ahead of print]

PMID: 28733151

http://sci-hub.cc/10.1016/j.appet.2017.07.015

Abstract

The impact of chewing gum on fasting appetite or meal intake has not been studied. We tested the hypothesis that chewing gum would decrease lunch intake after a controlled breakfast, and reduce hunger in fasting and fed states. Seventeen males and sixteen females (21.4 ± 6.3y, BMI 23.8 ± 2.7 kg/m2) participated in a randomized crossover study in which subjects chewed sugar-free gum a total of one hour on the test day (GC), and did not chew gum on a control day (NG). The 1 h of gum chewing included 20 min while fasting, and two 20-min sessions between breakfast and lunch. Subjects rated their appetite and mood on visual analog scales. After completing the fasting measures, subjects consumed a breakfast shake containing 30% of their measured resting energy expenditure. Three hours later they consumed an ad libitum lunch with water. Fasting ratings of hunger were lower in GC than NG (t = 2.66, p = 0.01). Subjects consumed significantly less pasta (41 g, 68 kcals, t = 2.32, p = 0.03) during GC than NG. In conclusion, gum chewing decreased fasting hunger ratings and lunch energy consumed. Chewing gum may be a useful tool impacting energy balance in this population. Longer studies, especially in other populations, will be required.

KEYWORDS:

Appetite; Chewing gum; Mood; Postprandial

 

Sleep duration and risk of myocardial infarction and all-cause death in a Chinese population: the Kailuan study.

Wang X, Liu X, Song Q, Wu S.

Sleep Med. 2016 Mar;19:13-6. doi: 10.1016/j.sleep.2015.09.027. Epub 2015 Nov 30.

PMID: 27198941

Abstract

OBJECTIVE:

Although sleep is one of the most important health-related factors, the association of sleep duration with incidence of myocardial infarction or all-cause death has not been fully understood, especially in the general Chinese population. The objective of this study was to explore the relationship between sleep duration and risk of myocardial infarction and all-cause death in China.

METHODS:

Out of the 101,510 participants who were originally included into the Kailuan prospective cohort study and followed up for an average of 3.98 years, 95,903 participants were actually sampled to evaluate the impacts of sleep duration on myocardial infarction and all-cause death. Sleep duration was categorized as ≤5, 6, 7, and 8 hours/night, and ≥9 hours per night. Cox proportional hazards models were used to analyze the association of sleep duration with the incidence of myocardial infarction and all-cause death.

RESULTS:

After a mean follow-up period of 3.98 years, 423 participants developed myocardial infarction and 1793 participants died. A U-shape association between sleep duration and all-cause death was found. The age- and gender-adjusted hazard ratios (95% confidence interval [CI]) of all-cause death (with seven hours of daily sleep being considered for the reference group) for individuals reporting ≤5, 6, and 8 hours, and ≥9 hours were 1.29 (1.08-1.55), 0.97 (0.82-1.14), 1.11 (0.97-1.27), and 1.77 (1.31-2.38), respectively, with a p ≤ 0.01. However, no significant association was seen between sleep duration and myocardial infarction.

CONCLUSION:

Both short and long duration of sleep might be potential predictors/markers for all-cause death, but not for myocardial infarction.

KEYWORDS:

All-cause death; Myocardial infarction; Sleep duration

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Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis.

Abdullah MMH, Marinangeli CPF, Jones PJH, Carlberg JG.

Nutrients. 2017 Jul 22;9(7). pii: E793. doi: 10.3390/nu9070793.

PMID: 28737688

http://www.mdpi.com/2072-6643/9/7/793/htm

file:///C:/Users/Owner/Downloads/nutrients-09-00793.pdf

Abstract

Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1) estimate the proportions of individuals who are likely to consume pulses; (2) evaluate the reductions in established risk factors for T2D and CVD; (3) assess the percent reduction in incidences or complications of the diseases of interest; and (4) calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6-$9.9) to Can$62.4 (95% CI $26-$98.8) and Can$31.6 (95% CI $11.1-$52) to Can$315.5 (95% CI $110.6-$520.4) million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.

KEYWORDS:

cardiovascular disease; diabetes; dietary pulses; healthcare cost savings; nutrition economics

 

Age-dependent relationships between body mass index and mortality: Singapore longitudinal ageing study.

Ng TP, Jin A, Chow KY, Feng L, Nyunt MSZ, Yap KB.

PLoS One. 2017 Jul 24;12(7):e0180818. doi: 10.1371/journal.pone.0180818. eCollection 2017.

PMID: 28738068

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180818

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0180818&type=printable

Abstract

OBJECTIVES:

The relationship between body mass index (BMI) with mortality risk, in particular the BMI category associated with the lowest all-cause and CVD-and-stroke mortality and the BMI threshold for defining overweight or obesity in older persons is controversial. This study investigated the age-dependent associations of BMI categories with all-cause and cardiovascular disease (CVD) and stroke mortality.

METHOD:

Prospective cohort study (Singapore Longitudinal Ageing Studies) of older adults aged 55 and above, followed up from 2003 to 2011. Participants were 2605 Chinese with baseline BMI and other variables. Outcome Measurement: Mortality hazard ratios (HR) for all-cause and CVD and stroke mortality.

RESULTS:

Overall, BMI showed a U-shaped relationship with all-cause and CVD and stroke mortality, being lowest at Normal Weight-II category (BMI 23.0-24.9 kg/m2). Most evidently among the middle-aged (55-64 years), all-cause mortality risks relative to Normal Weight-II were elevated for underweight (<BMI 18.5; HR = 4.92, p<0.0138), Normal Weight-I (BMI 18.5-22.9; HR = 3.41, p = 0.0149), and Overweight-Obese (BMI>30.0; HR = 4.05,p = 0.0423). Among the old (≥65 years), however, Overweight and Obese categories were not significantly associated with increased all-cause mortality (HR from 0.98 to 1.29), but Overweight-Obese was associated with increased CVD and stroke mortality (HR = 10.0, p = 0.0086).

CONCLUSION:

BMI showed a U-shaped relationship with mortality. Among older persons aged 65 and above, the overweight-or-obese category of BMI was not associated with excess all-cause mortality.

 

Independent associations of dairy and calcium intakes with colorectal cancers in the Adventist Health Study-2 cohort.

Tantamango-Bartley Y, Knutsen SF, Jaceldo-Siegl K, Fan J, Mashchak A, Fraser GE.

Public Health Nutr. 2017 Jul 24:1-10. doi: 10.1017/S1368980017001422. [Epub ahead of print]

PMID: 28735581

Abstract

OBJECTIVE:

Results associating dairy and Ca intakes with colorectal cancer (CRC) risk have been mixed. Most previous analyses have suffered from confounding between dairy and Ca intakes. We examined independent associations between these variables, also dairy foods, and CRC incidence in a population with a large range of dairy intakes.

DESIGN:

Adventist Health Study-2 is a cohort study where subjects were enrolled 2002-2007. Proportional hazard regression analyses were performed to estimate hazard ratios (HR). Regression calibration was used to correct for dietary measurement error.

SETTING:

The population lived in all states of the USA.

SUBJECTS:

There were 77712 analytic subjects, all of whom were Seventh-day Adventists. Much of their dietary Ca came from non-dairy sources.

SUBJECTS:

During a mean follow-up of 7·8 years, 380 incident colon cancer and 111 incident rectal cancer cases were observed.

RESULTS:

Comparing extreme quintiles of intake in measurement error-corrected analyses, dairy intake (HR=0·31; 95 % CI 0·09, 0·88), independent of total Ca, was inversely related with risk of rectal cancer but gave little indication of association with colon cancer. However, total Ca intake (independent of dairy) was associated with risk of colon cancer (HR=0·55; 95 % CI 0·28, 0·98) and there was little indication of association with rectal cancer. Traditional regression analyses and associations with macronutrients from dairy generally supported these results. Milk intake was also negatively associated with CRC (HR=0·63; 95 % CI 0·43, 0·89).

CONCLUSIONS:

Dairy intake may decrease the risk of rectal cancer, and Ca may reduce risk of colon cancer and CRC.

KEYWORDS:

Adventist Health Study; Calcium; Cancer; Colon; Colorectal; Dairy; Rectal

 

Dietary magnesium intake and fracture risk: data from a large prospective study.

Veronese N, Stubbs B, Solmi M, Noale M, Vaona A, Demurtas J, Maggi S.

Br J Nutr. 2017 Jun;117(11):1570-1576. doi: 10.1017/S0007114517001350. Epub 2017 Jun 20.

PMID: 28631583

Abstract

Research considering the relationship between dietary Mg and osteoporosis as well as fractures are sparse and conflicting. We therefore aimed to investigate Mg intake and the onset of fractures in a large cohort of American men and women involved in the Osteoarthritis Initiative over a follow-up period of 8 years. Dietary Mg intake (including that derived from supplementation) was evaluated through a FFQ at baseline and categorised using sex-specific quintiles (Q); osteoporotic fractures were evaluated through self-reported history. Overall, 3765 participants (1577 men; 2071 women) with a mean age of 60·6 (sd 9·1) years were included. During follow-up, 560 individuals (198 men and 368 women) developed a new fracture. After adjusting for fourteen potential confounders at baseline and taking those with lower Mg intake as reference (Q1), men (hazard ratio (HR) 0·47; 95 % CI 0·21, 1·00, P=0·05) and women (HR 0·38; 95 % CI 0·17, 0·82, P=0·01) in the highest quintile reported a significantly lower risk for fracture. Women meeting the recommended Mg intake were at a 27 % decreased risk for future fractures. In conclusion, higher dietary Mg intake has a protective effect on future osteoporotic fractures, especially in women with a high risk for knee osteoarthritis. Those women meeting the recommended Mg intake appear to be at a lower risk for fractures.

KEYWORDS:

HR hazard ratio; OAI Osteoarthritis Initiative; Epidemiology; Fractures; Magnesium; Osteoporosis

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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

 

Carbohydrate nutrition and risk of adiposity-related cancers: results from the Framingham Offspring cohort (1991-2013).

Makarem N, Bandera EV, Lin Y, Jacques PF, Hayes RB, Parekh N.

Br J Nutr. 2017 Jun;117(11):1603-1614. doi: 10.1017/S0007114517001489. Epub 2017 Jun 29.

PMID: 28660846

Abstract

Higher carbohydrate intake, glycaemic index (GI), and glycaemic load (GL) are hypothesised to increase cancer risk through metabolic dysregulation of the glucose-insulin axis and adiposity-related mechanisms, but epidemiological evidence is inconsistent. This prospective cohort study investigates carbohydrate quantity and quality in relation to risk of adiposity-related cancers, which represent the most commonly diagnosed preventable cancers in the USA. In exploratory analyses, associations with three site-specific cancers: breast, prostate and colorectal cancers were also examined. The study sample consisted of 3184 adults from the Framingham Offspring cohort. Dietary data were collected in 1991-1995 using a FFQ along with lifestyle and medical information. From 1991 to 2013, 565 incident adiposity-related cancers, including 124 breast, 157 prostate and sixty-eight colorectal cancers, were identified. Cox proportional hazards models were used to evaluate the role of carbohydrate nutrition in cancer risk. GI and GL were not associated with risk of adiposity-related cancers or any of the site-specific cancers. Total carbohydrate intake was not associated with risk of adiposity-related cancers combined or prostate and colorectal cancers. However, carbohydrate consumption in the highest v. lowest quintile was associated with 41 % lower breast cancer risk (hazard ratio (HR) 0·59; 95 % CI 0·36, 0·97). High-, medium- and low-GI foods were not associated with risk of adiposity-related cancers or prostate and colorectal cancers. In exploratory analyses, low-GI foods, were associated with 49 % lower breast cancer risk (HR 0·51; 95 % CI 0·32, 0·83). In this cohort of Caucasian American adults, associations between carbohydrate nutrition and cancer varied by cancer site. Healthier low-GI carbohydrate foods may prevent adiposity-related cancers among women, but these findings require confirmation in a larger sample.

KEYWORDS:

FHS Framingham Heart Study; FOS Framingham Offspring; GI glycaemic index; GL glycaemic load; HR hazard ratio; WC waist circumference; Adiposity-related cancers; Carbohydrate intakes; Framingham Offspring cohort; Glycaemic index; Glycaemic load

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Kidney function and cognitive decline in an oldest-old Chinese population.

Bai K, Pan Y, Lu F, Zhao Y, Wang J, Zhang L.

Clin Interv Aging. 2017 Jul 4;12:1049-1054. doi: 10.2147/CIA.S134205. eCollection 2017.

PMID: 28740370

Abstract

BACKGROUND:

Early-stage chronic kidney disease has been suggested to be correlated with cognitive decline, but the association has rarely been explored in the oldest old.

SUBJECTS AND METHODS:

This prospective study included 284 Chinese participants aged 80 years or older with serum creatinine levels <150 µmol/L. The median follow-up time was 3.3 years, and 247 (87.0%) participants provided valid data at their last visit. Kidney function was evaluated by measuring the estimated glomerular filtration rate (eGFR) at baseline, and cognitive function was evaluated using the Mini-Mental State Examination (MMSE) at both baseline and annual visits. A reliable decrease in the MMSE score over the follow-up period was observed based on a Reliable Change Index of 1.645 (equivalent to a 90% confidence interval [CI]), which was used to define cognitive decline. Poisson regression models were built to analyze the association between baseline kidney function and cognitive decline.

RESULTS:

A total of 18 (7.3%) cases of incident cognitive decline were observed during the follow-up period. After adjusting for potential confounders, the relative risk of developing cognitive decline was 4.03 (95% CI 1.09-13.81) among participants with an eGFR of 30-59 mL/min/1.73 m2 compared to participants with an eGFR of ≥60 mL/min/1.73 m2.

CONCLUSION:

Early-stage chronic kidney disease was correlated with cognitive decline in an oldest-old Chinese population.

KEYWORDS:

chronic kidney disease; cognitive decline; oldest old

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Kidney function and cognitive and functional decline in elderly adults: findings from the Singapore longitudinal aging study.

Feng L, Yap KB, Yeoh LY, Ng TP.

J Am Geriatr Soc. 2012 Jul;60(7):1208-14. doi: 10.1111/j.1532-5415.2012.04043.x. Epub 2012 Jun 15.

PMID: 22702744

Abstract

OBJECTIVES:

To investigate whether lower estimated glomerular filtration rate (eGFR) or chronic kidney disease (CKD) was associated with subsequent cognitive and instrumental activity of daily living (IADL) decline in a prospective cohort study.

DESIGN:

Prospective cohort study, followed for up to 4 years.

SETTING:

General community.

PARTICIPANTS:

One thousand three hundred fifteen adults aged 55 and older from the Singapore Longitudinal Aging Study.

MEASUREMENTS:

Baseline data included eGFR levels, presence of CKD (eGFR < 60 mL/min per 1.73 m(2) ), and known confounders. Cognitive decline was defined as a drop of 2 or more points on the Mini-Mental State Examination (MMSE) and functional decline as a drop of 2 or more points in IADL score.

RESULTS:

Decreasing levels of eGFR and the presence of CKD were associated with greater odds of cognitive decline at follow-up independent of confounding risk factors in multivariate analyses: estimated 14% increment in odds of cognitive decline per 10 mL/min/1.73 m(2) decrease in eGFR (odds ratio = 1.94, 95% confidence interval = 1.23-3.05; P = .004 for CKD vs non-CKD). Similar associations were found in a cognitively normal subgroup (MMSE > 23) at baseline. In the whole sample, CKD, but not eGFR, was found to be significantly associated with higher risk of IADL decline.

CONCLUSION:

CKD in older persons was significantly associated with cognitive and functional decline. Future research should target the development and evaluation of strategies to delay or prevent cognitive decline and physical disability in elderly adults with impaired kidney function.

 

Chemical composition of potato tubers: the effect of cultivars and growth conditions.

Leonel M, do Carmo EL, Fernandes AM, Soratto RP, Ebúrneo JAM, Garcia ÉL, Dos Santos TPR.

J Food Sci Technol. 2017 Jul;54(8):2372-2378. doi: 10.1007/s13197-017-2677-6. Epub 2017 May 30.

PMID: 28740294

http://sci-hub.cc/10.1007/s13197-017-2677-6

Abstract

The aim of the study involved evaluating the chemical composition of tubers of five potato cultivars that were grown under the same cultural practices in soils with low, medium, and high availability of phosphorus. The experimental designs corresponded to a randomized block with four replicates. Tuber samples were analyzed in terms of moisture, ash, protein, lipid, total sugar, fiber, starch, and phosphorus contents. The results suggested that increased availability of phosphorus in soil allowed the production of tubers with higher dry matter content, lower total sugar content, and a higher percentage of starch and protein. Hence, the aforementioned parameters constitute important factors corresponding to the nutritional and industrial quality of potatoes. Increased phosphorus availability in soil can promote significant changes in the composition of potato tubers, and thereby in potential uses of tubers.

KEYWORDS:

Nutrients; Soil fertility; Solanum tuberosum; Tuber quality

 

Diet and Risk of Cholecystectomy: A Prospective Study Based on the French E3N Cohort.

Barré A, Gusto G, Cadeau C, Carbonnel F, Boutron-Ruault MC.

Am J Gastroenterol. 2017 Jul 25. doi: 10.1038/ajg.2017.216. [Epub ahead of print]

PMID: 28741614

http://www.nature.com.sci-hub.cc/ajg/journal/vaop/ncurrent/full/ajg2017216a.html

Abstract

OBJECTIVES:

This study aimed to examine the relationship between diet and cholecystectomy risk, using three approaches, in a large French cohort.

METHODS:

In a prospective cohort study in French women who completed a food-frequency questionnaire at baseline, we analyzed diet with three approaches: food groups, dietary patterns obtained by factor analysis, and the Mediterranean diet score. The primary outcome was cholecystectomy. We used Cox proportional hazards regression to assess the relationship between diet and cholecystectomy risk, adjusting for the main potential confounders.

RESULTS:

During 1,033,955 person years of follow-up, we identified 2,778 incident cases of cholecystectomy. Higher intakes of legumes, fruit, vegetable oil, and wholemeal bread were associated with decreased cholecystectomy risk. Two dietary patterns were identified by factor analysis: "Western" (essentially processed meat, pizza, pies, high-alcohol beverages, French fries, sandwiches…) and "Mediterranean" (essentially fruits, vegetables, seafood, and olive oil). The "Mediterranean" pattern was inversely associated with cholecystectomy risk in the subgroup of postmenopausal women who ever used menopausal hormone therapy (hazard ratio for quartile 4 vs. 1=0.79, 95% confidence interval (CI): 0.65-0.95; P for linear trend=0.008). High adherence to the Mediterranean diet was associated with decreased risk of cholecystectomy (hazard ratio for a 6-9 score vs. 0-3=0.89, 95% CI: 0.80-0.99; P for linear trend=0.02).

CONCLUSIONS:

Adherence to a diet rich in fruit, vegetables, legumes, and olive oil was associated with a reduction in cholecystectomy risk in French women. Further studies in different settings are requested.

 

Dietary Fat Intake and Lung Cancer Risk: A Pooled Analysis.

Yang JJ, Yu D, Takata Y, Smith-Warner SA, Blot W, White E, Robien K, Park Y, Xiang YB, Sinha R, Lazovich D, Stampfer M, Tumino R, Aune D, Overvad K, Liao L, Zhang X, Gao YT, Johansson M, Willett W, Zheng W, Shu XO.

J Clin Oncol. 2017 Jul 25:JCO2017733329. doi: 10.1200/JCO.2017.73.3329. [Epub ahead of print]

PMID: 28742456

Abstract

Purpose Dietary fat may play a role in lung carcinogenesis. Findings from epidemiologic studies, however, remain inconsistent. In this pooled analysis of 10 prospective cohort studies from the United States, Europe, and Asia, we evaluated the associations of total and specific types of dietary fat with lung cancer risk. Methods Cox regression was used to estimate hazard ratios (HRs) and 95% CIs in each cohort. Study-specific risk estimates were pooled by random- or fixed-effects meta-analysis. The first 2 years of follow-up were excluded to address potential influence of preclinical dietary changes. Results Among 1,445,850 participants, 18,822 incident cases were identified (mean follow-up, 9.4 years). High intakes of total and saturated fat were associated with an increased risk of lung cancer (for highest v lowest quintile: HR, 1.07 and 1.14, respectively; 95% CI, 1.00 to 1.15 and 1.07 to 1.22, respectively; P for trend for both < .001). The positive association of saturated fat was more evident among current smokers (HR, 1.23; 95% CI, 1.13 to 1.35; P for trend < .001) than former/never smokers ( P for interaction = .004), and for squamous cell and small cell carcinoma (HR, 1.61 and 1.40, respectively; 95% CI, 1.38 to 1.88 and 1.17 to 1.67, respectively; P for trend for both < .001) than other histologic types ( P for heterogeneity < .001). In contrast, a high intake of polyunsaturated fat was associated with a decreased risk of lung cancer (HR, 0.92; 95% CI, 0.87 to 0.98 for highest v lowest quintile; P for trend = .02). A 5% energy substitution of saturated fat with polyunsaturated fat was associated with a 16% to 17% lower risk of small cell and squamous cell carcinoma. No associations were found for monounsaturated fat. Conclusion Findings from this large, international cohort consortium suggest that modifying dietary fat intake (ie, replacing saturated fat with polyunsaturated fat) may reduce lung cancer risk, particularly among smokers and for squamous cell and small cell carcinoma.

 

Testosterone and the Heart.

Goodale T, Sadhu A, Petak S, Robbins R.

Methodist Debakey Cardiovasc J. 2017 Apr-Jun;13(2):68-72. doi: 10.14797/mdcj-13-2-68.

PMID: 28740585

http://journal.houstonmethodist.org.sci-hub.cc/doi/10.14797/mdcj-13-2-68

Abstract

Testosterone (T) has a number of important effects on the cardiovascular system. In men, T levels begin to decrease after age 40, and this decrease has been associated with an increase in all-cause mortality and cardiovascular (CV) risk. Low T levels in men may increase their risk of developing coronary artery disease (CAD), metabolic syndrome, and type 2 diabetes. Reduced T levels in men with congestive heart failure (CHF) portends a poor prognosis and is associated with increased mortality. Studies have reported a reduced CV risk with higher endogenous T concentration, improvement of known CV risk factors with T therapy, and reduced mortality in T-deficient men who underwent T replacement therapy versus untreated men. Testosterone replacement therapy (TRT) has been shown to improve myocardial ischemia in men with CAD, improve exercise capacity in patients with CHF, and improve serum glucose levels, HbA1c, and insulin resistance in men with diabetes and prediabetes. There are no large long-term, placebo-controlled, randomized clinical trials to provide definitive conclusions about TRT and CV risk. However, there currently is no credible evidence that T therapy increases CV risk and substantial evidence that it does not. In fact, existing data suggests that T therapy may offer CV benefits to men.

KEYWORDS:

androgen; dihydrotestosterone; testosterone; testosterone deficiency; testosterone replacement therapy

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

Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials.

Xu L, Freeman G, Cowling BJ, Schooling CM.

BMC Med. 2013 Apr 18;11:108. doi: 10.1186/1741-7015-11-108.

PMID: 23597181 Free PMC Article

Abstract

BACKGROUND:

Testosterone therapy is increasingly promoted. No randomized placebo-controlled trial has been implemented to assess the effect of testosterone therapy on cardiovascular events, although very high levels of androgens are thought to promote cardiovascular disease.

METHODS:

A systematic review and meta-analysis was conducted of placebo-controlled randomized trials of testosterone therapy among men lasting 12+ weeks reporting cardiovascular-related events. We searched PubMed through the end of 2012 using "("testosterone" or "androgen") and trial and ("random*")" with the selection limited to studies of men in English, supplemented by a bibliographic search of the World Health Organization trial registry. Two reviewers independently searched, selected and assessed study quality with differences resolved by consensus. Two statisticians independently abstracted and analyzed data, using random or fixed effects models, as appropriate, with inverse variance weighting.

RESULTS:

Of 1,882 studies identified 27 trials were eligible including 2,994, mainly older, men who experienced 180 cardiovascular-related events. Testosterone therapy increased the risk of a cardiovascular-related event (odds ratio (OR) 1.54, 95% confidence interval (CI) 1.09 to 2.18). The effect of testosterone therapy varied with source of funding (P-value for interaction 0.03), but not with baseline testosterone level (P-value for interaction 0.70). In trials not funded by the pharmaceutical industry the risk of a cardiovascular-related event on testosterone therapy was greater (OR 2.06, 95% CI 1.34 to 3.17) than in pharmaceutical industry funded trials (OR 0.89, 95% CI 0.50 to 1.60).

CONCLUSIONS:

The effects of testosterone on cardiovascular-related events varied with source of funding. Nevertheless, overall and particularly in trials not funded by the pharmaceutical industry, exogenous testosterone increased the risk of cardiovascular-related events, with corresponding implications for the use of testosterone therapy.

 

[The Prevalence and Risk Factors of Dementia in Centenarians].

Arai Y.

Brain Nerve. 2017 Jul;69(7):771-780. doi: 10.11477/mf.1416200819. Japanese.

PMID: 28739991

Abstract

Centenarians are less susceptible to the diseases, functional losses and dependencies related to old age than the general public, and are therefore regarded as model cases of successful aging. For this reason, an important focus of the study of centenarians is their relative resilience to age-related cognitive decline or dementia. In the Tokyo Centenarian Study, we found approximately 60% of centenarians to have dementia; however, supercentenarians (those people living at least 110 years) maintained normal cognitive function at 100 years of age. Our preliminary data also demonstrated extremely low frequencies of the apolipoprotein E4 allele in supercentenarians. Moreover, postmortem brain samples from supercentenarians demonstrated relatively mild age-related neuropathological findings. Therefore, a more extensive investigation of supercentenarian populations might provide insight into successful brain aging.

 

The impact of meal timing on performance, sleepiness, gastric upset, and hunger during simulated night shift.

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

Ind Health. 2017 Jul 25. doi: 10.2486/indhealth.2017-0047. [Epub ahead of print]

PMID: 28740034

Abstract

This study examined the impact of eating during simulated night shift on performance and subjective complaints. Subjects were randomized to eating at night (n=5; 23.2±5.5y) or not eating at night (n=5; 26.2±6.4y). All participants were given one sleep opportunity of 8h (22:00h-06:00h) before transitioning to the night shift protocol. During the four days of simulated night shift participants were awake from 16:00h-10:00h with a daytime sleep of 6h (10:00h-16:00h). In the simulated night shift protocol, meals were provided at ≈0700h, 1900h and 0130h (eating at night); or ≈0700h, 0930h, 1410h and 1900h (not eating at night). Subjects completed sleepiness, hunger and gastric complaint scales, a Digit Symbol Substitution Task and a 10-minute Psychomotor Vigilance Task. Increased sleepiness and performance impairment was evident in both conditions at 0400h (p<0.05). Performance impairment at 0400h was exacerbated when eating at night. Not eating at night was associated with elevated hunger and a small but significant elevation in stomach upset across the night (p<0.026). Eating at night was associated with elevated bloating on night one, which decreased across the protocol. Restricting food intake may limit performance impairments at night. Dietary recommendations to improve night-shift performance must also consider worker comfort.

KEYWORDS:

Circadian misalignment; Hunger; Performance; Psychomotor vigilance; Shift-work; Sleep loss; Sleepiness; Timed eating

Edited by AlPater

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Explaining sex differences in lifespan in terms of optimal energy allocation in the baboon.

King AM, Kirkwood TBL, Shanley DP.

Evolution. 2017 Jul 26. doi: 10.1111/evo.13316. [Epub ahead of print]

PMID: 28744878

Abstract

We provide a quantitative test of the hypothesis that sex role specialisation may account for sex differences in lifespan in baboons if such specialisation causes the dependency of fitness upon longevity, and consequently the optimal resolution to an energetic trade-off between somatic maintenance and other physiological functions, to differ between males and females. We present a model in which females provide all offspring care and males compete for access to reproductive females and in which the partitioning of available energy between the competing fitness-enhancing functions of growth, maintenance and reproduction is modelled as a dynamic behavioural game, with the optimal decision for each individual depending upon his/her state and the behaviour of other members of the population. Our model replicates the sexual dimorphism in body size and sex differences in longevity and reproductive scheduling seen in natural populations of baboons. We show that this outcome is generally robust to perturbations in model parameters, an important finding given the same behaviour is seen across multiple populations and species in the wild. This supports the idea that sex differences in longevity result from differences in the value of somatic maintenance relative to other fitness-enhancing functions in keeping with the disposable soma theory.

KEYWORDS:

Disposable soma theory; ageing; dynamic programming; energy allocation; sex role specialisation

 

Inflammatory potential of diet and risk of cardiovascular disease or mortality: A meta-analysis.

Zhong X, Guo L, Zhang L, Li Y, He R, Cheng G.

Sci Rep. 2017 Jul 25;7(1):6367. doi: 10.1038/s41598-017-06455-x.

PMID: 28744020

Abstract

Inconsistent findings have reported on the inflammatory potential of diet and cardiovascular disease (CVD) and mortality risk. The aim of this meta-analysis was to investigate the association between the inflammatory potential of diet as estimated by the dietary inflammatory index (DII) score and CVD or mortality risk in the general population. A comprehensive literature search was conducted in PubMed and Embase databases through February 2017. All prospective observational studies assessing the association of inflammatory potential of diet as estimated by the DII score with CVD and all-cause, cancer-related, cardiovascular mortality risk were included. Nine prospective studies enrolling 134,067 subjects were identified. Meta-analyses showed that individuals with the highest category of DII (maximal pro-inflammatory) was associated with increased risk of all-cause mortality (hazard risk {HR} 1.22; 95% confidence interval [CI] 1.06-1.41), cardiovascular mortality (RR 1.24; 95% CI 1.01-1.51), cancer-related mortality (RR 1.28; 95% CI 1.04-1.58), and CVD (RR 1.32; 95% CI 1.09-1.60) than the lowest DII score. More pro-inflammatory diets, as estimated by the higher DII score are independently associated with an increased risk of all-cause, cardiovascular, cancer-related mortality, and CVD in the general population, highlighting low inflammatory potential diet may reduce mortality and CVD risk.

 

Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study.

Yu WC, Chou MY, Peng LN, Lin YT, Liang CK, Chen LK.

PLoS One. 2017 Jul 26;12(7):e0181741. doi: 10.1371/journal.pone.0181741. eCollection 2017.

PMID: 28746360

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181741

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181741&type=printable

Abstract

OBJECTIVE:

We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan.

METHODS:

This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI), geriatric syndromes, activities of daily living (ADL) using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE). Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk.

RESULTS:

Among 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years). Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036-3.673, p = 0.038) or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430-5.181, p = 0.002) after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition.

CONCLUSIONS:

Physical disability is a major risk factor for all-cause mortality among men aged 80 years and older, and risk increased synergistically when cognitive impairment was present. Cognitive impairment alone without physical disability did not increase mortality risk in this population.

 

Dietary acrylamide exposure was associated with mild cognition decline among non-smoking Chinese elderly men.

Liu ZM, Tse LA, Chen B, Wu S, Chan D, Kowk T, Woo J, Xiang YT, Wong SY.

Sci Rep. 2017 Jul 25;7(1):6395. doi: 10.1038/s41598-017-06813-9.

PMID: 28743904

https://www.nature.com/articles/s41598-017-06813-9

https://www.nature.com/articles/s41598-017-06813-9.pdf

Abstract

The aim of the study is to explore the longitudinal association of dietary acrylamide exposure with cognitive performance in Chinese elderly. The analysis was conducted among 2534 non-smoking elderly men and women based on a prospective study, Mr. and Ms. OS Hong Kong. Dietary acrylamide intake was assessed by food frequency questionnaires with data on local food contamination, derived from the first Hong Kong Total Diet Study. Global cognitive function was assessed by Cantonese version of Mini-Mental State Exam (MMSE) at the baseline and the 4th year of follow-up. Multivariable-adjusted linear and logistic regression models were used to assess the associations of dietary acrylamide with MMSE score changes or risk of poor cognition. The results indicated that among men with MMSE ≥ 18, each one SD increase of acrylamide decreased MMSE score by 7.698% (95%CI: -14.943%, -0.452%; p = 0.037). Logistic regression revealed an increased risk of poor cognition (MMSE ≤ 26) in men with HR of 3.356 (1.064~10.591, p = 0.039). The association became non-significance after further adjustment for telomere length. No significant association was observed in women. Dietary acrylamide exposure was associated with a mild cognitive decline or increased risk of poor cognition over a 4-year period in non-smoking Chinese elderly men.

PMID: 28743904 DOI: 10.1038/s41598-017-06813-9

 

Reproductive factors and risk of Parkinson's Disease in women: a meta-analysis of observational studies.

Lv M, Zhang Y, Chen GC, Li G, Rui Y, Qin L, Wan Z.

Behav Brain Res. 2017 Jul 22. pii: S0166-4328(17)30930-0. doi: 10.1016/j.bbr.2017.07.025. [Epub ahead of print] Review.

PMID: 28743601

Abstract

Evidence on the relationship between reproductive factors, use of oral contraceptives (OCs) and the incidence of Parkinson's disease (PD) remain inconclusive. The aim of this meta-analysis is to evaluate whether relevant reproductive factors including age at menarche, age at menopause, fertile lifespan, parity, type of menopause (surgical versus natural), and use of OCs are associated with risk of PD in women via random-effects model. PubMed and EMBASE database were used to search for case-control or cohort studies published before February17, 2017. 6 case-control and 5 cohort studies were included in the meta-analysis. The pooled relative risks (RRs) of PD risk were 1.00 (95% CI: 0.79-1.28) for use of OCs (ever versus never), 1.03 (95% CI: 0.84-1.26) for age at menarche, 0.98 (95% CI: 0.75-1.29) for age at menopause, 0.98(95% CI: 0.77-1.25) for fertile lifespan, 0.99(95% CI:0.0.79-1.25) for parity, 0.93 (95% CI:0.68-1.29) for type of menopause (surgical versus natural). In the subgroup analysis stratified by study design, age, caffeine intake and smoking, an inverse association was found between surgical menopause and risk of PD for those adjusting for caffeine intake (RR: 0.67, 95% CI: 0.45-0.99) and smoking (RR: 0.77, 95% CI: 0.63-0.94); while a positive association was found between surgical menopause and PD risk for those not adjusting for smoking (RR: 1.91, 95% CI: 1.29-2.83). In conclusion, our meta-analysis provided little epidemiological support for the role of reproductive factors in the incidence of PD. Whether surgical menopause is inversely associated with the risk of PD requires further explorations.

KEYWORDS:

Parkinson’s disease; menopause; meta-analysis; oral contraceptives; parity; reproductive factors

Edited by AlPater

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Impact of providing walnut samples in a lifestyle intervention for weight loss: a secondary analysis of the HealthTrack trial.

Neale EP, Tapsell LC, Martin A, Batterham MJ, Wibisono C, Probst YC.

Food Nutr Res. 2017 Jul 3;61(1):1344522. doi: 10.1080/16546628.2017.1344522. eCollection 2017.

PMID: 28747865

http://sci-hub.cc/10.1080/16546628.2017.1344522

Abstract

Background: Being more specific about individual food choices may be advantageous for weight loss. Including a healthy food (e.g. walnuts) may help to expose effects. Objective: To examine the impact of including walnuts in diets for weight loss. Design: Secondary analysis of the HealthTrack lifestyle intervention trial. Overweight and obese participants were randomized to: usual care ©, interdisciplinary intervention including individualized dietary advice (I), or interdisciplinary intervention including 30 g walnuts/day (IW). Changes in body weight, energy intake, intake of key foods, physical activity, and mental health over three and 12 months were explored. Results: A total of 293 participants completed the intensive three-month study period, and 175 had data available at 12 months. The IW group achieved the greatest weight loss at three months. IW reported significant improvements in healthy food choices, and decreased intakes of discretionary foods/beverages, compared to C. Weight loss remained greatest in IW at 12 months. Discussion: Significant effects were seen after three months, with the IW group achieving greater weight loss and more favorable changes in food choices. Conclusions: Including 30 grams walnuts/day in an individualized diet produced weight loss and positive changes in food choice.

KEYWORDS:

Walnut; diet quality; discretionary foods; weight loss

"Dr Neale, Professor Tapsell, and Associate Professor Batterham

have received grant funding from the International Nut and

Dried Fruit Council. Dr Neale and Professor Tapsell have

received consulting funding from Horticulture Australia

Limited. Professor Tapsell holds an unpaid position on the

California Walnut Commission Scientific Advisory Council."

 

Alcohol drinking patterns and risk of diabetes: a cohort study of 70,551 men and women from the general Danish population.

Holst C, Becker U, Jørgensen ME, Grønbæk M, Tolstrup JS.

Diabetologia. 2017 Jul 27. doi: 10.1007/s00125-017-4359-3. [Epub ahead of print]

PMID: 28748324

http://sci-hub.cc/10.1007/s00125-017-4359-3

Abstract

AIMS/HYPOTHESIS:

Alcohol consumption is inversely associated with diabetes, but little is known about the role of drinking patterns. We examined the association between alcohol drinking patterns and diabetes risk in men and women from the general Danish population.

METHODS:

This cohort study was based on data from the Danish Health Examination Survey 2007-2008. Of the 76,484 survey participants, 28,704 men and 41,847 women were eligible for this study. Participants were followed for a median of 4.9 years. Self-reported questionnaires were used to obtain information on alcohol drinking patterns, i.e. frequency of alcohol drinking, frequency of binge drinking, and consumption of wine, beer and spirits, from which we calculated beverage-specific and overall average weekly alcohol intake. Information on incident cases of diabetes was obtained from the Danish National Diabetes Register. Cox proportional hazards model was applied to estimate HRs and 95% CIs.

RESULTS:

During follow-up, 859 men and 887 women developed diabetes. The lowest risk of diabetes was observed at 14 drinks/week in men (HR 0.57 [95% CI 0.47, 0.70]) and at 9 drinks/week in women (HR 0.42 [95% CI 0.35, 0.51]), relative to no alcohol intake. Compared with current alcohol consumers consuming <1 day/week, consumption of alcohol on 3-4 days weekly was associated with significantly lower risk for diabetes in men (HR 0.73 [95% CI 0.59, 0.94]) and women (HR 0.68 [95% CI 0.53, 0.88]) after adjusting for confounders and average weekly alcohol amount.

CONCLUSIONS/INTERPRETATION:

Our findings suggest that alcohol drinking frequency is associated with risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes, even after taking average weekly alcohol consumption into account.

KEYWORDS:

Alcohol; Alcohol consumption; Alcohol drinking patterns; Basic science; Diabetes; Drinking patterns; Epidemiology; Human; Risk; Type 2 diabetes mellitus

 

Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials.

Meng Y, Bai H, Wang S, Li Z, Wang Q, Chen L.

Diabetes Res Clin Pract. 2017 Jul 8;131:124-131. doi: 10.1016/j.diabres.2017.07.006. [Epub ahead of print] Review.

PMID: 28750216

Abstract

AIMS:

The objective of this systematic review and meta-analysis is to assess the efficacy of Low Carbohydrate Diet (LCD) compared with a normal or high carbohydrate diet in patients with type 2 diabetes.

METHODS:

We searched MEDLINE, EMBASE, and Cochrane Library database for randomized controlled trials. Researches which reported the change in weight loss, blood glucose, and blood lipid levels were included.

RESULTS:

A total of 9 studies with 734 patients with diabetes were included. Pooled results suggested that LCD had a significantly effect on HbA1c level (WMD: -0.44; 95% CI: -0.61, -0.26; P=0.00). For cardiovascular risk factors, the LCD intervention significantly reduced triglycerides concentration (WMD: -0.33; 95% CI: -0.45, -0.21; P=0.00) and increased HDL cholesterol concentration (WMD: 0.07; 95% CI: 0.03, 0.11; P=0.00). But the LCD was not associated with decreased level of total cholesterol and LDL cholesterol. Subgroup analyses indicated that short term intervention of LCD was effective for weight loss (WMD: -1.18; 95% CI: -2.32, -0.04; P=0.04).

CONCLUSIONS:

The results suggested a beneficial effect of LCD intervention on glucose control in patients with type 2 diabetes. The LCD intervention also had a positive effect on triglycerides and HDL cholesterol concentrations, but without significant effect on long term weight loss.

KEYWORDS:

Low carbohydrate diet; Meta-analysis; Randomized controlled trials; Type 2 diabetes; Weight loss

 

Effects of medicinal food plants on impaired glucose tolerance: A systematic review of randomized controlled trials.

Demmers A, Korthout H, van Etten-Jamaludin FS, Kortekaas F, Maaskant JM.

Diabetes Res Clin Pract. 2017 Jun 13;131:91-106. doi: 10.1016/j.diabres.2017.05.024. [Epub ahead of print] Review.

PMID: 28750220

Abstract

BACKGROUND:

The objective of this systematic review was to assess available scientific data on the efficacy and safety of medicinal food plants for the treatment of impaired glucose tolerance.

METHODS:

We included randomized controlled trials (RCTs) with a minimum follow-up period of 6weeks. The diagnosis was determined by fasting plasma glucose values after two-hour oral glucose tolerance testing (OGTT). Two authors independently extracted data and evaluated bias. The Cochrane tool of risk of Bias Tool was used.

RESULTS:

This review included ten trials. Most studies were highly biased as data were incomplete or reporting was selective. The two-hour fasting plasma glucose after the curcumin extract intervention showed statistical significance after 3, 6 and 9months: p<0.01. Also, glycosylated haemoglobin levels A1c (HbA1c) values after curcumin extract intervention showed statistical significance after 3, 6 and 9months: p<0.01. Insulin resistance (HOMA-IR) after curcumin extract intervention showed statistical significance after 6months and after 9months: p<0.05 and p<0.01.

CONCLUSIONS:

Curcumin has shown the confident results to be effective for the treatment of impaired glucose tolerance. Fenugreek and flaxseed may also be effective, but due to low quality of these studies the results must be interpreted with caution.

KEYWORDS:

Diabetes; Food; IGT; Phytotherapy; Prediabetes; Preventive

 

Gout: An old disease in new perspective - A review.

Ragab G, Elshahaly M, Bardin T.

J Adv Res. 2017 Sep;8(5):495-511. doi: 10.1016/j.jare.2017.04.008. Epub 2017 May 10. Review.

PMID: 28748116

http://www.sciencedirect.com/science/article/pii/S2090123217300450

http://ac.els-cdn.com/S2090123217300450/1-s2.0-S2090123217300450-main.pdf?_tid=0ca76f5c-73bf-11e7-8387-00000aacb360&acdnat=1501265185_8ad359a8d1f91ba157d59b7febdfb4b6

Abstract

Gout is a picturesque presentation of uric acid disturbance. It is the most well understood and described type of arthritis. Its epidemiology is studied. New insights into the pathophysiology of hyperuricemia and gouty arthritis; acute and chronic allow for an even better understanding of the disease. The role of genetic predisposition is becoming more evident. The clinical picture of gout is divided into asymptomatic hyperuricemia, acute gouty arthritis, intercritical period, and chronic tophaceous gout. Diagnosis is based on laboratory and radiological features. The gold standard of diagnosis is identification of characteristic MSU crystals in the synovial fluid using polarized light microscopy. Imaging modalities include conventional radiography, ultrasonography, conventional CT, Dual-Energy CT, Magnetic Resonance Imaging, nuclear scintigraphy, and positron emission tomography. There is remarkable progress in the application of ultrasonography and Dual-Energy CT which is bound to influence the diagnosis, staging, follow-up, and clinical research in the field. Management of gout includes management of flares, chronic gout and prevention of flares, as well as management of comorbidities. Newer drugs in the pharmacological armamentarium are proving successful and supplement older ones. Other important points in its management include patient education, diet and life style changes, as well as cessation of hyperuricemic drugs.

KEYWORDS:

Clinical picture of gout; Gout; Hyperuricemia; Imaging modalities; Management of gout; Pathogenesis

 

NATURE | NEWS

Brain’s stem cells slow ageing in mice

Transplanted cells offer middle-aged rodents an increased lifespan.

Sara Reardon

Nature 547, 389 (27 July 2017) doi:10.1038/547389a

http://www.nature.com/news/brain-s-stem-cells-slow-ageing-in-mice-1.22367?WT.ec_id=NATURE-20170727&spMailingID=54575327&spUserID=MjA1NzQwNzAwNwS2&spJobID=1204202138&spReportId=MTIwNDIwMjEzOAS2

Mice aged more slowly when injected with stem cells from the brains of newborns.

Stem cells in the brain could be the key to extending life and slowing ageing. These cells — which are located in the hypothalamus, a region that produces hormones and other signalling molecules — can re­invigorate declining brain function and muscle strength in middle-aged mice, according to a study published on 26 July in Nature1.

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Shamini Bundell discovers more about the brain’s role in ageing

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Previous studies have suggested that the hypothalamus is involved in ageing, but the latest research shows that stem cells in this region can slow the process. That makes sense, because the hypothalamus is involved in many bodily functions, including inflammation and appetite, says Dongsheng Cai, a neuroendocrinologist at Albert Einstein College of Medicine in New York City.

In their study, Cai and his colleagues found that stem cells in the hypothalamus disappear as mice grow older. When the researchers injected their mice with viruses that destroy these cells, the animals seemed to grow older faster, experiencing declines in memory, muscle strength, endurance and coordination. They also died sooner than untreated mice of the same age.

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Next, the team injected stem cells taken from the hypothalami of newborn mice into the brains of middle-aged mice. After four months, these animals had better cognitive and muscular function than untreated mice of the same age. They also lived about 10% longer, on average.

The researchers found that these stem cells release molecules called microRNAs, which help to regulate gene expression, into the cerebro­spinal fluid. When the team injected these microRNAs into the brains of middle-aged mice, they found that the molecules slowed cognitive decline and muscle degeneration.

Forever young

It's an interesting paper, says Leonard Guarente, a molecular biologist at the Massachusetts Institute of Technology in Cambridge, who studies ageing. He adds that it could lead to various ways of developing anti-ageing therapies in people.

Stem-cell therapies might enhance the ability of the hypothalamus to act as a master regulator, given that the latest results suggest it controls ageing through signalling peptides such as hormones and microRNAs, Cai says. He says that his team is trying to identify which of the thousands of types of microRNA produced are involved in ageing, and hopes to investigate whether similar mechanisms exist in non-human primates.

The findings represent a breakthrough in ageing research, says Shin-ichiro Imai, who studies ageing at Washington University in St Louis, Missouri. The next steps would be to link these stem cells with other physiological mechanisms of ageing, he says. For instance, these cells may have a role in regulating the neurons that release a hormone called GnRH, which is secreted by the hypothalamus and is associated with ageing. Imai would also like to know whether the microRNAs from the cells can pass into the bloodstream, which would carry them throughout the body.

Cai suspects that anti-ageing therapies targeting the hypothalamus would need to be administered in middle age, before a person’s muscles and metabolism have degenerated beyond a point that could be reversed.

It is unclear by how much such a therapy could extend a human lifespan, but Guarente says that slowing the effects of ageing is the more important goal. “Living longer isn’t important if you’re not healthy,” he says.

References

1. Zhang, Y. et al. Nature http://dx.doi.org/10.1038/nature23282(2017).

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Hypothalamic stem cells control ageing speed partly through exosomal miRNAs

Yalin Zhang, Min Soo Kim, Baosen Jia, Jingqi Yan, Juan Pablo Zuniga-Hertz, Cheng Han & Dongsheng Cai

Nature (2017) doi:10.1038/nature23282

Received 03 July 2016 Accepted 12 June 2017 Published online 26 July 2017

Abstract

It has been proposed that the hypothalamus helps to control ageing, but the mechanisms responsible remain unclear. Here we develop several mouse models in which hypothalamic stem/progenitor cells that co-express Sox2 and Bmi1 are ablated, as we observed that ageing in mice started with a substantial loss of these hypothalamic cells. Each mouse model consistently displayed acceleration of ageing-like physiological changes or a shortened lifespan. Conversely, ageing retardation and lifespan extension were achieved in mid-aged mice that were locally implanted with healthy hypothalamic stem/progenitor cells that had been genetically engineered to survive in the ageing-related hypothalamic inflammatory microenvironment. Mechanistically, hypothalamic stem/progenitor cells contributed greatly to exosomal microRNAs (miRNAs) in the cerebrospinal fluid, and these exosomal miRNAs declined during ageing, whereas central treatment with healthy hypothalamic stem/progenitor cell-secreted exosomes led to the slowing of ageing. In conclusion, ageing speed is substantially controlled by hypothalamic stem cells, partially through the release of exosomal miRNAs.

 

Stimulation of functional neuronal regeneration from Müller glia in adult mice

Inhibition of histone deacetylation allows the transcription factor Ascl1 to bind to key gene loci in Müller glia and drive the functional generation of retinal neurons in adult mice.

Nature (2017) doi:10.1038/nature23283 Received 31 January 2017 Accepted 13 June 2017 Published online 26 July 2017

Many retinal diseases lead to the loss of retinal neurons and cause visual impairment. The adult mammalian retina has little capacity for regeneration. By contrast, teleost fish functionally regenerate their retina following injury, and Müller glia (MG) are the source of regenerated neurons1, 2, 3, 4, 5, 6. The proneural transcription factor Ascl1 is upregulated in MG after retinal damage1, 7 in zebrafish and is necessary for regeneration8. Although Ascl1 is not expressed in mammalian MG after injury9, forced expression of Ascl1 in mouse MG induces a neurogenic state in vitro10 and in vivo after NMDA (N-methyl-D-aspartate) damage in young mice11. However, by postnatal day 16, mouse MG lose neurogenic capacity, despite Ascl1 overexpression11. Loss of neurogenic capacity in mature MG is accompanied by reduced chromatin accessibility, suggesting that epigenetic factors limit regeneration. Here we show that MG-specific overexpression of Ascl1, together with a histone deacetylase inhibitor, enables adult mice to generate neurons from MG after retinal injury. The MG-derived neurons express markers of inner retinal neurons, synapse with host retinal neurons, and respond to light. Using an assay for transposase-accessible chromatin with high-throughput sequencing (ATAC–seq), we show that the histone deacetylase inhibitor promotes accessibility at key gene loci in the MG, and allows more effective reprogramming. Our results thus provide a new approach for the treatment of blinding retinal diseases.

 

Omega-3 Fatty Acids and Cardiovascular Disease: Are There Benefits?

Bowen KJ, Harris WS, Kris-Etherton PM.

Curr Treat Options Cardiovasc Med. 2016 Nov;18(11):69. Review.

PMID: 27747477 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067287/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067287/pdf/11936_2016_Article_487.pdf

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Effects of urban motorways on physical activity and sedentary behaviour in local residents: a natural experimental study.

Prins RG, Foley L, Mutrie N, Ogilvie DB; M74 study team.

Int J Behav Nutr Phys Act. 2017 Jul 27;14(1):102. doi: 10.1186/s12966-017-0557-0.

PMID: 28750678

Abstract

BACKGROUND:

There is little evidence on how changing the physical environment changes health-related behaviours. We studied the effects of the new M74 motorway (freeway) - opened in 2011 - and the existing M8 motorway in Glasgow, Scotland, on physical activity and sedentary behaviour among local residents.

METHODS:

This natural experimental study used baseline (T1; 2005) and follow-up data (T2; 2013) from a longitudinal cohort (N = 365) and two cross-sectional samples (T1 N = 980; T2 N = 978). Adult participants were recruited from three study areas: one surrounding the new motorway, one surrounding the existing motorway, and a third, control, area without a motorway. The outcomes were self-reported time spent sitting, walking, and in moderate-to-vigorous physical activity (MVPA). Motorway exposure was defined in terms of (1) study area and (2) distance from home to the nearest motorway junction. Outcomes were regressed on exposures in two-part (walking and MVPA) or linear (sedentary behaviour) cohort and repeat cross-sectional models, adjusted for baseline behaviour and sociodemographic covariates.

RESULTS:

Cohort participants living in the M8 area were less likely to participate in MVPA at follow-up than those living in the area without a motorway (OR 0.37; 95%CI 0.15, 0.91). Within the M8 area, those living closer to the motorway were also less likely to do so (OR 0.30; 95%CI 0.09, 0.97). No other statistically significant results were found.

CONCLUSIONS:

We found some evidence of a negative association between exposure to an existing urban motorway and MVPA. However, the behavioural impacts of motorways are likely to be complex and evolve over time.

KEYWORDS:

Environment; Health behaviour; Natural experimental study; Physical activity; Urban planning; Urban renewal

 

Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study.

Knüppel A, Shipley MJ, Llewellyn CH, Brunner EJ.

Sci Rep. 2017 Jul 27;7(1):6287. doi: 10.1038/s41598-017-05649-7.

PMID: 28751637

Abstract

Intake of sweet food, beverages and added sugars has been linked with depressive symptoms in several populations. Aim of this study was to investigate systematically cross-sectional and prospective associations between sweet food/beverage intake, common mental disorder (CMD) and depression and to examine the role of reverse causation (influence of mood on intake) as potential explanation for the observed linkage. We analysed repeated measures (23,245 person-observations) from the Whitehall II study using random effects regression. Diet was assessed using food frequency questionnaires, mood using validated questionnaires. Cross-sectional analyses showed positive associations. In prospective analyses, men in the highest tertile of sugar intake from sweet food/beverages had a 23% increased odds of incident CMD after 5 years (95% CI: 1.02, 1.48) independent of health behaviours, socio-demographic and diet-related factors, adiposity and other diseases. The odds of recurrent depression were increased in the highest tertile for both sexes, but not statistically significant when diet-related factors were included in the model (OR 1.47; 95% CI: 0.98, 2.22). Neither CMD nor depression predicted intake changes. Our research confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.

 

Are body mass index and waist circumference significant predictors of diabetes and prediabetes risk: Results from a population based cohort study.

Haghighatdoost F, Amini M, Feizi A, Iraj B.

World J Diabetes. 2017 Jul 15;8(7):365-373. doi: 10.4239/wjd.v8.i7.365.

PMID: 28751960

http://www.wjgnet.com.ololo.sci-hub.cc/1948-9358/full/v8/i7/365.htm

Abstract

AIM:

To determine the predictive role of body mass index (BMI) and waist circumference (WC) for diabetes and prediabetes risk in future in total sample as well as in men and women separately.

METHODS:

In a population based cohort study, 1765 with mean ± SD age: 42.32 ± 6.18 healthy participants were followed up from 2003 till 2013 (n = 960). Anthropometric and biochemical measures of participants were evaluated regularly during the follow up period. BMI and WC measures at baseline and diabetes and prediabetes status of participants at 2013 were determined. Multivariable logistic regression analysis was used for determining the risk of diabetes and prediabetes considering important potential confounding variables. Receiver operating characteristic curve analysis was conducted to determine the best cut of values of BMI and WC for diabetes and prediabetes.

RESULTS:

At 2013, among participants who had complete data, 45 and 307 people were diabetic and prediabetic, respectively. In final fully adjusted model, BMI value was a significant predictor of diabetes (RR = 1.39, 95%CI: 1.06-1.82 and AUC = 0.68, 95%CI: 0.59-0.75; P < 0.001) however not a significant risk factor for prediabetes. Also, WC was a significant predictor for diabetes (RR = 1.2, 95%CI: 1.05-1.38 and AUC = 0.67, 95%CI: 0.6-0.75) but not significant risk factor for prediabetes. Similar results were observed in both genders.

CONCLUSION:

General and abdominal obesity are significant risk factors for diabetes in future.

KEYWORDS:

Anthropometric measure; Body mass index; Diabetes; Prediabetes; Waist circumference

 

The Influence of a Bifidobacterium Animalis Probiotic on Gingival Health: a Randomized Controlled Clinical Trial.

Eren Kuru B, Laleman I, Yalnızoğlu T, Kuru L, Teughels W.

J Periodontol. 2017 Jul 28:1-14. doi: 10.1902/jop.2017.170213. [Epub ahead of print]

PMID: 28753102

http://www.joponline.org.sci-hub.cc/doi/10.1902/jop.2017.170213

Abstract

BACKGROUND:

There is a growing interest for probiotics in periodontal therapy, however, until to date, most research is focused on lactobacilli probiotics. The aim of this study was to evaluate the effect of the 4-week usage of a Bifidobacterium animalis subsp. lactis DN-173010 supplemented yoghurt versus a placebo yoghurt, followed by a 5-day non-brushing period.

METHODS:

Individuals were included in this single-blind, randomized controlled study if probing depth was (PD) ≤ 3 mm and attachment loss ≤ 2 mm. After professional prophylaxis, they were randomized into two groups receiving a placebo or Bifidobacterium containing yoghurt for 28 days, followed by a 5-day non-brushing period. The outcome measures were plaque and gingival indices, bleeding on probing, probing depth, gingival crevicular fluid (GCF) volume, total amount and concentration of interleukin-1β in GCF. These were measured at baseline, after 28 days of the study product usage and subsequently after the 5 days of plaque accumulation.

RESULTS:

51 patients were analyzed. No intergroup differences could be detected before and after the intake of the study products. However, after plaque accumulation, significant better results for all parameters could be seen in the probiotic group compared to the control group (p<0.001): lower plaque and gingivitis scores, less bleeding on probing, less increase in GCF volume and lower total interleukin-1β amount/ concentration.

CONCLUSION:

The use of a probiotic yoghurt supplemented with Bifidobacterium animalis can have a positive effect on plaque accumulation and gingival inflammatory parameters after refraining oral hygiene practices.

KEYWORDS:

Bifidobacterium; Bifidobacterium animalis; Gingivitis; probiotics; yoghurt

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

This study was not funded, the used probiotic and placebo yoghurts

were supplied by the researchers.

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Survival Outcomes in Octogenarian and Nonagenarian Patients Treated with First-line Androgen Deprivation Therapy for Organ-confined Prostate Cancer.

Dell'Oglio P, Bishr M, Boehm K, Trudeau V, Larcher A, Tian Z, Sosa J, Moschini M, Saad F, Capitanio U, Briganti A, Graefen M, Montorsi F, Karakiewicz PI.

Eur Urol Focus. 2017 Feb 11. pii: S2405-4569(17)30026-3. doi: 10.1016/j.euf.2017.01.017. [Epub ahead of print]

PMID: 28753853

Abstract

BACKGROUND:

The use of primary androgen deprivation therapy (PADT) is common in elderly men with early-stage prostate cancer (PCa), despite the absence of guideline recommendations.

OBJECTIVE:

To examine survival patterns of octo- and nonagenarian men with organ-confined PCa exposed to PADT, to assess whether their life expectancy warrants androgen deprivation therapy use.

DESIGN, SETTING, AND PARTICIPANTS:

In the Surveillance, Epidemiology, and End Results-Medicare-linked database, we identified 14 785 octo- and nonagenarian organ-confined PCa patients treated with PADT between 1991 and 2009.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:

The smoothed cumulative incidence method was used to examine 10-yr overall mortality, cancer-specific mortality (CSM), and other-cause mortality (OCM) rates. Multivariable Cox regression analyses focused on the combined effect of age and Charlson comorbidity index (CCI) after adjusting for different confounders.

RESULTS AND LIMITATIONS:

Of all the deaths observed during the study period, 80% were due to non-cancer causes and 20% were due to PCa. The 10-yr overall survival (OS) rate in the overall population was 15.4%. The 10-yr OS rates ranged from 19.9% in patients aged 80-84 yr to 3.1% in those aged ≥90 yr. Similarly, the 10-yr OS rates ranged from 18.7% in patients with CCI=0 to 11.5% in those with CCI≥2. The 10-yr OCM rate in the overall population was 68.2%. The 10-yr OCM rates ranged from 64.6% in patients aged 80-84 yr to 77.2% in patients aged ≥90 yr. Similarly, the 10-yr OCM rates ranged from 62.1% in patients with CCI=0 to 75.2% in those with CCI≥2. The 10-yr CSM rate in the overall population was 16.4%. The 10-yr CSM rates ranged from 15.5% in patients aged 80-84 yr to 19.7% in those aged ≥90 yr, and from 19.2% in patients with CCI=0 to 13.3% in those with CCI≥2.

CONCLUSIONS:

Of the elderly patients with organ-confined PCa exposed to PADT, only 15% survive at 10-yr follow-up. Mortality related to non-cancer causes is the leading cause of death in the same follow-up period. These figures question the rationale for PADT in elderly men with organ-confined PCa.

PATIENT SUMMARY:

In this study, we looked at the survival patterns of octo- and nonagenarians treated with primary androgen deprivation therapy for organ-confined prostate cancer. We found that a small proportion of patients who received primary androgen deprivation therapy remain alive at 10-yr follow-up, and the leading cause of death was not attributable to prostate cancer.

KEYWORDS:

Elderly patients; Localized prostate cancer; Overtreatment; Primary androgen deprivation therapy; Survival patterns

 

Centenarians maintain miRNA biogenesis pathway while it is impaired in octogenarians.

Borrás C, Serna E, Gambini J, Inglés M, Vina J.

Mech Ageing Dev. 2017 Jul 25. pii: S0047-6374(16)30292-5. doi: 10.1016/j.mad.2017.07.003. [Epub ahead of print]

PMID: 28754532

Abstract

Centenarians but not octogenarians up regulate the expression of miRNAs, as we previously reported. We have looked into miRNA biogenesis. We show that RNA POL II, DROSHA, EXPORTIN 5 and DICER, are up-regulated in centenarians compared with octogenarians. Furthermore, factors involved in the control of these miRNAs biogenesis genes are also up-regulated in centenarians. Therefore, the up-regulation of miRNA expression in centenarians can be explained in part because miRNA biogenesis pathway is depressed in octogenarians (ordinary aging) while it is maintained in centenarians (extraordinary aging).

 

Abnormally High Ankle-Brachial Index Is Associated with All-cause and Cardiovascular Mortality: The REGICOR Study.

Velescu A, Clara A, Martí R, Ramos R, Perez-Fernandez S, Marcos L, Grau M, Degano IR, Marrugat J, Elosua R.

Eur J Vasc Endovasc Surg. 2017 Jul 25. pii: S1078-5884(17)30372-6. doi: 10.1016/j.ejvs.2017.06.002. [Epub ahead of print]

PMID: 28754427

Abstract

INTRODUCTION:

The clinical significance of a high ankle brachial index (ABI) and its relationship to cardiovascular disease (CVD) and mortality is controversial. The aim of this study was to estimate the association between abnormally high ABI ≥ 1.4 and coronary heart disease (CHD), cerebrovascular disease, and all-cause mortality in a Mediterranean population without CVD.

METHODS:

A prospective population based cohort study of 6352 subjects was followed up for a median 6.2 years. Subjects under 35 years, with a history of CVD or an ABI < 0.9 were excluded. All CHD events (angina, myocardial infarction, coronary revascularisation), cerebrovascular events (stroke, transient ischaemic attack), and all-cause mortality were recorded.

RESULTS:

A total of 5679 subjects fulfilled the inclusion criteria, of which 5517 (97.1%) had a normal ABI whereas 162 (2.9%) had an ABI ≥ 1.4. The profile of individuals with abnormally high ABI revealed as independent related factors age (OR = 1.0; p = .045), female sex (OR = 0.4; p < .01), diabetes (OR = 1.9; p = .02), and lower diastolic blood pressure (OR = 0.9; p < .001). During follow-up 309 (5.4%) participants presented with a CV event and 286 (5.0%) died. An ABI ≥ 1.4 was associated with a higher incidence of CV events in the univariate (HR = 1.7) but not in the multivariate survival Cox regression analysis. An ABI ≥ 1.4 was independently associated with all-cause mortality (HR = 2.0; IC 95% 1.32-2.92) and cardiovascular mortality (HR = 3.1; IC 95% 1.52-6.48).

CONCLUSIONS:

In subjects without CVD, those with abnormally high ABI do not have a greater CV event rate than those with a normal ABI. However, there seems to be a trend towards higher mortality risk, supporting the guidelines that consider this subgroup to be a high risk population.

KEYWORDS:

All-cause mortality; Ankle brachial index; Cardiovascular events; Cardiovascular mortality

 

Two-year follow-up of 4 months metformin treatment vs. placebo in ST-elevation myocardial infarction: data from the GIPS-III RCT.

Hartman MHT, Prins JKB, Schurer RAJ, Lipsic E, Lexis CPH, van der Horst-Schrivers ANA, van Veldhuisen DJ, van der Horst ICC, van der Harst P.

Clin Res Cardiol. 2017 Jul 28. doi: 10.1007/s00392-017-1140-z. [Epub ahead of print]

PMID: 28755285

Abstract

OBJECTIVES:

Preclinical and clinical studies suggested cardioprotective effects of metformin treatment. In the GIPS-III trial, 4 months of metformin treatment did not improve left ventricular ejection fraction in patients presenting with ST-elevation myocardial infarction (STEMI). Here, we report the 2-year follow-up results.

METHODS:

Between January 2011 and May 2013, 379 STEMI patients without diabetes undergoing primary percutaneous coronary intervention were randomized to a 4-month treatment with metformin (500 mg twice daily) (N = 191) or placebo (N = 188) in the University Medical Center Groningen. Two-year follow-up data was collected to determine its effect on predefined secondary endpoints: the incidence of major adverse cardiac events (MACE), its individual components, all-cause mortality, and new-onset diabetes.

RESULTS:

For all 379 patients all-cause mortality data were available. For seven patients (2%) follow-up data on MACE was limited, ranging from 129 to 577 days. All others completed the 2-year follow-up visit. Incidence of MACE was 11 (5.8%) in metformin and 6 (3.2%) in placebo treated patients [hazard ratio (HR) 1.84, confidence interval (CI) 0.68-4.97, P = 0.22]. Three patients died in the metformin group and one in the placebo treatment group. Individual components of MACE were also comparable between both groups. New-onset diabetes mellitus was 34 (17.8%) in metformin and 32 (17.0%) in placebo treated patients (odds ratio 1.15, CI 0.66-1.98, P = 0.84). After multivariable adjustment the incidence of MACE was comparable between the treatment groups (HR 1.02, CI 0.10-10.78, P = 0.99).

CONCLUSIONS:

Four months metformin treatment initiated at the time of hospitalization in STEMI patients without diabetes did not exert beneficial long-term effects.

KEYWORDS:

Acute myocardial infarction; Diabetes; Heart failure; Metformin; Percutaneous coronary intervention

 

L-arginine supplementation and risk factors of cardiovascular diseases in healthy men: a double-blind randomized clinical trial.

Pahlavani N, Jafari M, Rezaei M, Rasad H, Sadeghi O, Rahdar HA, Entezari MH.

F1000Res. 2014 Dec 12;3:306. doi: 10.12688/f1000research.5877.1. eCollection 2014.

PMID: 28751963

https://f1000research.com/articles/3-306/v1

https://f1000researchdata.s3.amazonaws.com/manuscripts/6279/7fbc4c24-941d-4bc2-874e-61ca5ea9b777_5877_-_mostafa_jafari.pdf?doi=10.12688/f1000research.5877.1

Abstract

Context: The effect of L-arginine on risk factors of cardiovascular diseases (CVD) has mostly focused on western countries. Since cardiovascular diseases is the second cause of death in Iran and, as far as we are aware, there have been no studies about the effect of L-arginine on CVD risk factors, the aim of this trial was to assess the effects of L-arginine supplementation on CVD risk factors in healthy men. Objective: The purpose of this study was to evaluate the effect of low-dose L-arginine supplementation on CVD risk factors (lipid profile, blood sugar and blood pressure) in Iranian healthy men. Design, setting, participants: We conducted a double-blind randomized controlled trial in 56 patients selected from sport clubs at the Isfahan University of Medical Science between November 2013 and December 2013. Interventions: Healthy men received L-arginine supplementation (2000 mg daily) in the intervention group or placebo (2000 mg maltodextrin daily) in the control group for 45 days. Main outcome measure: The primary outcome measures were we measured the levels of fasting blood sugar, blood pressure and lipid profile including triglyceride (TG), cholesterol, LDL and HDL in healthy subjects. It was hypothesized that these measures would be significantly improved in those receiving L-arginine supplementation. at the beginning and end of the study. Results: In this trial, we had complete data for 52 healthy participants with mean age of 20.85±4.29 years. At the end of study, fasting blood sugar (P=0.001) and lipid profile (triglycerideTG (P<0.001), cholesterol (P<0.001), LDL (P=0.04), HDL (P=0.015)) decreased in the L-arginine group but we found no significant change in the placebo group. In addition, the reduction of fasting blood sugar and lipid profile in L-arginine was significant compared with placebo group. No significant changes were found about systolic (P=0.81) and diastolic blood pressure either in L-arginine or placebo group. (P=0.532). Conclusion: The use of L-arginine significantly improved outcomes compared to placebo.

 

Whole Grain Intake and Glycaemic Control in Healthy Subjects: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Marventano S, Vetrani C, Vitale M, Godos J, Riccardi G, Grosso G.

Nutrients. 2017 Jul 19;9(7). pii: E769. doi: 10.3390/nu9070769. Review.

PMID: 28753929

http://www.mdpi.com/2072-6643/9/7/769/htm

Abstract

BACKGROUNDS:

There is growing evidence from both observational and intervention studies that Whole Grain (WG) cereals exert beneficial effects on human health, especially on the metabolic profile. The aim of this study was to perform a meta-analysis of randomised controlled trials (RCT) to assess the acute and medium/long-term effect of WG foods on glycaemic control and insulin sensitivity in healthy individuals.

METHODS:

A search for all the published RCT on the effect of WG food intake on glycaemic and insulin response was performed up to December 2016. Effect size consisted of mean difference (MD) and 95% CI between the outcomes of intervention and the control groups using the generic inverse-variance random effects model.

RESULTS:

The meta-analysis of the 14 studies testing the acute effects of WG foods showed significant reductions of the post-prandial values of the glucose iAUC (0-120 min) by -29.71 mmol min/L (95% CI: -43.57, -15.85 mmol min/L), the insulin iAUC (0-120 min) by -2.01 nmol min/L (95% CI: -2.88, -1.14 nmol min/L), and the maximal glucose and insulin response. In 16 medium- and long-term RCTs, effects of WG foods on fasting glucose and insulin and homeostatic model assessment-insulin resistance values were not significant.

CONCLUSIONS:

The consumption of WG foods is able to improve acutely the postprandial glucose and insulin homeostasis compared to similar refined foods in healthy subjects. Further research is needed to better understand the long-term effects and the biological mechanisms.

KEYWORDS:

RTC; glycemia; healthy subjects; insulin; meta-analysis; whole grain

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[i could not find free full-texts for the first two below papers and one other paper below.]

 

BOOKS ET AL.EVOLUTION

Inevitable or improbable?

Adrian Woolfson

Improbable Destinies: Fate, Chance, and the Future of Evolution

Jonathan B. Losos

Riverhead Books, 2017. 384 pp.

Science 28 Jul 2017:

Vol. 357, Issue 6349, pp. 362

DOI: 10.1126/science.aan8380

In their seminal book Evolution and Healing, Randolph Nesse and George C. Williams describe the design of human bodies as “simultaneously extraordinarily precise and unbelievably slipshod.” Indeed, they conclude that our inconsistencies are so incongruous that one could be forgiven for thinking that we had been “shaped by a prankster.”

By what agency did this unfortunate state of affairs come into being, and how might we amend it? Gene editing and synthetic biology offer the possibility of, respectively, “correcting” or “rewriting” human nature, allowing us to expunge unfavorable aspects of ourselves—such as our susceptibility to diseases and aging—while enabling the introduction of more appealing features. The legitimacy of such enterprises, however, to some extent depends on whether the evolution of humans on Earth was inevitable.

If our origin and nature were deterministically programmed into life's history, it would be hard to argue that we should be any other way. If, on the other hand, we are the improbable products of a historically contingent evolutionary process, then human exceptionalism is compromised, and the artificial modification of our genomes may be perceived by some as being less of an affront to the natural order. In his compelling book Improbable Destinies, Jonathan Losos addresses this issue, recasting previous dialogues in the light of an experimental evolutionary agenda and, in so doing, arrives at a novel conclusion.

Until recently, the evolutionary determinism debate focused on two contrary interpretations of an outcrop of rock located in a small quarry in the Canadian Rocky Mountains known as the Burgess Shale. Contained within the Burgess Shale, and uniquely preserved by as-yet-unknown processes, are the fossilized remains of a bestiary of animals, both skeletal and soft-bodied. These fossils are remarkable in that they appear to have originated in a geological instant 570 to 530 million years ago during the Cambrian. They comprise a bizarre zoo of outlandish body plans, some of which appeared to be unrepresented in living species.

In his 1989 book Wonderful Life, the Harvard biologist Stephen Jay Gould argued that the apparently arbitrary deletion of distinct body plans in the Cambrian suggests that life's history was deeply contingent, underwritten by multiple chance events. As such, if the tape of life could be rewound back to the beginning and replayed again, it would be vanishingly unlikely that anything like humans would emerge again. The Cambridge paleontologist Simon Conway Morris, on the other hand, would have none of this.

Citing a long list of examples to illustrate the ubiquity of convergence—the phenomenon whereby unrelated species evolve a similar structure—Conway Morris claimed that the evolution of humanlike organisms would be a near inevitability of any replay. In his scheme, articulated in 2003 in Life's Solution, nature's deep self-organizing forces narrowly constrain potential evolutionary outcomes, resulting in a relatively sparse sampling of genetic space.

Losos closes the loop on this contentious debate, marshaling data from the burgeoning research area of experimental evolution. Unlike Darwin, who perceived the process of evolution to be imperceptibly slow and therefore inaccessible to direct experimentation, contemporary evolutionary biologists have realized that evolution can occur in rapid bursts and may consequently be captured on the wing.

Given that microbes have an intergenerational time of 20 minutes or less, in 1988, the evolutionary biologist Richard Lenski reasoned that the bacterium Escherichia coli would comprise the perfect model experimental system to study condensed evolutionary time scales. Bacteria could additionally be frozen, allowing multiple parallel replays to be run again and again from any time point in their history. Twenty-eight years and 64,000 bacterial generations later, he concluded that the history of life owes its complexity both to repeatability and contingency.

Losos and other investigators have demonstrated a similar degree of repeatability in the natural evolution of the Anolis lizard, three-spined sticklebacks, guppies, and deer mice. Importantly, however, when experimental populations evolve in divergent environments, novel outcomes are more commonly observed than convergence.

These experiments were not a replay of the tape of life in time so much as a replay in space, but the findings were surprising in that they emerged within a relatively short time frame—a far cry from what one might have expected would be necessary to falsify the predictability hypothesis.

Losos concludes that “both sets of forces—the random and the predictable … together give rise to what we call history.” With this, humans are humbled once again, cast firmly into the sea of ordered indeterminism. Although he does not attempt to use this as a justification for human genomic modification, Losos argues that the genetic principles underlying life's multifarious convergent solutions might, among other things, be coopted to rescue imperiled species.

 

'Scientific wellness' study divides researchers.

Cross R.

Science. 2017 Jul 28;357(6349):345. doi: 10.1126/science.357.6349.345. No abstract available.

PMID: 28751591

Summary

Leroy "Lee" Hood is famous for his role in the development of the first automated DNA sequencer and the establishment of systems biology. Now, his latest venture aims to monitor and predict health and disease to promote "scientific wellness" through a variety of measurements in a proposed 100,000-person wellness project: whole genome sequences; blood, saliva, urine, and stool samples taken every 3 months to measure hundreds of proteins and metabolites; and physical activity and sleep monitoring. A recently published study of Hood's 108-person pilot project collecting these data discovered something wrong in nearly every participant, such as low vitamin D levels or prediabetes. Monthly coaching helped improve some people's health during the study, prompting Hood to help launch a company called Arivale, which offers similar tracking, analysis, and coaching for a first-year subscription fee of $3499. But several doctors and scientists are unimpressed with the results. Some argue that standard medical checkups could detect many of health issues identified in the study, and others say it is simply too early to know how these data should be used clinically.

Leroy “Lee” Hood is one of biology's living legends. Now 78 years old, he played an influential role in the development of the first automated DNA sequencer, pioneered systems biology, and still leads an institute devoted to it in Seattle, Washington. But his latest venture may not burnish his reputation: a company promoting “scientific wellness,” the notion that intensive, costly monitoring and coaching of apparently healthy people can head off disease.

In a pilot study of the concept, Hood and colleagues compiled what he calls “personal, dense, dynamic data clouds” for 108 people: full genome sequences; blood, saliva, urine, and stool samples taken three times at 3-month intervals and analyzed for 643 metabolites and 262 proteins; and physical activity and sleep monitoring. The team reports in the August issue of Nature Biotechnology that dozens of the participants turned out to have undiscovered health risks, including prediabetes and low vitamin D, which the coaching helped them address.

Entrepreneur Clayton Lewis (left) and biologist Leroy Hood (right) offer a data-heavy approach to health monitoring through their company, Arivale.

PHOTO: ARIVALE

Hood says the findings justify commercializing the monitoring, in a service costing thousands of dollars a year. But some colleagues disagree. The effort takes health monitoring “to new heights, or depths, depending on how you look at it,” says Eric Topol, director of the Scripps Translational Science Institute in San Diego, California.

Atul Butte, a computational biologist and director of the Institute of Computational Health Sciences at the University of California, San Francisco, notes a “lack of sparkling findings” in the study. “All of these tests cost a lot of money, and it's not exactly clear what we are getting out of them yet,” he says. And many of the problems the monitoring uncovered could be detected with simpler and cheaper tests, he adds.

The new venture grew out of Hood's proposed 100K Wellness Project, for which he hopes to recruit 100,000 people by 2020. Hood says that tracking these individuals for several decades would create billions of data points for teasing out measurable markers for incipient diseases, and thus guide future preventative medicine efforts.

Data collected in the pilot study showed that nearly every participant had something to worry about: Ninety-five had low vitamin D levels, 81 had high mercury levels, and 52 were considered prediabetic. One person had high blood levels of the iron-containing protein ferritin and a genetic risk for developing hemochromatosis, a condition in which high iron levels can damage cartilage in joints. In monthly coaching sessions, subjects received advice about steps to improve their health indicators, from changing their diet to exercising to visiting a doctor.

One participant was Clayton Lewis, a friend of Hood's who works at the venture capital firm Maveron. Lewis, who was training for a triathlon, says he expected “to be the healthiest person in this study,” but he learned that he was prediabetic and that he had high blood mercury, presumably due to a decades-old dental filling. Despite the unsettling findings—which prompted him to change his diet and visit his dentist—he says he and other participants loved “that the data was all about them.” Lewis joined with study leaders Nathan Price and Hood to launch the new company, called Arivale, with Lewis as CEO.

Now 2 years old, the Seattle-based company has already enrolled 2500 people. They pay a first-year $3499 subscription fee for tracking and analysis similar to the pilot study, and nearly all have opted to let their data be used in research by Hood's Institute of Systems Biology.

Jennifer Lovejoy, Arivale's chief translational science officer, describes the company as “a bridge to the medical community” that specializes in analyzing the data so that the personal coaches—all registered dieticians, certified nutritionists, or registered nurses—can create lifestyle and wellness recommendations. “Our coaches do not diagnose or treat. We are not providing medical care,” she says. As such, the company has not asked the Food and Drug Administration to review or regulate its offerings.

But the commercial bid bothers some fans of the 100K Wellness Project. Jonathan Berg, a physician scientist who studies cancer and genetics at the University of North Carolina School of Medicine in Chapel Hill, considered that project “thrilling.” But, he adds, “when you link it to companies offering this as a service, that is where we start getting into trouble.”

The problem, Berg says, is that “we don't have any idea at all how this information should be used clinically.” Topol agrees, noting that he had comparable concerns about a similar barrage of tests on presumably healthy people, including genome sequencing and a full-body MRI scan, from a company launched by another genome legend, J. Craig Venter.

Such comments don't deter Hood. He concedes that for many of the variables his study measures, “we don't quite understand if they play important roles” in wellness. He also agrees that some of the tests in the study can be done during a standard doctor's visit, but that the personal coaches are a “real winner for getting people to change their behavior.”

Hood says the value of the approach will increase with time as more data from Arivale's customers and future 100K Wellness Project participants reveal new signposts for forecasting disease. “I think scientific wellness is here to stay.”

 

HEALTH

Why Everything We Know About Salt May Be Wrong

By GINA KOLATAMAY 8, 2017

https://www.nytimes.com/2017/05/08/health/salt-health-effects.html?sl_rec=mostpopular_sample_dedup&contentCollection=smarter-living&mData=articles%255B%255D%3Dhttps%253A%252F%252Fwww.nytimes.com%252F2017%252F05%252F08%252Fhealth%252Fsalt-health-effects.html%253Fsl_rec%253Dmostpopular_sample_dedup%26articles%255B%255D%3Dhttps%253A%252F%252Fwww.nytimes.com%252F2017%252F06%252F28%252Fwell%252Fmove%252Ffor-exercise-nothing-like-the-great-outdoors.html%253Fsl_rec%253Dmostpopular_sample_dedup&hp&action=click&pgtype=Homepage&clickSource=story-heading&module=smarterLiving-promo-region&region=smarterLiving-promo-region&WT.nav=smarterLiving-promo-region

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Increased salt consumption induces body water conservation and decreases fluid intake.

Rakova N, Kitada K, Lerchl K, Dahlmann A, Birukov A, Daub S, Kopp C, Pedchenko T, Zhang Y, Beck L, Johannes B, Marton A, Müller DN, Rauh M, Luft FC, Titze J.

J Clin Invest. 2017 May 1;127(5):1932-1943. doi: 10.1172/JCI88530. Epub 2017 Apr 17.

PMID: 28414302 Free Article

https://www.jci.org/articles/view/88530

https://www.jci.org/articles/view/88530/pdf

Abstract

BACKGROUND:

The idea that increasing salt intake increases drinking and urine volume is widely accepted. We tested the hypothesis that an increase in salt intake of 6 g/d would change fluid balance in men living under ultra-long-term controlled conditions.

METHODS:

Over the course of 2 separate space flight simulation studies of 105 and 205 days' duration, we exposed 10 healthy men to 3 salt intake levels (12, 9, or 6 g/d). All other nutrients were maintained constant. We studied the effect of salt-driven changes in mineralocorticoid and glucocorticoid urinary excretion on day-to-day osmolyte and water balance.

RESULTS:

A 6-g/d increase in salt intake increased urine osmolyte excretion, but reduced free-water clearance, indicating endogenous free water accrual by urine concentration. The resulting endogenous water surplus reduced fluid intake at the 12-g/d salt intake level. Across all 3 levels of salt intake, half-weekly and weekly rhythmical mineralocorticoid release promoted free water reabsorption via the renal concentration mechanism. Mineralocorticoid-coupled increases in free water reabsorption were counterbalanced by rhythmical glucocorticoid release, with excretion of endogenous osmolyte and water surplus by relative urine dilution. A 6-g/d increase in salt intake decreased the level of rhythmical mineralocorticoid release and elevated rhythmical glucocorticoid release. The projected effect of salt-driven hormone rhythm modulation corresponded well with the measured decrease in water intake and an increase in urine volume with surplus osmolyte excretion.

CONCLUSION:

Humans regulate osmolyte and water balance by rhythmical mineralocorticoid and glucocorticoid release, endogenous accrual of surplus body water, and precise surplus excretion.

FUNDING:

Federal Ministry for Economics and Technology/DLR; the Interdisciplinary Centre for Clinical Research; the NIH; the American Heart Association (AHA); the Renal Research Institute; and the TOYOBO Biotechnology Foundation. Food products were donated by APETITO, Coppenrath und Wiese, ENERVIT, HIPP, Katadyn, Kellogg, Molda, and Unilever.

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See the related Commentary at Salt and water: not so simple.

Salt and water: not so simple.

Zeidel ML.

J Clin Invest. 2017 May 1;127(5):1625-1626. doi: 10.1172/JCI94004. Epub 2017 Apr 17.

PMID: 28414294 [Not a] Free Article

Abstract

It has long been viewed that the maintenance of osmotic balance in response to high salt intake is a passive process that is mediated largely by increased water consumption to balance the salt load. Two studies in this issue of the JCI challenge this notion and demonstrate that osmotic balance in response to high salt intake involves a complex regulatory process that is influenced by hormone fluctuation, metabolism, food consumption, water intake, and renal salt and water excretion. Rakova et al. report the unexpected observation that long-term high salt intake did not increase water consumption in humans but instead increased water retention. Moreover, salt and water balance was influenced by glucocorticoid and mineralocorticoid fluctuations. Kitada et al. extend upon these findings in mouse models and determined that increased urea and a corresponding increase in urea transporters in the renal medulla as the result of increased protein intake promote the water retention that is needed to achieve osmotic homeostasis. Together, the results of these two studies lay the groundwork for future studies to determine how, in the face of chronic changes in salt intake, humans maintain volume and osmotic homeostasis.

Headnote

It has long been viewed that the maintenance of osmotic balance in response to high salt intake is a passive process that is mediated largely by increased water consumption to balance the salt load. Two studies in this issue of the JCI challenge this notion and demonstrate that osmotic balance in response to high salt intake involves a complex regulatory process that is influenced by hormone fluctuation, metabolism, food consumption, water intake, and renal salt and water excretion. Rakova et al. report the unexpected observation that long-term high salt intake did not increase water consumption in humans but instead increased water retention. Moreover, salt and water balance was influenced by glucocorticoid and mineralocorticoid fluctuations. Kitada et al. extend upon these findings in mouse models and determined that increased urea and a corresponding increase in urea transporters in the renal medulla as the result of increased protein intake promote the water retention that is needed to achieve osmotic homeostasis. Together, the results of these two studies lay the groundwork for future studies to determine how, in the face of chronic changes in salt intake, humans maintain volume and osmotic homeostasis.

Maintaining salt and water balance

The great French biologist Claude Bernard equated the body fluids with the ancient oceans that we all evolved from and asserted that the "constancy of the internal milieu is the condition of a free and independent existence," that is, the ability to live on land, apart from the primal seas (1). Since the time of Bernard, physiologists and physicians have worked to understand how we maintain stable osmolality and overall circulatory volume in the face of massive shifts in salt intake. On the basis of classical balance studies in humans and experimental animals (2), generations of renal physiologists viewed osmotic homeostasis during salt loading as a passive, reactive process. In this view, salt loading stimulates thirst by increasing blood osmolality, which in turn is sensed in the subfornical organ (SFO) of the brainstem. Along with the salt load, increased water intake raises extracellular fluid volume, elevates cardiac preload and cardiac output, and increases renal plasma flow and the glomerular filtration rate, thereby driving sufficient renal salt excretion to rebalance extracellular volume. As the kidney excretes the salt load, antidiuretic hormone-driven (ADH-driven) distal nephron free water reabsorption maintains osmotic homeostasis.

Two companion articles in this issue upend this classical narrative and reveal a complex interplay between the regulated metabolism of salt, water, protein, and fat, all of which are required for the maintenance of salt balance and osmotic homeostasis in the face of a chronic salt load. In the first study, Rakova et al. (3) took advantage of the planned isolation of Russian cosmonauts for a simulated long-duration space flight to evaluate, over the long term, the impact of changes in salt intake on water and salt excretion. The authors were startled to find that chronic high salt intake resulted in less, not more, fluid intake and that salt and water balance were influenced by rhythmic variations in glucocorticoid and mineralocorticoid release. Salt excretion was accompanied by free water retention, and while salt excretion rose, excretion of urea and potassium was reduced. Rakova and colleagues concluded that urea and potassium substituted for sodium in the medullary interstitium as the osmotic drivers of water reabsorption in the cosmonauts. The second study by Kitada et al. (4) replicated these findings in mice to explore the mechanisms behind the findings of Rakova and colleagues. Increased salt intake in mice similarly augmented salt excretion and failed to increase water intake. In the face of increased salt excretion, the free water retention needed for osmotic homeostasis was achieved by increased accumulation of urea in the renal medulla, which, in turn, arose from increased protein intake and catabolism, as well as through an upregulation of renal urea transporters.

The findings of these combined studies are important, because the careful measurements describe in detail the physiological events underlying chronic salt regulation in humans. Moreover, this work reveals the complex orchestration of adrenal hormone release, sympathetic nerve outflow, metabolism in muscle, fat, and liver, and renal handling of salt and water needed for excretion of a major salt load while maintaining stable blood osmolality.

In some respects, the lack of increase in water intake in response to the salt load is not surprising. Studies in normal humans have shown that acute increases in serum osmolality effected by infusion of hypertonic saline reliably result in rapid increases in ADH release, while the perception of thirst is variable and occurs at a higher serum osmolality (5). In this regard, it is interesting that urine osmolalities in the cosmonauts on high-salt diets did not rise to maximal levels, suggesting that serum osmolalities rarely rose to a level high enough to stimulate maximal ADH release and may not have risen enough to drive thirst (3). Sleep provides another example of the primacy of ADH release over thirst in response to small increases in serum osmolality. During sleep, insensible water loss starts to raise serum osmolality, which triggers ADH release, and increases renal reabsorption of free water, which corrects serum osmolality without the need for arousal and thirst to drive drinking. Similarly, in chronically salt-loaded mice and humans, the kidney's ability to concentrate urine, coupled with the generation of free water from increased protein and fat metabolism, was more than sufficient to maintain stable blood osmolality during salt loading (3, 4).

Unanswered questions

If osmolality must rise quite substantially before thirst is engaged, then how is thirst meshed with the fine control of serum osmolality? For that matter, where and how do organisms orchestrate the multiple control mechanisms (hormone release, metabolism, and excretion of renal salt and water) shown by the two articles in this issue? Can future studies define these control mechanisms with clarity? The brainstem, hypothalamus, and structures of the lamina terminalis (organum vasculosum laminae terminalis [OVLT], median preoptic nucleus [MnPO], and SFO) control salt balance and osmotic homeostasis and integrate external environmental stimuli to manage nearly all aspects of homeostasis. Because these regions have so many different neurons in such close proximity, it has been difficult to map out neural control circuits in them. Newer methods that combine genetic targeting with stereotactic localization of interventions and measurements permit monitoring and manipulation of specific neuronal types in specific locations, often in conscious, freely moving mice (6, 7). The very recent use of high-throughput single-cell transcriptomic technologies, such as Drop-seq, to define with great precision the different populations of neurons within anatomic regions of the brain will likely lead to the identification of ever more specific neuron populations, which can then be targeted genetically (8). Using these approaches, investigators have mapped with increasing definition the control within brain neurons of appetite and satiety (9), sleep and wakefulness (10), bladder function (11), as well as thirst and ADH release (12, 13).

Recent studies on the control of SFO neurons that regulate thirst revealed that the level of activation of these neurons is determined by serum osmolality, which they sense directly, and, at much higher sensitivity, by their estimate of the impact that drinking water or eating food will have on serum osmolality (12). Thus, water deprivation activates SFO neurons, and initiation of drinking reduces this activation, long before water ingestion alters serum osmolality. Additionally, food intake almost immediately activates SFO neurons, long before food ingestion alters serum osmolality. Similarly, ADHreleasing neurons in the hypothalamus are activated immediately by eating and are inhibited immediately by drinking and by the anticipation of drinking (13). Thus, we are beginning to understand how the brain integrates environmental cues with the homeostatic needs of the organism, so that in the future we can begin to explain, for example, why the cosmonauts did not drink more in response to salt loading, but instead accelerated catabolism and renal free water reabsorption.

The studies by Rakova et al. and Kitada et al. demonstrate that controlling salt excretion and osmotic homeostasis in the face of wide variations in salt load engages the release of hormones such as glucocorticoids and mineralocorticoids, alters filtration and tubular handling of sodium and water in the nephron, changes protein and fat metabolism, and alters drinking and eating. The neural circuits that adapt intake and excretion, as well as metabolism, to the ongoing needs of the organism in its environment are just being revealed. As these pathways become clearer, therapies targeted to the control of specific neural circuits may be possible and will permit improved treatment of conditions like hypertension, congestive heart failure, and hyponatremia.

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See the related article

Increased salt consumption induces body water conservation and decreases fluid intake

and

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High salt intake reprioritizes osmolyte and energy metabolism for body fluid conservation.

Kitada K, Daub S, Zhang Y, Klein JD, Nakano D, Pedchenko T, Lantier L, LaRocque LM, Marton A, Neubert P, Schröder A, Rakova N, Jantsch J, Dikalova AE, Dikalov SI, Harrison DG, Müller DN, Nishiyama A, Rauh M, Harris RC, Luft FC, Wassermann DH, Sands JM, Titze J.

J Clin Invest. 2017 May 1;127(5):1944-1959. doi: 10.1172/JCI88532. Epub 2017 Apr 17.

PMID: 28414295 Free Article

https://www.jci.org/articles/view/88532

https://www.jci.org/articles/view/88532/pdf

Abstract

Natriuretic regulation of extracellular fluid volume homeostasis includes suppression of the renin-angiotensin-aldosterone system, pressure natriuresis, and reduced renal nerve activity, actions that concomitantly increase urinary Na+ excretion and lead to increased urine volume. The resulting natriuresis-driven diuretic water loss is assumed to control the extracellular volume. Here, we have demonstrated that urine concentration, and therefore regulation of water conservation, is an important control system for urine formation and extracellular volume homeostasis in mice and humans across various levels of salt intake. We observed that the renal concentration mechanism couples natriuresis with correspondent renal water reabsorption, limits natriuretic osmotic diuresis, and results in concurrent extracellular volume conservation and concentration of salt excreted into urine. This water-conserving mechanism of dietary salt excretion relies on urea transporter-driven urea recycling by the kidneys and on urea production by liver and skeletal muscle. The energy-intense nature of hepatic and extrahepatic urea osmolyte production for renal water conservation requires reprioritization of energy and substrate metabolism in liver and skeletal muscle, resulting in hepatic ketogenesis and glucocorticoid-driven muscle catabolism, which are prevented by increasing food intake. This natriuretic-ureotelic, water-conserving principle relies on metabolism-driven extracellular volume control and is regulated by concerted liver, muscle, and renal actions.

Edited by AlPater

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The Risk of Major NSAID Toxicity with Celecoxib, Ibuprofen or Naproxen: a Secondary Analysis of the PRECISION Randomized Controlled Clinical Trial.

Solomon DH, Husni ME, Libby PA, Yeomans ND, Lincoff AM, Lüscher TF, Menon V, Brennan DM, Wisniewski LM, Nissen SE, Borer JS.

Am J Med. 2017 Jul 26. pii: S0002-9343(17)30717-9. doi: 10.1016/j.amjmed.2017.06.028. [Epub ahead of print]

PMID: 28756267

Abstract

BACKGROUND:

The relative safety of long-term utilization of non-steroidal anti-inflammatory drugs (NSAIDs) is unclear. Patients and providers are interested in an integrated view of risk . We examined the risk of major NSAID toxicity in the PRECISION trial.

METHODS:

We conducted a post-hoc analyses of double-blind randomized controlled multi-center trial enrolling 24,081 patients with osteoarthritis or rheumatoid arthritis at moderate or high cardiovascular risk.Patients were randomized to receive celecoxib 100-200mg twice daily, ibuprofen 600-800mg thrice daily, or naproxen 375-500mg twice daily. All patients were provided with a proton pump inhibitor. The outcome was major NSAID toxicity, including time to first occurrence of major adverse cardiovascular events, important gastrointestinal events, renal events and all-cause mortality.

RESULTS:

During follow-up, 4.1% of subjects in the celecoxib arm sustained any major toxicity, 4.8% in the naproxen arm, and 5.3% in the ibuprofen arm. Analyses adjusted for aspirin use and geographic region found that subjects in the naproxen arm had a 19% (95% CI 1-39%) higher risk of major toxicity than celecoxib users and ibuprofen users had a 41% (95% CI 21-65%) higher risk. These risks translate into numbers needed to harm of 135 (95% CI 72-971) for naproxen and 82 (95% CI 53-173) for ibuprofen, both compared with celecoxib.

CONCLUSIONS:

Among patients with symptomatic arthritis who had moderate to high risk of cardiovascular events, approximately one in twenty experienced a major toxicity over 1-2 years. Patients using naproxen or ibuprofen experienced significantly higher risk of major toxicity than those using celecoxib.

KEYWORDS:

Cox-2 selective inhibitor; Drug toxicity; NSAID; Randomized controlled trial

 

Visit-to-Visit Office Blood Pressure Variability and Cardiovascular Outcomes in SPRINT (Systolic Blood Pressure Intervention Trial).

Chang TI, Reboussin DM, Chertow GM, Cheung AK, Cushman WC, Kostis WJ, Parati G, Raj D, Riessen E, Shapiro B, Stergiou GS, Townsend RR, Tsioufis K, Whelton PK, Whittle J, Wright JT, Papademetriou V; SPRINT Research Group.

Hypertension. 2017 Jul 31. pii: HYPERTENSIONAHA.117.09788. doi: 10.1161/HYPERTENSIONAHA.117.09788. [Epub ahead of print]

PMID: 2876093

http://sci-hub.cc/10.1161/HYPERTENSIONAHA.117.09788

Abstract

Studies of visit-to-visit office blood pressure (BP) variability (OBPV) as a predictor of cardiovascular events and death in high-risk patients treated to lower BP targets are lacking. We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (<120 mm Hg) or standard (<140 mm Hg) systolic BP targets. We defined OBPV as the coefficient of variation of the systolic BP using measurements taken during the 3-,6-, 9-, and 12-month study visits. In our cohort of 7879 participants, older age, female sex, black race, current smoking, chronic kidney disease, and coronary disease were independent determinants of higher OBPV. Use of thiazide-type diuretics or dihydropyridine calcium channel blockers was associated with lower OBPV whereas angiotensin-converting enzyme inhibitors or angiotensin receptor blocker use was associated with higher OBPV. There was no difference in OBPV in participants randomized to standard or intensive treatment groups. We found that OBPV had no significant associations with the composite end point of fatal and nonfatal cardiovascular events (n=324 primary end points; adjusted hazard ratio, 1.20; 95% confidence interval, 0.85-1.69, highest versus lowest quintile) nor with heart failure or stroke. The highest quintile of OBPV (versus lowest) was associated with all-cause mortality (adjusted hazard ratio, 1.92; confidence interval, 1.22-3.03) although the association of OBPV overall with all-cause mortality was marginal (P=0.07). Our results suggest that clinicians should continue to focus on office BP control rather than on OBPV unless definitive benefits of reducing OBPV are shown in prospective trials.

KEYWORDS:

angiotensin-converting enzyme inhibitors; blood pressure; heart failure; kidney diseases; mortality

"A.K. Cheung is a consultant for Boehringer Ingelheim and a contributor

to Up-to-Date. W.C. Cushman has an institutional grant from Eli

Lilly and is an uncompensated consultant for Takeda. V. Papademetriou

received grants from Astra-Zeneca, Sanofi, DCRI, VA Co-Op studies,

and the National Institutes of Health. G.S. Stergiou received honoraria

from Boehringer, Mearini, Novartis, Omron, SanofiAventis, Servier,

and has research contracts with Bayer and Boehringer. K. Tsioufis

has received research grants or honoraria from Medtronic, St. Jude

Medical, Bayer, Novartis, Atra-Zeneca, Boehringer, Pfizer, Sanofi,

Vianex, and Servier."

 

Efficacy and Safety of Proton Pump Inhibitors in the Long-Term Aspirin Users: A Meta-Analysis of Randomized Controlled Trials.

Dahal K, Sharma SP, Kaur J, Anderson BJ, Singh G.

Am J Ther. 2017 Jul 26. doi: 10.1097/MJT.0000000000000637. [Epub ahead of print]

PMID: 28763306

http://sci-hub.cc/10.1097/MJT.0000000000000637

Abstract

BACKGROUND:

Long-term aspirin use in cardiovascular disease prevention may result in gastrointestinal bleeding. Although proton pump inhibitors (PPI) have been shown to reduce the risks of peptic ulcers and dyspeptic symptoms in long-term aspirin users in the randomized controlled trials, there are safety concerns about the long-term use of PPI.

STUDY QUESTION:

What is the safety and efficacy of PPI in patients using aspirin in long term for prevention of cardiovascular diseases and stroke?

METHODS:

We searched MEDLINE, EMBASE, CENTRAL, CINAHL, ProQuest, and relevant references from inception through February 2015, and used random-effects model for meta-analysis.

RESULTS:

A total of 10 publications from 9 studies (n = 6382) were included in the meta-analysis. Compared with control, PPI reduced the risks of peptic ulcers [risk ratio (RR): 0.19; 95% confidence interval: 0.13-0.26; P < 0.00001], gastric ulcers [0.24 (0.16-0.35); P < 0.00001], duodenal ulcers [0.12 (0.05-0.29); P < 0.00001], bleeding ulcers [0.22 (0.10-0.51); P = 0.0004], and erosive esophagitis [0.14 (0.07-0.28); P < 0.00001]. PPI increased the resolution of epigastric pain [1.13 (1.03-1.25); P = 0.01], heartburn [1.24 (1.18-1.31); P < 0.00001], and regurgitation [1.26 (1.13-1.40); P < 0.0001], but did not increase the risks of all-cause mortality [1.72 (0.61-4.87); P = 0.31], cardiovascular mortality [1.80 (0.59-5.44); P = 0.30], nonfatal myocardial infarction/ischemia [0.56 (0.22-1.41); P = 0.22], ischemic stroke/transient ischemic attack [1.09 (0.34-3.53); P = 0.89] and other adverse events.

CONCLUSIONS:

The PPI seems to be effective in preventing peptic ulcers and erosive esophagitis and in resolution of dyspeptic symptoms without increasing adverse events, cardiac risks or mortality in long-term aspirin users.

 

Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer’s-Type Dementia [internet].

Kane RL, Butler M, Fink HA, Brasure M, Davila H, Desai P, Jutkowitz E, McCreedy E, Nelson VA, McCarten JR, Calvert C, Ratner E, Hemmy LS, Barclay T.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2017 Mar.

PMID: 28759193 Free Books & Documents

Excerpt

OBJECTIVE:

This review assessed evidence for interventions aimed at preventing or delaying the onset of age-related cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer’s-type dementia (CATD).

DATA SOURCES:

Ovid Medline®, Ovid PsycINFO®, Ovid Embase®, and Cochrane Central Register of Controlled Trials (CENTRAL) bibliographic databases; hand searches of references of prior reviews, eligible studies, gray literature; expert recommendations.

REVIEW METHODS:

Two investigators screened abstracts and full-text articles of identified references. Eligible studies included randomized and nonrandomized controlled trials and quasi-experimental observational studies published to September 2016 that enrolled people with normal cognition and/or MCI. We extracted data, assessed risk of bias, summarized results for studies without high risk of bias, and evaluated strength of evidence for studies with sufficient sample size. Cognitive outcomes were grouped into domains to facilitate analysis; strength of evidence was assessed by MCI or CATD incidence and cognitive outcome domain.

RESULTS:

We identified 263 eligible studies addressing 13 classes of interventions: cognitive training, physical activity, nutraceuticals, diet, multimodal interventions, hormone therapy, vitamins, antihypertensive treatment, lipid lowering treatment, nonsteroidal anti-inflammatory drugs (NSAIDs), antidementia drugs, diabetes treatment, and “other interventions.” We found no high-strength evidence for the effectiveness of any intervention to delay or prevent age-related cognitive decline, MCI, and/or CATD. Moderate-strength evidence shows cognitive training in adults with presumed normal cognition improves performance in the cognitive domain trained (memory, reasoning, or processing speed), but not transfer of benefits to other cognitive areas and little evidence for benefit beyond 2 years; evidence for effect on CATD is weak. Interventions with moderate-strength evidence for having no benefit in cognitive performance included: vitamin E in women; B12 plus folic acid for executive/attention/processing speed; and angiotensin-converting enzyme plus thiazide versus placebo and angiotensin receptor blockers versus placebo on brief cognitive screening tests. We found low-strength evidence that the selective estrogen receptor modulator raloxifene reduced risk of probable MCI, but also that estrogen replacement with or without progesterone therapy increased risk of MCI and CATD. Physical activity interventions show no consistent benefit in preventing cognitive decline, but the percent of results showing benefit was unlikely to be explained solely by chance, providing a signal of a possible relationship. A few other interventions (vitamin B12 plus folic acid; nutraceuticals; one multimodal intervention using diet, physical activity, and cognitive training; antihypertensives; and NSAIDs) showed at least one positive finding for a specific outcome, some reaching low strength of evidence, but these were more than offset by findings of no effect for other outcomes. Many interventions (e.g., nutraceuticals; one multimodal intervention using lifestyle advice and drug treatment; hormone therapy; antihypertensives; NSAIDs; acetylcholinesterase inhibitors; diabetes management) showed low-strength evidence for no benefit for some cognitive performance tests. We found no eligible studies for the following interventions: depression treatment, smoking cessation, and community-level interventions.

CONCLUSIONS:

We found mostly low-strength evidence that a wide variety of interventions had little to no benefit for preventing or delaying age-related cognitive decline, MCI, or CATD. There was moderate-strength evidence that cognitive training improved performance in the trained cognitive domains, but not in domains not trained. Evidence of an effect on CATD incidence was weak. There was a mix of positive and negative findings for different outcomes, all of low strength, for physical activity, antihypertensives, NSAIDs, B vitamins, nutraceuticals, and multimodal interventions. Signals seem more promising for physical activity and vitamin B12 plus folic acid. Testing interventions that address modifiable risk factors can help to establish their causative role in MCI and CATD. Methodological problems in the available literature were widespread and should be addressed in future studies, including use of consistent cognitive outcome measures, longer followups, and recognizing that attrition is a major problem in longer studies. More work is needed to understand the relationship between intermediate outcomes such as cognitive test results and the onset of mild cognitive impairment and dementia.

 

Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension: Prospective Analysis From the NutriNet-Santé Cohort.

Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E.

Hypertension. 2017 Jul 31. pii: HYPERTENSIONAHA.117.09622. doi: 10.1161/HYPERTENSIONAHA.117.09622. [Epub ahead of print]

PMID: 28760943

Abstract

Dietary intake is pointed as one of the major determinants in hypertension development. Data in the area are mostly obtained from cross-sectional studies. We aimed to investigate the prospective association between (1) individual nutritional factors and (2) adherence to the Dietary Approach to Stop Hypertension and the risk of incident hypertension in a large cohort study. We prospectively examined the incidence of hypertension among 80 426 French adults participating in the NutriNet-Santé cohort study. Self-reported sociodemographic, lifestyle health questionnaires and dietary consumption assessed by three 24-hour records were completed at baseline and yearly thereafter. Associations between quartiles (Q) of nutrients and food groups and adherence to Dietary Approach to Stop Hypertension diet and hypertension risk were assessed by multivariable Cox proportional hazards models. During a mean follow-up of 3.4±2.1 years, 2413 cases of incident hypertension were documented. Dietary intakes of sodium (Q4 versus Q1): hazard ratio (HR)=1.17 (95% confidence interval [CI], 1.02-1.35), potassium: HR=0.82 (95% CI, 0.72-0.94), animal protein: HR=1.26 (95% CI, 1.11-1.43), vegetable protein: HR=0.85 (95% CI, 0.75-0.95), fiber: HR =0.81 (95% CI, 0.71-0.93), magnesium: HR=0.77 (95% CI, 0.67-0.89), fruit and vegetables: HR=0.85 (95% CI, 0.74-0.97), whole grain: HR=0.84(95% CI, 0.76-0.93), nuts: HR=0.72 (95% CI, 0.63-0.83), and red and processed meat: HR=1.25 (95% CI, 1.11-0.42) were associated with risk of hypertension. Besides, adherence to the Dietary Approach to Stop Hypertension was strongly inversely associated with incident hypertension: (Q4 versus Q1) HR=0.66 (95% CI, 0.58-0.75). Our results confirmed the association of several nutritional factors intake and incident hypertension and highlighted that adopting a global healthy diet could strongly contribute to the prevention of hypertension.

KEYWORDS:

blood pressure; diet; epidemiology; hypertension; meat

 

The association between A Body Shape Index and mortality: Results from an Australian cohort.

Grant JF, Chittleborough CR, Shi Z, Taylor AW.

PLoS One. 2017 Jul 31;12(7):e0181244. doi: 10.1371/journal.pone.0181244. eCollection 2017.

PMID: 28759582

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181244

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181244&type=printable

Abstract

It is well recognised that obesity increases the risk of premature death. A Body Shape Index (ABSI) is a formula that uses waist circumference (WC), body mass index (BMI) and height to predict risk of premature mortality, where a high score (Quartile 4) indicates that a person's WC is more than expected given their height and weight. Our study examines the association between ABSI quartiles and all-cause-, cardiovascular- and cancer-related mortality, and primary cause of death. Self-reported demographic and biomedically measured health-related risk factor and weight data was from the baseline stage of the North West Adelaide Health Study (1999-2003, n = 4056), a longitudinal cohort of Australian adults. Death-related information was obtained from the National Death Index. Primary cause of death across ABSI quartiles was examined. The association between mortality and ABSI (quartile and continuous scores) was investigated using a Cox proportional hazards survival model and adjusting for socioeconomic, and self-reported and biomedical risk factors. The proportion of all three types of mortality steadily increased from ABSI Quartile 1 through to Quartile 4. After adjusting for demographic and health-related risk factors, the risk of all-cause mortality was higher for people in ABSI Quartile 4 (HR 2.64, 95% CI 01.56-4.47), and ABSI Quartile 3 (HR 1.95, 95% CI 1.15-3.33), with a moderate association for the continuous ABSI score (HR 1.32, 95% CI 1.18-1.48). ABSI is therefore positively associated with mortality in Australian adults. Different combined measures of obesity such as the ABSI are useful in examining mortality risk.

 

Individual differences in circadian locomotor parameters correlate with anxiety- and depression-like behavior.

Anyan J, Verwey M, Amir S.

PLoS One. 2017 Aug 1;12(8):e0181375. doi: 10.1371/journal.pone.0181375. eCollection 2017.

PMID: 28763478

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181375

Abstract

Disrupted circadian rhythms are a core feature of mood and anxiety disorders. Circadian rhythms are coordinated by a light-entrainable master clock located in the suprachiasmatic nucleus. Animal models of mood and anxiety disorders often exhibit blunted rhythms in locomotor activity and clock gene expression. Interestingly, the changes in circadian rhythms correlate with mood-related behaviours. Although animal models of depression and anxiety exhibit aberrant circadian rhythms in physiology and behavior, it is possible that the methodology being used to induce the behavioral phenotype (e.g., brain lesions, chronic stress, global gene deletion) affect behavior independently of circadian system. This study investigates the relationship between individual differences in circadian locomotor parameters and mood-related behaviors in healthy rats. The circadian phenotype of male Lewis rats was characterized by analyzing wheel running behavior under standard 12h:12h LD conditions, constant dark, constant light, and rate of re-entrainment to a phase advance. Rats were then tested on a battery of behavioral tests: activity box, restricted feeding, elevated plus maze, forced swim test, and fear conditioning. Under 12h:12h LD conditions, percent of daily activity in the light phase and variability in activity onset were associated with longer latency to immobility in the forced swim test. Variability in onset also correlated positively with anxiety-like behavior in the elevated plus maze. Rate of re-entrainment correlated positively with measures of anxiety in the activity box and elevated plus maze. Lastly, we found that free running period under constant dark was associated with anxiety-like behaviors in the activity box and elevated plus maze. Our results provide a previously uncharacterized relationship between circadian locomotor parameters and mood-related behaviors in healthy rats and provide a basis for future examination into circadian clock functioning and mood.

 

Low glycaemic index diets for the prevention of cardiovascular disease.

Clar C, Al-Khudairy L, Loveman E, Kelly SA, Hartley L, Flowers N, Germanò R, Frost G, Rees K.

Cochrane Database Syst Rev. 2017 Jul 31;7:CD004467. doi: 10.1002/14651858.CD004467.pub3. [Epub ahead of print] Review.

PMID: 28759107

Abstract

BACKGROUND:

The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in this area for the clinical management of people at risk of, or with, established cardiovascular disease. There is a need to review the current evidence from randomised controlled trials (RCTs) in this area. This is an update of the original review published in 2008.

OBJECTIVES:

To assess the effect of the dietary GI on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible randomised controlled trials.

SEARCH METHODS:

We searched CENTRAL, MEDLINE, Embase and CINAHL in July 2016. We also checked reference lists of relevant articles. No language restrictions were applied.

SELECTION CRITERIA:

We selected RCTs that assessed the effects of low GI diets compared to diets with a similar composition but a higher GI on cardiovascular disease and related risk factors. Minimum trial duration was 12 weeks. Participants included were healthy adults or those at increased risk of cardiovascular disease, or previously diagnosed with cardiovascular disease. Studies in people with diabetes mellitus were excluded.

DATA COLLECTION AND ANALYSIS:

Two reviewers independently screened and selected studies. Two review authors independently assessed risk of bias, evaluated the overall quality of the evidence using GRADE, and extracted data following the Cochrane Handbook for Systematic Reviews of Interventions. We contacted trial authors for additional information. Analyses were checked by a second reviewer. Continuous outcomes were synthesized using mean differences and adverse events were synthesized narratively.

MAIN RESULTS:

Twenty-one RCTs were included, with a total of 2538 participants randomised to low GI intervention (1288) or high GI (1250). All 21 included studies reported the effect of low GI diets on risk factors for cardiovascular disease, including blood lipids and blood pressure.Twenty RCTs (18 of which were newly included in this version of the review) included primary prevention populations (healthy individuals or those at high risk of CVD, with mean age range from 19 to 69 years) and one RCT was in those diagnosed with pre-existing CVD (a secondary prevention population, with mean age 26.9 years). Most of the studies did not have an intervention duration of longer than six months. Difference in GI intake between comparison groups varied widely from 0.6 to 42.None of the included studies reported the effect of low GI dietary intake on cardiovascular mortality and cardiovascular events such as fatal and nonfatal myocardial infarction, unstable angina, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, and stroke. The unclear risk of bias of most of the included studies makes overall interpretation of the data difficult. Only two of the included studies (38 participants) reported on adverse effects and did not observe any harms (low-quality evidence).

AUTHORS' CONCLUSIONS:

There is currently no evidence available regarding the effect of low GI diets on cardiovascular disease events. Moreover, there is currently no convincing evidence that low GI diets have a clear beneficial effect on blood lipids or blood pressure parameters.

 

Serum FGF21 in girls with anorexia nervosa - comparison to normal weight and obese female adolescents.

[No authors listed]

Neuro Endocrinol Lett. 2017 Jul 31;38(3):173-181. [Epub ahead of print]

PMID: 28759185

Abstract

BACKGROUND:

Fibroblast growth factor 21 (FGF21) is a hepatokine, myokine and adipokine of a potent influence to energy homeostasis. Data according its serum concentrations in AN are contradictory.

OBJECTIVES:

Analysis of serum FGF21 in girls with acute anorexia nervosa and comparison the results with normal weight and obese female adolescents considering their nutritional status, carbohydrate and lipid metabolism.

METHODS:

Serum FGF21 concentrations were evaluated using commercially available ELISA kit in 32 Polish girls with restrictive AN (AN), 29 girls with obesity (O) and 21 healthy controls ©. Anthropometric measurements (weight, height, BMI) and laboratory assays (serum fasting glucose, insulin, HOMA-IR, total cholesterol, HDL, LDL, triglycerides, C-reactive protein) were performed.

RESULTS:

Mean serum FGF-21 in the AN group was significantly lower, whereas in the O group it was significantly higher than in healthy controls. In all examined girls significant positive correlations between FGF21 and BMI were noted. We also observed significant positive relationships between serum FGF21 levels and fasting glucose, triglycerides, CRP, insulin and HOMA-IR. In all examined girls serum concentrations of this hormone correlated negatively with age and HDL-cholesterol levels.

CONCLUSIONS:

1) Serum FGF21 concentrations are decreased in AN and elevated in obesity. They are independently and positively related to BMI and insulin resistance; 2) Decreased serum FGF21 in AN may support the maintenance of normal blood glucose through adjustment the insulin levels and insulin sensitivity; 3) Elevated FGF21 levels in obesity may be considered adaptive mechanism preventing insulin resistance and its metabolic consequences.

 

Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration.

Evans JR, Lawrenson JG.

Cochrane Database Syst Rev. 2017 Jul 30;7:CD000253. doi: 10.1002/14651858.CD000253.pub4. [Epub ahead of print] Review.

PMID: 28756617

Abstract

BACKGROUND:

There is inconclusive evidence from observational studies to suggest that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C, and E) or minerals (selenium and zinc) may be less likely to develop age-related macular degeneration (AMD).

OBJECTIVES:

To determine whether or not taking antioxidant vitamin or mineral supplements, or both, prevent the development of AMD.

SEARCH METHODS:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 2), MEDLINE Ovid (1946 to 29 March 2017), Embase Ovid (1947 to 29 March 2017), AMED (Allied and Complementary Medicine Database) (1985 to 29 March 2017), OpenGrey (System for Information on Grey Literature in Europe) (www.opengrey.eu/); searched 29 March 2017, the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 29 March 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 29 March 2017 and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 29 March 2017. We did not use any date or language restrictions in the electronic searches for trials.

SELECTION CRITERIA:

We included all randomised controlled trials (RCTs) comparing an antioxidant vitamin or mineral supplement (alone or in combination) to control.

DATA COLLECTION AND ANALYSIS:

Both review authors independently assessed risk of bias in the included studies and extracted data. One author entered data into RevMan 5; the other author checked the data entry. We pooled data using a fixed-effect model. We graded the certainty of the evidence using GRADE.

MAIN RESULTS:

We included a total of five RCTs in this review with data available for 76,756 people. The trials were conducted in Australia, Finland, and the USA, and investigated vitamin C, vitamin E, beta-carotene, and multivitamin supplements. All trials were judged to be at low risk of bias.Four studies reported the comparison of vitamin E with placebo. Average treatment and follow-up duration ranged from 4 to 10 years. Data were available for a total of 55,614 participants. There was evidence that vitamin E supplements do not prevent the development of any AMD (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.90 to 1.06; high-certainty evidence), and may slightly increase the risk of late AMD (RR 1.22, 95% CI 0.89 to 1.67; moderate-certainty evidence) compared with placebo. Only one study (941 participants) reported data separately for neovascular AMD and geographic atrophy. There were 10 cases of neovascular AMD (RR 3.62, 95% CI 0.77 to 16.95; very low-certainty evidence), and four cases of geographic atrophy (RR 2.71, 95% CI 0.28 to 26.0; very low-certainty evidence). Two trials reported similar numbers of adverse events in the vitamin E and placebo groups. Another trial reported excess of haemorrhagic strokes in the vitamin E group (39 versus 23 events, hazard ratio 1.74, 95% CI 1.04 to 2.91, low-certainty evidence).Two studies reported the comparison of beta-carotene with placebo. These studies took place in Finland and the USA. Both trials enrolled men only. Average treatment and follow-up duration was 6 years and 12 years. Data were available for a total of 22,083 participants. There was evidence that beta-carotene supplements did not prevent any AMD (RR 1.00, 95% CI 0.88 to 1.14; high-certainty evidence) nor have an important effect on late AMD (RR 0.90, 95% CI 0.65 to 1.24; moderate-certainty evidence). Only one study (941 participants) reported data separately for neovascular AMD and geographic atrophy. There were 10 cases of neovascular AMD (RR 0.61, 95% CI 0.17 to 2.15; very low-certainty evidence) and 4 cases of geographic atrophy (RR 0.31 95% CI 0.03 to 2.93; very low-certainty evidence). Beta-carotene was associated with increased risk of lung cancer in people who smoked.One study reported the comparison of vitamin C with placebo, and multivitamin (Centrum Silver) versus placebo. This was a study in men in the USA with average treatment duration and follow-up of 8 years for vitamin C and 11 years for multivitamin. Data were available for a total of 14,236 participants. AMD was assessed by self-report followed by medical record review. There was evidence that vitamin C supplementation did not prevent any AMD (RR 0.96, 95% CI 0.79 to 1.18; high-certainty evidence) or late AMD (RR 0.94, 0.61 to 1.46; moderate-certainty evidence). There was a slight increased risk of any AMD (RR 1.21, 95% CI 1.02 to 1.43; moderate-certainty evidence) and late AMD (RR 1.22, 95% CI 0.88 to 1.69; moderate-certainty evidence) in the multivitamin group. Neovascular AMD and geographic atrophy were not reported separately. Adverse effects were not reported but there was possible increased risk of skin rashes in the multivitamin group.Adverse effects were not consistently reported in these eye studies, but there is evidence from other large studies that beta-carotene increases the risk of lung cancer in people who smoke or who have been exposed to asbestos.None of the studies reported quality of life or resource use and costs.

AUTHORS' CONCLUSIONS:

Taking vitamin E or beta-carotene supplements will not prevent or delay the onset of AMD. The same probably applies to vitamin C and the multivitamin (Centrum Silver) investigated in the one trial reported to date. There is no evidence with respect to other antioxidant supplements, such as lutein and zeaxanthin. Although generally regarded as safe, vitamin supplements may have harmful effects, and clear evidence of benefit is needed before they can be recommended. People with AMD should see the related Cochrane Review on antioxidant vitamin and mineral supplements for slowing the progression of AMD, written by the same review team.

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Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration.

Evans JR, Lawrenson JG.

Cochrane Database Syst Rev. 2017 Jul 31;7:CD000254. doi: 10.1002/14651858.CD000254.pub4. [Epub ahead of print] Review.

PMID: 28756618

Abstract

BACKGROUND:

It has been proposed that antioxidants may prevent cellular damage in the retina by reacting with free radicals that are produced in the process of light absorption. Higher dietary levels of antioxidant vitamins and minerals may reduce the risk of progression of age-related macular degeneration (AMD).

OBJECTIVES:

The objective of this review was to assess the effects of antioxidant vitamin or mineral supplementation on the progression of AMD in people with AMD.

SEARCH METHODS:

We searched CENTRAL (2017, Issue 2), MEDLINE Ovid (1946 to March 2017), Embase Ovid (1947 to March 2017), AMED (1985 to March 2017), OpenGrey (System for Information on Grey Literature in Europe, the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 29 March 2017.

SELECTION CRITERIA:

We included randomised controlled trials (RCTs) that compared antioxidant vitamin or mineral supplementation (alone or in combination) to placebo or no intervention, in people with AMD.

DATA COLLECTION AND ANALYSIS:

Both review authors independently assessed risk of bias in the included studies and extracted data. One author entered data into RevMan 5; the other author checked the data entry. We graded the certainty of the evidence using GRADE.

MAIN RESULTS:

We included 19 studies conducted in USA, Europe, China, and Australia. We judged the trials that contributed data to the review to be at low or unclear risk of bias.Nine studies compared multivitamins with placebo (7 studies) or no treatment (2 studies) in people with early and moderate AMD. The duration of supplementation and follow-up ranged from nine months to six years; one trial followed up beyond two years. Most evidence came from the Age-Related Eye Disease Study (AREDS) in the USA. People taking antioxidant vitamins were less likely to progress to late AMD (odds ratio (OR) 0.72, 95% confidence interval (CI) 0.58 to 0.90; 2445 participants; 3 RCTs; moderate-certainty evidence). In people with very early signs of AMD, who are at low risk of progression, this would mean that there would be approximately 4 fewer cases of progression to late AMD for every 1000 people taking vitamins (1 fewer to 6 fewer cases). In people at high risk of progression (i.e. people with moderate AMD) this would correspond to approximately 8 fewer cases of progression for every 100 people taking vitamins (3 fewer to 13 fewer). In one study of 1206 people, there was a lower risk of progression for both neovascular AMD (OR 0.62, 95% CI 0.47 to 0.82; moderate-certainty evidence) and geographic atrophy (OR 0.75, 95% CI 0.51 to 1.10; moderate-certainty evidence) and a lower risk of losing 3 or more lines of visual acuity (OR 0.77, 95% CI 0.62 to 0.96; 1791 participants; moderate-certainty evidence). Low-certainty evidence from one study of 110 people suggested higher quality of life scores (National Eye Institute Visual Function Questionnaire) in treated compared with the non-treated people after 24 months (mean difference (MD) 12.30, 95% CI 4.24 to 20.36). Six studies compared lutein (with or without zeaxanthin) with placebo. The duration of supplementation and follow-up ranged from six months to five years. Most evidence came from the AREDS2 study in the USA. People taking lutein or zeaxanthin may have similar or slightly reduced risk of progression to late AMD (RR 0.94, 95% CI 0.87 to 1.01; 6891 eyes; low-certainty evidence), neovascular AMD (RR 0.92, 95% CI 0.84 to 1.02; 6891 eyes; low-certainty evidence), and geographic atrophy (RR 0.92, 95% CI 0.80 to 1.05; 6891 eyes; low-certainty evidence). A similar risk of progression to visual loss of 15 or more letters was seen in the lutein and control groups (RR 0.98, 95% CI 0.91 to 1.05; 6656 eyes; low-certainty evidence). Quality of life (measured with Visual Function Questionnaire) was similar between groups in one study of 108 participants (MD 1.48, 95% -5.53 to 8.49, moderate-certainty evidence). One study, conducted in Australia, compared vitamin E with placebo. This study randomised 1204 people to vitamin E or placebo, and followed up for four years. Participants were enrolled from the general population; 19% had AMD. The number of late AMD events was low (N = 7) and the estimate of effect was uncertain (RR 1.36, 95% CI 0.31 to 6.05, very low-certainty evidence). There were no data on neovascular AMD or geographic atrophy.There was no evidence of any effect of treatment on visual loss (RR 1.04, 95% CI 0.74 to 1.47, low-certainty evidence). There were no data on quality of life. Five studies compared zinc with placebo. The duration of supplementation and follow-up ranged from six months to seven years. People taking zinc supplements may be less likely to progress to late AMD (OR 0.83, 95% CI 0.70 to 0.98; 3790 participants; 3 RCTs; low-certainty evidence), neovascular AMD (OR 0.76, 95% CI 0.62 to 0.93; 2442 participants; 1 RCT; moderate-certainty evidence), geographic atrophy (OR 0.84, 95% CI 0.64 to 1.10; 2442 participants; 1 RCT; moderate-certainty evidence), or visual loss (OR 0.87, 95% CI 0.75 to 1.00; 3791 participants; 2 RCTs; moderate-certainty evidence). There were no data reported on quality of life.Very low-certainty evidence was available on adverse effects because the included studies were underpowered and adverse effects inconsistently reported.

AUTHORS' CONCLUSIONS:

People with AMD may experience some delay in progression of the disease with multivitamin antioxidant vitamin and mineral supplementation. This finding was largely drawn from one large trial, conducted in a relatively well-nourished American population. We do not know the generalisability of these findings to other populations. Although generally regarded as safe, vitamin supplements may have harmful effects. A systematic review of the evidence on harms of vitamin supplements is needed. Supplements containing lutein and zeaxanthin are heavily marketed for people with age-related macular degeneration but our review shows they may have little or no effect on the progression of AMD.

 

Biotin: From Nutrition to Therapeutics.

Mock DM.

J Nutr. 2017 Jul 12. pii: jn238956. doi: 10.3945/jn.116.238956. [Epub ahead of print] Review.

PMID: 28701385

http://sci-hub.cc/10.3945/jn.116.238956

Abstract

Although frank symptomatic biotin deficiency is rare, some evidence suggests that marginal biotin deficiency occurs spontaneously in a substantial proportion of women during normal human pregnancy and might confer an increased risk of birth defects. Herein I review 1) advances in assessing biotin status, including the relation between acylcarnitine excretion and biotin status; 2) recent studies of biotin status in pregnancy; 3) advances in understanding the role of biotin in gene expression and the potential roles of biotinylated proteins that are neither histones nor carboxylases; and 4) novel large-dose biotin supplementation as therapy for multiple sclerosis. The review concludes with a summary of recent studies that have reported potentially dangerous erroneous results in individuals consuming large amounts of biotin for measurements of various plasma hormones for common clinical assays that use streptavidin-biotin technology.

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https://en.wikipedia.org/wiki/Biotin#Toxicity

"excess biotin accumulation can inhibit endogenous sirtuin activity leading to increased inflammation, cellularity, and collagen deposition, and may be partly responsible for age related metabolic problems. Reversed by calorie restriction in mice.[31]"

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31. Calorie Restriction Prevents Metabolic Aging Caused by Abnormal SIRT1 Function in Adipose Tissues.

Xu C, Cai Y, Fan P, Bai B, Chen J, Deng HB, Che CM, Xu A, Vanhoutte PM, Wang Y.

Diabetes. 2015 May;64(5):1576-90. doi: 10.2337/db14-1180. Epub 2014 Dec 4.

PMID: 25475438 Free Article

http://diabetes.diabetesjournals.org/content/64/5/1576.long

http://diabetes.diabetesjournals.org/content/diabetes/64/5/1576.full.pdf

Abstract

Adipose tissue is a pivotal organ determining longevity, due largely to its role in maintaining whole-body energy homeostasis and insulin sensitivity. SIRT1 is a NAD-dependent protein deacetylase possessing antiaging activities in a wide range of organisms. The current study demonstrates that mice with adipose tissue–selective overexpression of hSIRT1(H363Y), a dominant-negative mutant that disrupts endogenous SIRT1 activity, show accelerated development of metabolic aging. These mice, referred to as Adipo-H363Y, exhibit hyperglycemia, dyslipidemia, ectopic lipid deposition, insulin resistance, and glucose intolerance at a much younger age than their wild-type littermates. The metabolic defects of Adipo-H363Y are associated with abnormal epigenetic modifications and chromatin remodeling in their adipose tissues, as a result of excess accumulation of biotin, which inhibits endogenous SIRT1 activity, leading to increased inflammation, cellularity, and collagen deposition. The enzyme acetyl-CoA carboxylase 2 plays an important role in biotin accumulation within adipose tissues of Adipo-H363Y. Calorie restriction prevents biotin accumulation, abolishes abnormal histone biotinylation, and completely restores the metabolic and adipose functions of Adipo-H363Y. The effects are mimicked by short-term restriction of biotin intake, an approach potentially translatable to humans for maintaining the epigenetic and chromatin remodeling capacity of adipose tissues and preventing aging-associated metabolic disorders.

 

Inclusion of Almonds in a Cholesterol-Lowering Diet Improves Plasma HDL Subspecies and Cholesterol Efflux to Serum in Normal-Weight Individuals with Elevated LDL Cholesterol.

Berryman CE, Fleming JA, Kris-Etherton PM.

J Nutr. 2017 Jun 14. pii: jn245126. doi: 10.3945/jn.116.245126. [Epub ahead of print]

PMID: 28615375 Free Article

http://jn.nutrition.org/content/147/8/1517.long

http://jn.nutrition.org/content/147/8/1517.full.pdf+html

Abstract

Background: Almonds may increase circulating HDL cholesterol when substituted for a high-carbohydrate snack in an isocaloric diet, yet little is known about the effects on HDL biology and function.

Objective: The objective was to determine whether incorporating 43 g almonds/d in a cholesterol-lowering diet would improve HDL subspecies and function, which were secondary study outcomes.

Methods: In a randomized, 2-period, crossover, controlled-feeding study, a diet with 43 g almonds/d (percentage of total energy: 51% carbohydrate, 16% protein, and 32% total and 8% saturated fat) was compared with a similar diet with an isocaloric muffin substitution (58% carbohydrate, 15% protein, and 26% total and 8% saturated fat) in men and women with elevated LDL cholesterol. Plasma HDL subspecies and cholesterol efflux from J774 macrophages to human serum were measured at baseline and after each diet period. Diet effects were examined in all participants (n = 48) and in normal-weight (body mass index: <25; n = 14) and overweight or obese (≥25; n = 34) participants by using linear mixed models.

Results: The almond diet, compared with the control diet, increased α-1 HDL [mean ± SEM: 26.7 ± 1.5 compared with 24.3 ± 1.3 mg apolipoprotein A-I (apoA-I)/dL; P = 0.001]. In normal-weight participants, the almond diet, relative to the control diet, increased α-1 HDL (33.7 ± 3.2 compared with 28.4 ± 2.6 mg apoA-I/dL), the α-1 to pre–β-1 ratio [geometric mean (95% CI): 4.3 (3.3, 5.7) compared with 3.1 (2.4, 4.0)], and non–ATP-binding cassette transporter A1 cholesterol efflux (8.3% ± 0.4% compared with 7.8% ± 0.3%) and decreased pre–β-2 (3.8 ± 0.4 compared with 4.6 ± 0.4 mg apoA-I/dL) and α-3 (23.5 ± 0.9 compared with 26.9 ± 1.1 mg apoA-I/dL) HDL (P < 0.05). No diet effects were observed in the overweight or obese group.

Conclusions: Substituting almonds for a carbohydrate-rich snack within a lower-saturated-fat diet may be a simple strategy to maintain a favorable circulating HDL subpopulation distribution and improve cholesterol efflux in normal-weight individuals with elevated LDL cholesterol.

"Supported by the Almond Board of California."

 

Fructose: back to the future?

Sievenpiper JL.

Am J Clin Nutr. 2017 Jul 19. pii: ajcn161539. doi: 10.3945/ajcn.117.161539. [Epub ahead of print] No abstract available.

PMID: 28724642

http://sci-hub.cc/10.3945/ajcn.117.161539

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Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis.

Evans RA, Frese M, Romero J, Cunningham JH, Mills KE.

Am J Clin Nutr. 2017 Jun 7. pii: ajcn145151. doi: 10.3945/ajcn.116.145151. [Epub ahead of print]

PMID: 28592611

Abstract

Background: Conflicting evidence exists on the effects of fructose consumption in people with type 1 and type 2 diabetes mellitus. No systematic review has addressed the effect of isoenergetic fructose replacement of glucose or sucrose on peak postprandial glucose, insulin, and triglyceride concentrations.Objective: The objective of this study was to review the evidence for postprandial glycemic and insulinemic responses after isoenergetic replacement of either glucose or sucrose in foods or beverages with fructose.Design: We searched the Cochrane Library, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform Search Portal, and clinicaltrials.gov The date of the last search was 26 April 2016. We included randomized controlled trials measuring peak postprandial glycemia after isoenergetic replacement of glucose, sucrose, or both with fructose in healthy adults or children with or without diabetes. The main outcomes analyzed were peak postprandial blood glucose, insulin, and triglyceride concentrations.Results: Replacement of either glucose or sucrose by fructose resulted in significantly lowered peak postprandial blood glucose, particularly in people with prediabetes and type 1 and type 2 diabetes. Similar results were obtained for insulin. Peak postprandial blood triglyceride concentrations did not significantly increase.Conclusions: Strong evidence exists that substituting fructose for glucose or sucrose in food or beverages lowers peak postprandial blood glucose and insulin concentrations. Isoenergetic replacement does not result in a substantial increase in blood triglyceride concentrations.

KEYWORDS:

body weight; diabetes; fructose; glucose; insulin; sucrose; sugar replacement; triglycerides

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Fructose replacement of glucose or sucrose in food or beverages lowers postprandial glucose and insulin without raising triglycerides: a systematic review and meta-analysis.

Evans RA, Frese M, Romero J, Cunningham JH, Mills KE.

Am J Clin Nutr. 2017 Jun 7. pii: ajcn145151. doi: 10.3945/ajcn.116.145151. [Epub ahead of print]

PMID: 28592611

Abstract

Background: Conflicting evidence exists on the effects of fructose consumption in people with type 1 and type 2 diabetes mellitus. No systematic review has addressed the effect of isoenergetic fructose replacement of glucose or sucrose on peak postprandial glucose, insulin, and triglyceride concentrations.Objective: The objective of this study was to review the evidence for postprandial glycemic and insulinemic responses after isoenergetic replacement of either glucose or sucrose in foods or beverages with fructose.Design: We searched the Cochrane Library, MEDLINE, EMBASE, the WHO International Clinical Trials Registry Platform Search Portal, and clinicaltrials.gov The date of the last search was 26 April 2016. We included randomized controlled trials measuring peak postprandial glycemia after isoenergetic replacement of glucose, sucrose, or both with fructose in healthy adults or children with or without diabetes. The main outcomes analyzed were peak postprandial blood glucose, insulin, and triglyceride concentrations.Results: Replacement of either glucose or sucrose by fructose resulted in significantly lowered peak postprandial blood glucose, particularly in people with prediabetes and type 1 and type 2 diabetes. Similar results were obtained for insulin. Peak postprandial blood triglyceride concentrations did not significantly increase.Conclusions: Strong evidence exists that substituting fructose for glucose or sucrose in food or beverages lowers peak postprandial blood glucose and insulin concentrations. Isoenergetic replacement does not result in a substantial increase in blood triglyceride concentrations.

KEYWORDS:

body weight; diabetes; fructose; glucose; insulin; sucrose; sugar replacement; triglycerides

 

Vitamin D and dementia risk: the cause and consequence story

Yong Mao and Haining Yu

Am J Clin Nutr 2017; 106:698 doi:10.3945/ajcn.117.155408

http://ajcn.nutrition.org.sci-hub.cc/lookup/doi/10.3945/ajcn.117.156752

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Reply to Y Mao and H Yu

Liisa Byberg, Erika Olsson, Brita Karlström, Tommy Cederholm, Håkan Melhus, Per Sjögren, and Lena Kilander

Am J Clin Nutr 2017; 106:698-699 doi:10.3945/ajcn.117.156752

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Vitamin D and incident dementia and cognitive impairment

William B Grant

Am J Clin Nutr 2017; 106:699-700 doi:10.3945/ajcn.117.158568

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Reply to WB Grant

Liisa Byberg, Erika Olsson, Brita Karlström, Tommy Cederholm, Håkan Melhus, Per Sjögren, and Lena Kilander

Am J Clin Nutr 2017; 106:700-701 doi:10.3945/ajcn.117.160168

 

Artificially sweetened beverages, sugar-sweetened beverages, plain water, and incident diabetes mellitus in postmenopausal women: the prospective Women's Health Initiative observational study.

Huang M, Quddus A, Stinson L, Shikany JM, Howard BV, Kutob RM, Lu B, Manson JE, Eaton CB.

Am J Clin Nutr. 2017 Jun 28. pii: ajcn145391. doi: 10.3945/ajcn.116.145391. [Epub ahead of print]

PMID: 28659294

Abstract

Background: Sugar-sweetened beverages (SSBs) have been associated with an increased risk of diabetes mellitus (DM), whereas the association with artificially sweetened beverages (ASBs) is unclear.Objective: We aimed to evaluate the associations of ASB and SSB consumption with the risk of developing DM and the potential benefit of replacing SSBs with ASBs or water.Design: The national Women's Health Initiative recruited a large prospective cohort of postmenopausal women between 1993 and 1998. ASB, SSB, and water consumption was measured by lifestyle questionnaires, and DM was self-reported.Results: Of 64,850 women, 4675 developed diabetes over an average of 8.4 y of follow-up. ASBs and SSBs were both associated with an increased risk of DM with an HR of 1.21 (95% CI: 1.08, 1.36) comparing ASB consumption of ≥2 serving/d to never or <3 serving/mo, and an HR of 1.43 (95% CI: 1.17, 1.75) comparing SSB consumption of ≥2 serving/d to <1 serving/wk (1 serving = one 12-ounce can or 355 mL). Subgroup analysis found an increased risk of DM associated with ASBs only in the obese group. Modeling the substitution of SSBs with an equal amount of ASBs did not significantly reduce the risk of developing DM. However, statistically substituting 1 serving of ASBs with water was associated with a significant risk reduction of 5% (HR: 0.95; 95% CI: 0.91, 0.99), whereas substituting 1 serving of SSBs with water was associated with a risk reduction of 10% (HR: 0.90; 95% CI: 0.85, 0.95).Conclusions: ASBs were associated with a 21% increased risk of developing DM, approximately half the magnitude of SSBs (associated with a 43% increased risk). Replacing ASBs and SSBs with water could potentially reduce the risk. However, caution should be taken in interpreting these results as causal because both residual confounding and reverse causation could explain these results.

KEYWORDS:

diabetes mellitus; diet soda; nonnutritive sweeteners; sweetened beverages; sweetening agents

 

Diet, height, and health.

Yeboah J.

Am J Clin Nutr. 2017 Jul 5. pii: ajcn161562. doi: 10.3945/ajcn.117.161562. [Epub ahead of print] No abstract available.

PMID: 28679549

http://sci-hub.cc/10.3945/ajcn.117.161562

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Adult height, dietary patterns, and healthy aging.

Ma W, Hagan KA, Heianza Y, Sun Q, Rimm EB, Qi L.

Am J Clin Nutr. 2017 Jun 7. pii: ajcn147256. doi: 10.3945/ajcn.116.147256. [Epub ahead of print]

PMID: 28592610

http://sci-hub.cc/10.3945/ajcn.116.147256

Abstract

Background: Adult height has shown directionally diverse associations with several age-related disorders, including cardiovascular disease, cancer, decline in cognitive function, and mortality.Objectives: We investigated the associations of adult height with healthy aging measured by a full spectrum of health outcomes, including incidence of chronic diseases, memory, physical functioning, and mental health, among populations who have survived to older age, and whether lifestyle factors modified such relations.Design: We included 52,135 women (mean age: 44.2 y) from the Nurses' Health Study without chronic diseases in 1980 and whose health status was available in 2012. Healthy aging was defined as being free of 11 major chronic diseases and having no reported impairment of subjective memory, physical impairment, or mental health limitations.Results: Of all eligible study participants, 6877 (13.2%) were classified as healthy agers. After adjustment for demographic and lifestyle factors, we observed an 8% (95% CI: 6%, 11%) decrease in the odds of healthy aging per SD (0.062 m) increase in height. Compared with the lowest category of height (≤1.57 m), the OR of achieving healthy aging in the highest category (≥1.70 m) was 0.80 (95% CI: 0.73, 0.87; P-trend < 0.001). In addition, we found a significant interaction of height with a prudent dietary pattern in relation to healthy aging (P-interaction = 0.005), and among the individual dietary factors characterizing the prudent dietary pattern, fruit and vegetable intake showed the strongest effect modification (P-interaction = 0.01). The association of greater height with reduced odds of healthy aging appeared to be more evident among women with higher adherence to the prudent dietary pattern rich in vegetable and fruit intake.Conclusions: Greater height was associated with a modest decrease in the likelihood of healthy aging. A prudent diet rich in fruit and vegetables might modify the relation.

KEYWORDS:

adult height; dietary pattern; fruit and vegetables; healthy aging; lifestyle

 

Differences in genetic and environmental variation in adult body mass index by sex, age, time period, and region: an individual-based pooled analysis of 40 twin cohorts.

Silventoinen K, Jelenkovic A, Sund R, Yokoyama Y, Hur YM, Cozen W, Hwang AE, Mack TM, Honda C, Inui F, Iwatani Y, Watanabe M, Tomizawa R, Pietiläinen KH, Rissanen A, Siribaddana SH, Hotopf M, Sumathipala A, Rijsdijk F, Tan Q, Zhang D, Pang Z, Piirtola M, Aaltonen S, Öncel SY, Aliev F, Rebato E, Hjelmborg JB, Christensen K, Skytthe A, Kyvik KO, Silberg JL, Eaves LJ, Cutler TL, Ordoñana JR, Sánchez-Romera JF, Colodro-Conde L, Song YM, Yang S, Lee K, Franz CE, Kremen WS, Lyons MJ, Busjahn A, Nelson TL, Whitfield KE, Kandler C, Jang KL, Gatz M, Butler DA, Stazi MA, Fagnani C, D'Ippolito C, Duncan GE, Buchwald D, Martin NG, Medland SE, Montgomery GW, Jeong HU, Swan GE, Krasnow R, Magnusson PK, Pedersen NL, Dahl Aslan AK, McAdams TA, Eley TC, Gregory AM, Tynelius P, Baker LA, Tuvblad C, Bayasgalan G, Narandalai D, Spector TD, Mangino M, Lachance G, Burt SA, Klump KL, Harris JR, Brandt I, Nilsen TS, Krueger RF, McGue M, Pahlen S, Corley RP, Huibregtse BM, Bartels M, van Beijsterveldt CE, Willemsen G, Goldberg JH, Rasmussen F, Tarnoki AD, Tarnoki DL, Derom CA, Vlietinck RF, Loos RJ, Hopper JL, Sung J, Maes HH, Turkheimer E, Boomsma DI, Sørensen TI, Kaprio J.

Am J Clin Nutr. 2017 Jul 5. pii: ajcn153643. doi: 10.3945/ajcn.117.153643. [Epub ahead of print]

PMID: 28679550

Abstract

Background: Genes and the environment contribute to variation in adult body mass index [bMI (in kg/m2)], but factors modifying these variance components are poorly understood.Objective: We analyzed genetic and environmental variation in BMI between men and women from young adulthood to old age from the 1940s to the 2000s and between cultural-geographic regions representing high (North America and Australia), moderate (Europe), and low (East Asia) prevalence of obesity.Design: We used genetic structural equation modeling to analyze BMI in twins ≥20 y of age from 40 cohorts representing 20 countries (140,379 complete twin pairs).Results: The heritability of BMI decreased from 0.77 (95% CI: 0.77, 0.78) and 0.75 (95% CI: 0.74, 0.75) in men and women 20-29 y of age to 0.57 (95% CI: 0.54, 0.60) and 0.59 (95% CI: 0.53, 0.65) in men 70-79 y of age and women 80 y of age, respectively. The relative influence of unique environmental factors correspondingly increased. Differences in the sets of genes affecting BMI in men and women increased from 20-29 to 60-69 y of age. Mean BMI and variances in BMI increased from the 1940s to the 2000s and were greatest in North America and Australia, followed by Europe and East Asia. However, heritability estimates were largely similar over measurement years and between regions. There was no evidence of environmental factors shared by co-twins affecting BMI.Conclusions: The heritability of BMI decreased and differences in the sets of genes affecting BMI in men and women increased from young adulthood to old age. The heritability of BMI was largely similar between cultural-geographic regions and measurement years, despite large differences in mean BMI and variances in BMI. Our results show a strong influence of genetic factors on BMI, especially in early adulthood, regardless of the obesity level in the population.

KEYWORDS:

BMI; adults; genetics; international comparisons; twins

 

Pretreatment fasting plasma glucose and insulin modify dietary weight loss success: results from 3 randomized clinical trials.

Hjorth MF, Ritz C, Blaak EE, Saris WH, Langin D, Poulsen SK, Larsen TM, Sørensen TI, Zohar Y, Astrup A.

Am J Clin Nutr. 2017 Jul 5. pii: ajcn155200. doi: 10.3945/ajcn.117.155200. [Epub ahead of print]

PMID: 28679551

Abstract

Background: Which diet is optimal for weight loss and maintenance remains controversial and implies that no diet fits all patients.Objective: We studied concentrations of fasting plasma glucose (FPG) and fasting insulin (FI) as prognostic markers for successful weight loss and maintenance through diets with different glycemic loads or different fiber and whole-grain content, assessed in 3 randomized trials of overweight participants.Design: After an 8-wk weight loss, participants in the DiOGenes (Diet, Obesity, and Genes) trial consumed ad libitum for 26 wk a diet with either a high or a low glycemic load. Participants in the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) Supermarket intervention (SHOPUS) trial consumed ad libitum for 26 wk the New Nordic Diet, which is high in fiber and whole grains, or a control diet. Participants in the NUGENOB (Nutrient-Gene Interactions in Human Obesity) trial consumed a hypocaloric low-fat and high-carbohydrate or a high-fat and low-carbohydrate diet for 10 wk. On the basis of FPG before treatment, participants were categorized as normoglycemic (FPG <5.6 mmol/L), prediabetic (FPG 5.6-6.9 mmol/L), or diabetic (FPG ≥7.0 mmol/L). Modifications of the dietary effects of FPG and FI before treatment were examined with linear mixed models.Results: In the DiOGenes trial, prediabetic individuals regained a mean of 5.83 kg (95% CI: 3.34, 8.32 kg; P < 0.001) more on the high- than on the low-glycemic load diet, whereas normoglycemic individuals regained a mean of 1.44 kg (95% CI: 0.48, 2.41 kg; P = 0.003) more [mean group difference: 4.39 kg (95% CI: 1.76, 7.02 kg); P = 0.001]. In SHOPUS, prediabetic individuals lost a mean of 6.04 kg (95% CI: 4.05, 8.02 kg; P < 0.001) more on the New Nordic Diet than on the control diet, whereas normoglycemic individuals lost a mean of 2.20 kg (95% CI: 1.21, 3.18 kg; P < 0.001) more [mean group difference: 3.84 kg (95% CI: 1.62, 6.06 kg); P = 0.001]. In NUGENOB, diabetic individuals lost a mean of 2.04 kg (95% CI: -0.20, 4.28 kg; P = 0.07) more on the high-fat and low-carbohydrate diet than on the low-fat and high-carbohydrate diet, whereas normoglycemic individuals lost a mean of 0.43 kg (95% CI: 0.03, 0.83 kg; P = 0.03) more on the low-fat and high-carbohydrate diet [mean group difference: 2.47 kg (95% CI: 0.20, 4.75 kg); P = 0.03]. The addition of FI strengthened these associations.Conclusion: Elevated FPG before treatment indicates success with dietary weight loss and maintenance among overweight patients consuming diets with a low glycemic load or with large amounts of fiber and whole grains.

KEYWORDS:

diabetes; fiber; glucose; glycemic index; glycemic load; insulin; personalized nutrition; precision medicine; prediabetes; weight

 

https://www.nytimes.com/2017/04/12/well/move/an-hour-of-running-may-add-seven-hours-to-your-life.html?sl_rec=mostpopular_sample_dedup&contentCollection=smarter-living&mData=articles%5B%5D%3Dhttps%3A%2F%2Fwww.nytimes.com%2F2017%2F07%2F30%2Fsmarter-living%2Fno-its-not-too-late-theres-only-one-real-finish-line-in-life.html%3Fsl_rec%3Dmostpopular_sample_dedup%26articles%5B%5D%3Dhttps%3A%2F%2Fwww.nytimes.com%2F2017%2F04%2F12%2Fwell%2Fmove%2Fan-hour-of-running-may-add-seven-hours-to-your-life.html%3Fsl_rec%3Dmostpopular_sample_dedup&hp&action=click&pgtype=Homepage&clickSource=story-heading&module=smarterLiving-promo-region&region=smarterLiving-promo-region&WT.nav=smarterLiving-promo-region

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Running as a Key Lifestyle Medicine for Longevity.

Lee DC, Brellenthin AG, Thompson PD, Sui X, Lee IM, Lavie CJ.

Prog Cardiovasc Dis. 2017 Mar 30. pii: S0033-0620(17)30048-8. doi: 10.1016/j.pcad.2017.03.005. [Epub ahead of print] Review.

PMID: 28365296

Abstract

Running is a popular and convenient leisure-time physical activity (PA) with a significant impact on longevity. In general, runners have a 25%-40% reduced risk of premature mortality and live approximately 3 years longer than non-runners. Recently, specific questions have emerged regarding the extent of the health benefits of running versus other types of PA, and perhaps more critically, whether there are diminishing returns on health and mortality outcomes with higher amounts of running. This review details the findings surrounding the impact of running on various health outcomes and premature mortality, highlights plausible underlying mechanisms linking running with chronic disease prevention and longevity, identifies the estimated additional life expectancy among runners and other active individuals, and discusses whether there is adequate evidence to suggest that longevity benefits are attenuated with higher doses of running.

KEYWORDS:

Cardiovascular disease; Exercise; Mortality; Physical activity; Running

Edited by AlPater

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Anticholinergic burden and health outcomes among older adults discharged from hospital: results from the CRIME study.

Gutiérrez-Valencia M, Martínez-Velilla N, Vetrano DL, Corsonello A, Lattanzio F, Ladrón-Arana S, Onder G.

Eur J Clin Pharmacol. 2017 Aug 1. doi: 10.1007/s00228-017-2312-5. [Epub ahead of print]

PMID: 28766100

Abstract

PURPOSE:

The purpose of this study is to investigate whether there is an association between anticholinergic burden and mortality or rehospitalization in older adults discharged from hospital.

METHODS:

Prospective multicenter cohort study carried out with patients aged 65 and older discharged from seven acute care hospitals. The primary outcomes of the study were rehospitalization and mortality within 1 year after discharge. The study population was classified in three groups according to the anticholinergic exposure measured by the Anticholinergic Risk Scale (ARS) and Durán's list at the time of hospital discharge: without risk (ARS/Durán = 0), low risk (ARS/Durán = 1), and high risk (ARS/Durán ≥ 2). Predictors of hospitalizations and mortality were examined using regression models adjusting for important covariates.

RESULTS:

The mean age of the 921 participants was 81.2 years (SD = 7.4 years). Prevalence of exposure to medications with anticholinergic activity ranged from 19.6% with ARS to 32.1% with Durán's list. During the follow-up period, 30.4% of participants were hospitalized and 19.4% died. Multivariate regression analysis showed that low anticholinergic burden quantified according to Durán's list was significantly associated with all-cause mortality (OR 1.69, 95% CI 1.02-2.82). This association was not present after adjustment when using ARS. No statistically significant association was found between anticholinergic burden and hospitalizations.

CONCLUSIONS:

Taking medications with anticholinergic activity is associated with greater risk of mortality in older adults discharged from acute care hospitals. Strategies to reduce anticholinergic burden in vulnerable elders could be useful to improve health outcomes. Further research is required to assess the association between anticholinergic burden and hospitalizations in older patients.

KEYWORDS:

Adverse drug events; Anticholinergic burden; Elderly; Hospitalization; Mortality

 

Neighbouring green space and mortality in community-dwelling elderly Hong Kong Chinese: a cohort study.

Wang D, Lau KK, Yu R, Wong SYS, Kwok TTY, Woo J.

BMJ Open. 2017 Aug 1;7(7):e015794. doi: 10.1136/bmjopen-2016-015794.

PMID: 28765127

Abstract

OBJECTIVE:

Green space has been shown to be beneficial for human wellness through multiple pathways. This study aimed to explore the contributions of neighbouring green space to cause-specific mortality.

METHODS:

Data from 3544 Chinese men and women (aged ≥65 years at baseline) in a community-based cohort study were analysed. Outcome measures, identified from the death registry, were death from all-cause, respiratory system disease, circulatory system disease. The quantity of green space (%) within a 300 m radius buffer was calculated for each subject from a map created based on the Normalised Difference Vegetation Index. Cox proportional hazard models adjusted for demographics, socioeconomics, lifestyle, health conditions and housing type were used to estimate the HRs and 95% CIs.

RESULTS:

During a mean of 10.3 years of follow-up, 795 deaths were identified. Our findings showed that a 10% increase in coverage of green space was significantly associated with a reduction in all-cause mortality (HR 0.963, 95% CI 0.930 to 0.998), circulatory system-caused mortality (HR 0.887, 95% CI 0.817 to 0.963) and stroke-caused mortality (HR 0.661, 95% CI 0.524 to 0.835), independent of age, sex, marital status, years lived in Hong Kong, education level, socioeconomic ladder, smoking, alcohol intake, diet quality, self-rated health and housing type. The inverse associations between coverage of green space with all-cause mortality (HR 0.964, 95% CI 0.931 to 0.999) and circulatory system disease-caused mortality (HR 0.888, 95% CI 0.817 to 0.964) were attenuated when the models were further adjusted for physical activity and cognitive function. The effects of green space on all-cause and circulatory system-caused mortality tended to be stronger in females than in males.

CONCLUSION:

Higher coverage of green space was associated with reduced risks of all-cause mortality, circulatory system-caused mortality and stroke-caused mortality in Chinese older people living in a highly urbanised city.

KEYWORDS:

Age-friendly; Ageing in place; Elderly; Green space; Mortality; NDVI.

 

Association of Blood Pressure Control Level With Left Ventricular Morphology and Function and With Subclinical Cerebrovascular Disease.

Nakanishi K, Jin Z, Homma S, Elkind MSV, Rundek T, Tugcu A, Sacco RL, Di Tullio MR.

J Am Heart Assoc. 2017 Jul 30;6(8). pii: e006246. doi: 10.1161/JAHA.117.006246.

PMID: 28757483 Free Article

Abstract

BACKGROUND:

Left ventricular (LV) hypertrophy and subclinical cerebrovascular disease are early manifestations of cardiac and brain target organ damage caused by hypertension. This study aimed to investigate whether intensive office systolic blood pressure (SBP) control has beneficial effects on LV morphology and function and subclinical cerebrovascular disease in elderly patients with hypertension.

METHODS AND RESULTS:

We examined 420 patients treated for hypertension without history of heart failure and stroke from the CABL (Cardiovascular Abnormalities and Brain Lesions) study. All patients underwent 2-dimensional echocardiographic examination and brain magnetic resonance imaging. Subclinical cerebrovascular disease was defined as silent brain infarcts and white matter hyperintensity volume. Patients were divided into 3 groups: SBP <120 mm Hg (intensive control); SBP 120 to 139 mm Hg (less intensive control); and SBP ≥140 mm Hg (uncontrolled). Prevalence of LV hypertrophy and diastolic dysfunction were lowest in the intensive control, intermediate in the less intensive control, and highest in the uncontrolled groups (12.8%, 31.8%, and 44.7%, respectively [P<0.001], for LV hypertrophy; 46.8%, 61.7%, and 72.6%, respectively [P=0.003], for diastolic dysfunction). Patients with less intensive SBP control had greater risk of LV hypertrophy than those with intensive control (adjusted odds ratio, 3.26; P=0.013). A similar trend was observed for LV diastolic dysfunction but did not reach statistical significance (adjusted odds ratio, 1.65; P=0.144). Conversely, intensive SBP control was not significantly associated with reduced risk of silent brain infarcts and white matter hyperintensity volume compared with less intensive control.

CONCLUSIONS:

Compared with less intensive control, intensive SBP control may have a stronger beneficial effect on cardiac than cerebral subclinical disease.

KEYWORDS:

blood pressure; hypertension; left ventricular diastolic dysfunction; left ventricular hypertrophy; silent brain infarction

 

Time-Restricted Feeding Shifts the Skin Circadian Clock and Alters UVB-Induced DNA Damage.

Wang H, van Spyk E, Liu Q, Geyfman M, Salmans ML, Kumar V, Ihler A, Li N, Takahashi JS, Andersen B.

Cell Rep. 2017 Aug 1;20(5):1061-1072. doi: 10.1016/j.celrep.2017.07.022.

PMID: 28768192

http://www.cell.com/cell-reports/fulltext/S2211-1247(17)30988-9

http://www.cell.com/cell-reports/pdf/S2211-1247(17)30988-9.pdf

Abstract

The epidermis is a highly regenerative barrier protecting organisms from environmental insults, including UV radiation, the main cause of skin cancer and skin aging. Here, we show that time-restricted feeding (RF) shifts the phase and alters the amplitude of the skin circadian clock and affects the expression of approximately 10% of the skin transcriptome. Furthermore, a large number of skin-expressed genes are acutely regulated by food intake. Although the circadian clock is required for daily rhythms in DNA synthesis in epidermal progenitor cells, RF-induced shifts in clock phase do not alter the phase of DNA synthesis. However, RF alters both diurnal sensitivity to UVB-induced DNA damage and expression of the key DNA repair gene, Xpa. Together, our findings indicate regulation of skin function by time of feeding and emphasize a link between circadian rhythm, food intake, and skin health.

KEYWORDS:

DNA damage; aging; cell cycle; circadian clock; metabolism; skin; time-restricted feeding

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The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients.

Yang MH, Kang SY, Lee JA, Kim YS, Sung EJ, Lee KY, Kim JS, Oh HJ, Kang HC, Lee SY.

Korean J Fam Med. 2017 Jul;38(4):173-180. doi: 10.4082/kjfm.2017.38.4.173. Epub 2017 Jul 20.

PMID: 28775806

Abstract

BACKGROUND:

Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents.

METHODS:

This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic.

RESULTS:

Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control.

CONCLUSION:

Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

KEYWORDS:

Hypertension; Lifestyle Change; Physical Activity; Salt Intake

 

Blood Pressure Targets in the Hypertensive Elderly.

Liu P, Zheng JG.

Chin Med J (Engl). 2017 Aug 20;130(16):1968-1972. doi: 10.4103/0366-6999.211885. Review.

PMID: 28776550

Abstract

OBJECTIVE:

Hypertension is an important risk factor of cardiovascular disease and increases mortality in the elderly. However, the available medical evidences are both inconsistent and insufficient regarding establishing credible and useful blood pressure (BP) targets in the hypertensive elderly. This review summarizes the existing evidences used for establishing optimal BP targets for this patient population and points out some data inconsistencies which have added to the uncertainty.

DATA SOURCES:

We conducted a search for the articles published in English in the PubMed database up to March 2017, with the keywords "hypertension," "elderly," "blood pressure," and "antihypertensive."

STUDY SELECTION:

Articles that related to BP targeting in the hypertensive elderly were selected for this review.

RESULTS:

The selected studies indicated that antihypertensive therapy can substantially reduce the risk of cardiovascular events and mortality, for a subset of the elderly (60 years or older) with systolic BP> 160 mmHg. Studies regarding more strict targets yielded mixed findings. For the very old and frail patients (80 years or older), there is a lack of evidence that optimal BP targets and intensive antihypertensives are helpful but in fact may be harmful.

CONCLUSIONS:

There are solid evidences that patients who are 60-80 years old and in good health have benefited from lowering their BP to below 150/90 mmHg. If well tolerated, the BP target can be further lowered to below 140/90 mmHg. However, for the very old and frail, individualized and careful assessment is crucial. Antihypertensive treatment should be cautious and the adverse effect of drugs requires close monitoring as such treatment can be counterproductive.

 

The combined effect of Sango sprout juice and caloric restriction on metabolic disorders and gut microbiota composition in an obesity model.

Vivarelli F, Canistro D, Babot Marquillas C, Cirillo S, De Nicola GR, Iori R, Biagi G, Pinna C, Gentilini F, Pozzo L, Longo V, Paolini M.

Int J Food Sci Nutr. 2017 Aug 3:1-13. doi: 10.1080/09637486.2017.1350940. [Epub ahead of print]

PMID: 28770644

Abstract

The main purpose of this study was to compare the benefits of SSJ supplementation in obese rats with those achieved only by switching the alimentary regimen from high-fat (HFD) to the regular one (RD) in liver, ileum and prostate. Furthermore, changings in caecal chime microbiota were investigated. SSJ was administered to rats in combination with a RD (HFD-RD + SSJ). The switch from HFD to RD led to a weight loss of almost 9.8 g, and the total cholesterol was found to be significantly lower. In the HFD-RD + SSJ group, all values were improved compared with the HFD control, and the weight decrement was higher (-23.29 g) with respect to HFD-RD. HFD led to a widespread increment of oxidative stress (OS) markers in liver, ileum and prostate. SSJ has shown to improve the results achieved by the suspension of HFD and it has proven effective wherever the only switch in diet regimen failed.

KEYWORDS:

Raphanus sativus; Sango; anti-obesity; antioxidants; microbiota

 

The ω-3 fatty acid α-linolenic acid extends Caenorhabditis elegans lifespan via NHR-49/PPARα and oxidation to oxylipins.

Qi W, Gutierrez GE, Gao X, Dixon H, McDonough JA, Marini AM, Fisher AL.

Aging Cell. 2017 Aug 3. doi: 10.1111/acel.12651. [Epub ahead of print]

PMID: 28772063

http://onlinelibrary.wiley.com/doi/10.1111/acel.12651/full

http://onlinelibrary.wiley.com/doi/10.1111/acel.12651/epdf

Abstract

The dietary intake of ω-3 polyunsaturated fatty acids has been linked to a reduction in the incidence of aging-associated disease including cardiovascular disease and stroke. Additionally, long-lived Caenorhabditis elegans glp-1 germ line-less mutant animals show a number of changes in lipid metabolism including the increased production of the ω-3 fatty acid, α-linolenic acid (ALA). Here, we show that the treatment of C. elegans with ALA produces a dose-dependent increase in lifespan. The increased longevity of the glp-1 mutant animals is known to be dependent on both the NHR-49/PPARα and SKN-1/Nrf2 transcription factors, although the mechanisms involved are incompletely understood. We find that ALA treatment increased the lifespan of wild-type worms and that these effects required both of these transcription factors. Specifically, NHR-49 was activated by ALA to promote the expression of genes involved in the β-oxidation of lipids, whereas SKN-1 is not directly activated by ALA, but instead, the exposure of ALA to air results in the oxidation of ALA to a group of compounds termed oxylipins. At least one of the oxylipins activates SKN-1 and enhances the increased longevity resulting from ALA treatment. The results show that ω-3 fatty acids inhibit aging and that these effects could reflect the combined effects of the ω-3 fatty acid and the oxylipin metabolites. The benefits of ω-3 fatty acid consumption on human health may similarly involve the production of oxylipins, and differences in oxylipin conversion could account for at least part of the variability found between observational vs. interventional clinical trials.

KEYWORDS:

Caenorhabditis elegans ; NHR-49; SKN-1; aging; oxylipin; ω-3 fatty acids

 

Treatment of Cholesterol in 2017.

Krumholz HM.

JAMA. 2017 Aug 1;318(5):417-418. doi: 10.1001/jama.2017.6753. No abstract available.

PMID: 28738130

http://jamanetwork.com/journals/jama/fullarticle/2645740

 

The Scientist » News & Opinion » News Analysis

Company Sells a “Biological Age” Kit

While the epigenetic clock is a useful tool for research and has solid scientific backing, scientists say the product’s use to consumers is limited.

By Diana Kwon | August 2, 2017

http://www.the-scientist.com/?articles.view/articleNo/50011/title/Company-Sells-a--Biological-Age--Kit/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=54971783&_hsenc=p2ANqtz--miJUVamIhZYE9LPNM1LDhhhV4qfX7iXgE2-VePffTjQ_y_itQfJvnJmeZnVtcxg7q8mvb32iGD7TXaGVUxepHOJElQQ&_hsmi=54971783

 

Association between coffee or tea drinking and Barrett's esophagus or esophagitis: an Italian study.

Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, Foti M, Laterza F, D'Onofrio V, Iaquinto G, Conio M.

Eur J Clin Nutr. 2017 Aug;71(8):980-986. doi: 10.1038/ejcn.2017.64. Epub 2017 May 10.

PMID: 28488688

Abstract

BACKGROUND/OBJECTIVES:

Only a few papers have treated of the relationship between Barrett's esophagus (BE) or erosive esophagitis (E) and coffee or tea intake. We evaluated the role of these beverages in BE and E occurrence.

SUBJECTS/METHODS:

Patients with BE (339), E (462) and controls (619) were recruited. Data on coffee and tea and other individual characteristics were collected using a structured questionnaire.

RESULTS:

BE risk was higher in former coffee drinkers, irrespective of levels of exposure (cup per day; ⩽1: OR=3.76, 95% CI 1.33-10.6; >1: OR=3.79, 95% CI 1.31-11.0; test for linear trend (TLT) P=0.006) and was higher with duration (>30 years: OR=4.18, 95% CI 1.43-12.3; TLT P=0.004) and for late quitters, respectively (⩽3 years from cessation: OR=5.95, 95% CI 2.19-16.2; TLT P<0.001). The risk of BE was also higher in subjects who started drinking coffee later (age >18 years: OR=6.10, 95% CI 2.15-17.3). No association was found in current drinkers, but for an increased risk of E in light drinkers (<1 cup per day OR =1.85, 95% CI 1.00-3.43).A discernible risk reduction of E (about 20%, not significant) and BE (about 30%, P<0.05) was observed in tea drinkers.

CONCLUSIONS:

Our data were suggestive of a reduced risk of BE and E with tea intake. An adverse effect of coffee was found among BE patients who had stopped drinking coffee. Coffee or tea intakes could be indicative of other lifestyle habits with protective or adverse impact on esophageal mucosa.

 

Elif Inan Eroglu, Zehra Buyuktuncer, (2017)

The effect of various cooking methods on resistant starch content of foods

Nutrition & Food Science, Vol. 47 Issue: 4, pp.522-533, https://doi.org/10.1108/NFS-10-2016-0154

http://sci-hub.cc/10.1108/NFS-10-2016-0154

Abstract:

Purpose

Resistant starch, defined as all starch and starch-degradation products not absorbed by small intestine of healthy individuals, is included in the diet of individuals due to its prebiotic characteristics and protective effects against diseases like colon cancer, type II diabetes, obesity and cardiovascular diseases. Some cooking methods are known as effective on resistant starch content of foods. The purpose of this paper is to explore the effect of various cooking methods on resistant starch content of foods.

Design/methodology/approach

Potential health benefits and functional features of the resistant starch have been emphasized in the recent years. This review includes up-to-date scientific findings in different studies on the effect of various cooking methods on resistant starch content of foods. Advantages and nutritional quality of resistant starch are included to topic.

Findings

Cooking methods including baking, steaming and autoclave cooking increased the amount of the resistant starch of foods, but cooking method such as pressure cooking decreased the amount of the resistant starch of foods. Boiling, frying, microwave cooking and extrusion cooking have the potential of increasing the amount of resistant starch, which depends on the source of starch and the process conditions. Although frying method has a high potential to increase the resistant starch content of foods, it is inconvenient to recommend frying to modify resistant starch content of foods due to detrimental effects of frying and products on health.

Originality/value

This paper focuses on the effects of various cooking methods on resistant starch content of foods, which offers a promising future for the inartificial development of the prebiotic content of diet. Due to its potential health benefits, appropriate cooking methods should be preferred to increase resistant starch content of foods.

Keywords:

Dietary intake, Resistant starch, Cooking methods

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Association between alcohol consumption pattern and the incidence risk of type 2 diabetes in Korean men: A 12-years follow-up study.

Lee DY, Yoo MG, Kim HJ, Jang HB, Kim JH, Lee HJ, Park SI.

Sci Rep. 2017 Aug 4;7(1):7322. doi: 10.1038/s41598-017-07549-2.

PMID: 28779170

https://www.nature.com/articles/s41598-017-07549-2

https://www.nature.com/articles/s41598-017-07549-2.pdf

Abstract

Moderate alcohol consumption is generally associated with reduced risk of type 2 diabetes. However, this beneficial effects of alcohol intake remains controversial due to inconsistent results across studies. The analysis was performed using data from the Ansung-Ansan cohort study. We categorized the participants into four groups-based on the baseline (one-point measure; non-drinking, <5 g/day, ≥5, <30 g/day, and ≥30 g/day) and follow-up (consumption pattern; never-drinking, light, moderate, and heavy drinking) measurement. At baseline, ≥30 g/day alcohol consumption increased the risk of incident diabetes (HR: 1.42; 95% CI, 1.10-1.85), but ≥5, <30 g/day alcohol consumption had no effects on the incident diabetes. Meanwhile, when using the alcohol consumption pattern, a heavy-drinking pattern increased the risk of incident diabetes (HR = 1.32, 1.01-1.73), but the light and moderate consumption pattern was associated with a reduced risk of type 2 diabetes (HR: 0.66; 0.50-0.87 and HR: 0.74; 0.57-0.95, respectively). At the end point of follow-up, the insulinogenic index (IGI), but not the insulin sensitivity index (ISI), differed among the groups. Alcohol consumption pattern had a J-shaped association with the incident type 2 diabetes in Korean men. The IGI showed an inverted J-shaped association according to alcohol drinking pattern, but the ISI was not a J-shape.

 

Effect of carbohydrate and protein solutions consumed during a moderate-intensity exercise on post-exercise appetite.

Sun FH, Gang-Yan S.

Physiol Behav. 2017 Aug 1. pii: S0031-9384(16)30676-X. doi: 10.1016/j.physbeh.2017.07.030. [Epub ahead of print]

PMID: 28778550

Abstract

This study aimed to investigate whether co-ingestion of carbohydrate and protein during exercise affect the post-exercise ad libitum food intake. Twelve healthy active male participants (mean±SD, age: 20±1; height: 176±6cm; weight: 63.6±5.3kg; VO2peak: 51.2±7.1ml/kg/min) completed three main experimental trials in a randomized cross-over design. In each trial, the participants completed 1h of ergometer cycling at 60% VO2peak, followed by 2h recovery. The participants were required to consume one of three solutions every 15min during exercise: distilled water (DW), carbohydrate-electrolyte solution (CE), and carbohydrate-electrolyte-protein solution (CEP). The energy content was matched between the two latter solutions. The CHO-to-protein ration in CEP was 2:1. At the end of recovery period, participants were provided with pizza lunch ad libitum, and the amount consumed was recorded. Several subjective feelings including appetite scores and blood glucose were determined during the experimental trials. No differences were found in either the amount of consumed pizza (DW vs. CE vs. CEP: 607±128 vs. 592±119 vs. 599±125g, P=0.845) or the appetite score before pizza was consumed (DW vs. CE vs. CEP: 14±9 vs. 12±14 vs. 14±10, P=0.357) among the three trials. The blood glucose concentrations during exercise were higher in the CE and CEP trials than in the DW trial. In conclusion, different solutions consumed during a 1h moderate-intensity exercise in the present study did not affect post-exercise appetite.

KEYWORDS:

Ad libitum food intake; Appetite score; Carbohydrate electrolyte solution; Protein solution

 

Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium.

Bamia C, Orfanos P, Juerges H, Schöttker B, Brenner H, Lorbeer R, Aadahl M, Matthews CE, Klinaki E, Katsoulis M, Lagiou P, Bueno-de-Mesquita HBA, Eriksson S, Mons U, Saum KU, Kubinova R, Pajak A, Tamosiunas A, Malyutina S, Gardiner J, Peasey A, de Groot LC, Wilsgaard T, Boffetta P, Trichopoulou A, Trichopoulos D.

Maturitas. 2017 Sep;103:37-44. doi: 10.1016/j.maturitas.2017.06.023. Epub 2017 Jun 17.

PMID: 28778331

http://sci-hub.cc/10.1016/j.maturitas.2017.06.023

Abstract

OBJECTIVES:

To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as "at-least-good".

STUDY DESIGN:

Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982-2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.

MAIN OUTCOME MEASURES:

All-cause, cardiovascular and cancer mortality.

RESULTS:

Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH "fair" or "poor" vs. "at-least-good" was associated with increased mortality: HRs 1.46 (95% CI 1·23-1.74) and 2.31 (1.79-2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).

CONCLUSION:

SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to "feel healthy" and "be healthy".

KEYWORDS:

Ageing; All-cause mortality; CHANCES; Cohort; Elderly; Self-rated health

 

Sarcopenia as a predictor of all-cause mortality among community-dwelling older people: A systematic review and meta-analysis.

Liu P, Hao Q, Hai S, Wang H, Cao L, Dong B.

Maturitas. 2017 Sep;103:16-22. doi: 10.1016/j.maturitas.2017.04.007. Epub 2017 Apr 11. Review.

PMID: 28778327

http://sci-hub.cc/10.1016/j.maturitas.2017.04.007

Abstract

The aim of this systematic review and meta-analysis was to examine the association between sarcopenia and all-cause mortality among community-dwelling older people. A systematic review was performed using three electronic databases (EMBASE, MEDLINE and the Cochrane Library) to identify prospective cohort studies from January 2009 to February 2017 examining sarcopenia as a predictor of all-cause mortality among community-dwelling older people. We conducted a pooled analysis of mortality associated with sarcopenia, and subgroup analyses based on measurements of muscle mass and length of follow-up by employing a random-effects model. Sensitivity analyses were performed evaluate the cause of high heterogeneity. In addition, methodological quality, heterogeneity and publication bias were evaluated. Of 1703 studies identified, 6 studies incorporating 7367 individuals were included in the meta-analysis for all-cause mortality. The pooled hazard ratios (HRs) of all-cause mortality from the combination of included studies suggested participants with sarcopenia had a significantly higher rate of mortality (pooled HR 1.60, 95%CI 1.24-2.06, I2=27.8%, p=0.216) than participants without sarcopenia. The subgroup analysis for length of follow-up suggested studies with a follow-up period of less than 5 years found a higher risk of all-cause mortality (pooled HR 2.09, 95%CI 1.21-3.60) than studies with a follow-up period of 5 years or more (pooled HR 1.52, 95%CI 1.14-2.01). A subgroup of anthropometric measures was found to identify higher mortality risks (pooled HR 2.26, 95%CI 1.30-3.92) than a subgroup of dual-energy x-ray (DXA) absorptiometry (pooled HR 1.82, 95%CI 1.04-3.18) factors or a subgroup of bioelectrical impedance analysis (BIA) factors (pooled HR 1.31, 95%CI 1.15-1.49). Sarcopenia is a predictor of all-cause mortality among community-dwelling older people. Therefore, it is important to diagnose sarcopenia and to intervene, in order to reduce mortality rates in the elderly.

KEYWORDS:

All-cause mortality; Meta-analysis; Sarcopenia

 

Challenges in Treating Cardiovascular Disease: Restricting Sodium and Managing Hyperkalemia.

Clegg DJ, Cody M, Palmer BF.

Mayo Clin Proc. 2017 Aug;92(8):1248-1260. doi: 10.1016/j.mayocp.2017.04.006. Review.

PMID: 28778258

Abstract

High sodium intake, whether via diet or drugs, augments cardiorenal risk. Regardless of its source, high sodium intake can both lead to hypertension and reduce the efficacy of renin-angiotensin-aldosterone system inhibitors, which are currently guideline-recommended treatments for hypertension, chronic kidney disease, and heart failure. Reducing sodium intake is therefore recommended to reduce the risk of adverse cardiorenal outcomes. An inverse relationship exists between sodium and potassium, with foods high in sodium being lower in potassium. Diets high in potassium have been associated with reducing hypertension and heart failure; however, optimal renin-angiotensin-aldosterone system inhibitor dosing is often limited by hyperkalemia, which can lead to life-threatening cardiac arrhythmias and increased mortality. Potassium binders are effective at reducing potassium levels. Although some use sodium as the potassium exchange ion, thus increasing sodium intake, a new potassium binder uses another exchange ion and therefore does not increase sodium intake. When treatment options require agents that may precipitate hyperkalemia, particularly in patients at high cardiorenal risk, drugs that do not add to the sodium load may be preferred. A literature search was conducted using PubMed; search terms included potassium, sodium, hyperkalemia, potassium binders, and the literature search focused on manuscripts published more recently since 2000.

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Exercise during pregnancy and its impact on mothers and offspring in humans and mice.

Ferrari N, Bae-Gartz I, Bauer C, Janoschek R, Koxholt I, Mahabir E, Appel S, Alejandre Alcazar MA, Grossmann N, Vohlen C, Brockmeier K, Dötsch J, Hucklenbruch-Rother E, Graf C.

J Dev Orig Health Dis. 2017 Aug 7:1-14. doi: 10.1017/S2040174417000617. [Epub ahead of print]

PMID: 28780912

http://www.cambridge.org.ololo.sci-hub.cc/core/journals/journal-of-developmental-origins-of-health-and-disease/article/exercise-during-pregnancy-and-its-impact-on-mothers-and-offspring-in-humans-and-mice/F361A2052F41B08F02406FA9948DE285

Abstract

Exercise during pregnancy has beneficial effects on maternal and offspring's health in humans and mice. The underlying mechanisms remain unclear. This comparative study aimed to determine the long-term effects of an exercise program on metabolism, weight gain, body composition and changes in hormones [insulin, leptin, brain-derived neurotrophic factor (BDNF)]. Pregnant women (n=34) and mouse dams (n=44) were subjected to an exercise program compared with matched controls (period I). Follow-up in the offspring was performed over 6 months in humans, corresponding to postnatal day (P) 21 in mice (period II). Half of the mouse offspring was challenged with a high-fat diet (HFD) for 6 weeks between P70 and P112 (period III). In period I, exercise during pregnancy led to 6% lower fat content, 40% lower leptin levels and an increase of 50% BDNF levels in humans compared with controls, which was not observed in mice. After period II in humans and mice, offspring body weight did not differ from that of the controls. Further differences were observed in period III. Offspring of exercising mouse dams had significantly lower fat mass and leptin levels compared with controls. In addition, at P112, BDNF levels in offspring were significantly higher from exercising mothers while this effect was completely blunted by HFD feeding. In this study, we found comparable effects on maternal and offspring's weight gain in humans and mice but different effects in insulin, leptin and BDNF. The long-term potential protective effects of exercise on biomarkers should be examined in human studies.

KEYWORDS:

brain-derived neurotrophic factor; comparative study; high-fat feeding; leptin; physical activity

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Circulating trimethylamine N-oxide and the risk of cardiovascular diseases: a systematic review and meta-analysis of 11 prospective cohort studies.

Qi J, You T, Li J, Pan T, Xiang L, Han Y, Zhu L.

J Cell Mol Med. 2017 Aug 7. doi: 10.1111/jcmm.13307. [Epub ahead of print]

PMID: 28782886

http://onlinelibrary.wiley.com/doi/10.1111/jcmm.13307/full

http://onlinelibrary.wiley.com/doi/10.1111/jcmm.13307/epdf

Abstract

Circulating trimethylamine N-oxide (TMAO), a canonical metabolite from gut flora, has been related to the risk of cardiovascular disorders. However, the association between circulating TMAO and the risk of cardiovascular events has not been quantitatively evaluated. We performed a systematic review and meta-analysis of all available cohort studies regarding the association between baseline circulating TMAO and subsequent cardiovascular events. Embase and PubMed databases were searched for relevant cohort studies. The overall hazard ratios for the developing of cardiovascular events (CVEs) and mortality were extracted. Heterogeneity among the included studies was evaluated with Cochran's Q Test and I2 statistics. A random-effect model or a fixed-effect model was applied depending on the heterogeneity. Subgroup analysis and meta-regression were used to evaluate the source of heterogeneity. Among the 11 eligible studies, three reported both CVE and mortality outcome, one reported only CVEs and the other seven provided mortality data only. Higher circulating TMAO was associated with a 23% higher risk of CVEs (HR = 1.23, 95% CI: 1.07-1.42, I2 = 31.4%) and a 55% higher risk of all-cause mortality (HR = 1.55, 95% CI: 1.19-2.02, I2 = 80.8%). Notably, the latter association may be blunted by potential publication bias, although sensitivity analysis by omitting one study at a time did not significantly change the results. Further subgroup analysis and meta-regression did not support that the location of the study, follow-up duration, publication year, population characteristics or the samples of TMAO affect the results significantly. Higher circulating TMAO may independently predict the risk of subsequent cardiovascular events and mortality.

KEYWORDS:

cardiovascular events; meta-analysis; mortality; trimethylamine N-oxide

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A genome-wide systems analysis reveals strong link between colorectal cancer and trimethylamine N-oxide (TMAO), a gut microbial metabolite of dietary meat and fat.

Xu R, Wang Q, Li L.

BMC Genomics. 2015;16 Suppl 7:S4. doi: 10.1186/1471-2164-16-S7-S4. Epub 2015 Jun 11.

PMID: 26100814 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474417/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474417/pdf/1471-2164-16-S7-S4.pdf

 

Mediterranean diet tied to lower risk of gallbladder surgery: study

Mediterranean diet led to 13 to 27 per cent lower risk of surgery in women surveyed

By Shereen Lehman, Thomson Reuters Posted: Aug 07, 2017

http://www.cbc.ca/news/health/mediterranean-diet-gallbladder-surgery-1.4237986

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Diet and Risk of Cholecystectomy: A Prospective Study Based on the French E3N Cohort.

Barré A, Gusto G, Cadeau C, Carbonnel F, Boutron-Ruault MC.

Am J Gastroenterol. 2017 Jul 25. doi: 10.1038/ajg.2017.216. [Epub ahead of print]

PMID: 28741614

Abstract

OBJECTIVES:

This study aimed to examine the relationship between diet and cholecystectomy risk, using three approaches, in a large French cohort.

METHODS:

In a prospective cohort study in French women who completed a food-frequency questionnaire at baseline, we analyzed diet with three approaches: food groups, dietary patterns obtained by factor analysis, and the Mediterranean diet score. The primary outcome was cholecystectomy. We used Cox proportional hazards regression to assess the relationship between diet and cholecystectomy risk, adjusting for the main potential confounders.

RESULTS:

During 1,033,955 person years of follow-up, we identified 2,778 incident cases of cholecystectomy. Higher intakes of legumes, fruit, vegetable oil, and wholemeal bread were associated with decreased cholecystectomy risk. Two dietary patterns were identified by factor analysis: "Western" (essentially processed meat, pizza, pies, high-alcohol beverages, French fries, sandwiches…) and "Mediterranean" (essentially fruits, vegetables, seafood, and olive oil). The "Mediterranean" pattern was inversely associated with cholecystectomy risk in the subgroup of postmenopausal women who ever used menopausal hormone therapy (hazard ratio for quartile 4 vs. 1=0.79, 95% confidence interval (CI): 0.65-0.95; P for linear trend=0.008). High adherence to the Mediterranean diet was associated with decreased risk of cholecystectomy (hazard ratio for a 6-9 score vs. 0-3=0.89, 95% CI: 0.80-0.99; P for linear trend=0.02).

CONCLUSIONS:

Adherence to a diet rich in fruit, vegetables, legumes, and olive oil was associated with a reduction in cholecystectomy risk in French women. Further studies in different settings are requested.

 

Dementia prevention, intervention, and care.

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N.

Lancet. 2017 Jul 19. pii: S0140-6736(17)31363-6. doi: 10.1016/S0140-6736(17)31363-6. [Epub ahead of print] Review. No abstract available.

PMID: 28735855

http://sci-hub.cc/10.1016/S0140-6736(17)31363-6

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Mortality, Geriatric, and Nongeriatric Surgical Risk Factors Among the Eldest Old: A Prospective Observational Study.

Pelavski AD, De Miguel M, Alcaraz Garcia-Tejedor G, Villarino L, Lacasta A, Señas L, Rochera MI.

Anesth Analg. 2017 Aug 3. doi: 10.1213/ANE.0000000000002389. [Epub ahead of print]

PMID: 28786844

Abstract

BACKGROUND:

Preoperative risk and postoperative outcomes among the elderly are the subject of extensive debate. However, the eldest old, that is, the fastest-growing and most vulnerable group, are insufficiently studied; even their mortality rate is unclear. This prospective observational study was performed with the aim of determining the mortality rate of this population and establishing which preoperative conditions were predictors of which postoperative outcomes. The study was undertaken between 2011 and 2015 in a major tertiary care university hospital.

METHODS:

All patients aged ≥85 years undergoing any elective procedure during the study period were included. Patients were followed up for 30 days postoperatively. The preoperative conditions studied were demographic data, grade of surgical complexity (1-3), preoperative comorbidities, and some characteristically geriatric conditions (functional reserve, nutrition, cognitive status, polypharmacy, dependency, and frailty). The outcome measures were 30-day all-cause mortality (primary end point), morbidity, prolonged length of stay, and escalation of care in living conditions.

RESULTS:

Of 139 eligible patients, 127 completed follow-up. The 30-day mortality was 7.9%; 95% confidence interval (CI), 3.2-12.6. It had 3 predictors: malnutrition (odds ratio [OR], 15; 95% CI, 3-89), complexity 3 (OR, 9.1; CI, 2-52), and osteoporosis/osteoporotic fractures (OR, 14.7; CI, 2-126). Significant predictors for morbidity (40%) were ischemic heart disease (OR, 3.9; CI, 1-11) and complexity 3 (OR, 3.6; CI, 2-9), while a nonfrail phenotype (OR, 0.3; CI, 0.1-0.8) was found to be protective. Only 2 factors were found to be predictive of longer admissions, namely complexity 3 (OR, 4.4; CI, 2-10) and frailty (OR, 2.7; CI, 2-7). Finally, risk factors for escalation of care in living conditions were slow gait (a surrogate for frailty, OR, 2.5; CI, 1-6), complexity 3 (OR, 3.2; CI, 1-7), and hypertension (OR, 2.9; CI, 1-9).

CONCLUSIONS:

The eldest old is a distinct group with a considerable mortality rate and their own particular risk factors. Surgical complexity and certain geriatric variables (malnutrition and frailty), which are overlooked in American Society of Anesthesiologists and most other usual scores, are particularly relevant in this population. Inclusion of these factors along with appropriate comorbidities for risk stratification should guide better decision making for families and doctors alike and encourage preoperative optimization of patients.

 

Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.

Whitlock EL, Diaz-Ramirez LG, Glymour MM, Boscardin WJ, Covinsky KE, Smith AK.

JAMA Intern Med. 2017 Aug 1;177(8):1146-1153. doi: 10.1001/jamainternmed.2017.1622.

PMID: 28586818

Abstract

IMPORTANCE:

Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown.

OBJECTIVE:

To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline.

DESIGN, SETTING, AND PARTICIPANTS:

Cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000. Data analysis was conducted between June 24 and October 31, 2016.

EXPOSURES:

"Persistent pain," defined as a participant reporting that he or she was often troubled with moderate or severe pain in both the 1998 and 2000 interviews.

MAIN OUTCOMES AND MEASURES:

Coprimary outcomes were composite memory score and dementia probability, estimated by combining neuropsychological test results and informant and proxy interviews, which were tracked from 2000 through 2012. Linear mixed-effects models, with random slope and intercept for each participant, were used to estimate the association of persistent pain with slope of the subsequent cognitive trajectory, adjusting for demographic characteristics and comorbidities measures in 2000 and applying sampling weights to represent the 2000 US population. We hypothesized that persistent pain would predict accelerated memory decline and increased probability of dementia. To quantify the impact of persistent pain on functional independence, we combined our primary results with information on the association between memory and ability to manage medications and finances independently.

RESULTS:

Of the 10 065 eligible HRS sample members, 60% were female, and median baseline age was 73 years (interquartile range, 67-78 years). At baseline, persistent pain affected 10.9% of participants and was associated with worse depressive symptoms and more limitations in activities of daily living. After covariate adjustment, persistent pain was associated with 9.2% (95% CI, 2.8%-15.0%) more rapid memory decline compared with those without persistent pain. After 10 years, this accelerated memory decline implied a 15.9% higher relative risk of inability to manage medications and an 11.8% higher relative risk of inability to manage finances independently. Adjusted dementia probability increased 7.7% faster (95% CI, 0.55%-14.2%); after 10 years, this translates to an absolute 2.2% increase in dementia probability for those with persistent pain.

CONCLUSIONS AND RELEVANCE:

Persistent pain was associated with accelerated memory decline and increased probability of dementia.

 

Association of Educational Attainment With Lifetime Risk of Cardiovascular Disease: The Atherosclerosis Risk in Communities Study.

Kubota Y, Heiss G, MacLehose RF, Roetker NS, Folsom AR.

JAMA Intern Med. 2017 Aug 1;177(8):1165-1172. doi: 10.1001/jamainternmed.2017.1877.

PMID: 28604921

http://sci-hub.cc/10.1001/jamainternmed.2017.1877

Abstract

IMPORTANCE:

Estimates of lifetime risk may help raise awareness of the extent to which educational inequalities are associated with risk of cardiovascular disease (CVD).

OBJECTIVE:

To estimate lifetime risks of CVD according to categories of educational attainment.

DESIGN, SETTING, AND PARTICIPANTS:

Participants were followed from 1987 through December 31, 2013. All CVD events (coronary heart disease, heart failure, and stroke) were confirmed by physician review and International Classification of Diseases codes. A total of 13 948 whites and African Americans who were 45 to 64 years old and free of CVD at baseline were included from 4 US communities (Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and suburbs of Minneapolis, Minnesota). The data analysis was performed from June 7 to August 31, 2016.

EXPOSURES:

Educational attainment.

MAIN OUTCOMES AND MEASURES:

We used a life table approach to estimate lifetime risks of CVD from age 45 through 85 years according to educational attainment. We adjusted for competing risks of death from underlying causes other than CVD.

RESULTS:

The sample of 13 948 participants was 56% female and 27% African American. During 269 210 person-years of follow-up, we documented 4512 CVD events and 2401 non-CVD deaths. Educational attainment displayed an inverse dose-response relation with cumulative risk of CVD, which became evident in middle age, with the most striking gap between those not completing vs completing high school. In men, lifetime risks of CVD were 59.0% (95% CI, 54.0%-64.1%) for grade school, 52.5% (95% CI, 47.7%-56.8%) for high school education without graduation, 50.9% (95% CI, 47.3%-53.9%) for high school graduation, 47.2% (95% CI, 41.5%-52.5%) for vocational school, 46.4% (95% CI, 42.8%-49.6%) for college with or without graduation, and 42.2% (95% CI, 36.6%-47.0%) for graduate/professional school; in women, 50.8% (95% CI, 45.7%-55.8%), 49.3% (95% CI, 45.1%-53.1%), 36.3% (95% CI, 33.4%-39.1%), 32.2% (95% CI, 26.0%-37.3%), 32.8% (95% CI, 29.1%-35.9%), and 28.0% (95% CI, 21.9%-33.3%), respectively. Educational attainment was inversely associated with CVD even within categories of family income, income change, occupation, or parental educational level.

CONCLUSIONS AND RELEVANCE:

More than 1 in 2 individuals with less than high school education had a lifetime CVD event. Educational attainment was inversely associated with the lifetime risk of CVD, regardless of other important socioeconomic characteristics. Our findings emphasize the need for further efforts to reduce CVD inequalities related to educational disparities.

 

Fecal Immunochemical Tests in Patients at Increased Risk for Colorectal Cancer-Is It Prime Time Yet?

Leontiadis GI.

JAMA Intern Med. 2017 Aug 1;177(8):1119-1120. doi: 10.1001/jamainternmed.2017.2317. No abstract available.

PMID: 28628694

http://sci-hub.cc/10.1001/jamainternmed.2017.2317

"colonoscopy should be offered to the

majority of individuals with higher-than-average risk of CRC,

with triage tests reserved for those who, after a detailed discussion

of the benefits and risk of each strategy, will not consent

to having a colonoscopy unless they have a positive triage

test result."

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

Diagnostic Accuracy of Fecal Immunochemical Test in Patients at Increased Risk for Colorectal Cancer: A Meta-analysis.

Katsoula A, Paschos P, Haidich AB, Tsapas A, Giouleme O.

JAMA Intern Med. 2017 Aug 1;177(8):1110-1118. doi: 10.1001/jamainternmed.2017.2309.

PMID: 28628706

10.1001/jamainternmed.2017.2309

Abstract

IMPORTANCE:

The potential role of the fecal immunochemical test (FIT) for screening patients at increased risk for colorectal cancer (CRC) has not yet been elucidated.

OBJECTIVE:

To assess the diagnostic accuracy of FIT for CRC or advanced neoplasia (AN) in asymptomatic patients at above-average risk.

DATA SOURCES:

MEDLINE, EMBASE, Cochrane Library, and gray literature sources through August 2016.

STUDY SELECTION:

Diagnostic studies evaluating the accuracy of FIT for CRC or AN in patients with a personal or familial history of CRC using colonoscopy as the reference standard.

DATA EXTRACTION AND SYNTHESIS:

Two authors (A.K. and P.P.) independently extracted data and evaluated study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool, and evaluated the quality of the body of evidence by means of GRADE (Grading of Recommendations Assessment, Development, and Evaluation). Hierarchical models were used to synthesize available evidence.

MAIN OUTCOMES AND MEASURES:

The primary outcome was the diagnostic performance of FIT for detecting CRC or AN.

RESULTS:

We included 12 studies (6204 participants). Seven studies were deemed at high or unclear risk of bias. The average sensitivity of FIT for CRC was 93% (95% CI, 53%-99%), and the average specificity was 91% (95% CI, 89%-92%), yielding a positive likelihood ratio (LR+) of 10.30 (CI 7.7-13.9) and a negative likelihood ratio (LR-) of 0.08 (95% CI, 0.01-0.75) (GRADE: very low). The average sensitivity of FIT for AN was 48% (95% CI, 39%-57%); and the average specificity was 93% (95% CI, 91%-94%), yielding an LR+ of 6.55 (95% CI, 5.0-8.5) and an LR- of 0.57 (95% CI, 0.48-0.67) (GRADE: very low). Subgroup analyses indicated that FIT cutoff values between 15- and 25-μg/g feces provided the best combination of sensitivity and specificity for the diagnosis of CRC (93% and 94%, respectively). Quantitative and 1-sample FIT showed adequate test performance, but data on other FIT brands and multiple samples were insufficient.

CONCLUSIONS AND RELEVANCE:

The FIT has high overall diagnostic accuracy for CRC but moderate accuracy for AN in patients at above-average personal or familial risk. Heterogeneity and wide confidence intervals limit the trustworthiness of our findings.

 

Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals.

Raatz SK, Johnson LK, Picklo MJ.

J Nutr. 2015 Oct;145(10):2265-72. doi: 10.3945/jn.115.218016. Epub 2015 Sep 2.

PMID: 26338891 Free Article

http://jn.nutrition.org/content/145/10/2265.long

http://jn.nutrition.org/content/145/10/2265.full.pdf+html

Abstract

BACKGROUND:

Public health recommendations call for a reduction in added sugars; however, controversy exists over whether all nutritive sweeteners produce similar metabolic effects.

OBJECTIVE:

The objective was to compare the effects of the chronic consumption of 3 nutritive sweeteners [honey, sucrose, and high-fructose corn syrup containing 55% fructose (HFCS55)] on circulating glucose, insulin, lipids, and inflammatory markers; body weight; and blood pressure in individuals with normal glucose tolerance (GT) and those with impaired glucose tolerance (IGT).

METHODS:

In a crossover design, participants consumed daily, in random order, 50 g carbohydrate from assigned sweeteners for 2 wk with a 2- to 4-wk washout period between treatments. Participants included 28 GT and 27 IGT volunteers with a mean age of 38.9 ± 3.6 y and 52.1 ± 2.7 y, respectively, and a body mass index (in kg/m(2)) of 26 ± 0.8 and 31.5 ± 1.0, respectively. Body weight, blood pressure (BP), serum inflammatory markers, lipids, fasting glucose and insulin, and oral-glucose-tolerance tests (OGTTs) were completed pre- and post-treatment. The OGTT incremental areas under the curve (iAUCs) for glucose and insulin were determined and homeostasis model assessment of insulin resistance (HOMA-IR) scores were calculated.

RESULTS:

Body weight and serum glucose, insulin, inflammatory markers, and total and LDL-cholesterol concentrations were significantly higher in the IGT group than in the GT group at baseline. Glucose, insulin, HOMA-IR, and the OGTT iAUC for glucose or insulin did not differ by treatment, but all responses were significantly higher in the IGT group compared with the GT group. Body weight was unchanged by treatment. Systolic BP was unchanged, whereas diastolic BP was significantly lower in response to sugar intake across all treatments. An increase in high-sensitivity C-reactive protein (hsCRP) was observed in the IGT group in response to all sugars. No treatment effect was observed for interleukin 6. HDL cholesterol did not differ as a result of status or treatment. Triglyceride (TG) concentrations increased significantly from pre- to post-treatment in response to all sugars tested.

CONCLUSIONS:

Daily intake of 50 g carbohydrate from honey, sucrose, or HFCS55 for 14 d resulted in similar effects on measures of glycemia, lipid metabolism, and inflammation. All 3 increased TG concentrations in both GT and IGT individuals and elevated glycemic and inflammatory responses in the latter. This trial was registered at clinicaltrials.gov as NCT01371266.

KEYWORDS:

glycemia; high-fructose corn syrup; honey; sucrose; triglycerides

 

The Transcription Factor DAF-16 is Essential for Increased Longevity in C. elegans Exposed to Bifidobacterium longum BB68.

Zhao L, Zhao Y, Liu R, Zheng X, Zhang M, Guo H, Zhang H, Ren F.

Sci Rep. 2017 Aug 7;7(1):7408. doi: 10.1038/s41598-017-07974-3.

PMID: 28785042

https://www.nature.com/articles/s41598-017-07974-3

Abstract

The longevity-promoting benefits of lactobacilli were hypothesized as early as 1907. Although the anti-aging effects of lactic acid bacteria (LAB) have been observed in nematodes, rodents and humans for over a century, the mechanisms underlying the effects of probiotics on aging have rarely been assessed. Using the Caenorhabditis elegans (C. elegans) model, various studies have elucidated the role of different signaling cascades, especially the DAF-16 cascade, on lifespan extension by LAB. In this study, the mechanisms through which Bifidobacterium longum strain BB68 affects the longevity of C. elegans were assessed. The lifespan of nematodes increased by 28% after worms were fed BB68, and this extension of lifespan was completely lost in backgrounds containing a mutated DAF-16 gene. High levels of DAF-16 (in the daf-16 (mu86); muIs61 strain) nuclear accumulation and high expression of the SOD-3 gene (a DAF-16-specific target gene) were observed as a result of BB68 treatment. Immunofluorescence microscopy revealed that TIR-1 and JNK-1 are involved in the phosphorylation and activation of DAF-16. Thus, BB68 increased the longevity of nematodes by activating the TIR-1 - JNK-1 - DAF-16 signaling pathway, and the cell wall component of BB68 contributed to longevity.

 

EDITORIALS

Increasing the rigor of obesity research publications

R L Atkinson and I A Macdonald

Int J Obes 2017 41: 1159; 10.1038/ijo.2017.118

http://sci-hub.cc/10.1038/ijo.2017.118

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

Telling people they are overweight: helpful, harmful or beside the point?

E Robinson, A Haynes, A R Sutin and M Daly

Int J Obes 2017 41: 1160-1161; 10.1038/ijo.2017.85

http://sci-hub.cc/10.1038/ijo.2017.85

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

The 'obesity paradox' may not be a paradox at all.

Banack HR, Stokes A.

Int J Obes (Lond). 2017 Jun 6. doi: 10.1038/ijo.2017.99. [Epub ahead of print] No abstract available.

PMID: 28584251

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

Renal cell carcinoma survival and body mass index: a dose-response meta-analysis reveals another potential paradox within a paradox.

Bagheri M, Speakman JR, Shemirani F, Djafarian K.

Int J Obes (Lond). 2016 Dec;40(12):1817-1822. doi: 10.1038/ijo.2016.171. Epub 2016 Sep 30. Review.

PMID: 27686524

http://sci-hub.cc/10.1038/ijo.2016.171

Abstract

BACKGROUND:

In healthy subjects increasing body mass index (BMI) leads to greater mortality from a range of causes. Following onset of specific diseases, however, the reverse is often found: called the 'obesity paradox'. But we recently observed the phenomenon called the 'paradox within the paradox' for stroke patients.

OBJECTIVE:

The objective of our study was to examine the effect of each unit increase in BMI on renal cancer-specific survival (CSS), cancer-specific mortality, overall survival (OS) and overall mortality.

DESIGN:

Random-effects generalized least squares models for trend estimation were used to analyze the data. Eight studies, comprising of 8699 survivals of 10 512 renal cell carcinoma (RCC) patients met the inclusion criteria, including 5 on CSS and 3 on OS.

RESULTS:

The association of BMI with CSS and OS was non-linear (P<0.0001, P=0.004, respectively). We observed that CSS increased in relation to BMI, indicating that there was the obesity paradox in RCC. However, each unit increase in BMI over 25 was associated with decreased OS, indicating that RCC may also exhibit a paradox within the paradox.

CONCLUSIONS:

Inconsistent effects of increases in BMI on CSS and OS, as previously observed for stroke, creates a paradox (different directions of mortality for different causes) within the obesity paradox.

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

Obesity paradox in group 1 pulmonary hypertension: analysis of the NIH-Pulmonary Hypertension registry.

Mazimba S, Holland E, Nagarajan V, Mihalek AD, Kennedy JL, Bilchick KC.

Int J Obes (Lond). 2017 Mar 21. doi: 10.1038/ijo.2017.45. [Epub ahead of print]

PMID: 28209971

http://sci-hub.cc/10.1038/ijo.2017.45

Abstract

BACKGROUND:

The 'obesity paradox' refers to the fact that obese patients have better outcomes than normal weight patients. This has been observed in multiple cardiovascular conditions, but evidence for obesity paradox in pulmonary hypertension (PH) remains sparse.

METHODS:

We categorized 267 patients from the National Institute of Health-PH registry into five groups based on body mass index (BMI): underweight, normal weight, overweight, obese and morbidly obese. Mortality was compared in BMI groups using the χ2 statistic. Five-year probability of death using the PH connection (PHC) risk equation was calculated, and the model was compared with BMI groups using Cox proportional hazards regression and Kaplan-Meier (KM) survival curves.

RESULTS:

Patients had a median age of 39 years (interquartile range 30-50 years), a median BMI of 23.4 kg m-2 (21.0-26.8 kg m-2) and an overall mortality at 5 years of 50.2%. We found a U-shaped relationship between survival and 1-year mortality with the best 1-year survival in overweight patients. KM curves showed the best survival in the overweight, followed by obese and morbidly obese patients, and the worst survival in normal weight and underweight patients (log-rank P=0.0008). In a Cox proportional hazards analysis, increasing BMI was a highly significant predictor of improved survival even after adjustment for the PHC risk equation with a hazard ratio for death of 0.921 per kg m-2 (95% confidence interval: 0.886-0.954) (P<0.0001).

CONCLUSION:

We observed that the best survival was in the overweight patients, making this more of an 'overweight paradox' than an 'obesity paradox'. This has implications for risk stratification and prognosis in group 1 PH patients.

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

On food supply and obesity, missing the point is easy.

Voss JD.

Int J Obes (Lond). 2017 Apr 26. doi: 10.1038/ijo.2017.101. [Epub ahead of print] No abstract available.

PMID: 28442779

http://sci-hub.cc/10.1038/ijo.2017.101

 

Abdominal adiposity intensifies the negative effects of ambient air pollution on lung function in Korean men.

Kim HJ, Park JH, Min JY, Min KB, Seo YS, Yun JM, Kwon H, Kim JI, Cho B.

Int J Obes (Lond). 2017 Apr 25. doi: 10.1038/ijo.2017.97. [Epub ahead of print]

PMID: 28439091

Abstract

BACKGROUND:

Some studies have provided the possibility that adipose tissue may mediate air pollution-induced lung dysfunction. Studies using quantified fat mass data are needed to understand the biological mechanisms between adipocyte and air pollution in lung function. We aimed to investigate whether abdominal adiposity measured by computed tomography (CT) modifies the effects of air pollution on lung function in Korean men.

METHODS:

A total of 1876 men who visited one of two health checkup centers were recruited for this study. Adiposity traits such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and total adipose tissue (TAT) areas were measured by CT. We used the annual mean concentrations of ambient air pollutants including nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter ⩽10 μm (PM10).

RESULTS:

Interquartile range (IQR) increase in annual mean concentration of NO2 was significantly associated with a 2.5% lower forced expiratory volume in 1 s (FEV1) and 2.9% lower forced vital capacity (FVC) (both P<0.05). The decrease in lung function was more strongly associated with adiposity traits than with body mass index. In a stratified analysis of adiposity, compared with subjects with low-VAT area (VAT⩽200 cm2), those with high-VAT area (VAT>200 cm2) showed a rapid decrease in FEV1 with each IQR increase in PM10 (β=-0.0812; 95% confidence interval (CI) =-0.1590, -0.0035) and NO2 (β=-0.0979; 95% CI=-0.1611, -0.0346). In the high-VAT group, each IQR increase in NO2 content was significantly associated with a 10.6% decrease (β=-0.1056; 95% CI=-0.1770, -0.0343) in FVC. SAT and TAT areas showed similar patterns.

CONCLUSIONS:

We report the first finding that abdominal adiposity intensifies the inverse relationship between air pollution and lung function.

 

Obesity-induced decreases in muscle performance are not reversed by weight loss.

Seebacher F, Tallis J, McShea K, James RS.

Int J Obes (Lond). 2017 Apr 25. doi: 10.1038/ijo.2017.81. [Epub ahead of print]

PMID: 28337027

Abstract

BACKGROUND/OBJECTIVES:

Obesity can affect muscle phenotypes, and may thereby constrain movement and energy expenditure. Weight loss is a common and intuitive intervention for obesity, but it is not known whether the effects of obesity on muscle function are reversible by weight loss. Here we tested whether obesity-induced changes in muscle metabolic and contractile phenotypes are reversible by weight loss.

SUBJECTS/METHODS:

We used zebrafish (Danio rerio) in a factorial design to compare energy metabolism, locomotor capacity, muscle isometric force and work-loop power output, and myosin heavy chain (MHC) composition between lean fish, diet-induced obese fish, and fish that were obese and then returned to lean body mass following diet restriction.

RESULTS:

Obesity increased resting metabolic rates (P<0.001) and decreased maximal metabolic rates (P=0.030), but these changes were reversible by weight loss, and were not associated with changes in muscle citrate synthase activity. In contrast, obesity-induced decreases in locomotor performance (P=0.0034), and isolated muscle isometric stress (P=0.01), work-loop power output (P<0.001) and relaxation rates (P=0.012) were not reversed by weight loss. Similarly, obesity-induced decreases in concentrations of fast and slow MHCs, and a shift toward fast MHCs were not reversed by weight loss.

CONCLUSION:

Obesity-induced changes in locomotor performance and muscle contractile function were not reversible by weight loss. These results show that weight loss alone may not be a sufficient intervention.

 

Blood pressure fluctuations linked to dementia: study

Participants with fluctuating blood pressure were almost 2 times as likely to develop dementia

Thomson Reuters Posted: Aug 07, 2017

http://www.cbc.ca/news/health/blood-pressure-dementia-1.4238131

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

Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population

The Hisayama Study

Emi Oishi, Tomoyuki Ohara, Satoko Sakata, Masayo Fukuhara, Jun Hata, Daigo Yoshida, Mao Shibata, Toshio Ohtsubo, Takanari Kitazono, Yutaka Kiyohara, Toshiharu Ninomiya

Circulation. 2017;136:516-525, originally published August 7, 2017

https://doi.org/10.1161/CIRCULATIONAHA.116.025667

http://circ.ahajournals.org/content/136/6/516

Abstract

Background: Several observational studies have reported that higher visit-to-visit blood pressure variability is a risk factor for cognitive impairment and dementia. However, no studies have investigated the association of day-to-day blood pressure variability assessed by home blood pressure measurement with the development of dementia.

Methods: A total of 1674 community-dwelling Japanese elderly without dementia, ≥60 years of age, were followed up for 5 years (2007–2012). Home blood pressure was measured 3 times every morning for a median of 28 days. Day-to-day systolic (SBP) and diastolic blood pressure variabilities, calculated as coefficients of variation (CoV) of home SBP and diastolic blood pressure, were categorized into quartiles. The hazard ratios and their 95% confidence intervals of the CoV levels of home blood pressure on the development of all-cause dementia, vascular dementia (VaD), and Alzheimer disease (AD) were computed with a Cox proportional hazards model.

Results: During the follow-up, 194 subjects developed all-cause dementia; of these, 47 had VaD and 134 had AD. The age- and sex-adjusted incidences of all-cause dementia, VaD, and AD increased significantly with increasing CoV levels of home SBP (all P for trend <0.05). These associations remained unchanged after adjustment for potential confounding factors, including home SBP. Compared with subjects in the first quartile of CoV levels of home SBP, the risks of the development of all-cause dementia, VaD, and AD were significantly higher in those in the fourth quartile (hazard ratio=2.27, 95% confidence interval=1.45–3.55, P<0.001 for all-cause dementia; hazard ratio=2.79, 95% confidence interval=1.04–7.51, P=0.03 for VaD; hazard ratio=2.22, 95% confidence interval=1.31–3.75, P<0.001 for AD). Similar associations were observed for CoV levels of home diastolic blood pressure. Meanwhile, home SBP levels were significantly associated with the risk of VaD but not with the risks of all-cause dementia and AD. There was no interaction between home SBP levels and CoV levels of home SBP on the risk of each subtype of dementia.

Conclusions: Our findings suggest that increased day-to-day blood pressure variability is, independently of average home blood pressure, a significant risk factor for the development of all-cause dementia, VaD, and AD in the general elderly Japanese population.

blood pressuredementiaepidemiologyfollow-up studies

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EDITORIAL

Rollercoaster Blood Pressure

An Alzheimer Disease Risk Factor?

Alexander E. Merkler, Costantino Iadecola

https://doi.org/10.1161/CIRCULATIONAHA.117.029618

Circulation. 2017;136:526-528

Originally published August 7, 2017

http://sci-hub.cc/10.1161/CIRCULATIONAHA.117.029618

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Incidence of atrial fibrillation and its risk prediction model based on a prospective urban Han Chinese cohort.

Ding L, Li J, Wang C, Li X, Su Q, Zhang G, Xue F.

J Hum Hypertens. 2017 Sep;31(9):574-579. doi: 10.1038/jhh.2017.23. Epub 2017 Mar 30.

PMID: 28357998

http://sci-hub.cc/10.1038/jhh.2017.23

Abstract

Prediction models of atrial fibrillation (AF) have been developed; however, there was no AF prediction model validated in Chinese population. Therefore, we aimed to investigate the incidence of AF in urban Han Chinese health check-up population, as well as to develop AF prediction models using behavioral, anthropometric, biochemical, electrocardiogram (ECG) markers, as well as visit-to-visit variability (VVV) in blood pressures available in the routine health check-up. A total of 33 186 participants aged 45-85 years and free of AF at baseline were included in this cohort, to follow up for incident AF with an annually routine health check-up. Cox regression models were used to develop AF prediction model and 10-fold cross-validation was used to test the discriminatory accuracy of prediction model. We developed three prediction models, with age, sex, history of coronary heart disease (CHD), hypertension as predictors for simple model, with left high-amplitude waves, premature beats added for ECG model, and with age, sex, history of CHD and VVV in systolic and diabolic blood pressures as predictors for VVV model, to estimate risk of incident AF. The calibration of our models ranged from 1.001 to 1.004 (P for Hosmer Lemeshow test >0.05). The area under receiver operator characteristics curve were 78%, 80% and 82%, respectively, for predicting risk of AF. In conclusion, we have identified predictors of incident AF and developed prediction models for AF with variables readily available in routine health check-up.

 

Exercise Preserves Lean Mass and Performance during Severe Energy Deficit: The Role of Exercise Volume and Dietary Protein Content.

Calbet JAL, Ponce-González JG, Calle-Herrero J, Perez-Suarez I, Martin-Rincon M, Santana A, Morales-Alamo D, Holmberg HC.

Front Physiol. 2017 Jul 24;8:483. doi: 10.3389/fphys.2017.00483. eCollection 2017.

PMID: 28790922

Abstract

The loss of fat-free mass (FFM) caused by very-low-calorie diets (VLCD) can be attenuated by exercise. The aim of this study was to determine the role played by exercise and dietary protein content in preserving the lean mass and performance of exercised and non-exercised muscles, during a short period of extreme energy deficit (~23 MJ deficit/day). Fifteen overweight men underwent three consecutive experimental phases: baseline assessment (PRE), followed by 4 days of caloric restriction and exercise (CRE) and then 3 days on a control diet combined with reduced exercise (CD). During CRE, the participants ingested a VLCD and performed 45 min of one-arm cranking followed by 8 h walking each day. The VLCD consisted of 0.8 g/kg body weight/day of either whey protein (PRO, n = 8) or sucrose (SU, n = 7). FFM was reduced after CRE (P < 0.001), with the legs and the exercised arm losing proportionally less FFM than the control arm [57% (P < 0.05) and 29% (P = 0.05), respectively]. Performance during leg pedaling, as reflected by the peak oxygen uptake and power output (Wpeak), was reduced after CRE by 15 and 12%, respectively (P < 0.05), and recovered only partially after CD. The deterioration of cycling performance was more pronounced in the whey protein than sucrose group (P < 0.05). Wpeak during arm cranking was unchanged in the control arm, but improved in the contralateral arm by arm cranking. There was a linear relationship between the reduction in whole-body FFM between PRE and CRE and the changes in the cortisol/free testosterone ratio (C/FT), serum isoleucine, leucine, tryptophan, valine, BCAA, and EAA (r = -0.54 to -0.71, respectively, P < 0.05). C/FT tended to be higher in the PRO than the SU group following CRE (P = 0.06). In conclusion, concomitant low-intensity exercise such as walking or arm cranking even during an extreme energy deficit results in remarkable preservation of lean mass. The intake of proteins alone may be associated with greater cortisol/free testosterone ratio and is not better than the ingestion of only carbohydrates for preserving FFM and muscle performance in interventions of short duration.

KEYWORDS:

VLCD; exercise; obesity; sucrose; very-low-calorie diet; whey protein

 

Is two days of intermittent energy restriction per week a feasible weight loss approach in obese males? A randomised pilot study.

Conley M, Le Fevre L, Haywood C, Proietto J.

Nutr Diet. 2017 Aug 9. doi: 10.1111/1747-0080.12372. [Epub ahead of print]

PMID: 28791787

Abstract

AIM:

The 5:2 diet (two non-consecutive days of 2460 KJ (600 calories) and 5 days of ad libitum eating per week) is becoming increasingly popular. This pilot study aimed to determine whether the 5:2 diet can achieve ≥5% weight loss and greater improvements in weight and biochemical markers than a standard energy-restricted diet (SERD) in obese male war veterans.

METHODS:

A total of 24 participants were randomised to consume either the 5:2 diet or a SERD (2050 KJ (500 calorie) reduction per day) for 6 months. Weight, waist circumference (WC), fasting blood glucose, blood lipids, blood pressure and dietary intake were measured at baseline, 3 and 6 months by a blinded investigator.

RESULTS:

After 6 months, participants in both groups significantly reduced body weight (P = <0.001), WC (P = <0.001) and systolic blood pressure (P = 0.001). Mean weight loss was 5.3 ± 3.0 kg (5.5 ± 3.2%) for the 5:2 group and 5.5 ± 4.3 kg (5.4 ± 4.2%) for the SERD group. Mean WC reduction for the 5:2 group was 8.0 ± 4.5 and 6.4 ± 5.8 cm for the SERD group. There was no significant difference in the amount of weight loss or WC reduction between diet groups. There was no significant change in diastolic blood pressure, fasting blood glucose or blood lipids in either dietary group.

CONCLUSIONS:

Results suggest that the 5:2 diet is a successful but not superior weight loss approach in male war veterans when compared to a SERD. Future research is needed to determine the long-term effectiveness of the 5:2 diet and its effectiveness in other population groups.

KEYWORDS:

5:2 diet; intermittent energy restriction; obesity; war veterans; weight loss

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