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The joint effects of major lifestyle factors on colorectal cancer risk among Chinese men: A prospective cohort study.

Zhang QL, Zhao LG, Li HL, Gao J, Yang G, Wang J, Zheng W, Shu XO, Xiang YB.

Int J Cancer. 2017 Oct 21. doi: 10.1002/ijc.31126. [Epub ahead of print]

PMID: 29055095

http://sci-hub.cc/10.1002/ijc.31126

Abstract

Previous studies have suggested individual healthy lifestyle factors are related to lower risk of colorectal cancer. Their joint effects, however, have rarely been investigated. We aimed to assess the combined lifestyle impact on colorectal cancer risk and to estimate the population attributable risks of these lifestyle factors. Using data from the Shanghai Men's Health Study (2002-2013), we constructed healthy lifestyle index composing the following lifestyle factors: smoking, alcohol consumption, diet, waist-hip ratio and exercise participation. Cox proportional hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs). Over a median of 9.28 years' follow-up, 671 colorectal cancer cases occurred (400 colon cancer and 274 rectal cancer) among 59503 men. Each increment of healthy lifestyle index was associated with a 17% lower risk of colorectal cancer (HR=0.83, 95%CI: 0.78, 0.89), 10% of colon cancer (HR=0.90, 95%CI: 0.83, 0.99) and 27% of rectal cancer (HR=0.73, 95%CI: 0.66, 0.82). If all men in the cohort followed a lifestyle as defined by these five factors, 21% colorectal cancer cases would have been prevented (PAR=21%, 95%CI: 4%, 36%). In conclusion, combined lifestyle factors are significantly related to lower risk of colorectal cancer and the effects are more pronounced on rectal cancer than on colon cancer.

KEYWORDS:

cohort study; colorectal cancer; lifestyle behaviors; population attributable risk; public health

Edited by AlPater

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The Scientist » The Nutshell

WHO Cherry-Picked Data on Pesticide, Investigation Finds

A group evaluating glyphosate’s cancer risk omitted evidence that the chemical is not carcinogenic.

By Ashley P. Taylor | October 22, 2017

http://www.the-scientist.com/?articles.view/articleNo/50693/title/WHO-Cherry-Picked-Data-on-Pesticide--Investigation-Finds/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=57627135&_hsenc=p2ANqtz-_TYm_94uGDoXXOLbIKz2mx7Lw2zOqjKocA42ep9kB87tEYIOll0BfEXpjXUDamXB_16o7JVorzKoPvPCjyW0_YW3Mqkw&_hsmi=57627135

 

Chasing the top quartile of cross-sectional data: Is it possible with resistance training?

Buckner SL, Dankel SJ, Mouser JG, Mattocks KT, Jessee MB, Loenneke JP.

Med Hypotheses. 2017 Oct;108:63-68. doi: 10.1016/j.mehy.2017.08.009. Epub 2017 Aug 7.

PMID: 29055404

http://sci-hub.cc/10.1016/j.mehy.2017.08.009

Abstract

Resistance exercise is believed to be important for improving several biomarkers of health and contributing to decreased all-cause mortality. However, a careful examination of the literature reveals a growing body of cross-sectional studies finding stronger associations between strength independent of physical activity on these various outcomes and biomarkers (i.e., C - reactive protein, homocysteine, total cholesterol) of health. Considering that engagement in resistance type exercise is associated with an increase in strength, such cross-sectional data is often used to promote engagement in resistance training. When one examines the cross-sectional studies together with the experimental work, however, this relationship becomes less clear. For example, being in a higher tertile or quartile for grip strength may be associated with more favorable biomarkers or health outcomes, yet, experimental work shows that grip strength does not change with traditional resistance exercise. This seems to suggest that our interpretation and application of this literature may be incorrect. It is our opinion that much of the cross-sectional work may more accurately illustrate inherent differences between individuals who are "weak" and individuals who are "strong". In addition, there is conflicting experimental evidence and a lack of longitudinal support that resistance exercise may have a meaningful effect on long-term health outcomes. Using this evidence, we present our "human baseline hypothesis", which proposes that the baseline value of strength that a person possesses prior to training may be a more appropriate indicator regarding long-term health outcomes than the act of training itself.

KEYWORDS:

Cross-sectional; Human baseline; Medicine; Resistance exercise

 

The effect of alcohol and red wine consumption on clinical and MRI outcomes in multiple sclerosis.

Diaz-Cruz C, Chua AS, Malik MT, Kaplan T, Glanz BI, Egorova S, Guttmann CRG, Bakshi R, Weiner HL, Healy BC, Chitnis T.

Mult Scler Relat Disord. 2017 Oct;17:47-53. doi: 10.1016/j.msard.2017.06.011. Epub 2017 Jun 27.

PMID: 29055473

Abstract

BACKGROUND:

Alcohol and in particular red wine have both immunomodulatory and neuroprotective properties, and may exert an effect on the disease course of multiple sclerosis (MS).

OBJECTIVE:

To assess the association between alcohol and red wine consumption and MS course.

METHODS:

MS patients enrolled in the Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women's Hospital (CLIMB) who completed a self-administered questionnaire about their past year drinking habits at a single time point were included in the study. Alcohol and red wine consumption were measured as servings/week. The primary outcome was the Expanded Disability Status Scale (EDSS) at the time of the questionnaire. Secondary clinical outcomes were the Multiple Sclerosis Severity Score (MSSS) and number of relapses in the year before the questionnaire. Secondary MRI outcomes included brain parenchymal fraction and T2 hyperintense lesion volume (T2LV). Appropriate regression models were used to test the association of alcohol and red wine intake on clinical and MRI outcomes. All analyses were controlled for sex, age, body mass index, disease phenotype (relapsing vs. progressive), the proportion of time on disease modifying therapy during the previous year, smoking exposure, and disease duration. In the models for the MRI outcomes, analyses were also adjusted for acquisition protocol.

RESULTS:

923 patients (74% females, mean age 47 ± 11 years, mean disease duration 14 ± 9 years) were included in the analysis. Compared to abstainers, patients drinking more than 4 drinks per week had a higher likelihood of a lower EDSS score (OR, 0.41; p = 0.0001) and lower MSSS (mean difference, - 1.753; p = 0.002) at the time of the questionnaire. Similarly, patients drinking more than 3 glasses of red wine per week had greater odds of a lower EDSS (OR, 0.49; p = 0.0005) and lower MSSS (mean difference, - 0.705; p = 0.0007) compared to nondrinkers. However, a faster increase in T2LV was observed in patients consuming 1-3 glasses of red wine per week compared to nondrinkers.

CONCLUSIONS:

Higher total alcohol and red wine intake were associated with a lower cross-sectional level of neurologic disability in MS patients but increased T2LV accumulation. Further studies should explore a potential cause-effect neuroprotective relationship, as well as the underlying biological mechanisms.

KEYWORDS:

Alcohol; EDSS; MRI; MSSS; Multiple sclerosis

 

Metabotyping for the development of tailored dietary advice solutions in a European population: the Food4Me study

Clare B. O’Donovan, Marianne C. Walsh, Clara Woolhead, Hannah Forster, Carlos Celis-Morales, Rosalind Fallaize, Anna L. Macready, Cyril F. M. Marsaux, Santiago Navas-Carretero, S. Rodrigo San-Cristobal, Silvia Kolossa, Lydia Tsirigoti, Christina Mvrogianni, Christina P. Lambrinou, George Moschonis, Magdalena Godlewska, Agnieszka Surwillo, Iwona Traczyk, Christian A. Drevon, Hannelore Daniel, Yannis Manios, J. Alfredo Martinez, Wim H. M. Saris, Julie A. Lovegrove, John C. Mathers, Michael J. Gibney, Eileen R. Gibney, Lorraine Brennan

https://doi.org/10.1017/S0007114517002069

Published online: 23 October 2017, pp. 561-569

Br J Nutr Volume 118, Issue 8 28 October 2017 , pp. 561-569

https://sci-hub.cc/https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/metabotyping-for-the-development-of-tailored-dietary-advice-solutions-in-a-european-population-the-food4me-study/948DCE2FA9254317B0A8235145D5E741

Abstract

Traditionally, personalised nutrition was delivered at an individual level. However, the concept of delivering tailored dietary advice at a group level through the identification of metabotypes or groups of metabolically similar individuals has emerged. Although this approach to personalised nutrition looks promising, further work is needed to examine this concept across a wider population group. Therefore, the objectives of this study are to: (1) identify metabotypes in a European population and (2) develop targeted dietary advice solutions for these metabotypes. Using data from the Food4Me study (n 1607), k-means cluster analysis revealed the presence of three metabolically distinct clusters based on twenty-seven metabolic markers including cholesterol, individual fatty acids and carotenoids. Cluster 2 was identified as a metabolically healthy metabotype as these individuals had the highest Omega-3 Index (6·56 (sd 1·29) %), carotenoids (2·15 (sd 0·71) µm) and lowest total saturated fat levels. On the basis of its fatty acid profile, cluster 1 was characterised as a metabolically unhealthy cluster. Targeted dietary advice solutions were developed per cluster using a decision tree approach. Testing of the approach was performed by comparison with the personalised dietary advice, delivered by nutritionists to Food4Me study participants (n 180). Excellent agreement was observed between the targeted and individualised approaches with an average match of 82 % at the level of delivery of the same dietary message. Future work should ascertain whether this proposed method could be utilised in a healthcare setting, for the rapid and efficient delivery of tailored dietary advice solutions.

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Walking in Relation to Mortality in a Large Prospective Cohort of Older U.S. Adults.

Patel AV, Hildebrand JS, Leach CR, Campbell PT, Doyle C, Shuval K, Wang Y, Gapstur SM.

Am J Prev Med. 2017 Oct 11. pii: S0749-3797(17)30460-9. doi: 10.1016/j.amepre.2017.08.019. [Epub ahead of print]

PMID: 29056372

http://www.ajpmonline.org/article/S0749-3797(17)30460-9/fulltext

http://www.ajpmonline.org/article/S0749-3797(17)30460-9/pdf

Abstract

INTRODUCTION:

Engaging in >150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity weekly is recommended for optimal health. The relationship between walking, the most common activity especially for older adults, and total mortality is not well documented.

METHODS:

Data from a large U.S. prospective cohort study including 62,178 men (mean age 70.7 years) and 77,077 women (mean age 68.9 years), among whom 24,688 men and 18,933 women died during 13 years of follow-up (1999-2012), were used to compute multivariable-adjusted hazard rate ratios and 95% CIs for walking as the sole form of activity or adjusted for other moderate- or vigorous-intensity physical activity in relation to total and cause-specific mortality (data analysis 2015-2016).

RESULTS:

Inactivity compared with walking only at less than recommended levels was associated with higher all-cause mortality (hazard rate ratio=1.26, 95% CI=1.21, 1.31). Meeting one to two times the recommendations through walking only was associated with lower all-cause mortality (hazard rate ratio=0.80, 95% CI=0.78, 0.83). Associations with walking adjusted for other moderate- or vigorous-intensity physical activity were similar to walking only. Walking was most strongly associated with respiratory disease mortality followed by cardiovascular disease mortality and then cancer mortality.

CONCLUSIONS:

In older adults, walking below minimum recommended levels is associated with lower all-cause mortality compared with inactivity. Walking at or above physical activity recommendations is associated with even greater decreased risk. Walking is simple, free, and does not require any training, and thus is an ideal activity for most Americans, especially as they age.

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TMAO is Associated with Mortality: Impact of Modestly Impaired Renal Function.

Gruppen EG, Garcia E, Connelly MA, Jeyarajah EJ, Otvos JD, Bakker SJL, Dullaart RPF.

Sci Rep. 2017 Oct 23;7(1):13781. doi: 10.1038/s41598-017-13739-9.

PMID: 29061990

https://www.nature.com/articles/s41598-017-13739-9

https://www.nature.com/articles/s41598-017-13739-9.pdf

Abstract

Trimethylamine-N-Oxide (TMAO) is a microbiome-related metabolite that is cleared by the kidney and linked to renal function. We explored the relationship between TMAO and all-cause mortality, and determined whether this association was modified by renal function. A prospective study was performed among PREVEND participants to examine associations of plasma TMAO with all-cause mortality. After median follow-up of 8.3 years in 5,469 participants, 322 subjects died. TMAO was positively associated with age, body mass index, type 2 diabetes mellitus and inversely with estimated glomerular filtration rate (eGFRcreatcysC)(all P < 0.001). Subjects in the highest versus lowest TMAO quartile had a crude 1.86-fold higher mortality risk (Ptrend < 0.001). After adjustment for several risk factors, TMAO remained associated with all-cause mortality [hr:1.36 (95% CI, 0.97-1.91),Ptrend = 0.016]. This association was lost after further adjustment for urinary albumin excretion and eGFR [hr:1.15 (95% CI, 0.81-1.64),Ptrend = 0.22]. The association of TMAO with mortality was modified by eGFR in crude and age- and sex-adjusted analyses (interaction P = 0.002). When participants were stratified by renal function (eGFR < vs. ≥90 mL/min/1.73 m2), TMAO was associated with all-cause mortality only in subjects with eGFR <90 mL/min/1.73 m2 [adjusted HR:1.18 (95% CI, 1.02-1.36),P = 0.023]. In conclusion, TMAO is associated with all-cause mortality, particularly in subjects with eGFR <90 mL/min/1.73 m2.

 

Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies.

Xu W, Wang HF, Wan Y, Tan CC, Yu JT, Tan L.

BMJ Open. 2017 Oct 22;7(10):e014706. doi: 10.1136/bmjopen-2016-014706.

PMID: 29061599

http://bmjopen.bmj.com/content/7/10/e014706.long

http://bmjopen.bmj.com/content/bmjopen/7/10/e014706.full.pdf

Abstract

BACKGROUND:

There is considerable evidence of the favourable role of more physical activity (PA) in fighting against dementia. However, the shape of the dose-response relationship is still unclear.

OBJECTIVE:

To quantitatively investigate the relationship between dementia and PA.

DESIGN:

PubMed, EMBASE, Ovid and the Cochrane Library were searched for prospective studies published from 1 January 1995 to 15 October 2016. Two types of meta-analyses were performed with a focus on the dose-response relationship using two stage generalised least squares regression.

RESULTS:

The primary analysis exhibited a dose-response trend for all-cause dementia (ACD), Alzheimer's disease (AD) but not for vascular dementia (VD). In the dose-response analysis, either ACD (ptrend <0.005; pnon-linearity=0.87) or AD (p trend <0.005; pnon-linearity=0.10) exhibited a linear relationship with leisure time PA (LTPA) over the observed range (0-2000 kcal/week or 0-45 metabolic equivalent of task hours per week (MET-h/week)). Specifically, for every 500 kcal or 10 MET-h increase per week, there was, on average, 10% and 13% decrease in the risk of ACD and AD, respectively.

CONCLUSIONS:

We have reported, for the first time, the dose-response relationship between LTPA and dementia, further supporting the international PA guideline from the standpoint of dementia prevention.

KEYWORDS:

alzheimer; dementia; dose-response; physical Activity

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Meditation and yoga associated with changes in brain

Michaela Jarvis

Science 27 Oct 2017:

Vol. 358, Issue 6362, pp. 461

DOI: 10.1126/science.358.6362.461

http://sci-hub.cc/10.1126/science.358.6362.461

Studies of meditation and yoga report changes in brain activation and chemistry. -- PHOTO: AVESUN/ISTOCKPHOTO

Brain researchers have detected improvements in cognition and emotional well-being associated with meditation and yoga, as well as differences in how meditation and prayer affect the brains of those who believe in God and those who do not.

At a 28 September Neuroscience & Society event cosponsored by AAAS and the Dana Foundation, neuroscientist Sara Lazar said that not only were the brain images in a study of people who meditated different from those who did not, other research showed that certain changes in performance such as improved scores on the Graduate Record Exam (GRE) occurred in controlled experiments involving mindfulness training.

“This suggests neuroplasticity to me,” said Lazar, associate researcher in the psychiatry department at Massachusetts General Hospital and an assistant professor in psychology at Harvard Medical School, “the ability of your brain to change, to grow and adapt” in correlation with meditation.

AAAS and the Dana Foundation have collaborated on the Neuroscience & Society lecture series since 2012, with 20 events so far reaching 3400 attendees. The purpose of the series is to provide a public forum for experts to share the latest advances in brain research and what they might mean for individuals and society.

In another presentation at the event, Chris Streeter, associate professor of psychology and neurology at Boston University School of Medicine, reported that the brain chemical GABA, a neurotransmitter associated with control of anxiety, peaked in experienced yoga practitioners after they executed 60 minutes of postures.

“That was the first time people could say there was a change in brain chemistry associated with yoga,” Streeter said.

In order to test whether yoga improved mood and lessened anxiety more than other physical exercise, study subjects were tested before and after a 12-week intervention in which they did yoga or walked. The activities were metabolically matched to involve the same amount of physical exercise.

The yoga group consistently felt better, according to various markers of mood and anxiety, Streeter said. An hour after the yoga, acute changes—revitalization, tranquillity, positivity, and increases in GABA levels—were reported.

In depressed patients, even those already on antidepressants, yoga was associated with improved sleep, increased positivity, and decreased suicidal ideation (although none of the participants had shown intent to commit suicide). All the measurements indicating mood began “moving in the right direction,” Streeter said.

In contexts involving meditation and prayer, brain scans show differences in how the brain reacts depending on whether a subject believes in God, said Andrew Newberg, director of research at the Marcus Institute of Integrative Health and a physician at Thomas Jefferson University Hospital.

According to one of Newberg's studies, when nuns contemplated God, activation was detected in images of the prefrontal cortex, the center of cognitive control, but there was no such activation in the brains of atheists.

Newberg also discussed brain chemistry changes associated with retreat experiences involving prayer, meditation, and silence. Tests from before and after the retreat experience showed decreases in dopamine and serotonin transporter levels, which w ould allow the neurotransmitter chemicals to be stored in the brain for later use.

Finishing his presentation, Newberg said the work of all three researchers could be seen as interconnected.

“All of this work is coalescing and helping us to understand the overall nature of these experiences,” he said.

 

[[The below paper is not pdf-availed.]

High adherence to the Mediterranean diet is associated with cardiovascular protection in higher but not in lower socioeconomic groups: prospective findings from the Moli-sani study.

Bonaccio M, Di Castelnuovo A, Pounis G, Costanzo S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L; Moli-sani Study Investigators.

Int J Epidemiol. 2017 Aug 1. doi: 10.1093/ije/dyx145. [Epub ahead of print]

PMID: 29040542

https://sci-hub.cc/http://fdslive.oup.com/www.oup.com/pdf/production_in_progress.pdf

Abstract

BACKGROUND:

It is uncertain whether the cardiovascular benefits associated with Mediterranean diet (MD) may differ across socioeconomic groups.

METHODS:

Prospective analysis on 18991 men and women aged ≥35 years from the general population of the Moli-sani cohort (Italy). Adherence to MD was appraised by the Mediterranean diet score (MDS). Household income (euros/year) and educational level were used as indicators of socioeconomic status. Hazard ratios (HR) were calculated by multivariable Cox proportional hazard models.

RESULTS:

Over 4.3 years of follow-up, 252 cardiovascular disease (CVD) events occurred. Overall, a two-point increase in MDS was associated with 15% reduced CVD risk (95% confidence interval: 1% to 27%). Such association was evident in highly (HR = 0.43; 0.25-0.72) but not in less (HR = 0.94; 0.78-1.14) educated subjects ( P for interaction = 0.042). Similarly, CVD advantages associated with the MD were confined to the high household income group (HR = 0.39; 0.23-0.66, and HR = 1.01; 0.79-1.29 for high- and low-income groups, respectively; P for interaction = 0.0098). In a subgroup of individuals of different socioeconomic status but sharing similar MDS, diet-related disparities were found as different intakes of antioxidants and polyphenols, fatty acids, micronutrients, dietary antioxidant capacity, dietary diversity, organic vegetables and whole grain bread consumption.

CONCLUSIONS:

MD is associated with lower CVD risk but this relationship is confined to higher socioeconomic groups. In groups sharing similar scores of adherence to MD, diet-related disparities across socioeconomic groups persisted. These nutritional gaps may reasonably explain at least in part the socioeconomic pattern of CVD protection from the MD.

KEYWORDS:

Cardiovascular disease; Mediterranean diet; coronary heart disease; interaction; socioeconomic status; stroke

 

The Effects of Breakfast Consumption and Composition on Metabolic Wellness with a Focus on Carbohydrate Metabolism.

Maki KC, Phillips-Eakley AK, Smith KN.

Adv Nutr. 2016 May 16;7(3):613S-21S. doi: 10.3945/an.115.010314. Print 2016 May. Review.

PMID: 27184288

Abstract

Findings from epidemiologic studies indicate that there are associations between breakfast consumption and a lower risk of type 2 diabetes mellitus (T2DM) and metabolic syndrome, prompting interest in the influence of breakfast on carbohydrate metabolism and indicators of T2DM risk. The objective of this review was to summarize the available evidence from randomized controlled trials assessing the impact of breakfast on variables related to carbohydrate metabolism and metabolic wellness. Consuming compared with skipping breakfast appeared to improve glucose and insulin responses throughout the day. Breakfast composition may also be important. Dietary patterns high in rapidly available carbohydrate were associated with elevated T2DM risk. Therefore, partial replacement of rapidly available carbohydrate with other dietary components, such as whole grains and cereal fibers, proteins, and unsaturated fatty acids (UFAs), at breakfast may be a useful strategy for producing favorable metabolic outcomes. Consumption of fermentable and viscous dietary fibers at breakfast lowers glycemia and insulinemia. Fermentable fibers likely act through enhancing insulin sensitivity later in the day, and viscous fibers have an acute effect to slow the rate of carbohydrate absorption. Partially substituting protein for rapidly available carbohydrate enhances satiety and diet-induced thermogenesis, and also favorably affects lipoprotein lipids and blood pressure. Partially substituting UFA for carbohydrate has been associated with improved insulin sensitivity, lipoprotein lipids, and blood pressure. Overall, the available evidence suggests that consuming breakfast foods high in whole grains and cereal fiber, while limiting rapidly available carbohydrate, is a promising strategy for metabolic health promotion.

KEYWORDS:

breakfast; carbohydrate metabolism; diabetes; dietary patterns; energy metabolism; metabolic syndrome

 

[One capsule of fish oil contained 182 mg eicosapentaenoic acid (EPA) and 129 mg

docosahexaenoic acid (DHA). One capsule of placebo contained the same amount of corn oil.

Both the fish oil and placebo oil contained 1000 ppm of tocopherol as an antioxidant.]

Effects of fish oil-derived fatty acids on suboptimal cardiovascular health: A multicenter, randomized, double-blind, placebo-controlled trial.

Zeng Q, Dong SY, Liu YP, Fu J, Shuai P, Zhao ZM, Li TX.

Nutr Metab Cardiovasc Dis. 2017 Sep 21. pii: S0939-4753(17)30205-3. doi: 10.1016/j.numecd.2017.09.004. [Epub ahead of print]

PMID: 29066159

Abstract

BACKGROUND AND AIMS:

Suboptimal health and metabolic disorders are common in the general population. Both are related to cardiovascular disease. Suboptimal cardiovascular health is defined by the presence of both suboptimal health and metabolic disorders. The aim of the study was to investigate the potential benefit of n-3 long-chain polyunsaturated fatty acids (LCPUFA) in participants with suboptimal cardiovascular health.

METHODS AND RESULTS:

A total of 422 participants with suboptimal cardiovascular health, from two clinics in China, were enrolled from September 2014 to April 2015. All the enrolled participants were randomly assigned to receive 4 g/d of fish oil or placebo for three months. Suboptimal health was defined using an accepted questionnaire. Metabolic disorders were defined as one or more abnormalities in blood pressure, fasting plasma glucose, blood lipids, and body mass index (BMI). After treatment, the mean BMI fell significantly more in the n-3 LCPUFA group than in the placebo group (-0.29 ± 0.06 kg/m2 vs. -0.02 ± 0.06 kg/m2, P = 0.003). Similar results were found in the changes of suboptimal health status and suboptimal cardiovascular health status (P < 0.05 for all). In a multivariate analysis, the n-3 LCPUFA group was 5.44 (1.15, 25.67) times more likely to have optimal cardiovascular health status after treatment.

CONCLUSIONS:

n-3 LCPUFA intake improved suboptimal cardiovascular health in this placebo-controlled, randomized, double-blind trial.

TRIAL REGISTRATION:

This study is registered at www.clinicaltrials.govNCT02103517.

KEYWORDS:

Cardiovascular risk; Fish oil; Metabolic disorders; Suboptimal cardiovascular health; Suboptimal health; n-3 long-chain polyunsaturated fatty acids

 

Carbohydrate-Restriction with High-Intensity Interval Training: An Optimal Combination for Treating Metabolic Diseases?

Francois ME, Gillen JB, Little JP.

Front Nutr. 2017 Oct 12;4:49. doi: 10.3389/fnut.2017.00049. eCollection 2017.

PMID: 29075629

Abstract

Lifestyle interventions incorporating both diet and exercise strategies remain cornerstone therapies for treating metabolic disease. Carbohydrate-restriction and high-intensity interval training (HIIT) have independently been shown to improve cardiovascular and metabolic health. Carbohydrate-restriction reduces postprandial hyperglycemia, thereby limiting potential deleterious metabolic and cardiovascular consequences of excessive glucose excursions. Additionally, carbohydrate-restriction has been shown to improve body composition and blood lipids. The benefits of exercise for improving insulin sensitivity are well known. In this regard, HIIT has been shown to rapidly improve glucose control, endothelial function, and cardiorespiratory fitness. Here, we report the available evidence for each strategy and speculate that the combination of carbohydrate-restriction and HIIT will synergistically maximize the benefits of both approaches. We hypothesize that this lifestyle strategy represents an optimal intervention to treat metabolic disease; however, further research is warranted in order to harness the potential benefits of carbohydrate-restriction and HIIT for improving cardiometabolic health.

KEYWORDS:

cardiometabolic disease; exercise; glycemic control; high-intensity interval training; low-carb diets; metabolism

 

Mitochondrial determinants of mammalian longevity.

Kitazoe Y, Hasegawa M, Tanaka M, Futami M, Futami J.

Open Biol. 2017 Oct;7(10). pii: 170083. doi: 10.1098/rsob.170083.

PMID: 29070610 Free Article

Abstract

Current ageing theories are far from satisfactory because of the many determinants involved in ageing. The well-known rate-of-living theory assumes that the product (lifetime energy expenditure, LEE) of maximum lifespan (MLS) and mass-specific basal metabolic rate (msBMR) is approximately constant. Although this theory provides a significant inverse correlation between msBMR and MLS as a whole for mammals, it remains problematic for two reasons. First, several interspecies studies within respective orders (typically within rodents) have shown no inverse relationships between msBMR and MLS. Second, LEE values widely vary in mammals and birds. Here, to solve these two problems, we introduced a new quantity designated as mitochondrial (mt) lifetime energy output, mtLEO = MLS × mtMR, in place of LEE, by using the mt metabolic rate (mtMR) per mitochondrion. Thereby, we found that mtLEO values were distributed more narrowly than LEE ones, and strongly correlated with the four amino-acid variables (AAVs) of Ser, Thr and Cys contents and hydrophobicity of mtDNA-encoded membrane proteins (these variables were related to the stability of these proteins). Consequently, only these two mt items, mtMR and the AAVs, solved the above-mentioned problems in the rate-of-living theory, and thus extensively improved the correlation with MLS compared with that given by LEE.

KEYWORDS:

ageing theory; mammalian longevity; metabolic rate; mitochondrial membrane proteins

 

Thyroid status and mortality in nonagenarians from long-lived families and the general population.

van Vliet NA, van der Spoel E, Beekman M, Slagboom PE, Blauw GJ, Gussekloo J, Westendorp RGJ, van Heemst D.

Aging (Albany NY). 2017 Oct 25. doi: 10.18632/aging.101310. [Epub ahead of print]

PMID: 29070732

Abstract

The relationship between thyroid status and longevity has been investigated extensively. However, data on thyroid status and survival in old age is scarce. In this study we investigated associations of different parameters of thyroid status with mortality in nonagenarians, and whether these associations were different in nonagenarians from long-lived families than in nonagenarians from the general population. In total, 805 nonagenarians from the Leiden Longevity Study and 259 nonagenarians from the Leiden 85-plus Study were followed up to collect mortality data. At baseline, levels of thyrotropin (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured. In nonagenarians from long-lived families and from the general population, associations between thyroid parameters and mortality were similar. We found no interaction between study population and parameters of thyroid status on mortality (P-values>0.70). The results from both studies were combined to derive generalizable associations. Hazard ratios (HRs) for the highest compared to lowest tertiles were determined, resulting in TSH HR 0.91 (P=0.25), fT4 HR 1.22 (P=0.02), fT3 HR 0.74 (P=1.31e-4), and fT3/fT4 HR 0.66 (P=5.64e-7). In conclusion, higher fT3/fT4 ratios, higher levels of fT3, and lower levels of fT4 were associated with lower mortality rate in nonagenarians and independent of familial longevity status.

KEYWORDS:

familial; longevity; mortality; nonagenarians; thyroid

 

Negative legacy of obesity.

Shirakawa K, Endo J, Katsumata Y, Yamamoto T, Kataoka M, Isobe S, Yoshida N, Fukuda K, Sano M.

PLoS One. 2017 Oct 26;12(10):e0186303. doi: 10.1371/journal.pone.0186303. eCollection 2017.

PMID: 29073165

Abstract

Obesity promotes excessive inflammation, which is associated with senescence-like changes in visceral adipose tissue (VAT) and the development of type 2 diabetes (T2DM) and cardiovascular diseases. We have reported that a unique population of CD44hi CD62Llo CD4+ T cells that constitutively express PD-1 and CD153 exhibit cellular senescence and cause VAT inflammation by producing large amounts of osteopontin. Weight loss improves glycemic control and reduces cardiovascular disease risk factors, but its long-term effects on cardiovascular events and longevity in obese individuals with T2DM are somewhat disappointing and not well understood. High-fat diet (HFD)-fed obese mice were subjected to weight reduction through a switch to a control diet. They lost body weight and visceral fat mass, reaching the same levels as lean mice fed a control diet. However, the VAT of weight reduction mice exhibited denser infiltration of macrophages, which formed more crown-like structures compared to the VAT of obese mice kept on the HFD. Mechanistically, CD153+ PD-1+ CD4+ T cells are long-lived and not easily eliminated, even after weight reduction. Their continued presence maintains a self-sustaining chronic inflammatory loop via production of large amounts of osteopontin. Thus, we concluded that T-cell senescence is essentially a negative legacy effect of obesity.

 

Increased dietary long-chain polyunsaturated fatty acids alter serum fatty acid concentrations and lower risk of urine stone formation in cats.

Hall JA, Brockman JA, Davidson SJ, MacLeay JM, Jewell DE.

PLoS One. 2017 Oct 26;12(10):e0187133. doi: 10.1371/journal.pone.0187133. eCollection 2017.

PMID: 29073223

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0187133

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0187133&type=printable

Abstract

The lifespan of cats with non-obstructive kidney stones is shortened compared with healthy cats indicating a need to reduce stone formation and minimize chronic kidney disease. The purpose of this study was to investigate the effects of increasing dietary polyunsaturated fatty acids (PUFA) on urine characteristics. Domestic-short-hair cats (n = 12; mean age 5.6 years) were randomized into two groups and fed one of two dry-cat foods in a cross-over study design. For one week before study initiation, all cats consumed control food that contained 0.07% arachidonic acid (AA), but no eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA). Group 1 continued eating control food for 56 days. Group 2 was fed test food for 56 days, which was control food plus fish oil and high-AA oil. Test food contained 0.17% AA, 0.09% EPA and 0.18% DHA. After 56 days, cats were fed the opposite food for another 56 days. At baseline and after each feeding period, serum was analyzed for fatty acid concentrations, and urine for specific gravity, calcium concentration, relative-super-saturation for struvite crystals, and a calcium-oxalate-titrimetric test was performed. After consuming test food, cats had increased (all P<0.001) serum concentrations of EPA (173%), DHA (61%), and AA (35%); decreased urine specific gravity (P = 0.02); decreased urine calcium concentration (P = 0.06); decreased relative-super-saturation for struvite crystals (P = 0.03); and increased resistance to oxalate crystal formation (P = 0.06) compared with cats consuming control food. Oxalate crystal formation was correlated with serum calcium concentration (r = 0.41; P<0.01). These data show benefits for reducing urine stone formation in cats by increasing dietary PUFA.

 

Influenza and pneumococcal vaccination in older adults living in nursing home: a survival analysis on the shelter study.

Poscia A, Collamati A, Carfì A, Topinkova E, Richter T, Denkinger M, Pastorino R, Landi F, Ricciardi W, Bernabei R, Onder G.

Eur J Public Health. 2017 Oct 23. doi: 10.1093/eurpub/ckx150. [Epub ahead of print]

PMID: 29069321

Abstract

BACKGROUND:

Influenza and pneumococcal vaccines have been proved to be effective and safe in preventing and controlling infection among elderly, reducing morbidity and mortality. However, some evidences raised health concerns related to these vaccinations. This study aims to identify prevalence and outcomes related to influenza and pneumococcal vaccinations in a large European population of frail old people living in nursing homes (NHs).

METHODS:

We conducted a survival analysis of NH residents participating to the Services and Health for Elderly in Long-TERm project, a prospective cohort study collecting information on residents admitted to 57 NH in eight countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel). Clinical and demographical data were collected using the international resident assessement instrument for long-term care facilities. Incident mortality was recorded during 1-year follow-up. A shared-frailty Cox regression model was used to assess the impact of vaccination status on mortality.

RESULTS:

Mean age of 3510 participants was 84.6 years (SD = 7.7). In total, 81.7 and 27.0% received influenza and pneumococcal vaccination, respectively. Overall, 727 (20.7%) residents died during the follow-up period. After adjusting for potential confounders, which included age, sex, number of diseases, depression, cognitive and functional status, influenza (HR = 0.80; 95% CI 0.66-0.97) and the combination of influenza and pneumococcal vaccination (HR = 0.72; 95% CI 0.57-0.91), but not pneumococcal vaccination alone (HR = 0.52; 95% CI 0.25-1.06), were associated with a statistically significant reduction in mortality in respect of no vaccinations.

CONCLUSION:

In a population of older adult living in NH influenza and the combination of influenza and pneumococcal vaccination were associated with a reduction in all-cause mortality respect to no vaccination.

 

Association of Cataract Surgery With Mortality in Older Women: Findings from the Women's Health Initiative.

Tseng VL, Chlebowski RT, Yu F, Cauley JA, Li W, Thomas F, Virnig BA, Coleman AL.

JAMA Ophthalmol. 2017 Oct 26. doi: 10.1001/jamaophthalmol.2017.4512. [Epub ahead of print]

PMID: 29075781

Abstract

IMPORTANCE:

Previous studies have suggested an association between cataract surgery and decreased risk for all-cause mortality potentially through a mechanism of improved health status and functional independence, but the association between cataract surgery and cause-specific mortality has not been previously studied and is not well understood.

OBJECTIVE:

To examine the association between cataract surgery and total and cause-specific mortality in older women with cataract.

DESIGN, SETTING, AND PARTICIPANTS:

This prospective cohort study included nationwide data collected from the Women's Health Initiative (WHI) clinical trial and observational study linked with the Medicare claims database. Participants in the present study were 65 years or older with a diagnosis of cataract in the linked Medicare claims database. The WHI data were collected from January 1, 1993, through December 31, 2015. Data were analyzed for the present study from July 1, 2014, through September 1, 2017.

EXPOSURES:

Cataract surgery as determined by Medicare claims codes.

MAIN OUTCOMES AND MEASURES:

The outcomes of interest included all-cause mortality and mortality attributed to vascular, cancer, accidental, neurologic, pulmonary, and infectious causes. Mortality rates were compared by cataract surgery status using the log-rank test and Cox proportional hazards regression models adjusting for demographics, systemic and ocular comorbidities, smoking, alcohol use, body mass index, and physical activity.

RESULTS:

A total of 74 044 women with cataract in the WHI included 41 735 who underwent cataract surgery. Mean (SD) age was 70.5 (4.6) years; the most common ethnicity was white (64 430 [87.0%]), followed by black (5293 [7.1%]) and Hispanic (1723 [2.3%]). The mortality rate was 2.56 per 100 person-years in both groups. In covariate-adjusted Cox models, cataract surgery was associated with lower all-cause mortality (adjusted hazards ratio [AHR], 0.40; 95% CI, 0.39-0.42) as well as lower mortality specific to vascular (AHR, 0.42; 95% CI, 0.39-0.46), cancer (AHR, 0.31; 95% CI, 0.29-0.34), accidental (AHR, 0.44; 95% CI, 0.33-0.58), neurologic (AHR, 0.43; 95% CI, 0.36-0.53), pulmonary (AHR, 0.63; 95% CI, 0.52-0.78), and infectious (AHR, 0.44; 95% CI, 0.36-0.54) diseases.

CONCLUSIONS AND RELEVANCE:

In older women with cataract in the WHI, cataract surgery is associated with lower risk for total and cause-specific mortality, although whether this association is explained by the intervention of cataract surgery is unclear. Further study of the interplay of cataract surgery, systemic disease, and disease-related mortality would be informative for improved patient care.

 

Association of serum magnesium with all-cause mortality in patients with and without chronic kidney disease in the Dallas Heart Study.

Ferrè S, Li X, Adams-Huet B, Maalouf NM, Sakhaee K, Toto RD, Moe OW, Neyra JA.

Nephrol Dial Transplant. 2017 Oct 25. doi: 10.1093/ndt/gfx275. [Epub ahead of print]

PMID: 29077944

http://sci-hub.cc/10.1093/ndt/gfx275

Abstract

BACKGROUND:

Low serum magnesium (SMg) has been linked to increased mortality and cardiovascular disease (CVD) in the general population. We examined whether this association is similar in participants with versus without prevalent chronic kidney disease (CKD) in the multiethnic Dallas Heart Study (DHS) cohort.

METHODS:

SMg was analyzed as a continuous variable and divided into tertiles. Study outcomes were all-cause death, cardiovascular (CV) death or event, and CVD surrogate markers, evaluated using multivariable Cox regression models adjusted for demographics, comorbidity, anthropometric and biochemical parameters including albumin, phosphorus and parathyroid hormone, and diuretic use. Median follow-up was 12.3 years (11.9-12.8, 25th percentile-75th percentile).

RESULTS:

Among 3551 participants, 306 (8.6%) had prevalent CKD. Mean SMg was 2.08 ± 0.19 mg/dL (0.85 ± 0.08 mM, mean ± SD) in the CKD and 2.07 ± 0.18 mg/dL (0.85 ± 0.07 mM) in the non-CKD subgroups. During the follow-up period, 329 all-cause deaths and 306 CV deaths or events occurred. In a fully adjusted model, every 0.2 mg/dL decrease in SMg was associated with ∼20-40% increased hazard for all-cause death in both CKD and non-CKD subgroups. In CKD participants, the lowest SMg tertile was also independently associated with all-cause death (adjusted hazard ratio 2.31; 95% confidence interval 1.23-4.36 versus 1.15; 0.55-2.41; for low versus high tertile, respectively).

CONCLUSIONS:

Low SMg levels (1.4-1.9 mg/dL; 0.58-0.78 mM) were independently associated with all-cause death in patients with prevalent CKD in the DHS cohort. Randomized clinical trials are important to determine whether Mg supplementation affects survival in CKD patients.

KEYWORDS:

cardiovascular disease; chronic kidney disease; magnesium; mineral metabolism; mortality

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[The below paper is pdf-availed.]

Does the association between leisure activities and survival in old age differ by living arrangement?

Nilsen C, Agahi N, Shaw BA.

J Epidemiol Community Health. 2017 Oct 27. pii: jech-2017-209614. doi: 10.1136/jech-2017-209614. [Epub ahead of print]

PMID: 29079586

Abstract

BACKGROUND:

Government policies to promote ageing in place have led to a growing frail population living at home in advanced old age, many of whom live alone. Living alone in old age is associated with adverse health outcomes, but we know little about whether it moderates the health impact of other risk and protective factors. Engagement in leisure activities is considered critical to successful ageing. We investigated whether the association between different types of leisure activities and survival in non-institutionalised older adults (aged 76 and above) differs by living arrangement and gender.

METHODS:

We used the Swedish Panel Study of Living Conditions of the Oldest Old study from 2011 and the Swedish Cause of Death Register (until 30 June 2014) to conduct Cox regression analyses (n=669). Incident mortality was 30.2% during the follow-up period.

RESULTS:

Overall level of leisure activity was not significantly associated with survival in either living arrangement, but some specific leisure activities, and associations, were different across gender and living arrangement. More specifically, certain social activities (participation in organisations and having relatives visit) were associated with longer survival, but only in men living alone. In women, most results were statistically non-significant, with the exception of solving crosswords being associated with longer survival in women living with someone.

CONCLUSION:

In order to facilitate engagement with life, interventions focusing on leisure activities in the oldest age groups should take gender and living arrangement into consideration when determining the type of activity most needed.

KEYWORDS:

elderly; gender; mortality; social activities

 

Fasting blood glucose and risk of prostate cancer: A systematic review and meta-analysis of dose-response.

Jayedi A, Djafarian K, Rezagholizadeh F, Mirzababaei A, Hajimohammadi M, Shab-Bidar S.

Diabetes Metab. 2017 Oct 23. pii: S1262-3636(17)30516-5. doi: 10.1016/j.diabet.2017.09.004. [Epub ahead of print] Review.

PMID: 29074328

Abstract

AIM:

This study aimed to test the dose-response relationship between fasting blood glucose (FBG) levels and risk of prostate cancer.

METHODS:

A systematic search was done of PubMed and Scopus from their inception up to January 2017. Prospective and retrospective studies reporting risk estimates of prostate cancer for two or more categories of blood glucose levels were identified, and two independent authors extracted the information. Relative risk (RR) was calculated using random-effects models and pooled.

RESULTS:

Ten prospective cohort studies, one nested case-control study, one case-cohort study and three case-control studies (total n=1,214,947) involving 12,494 cases of prostate cancer were reviewed. The pooled RR of prostate cancer for the highest vs. lowest category of FBG was 0.88 (95% CI: 0.78-0.98, I2=25.5%, n=15 studies). A 10mg/dL increment in FBG level was not associated with risk of prostate cancer (0.98, 95% CI: 0.96-1.00, I2=45.4%, n=11 studies). Subgroup analyses yielded a significant inverse association only in the subgroup of cohort studies. Non-linear dose-response meta-analysis showed a very slight decrement in risk with increasing FBG levels. Sensitivity analyses using cohort studies showed a steep decrease in risk along with an increase in FBG from baseline levels of ≈70mg/dL across prediabetes and diabetes ranges.

CONCLUSION:

Higher FBG levels are associated with lower risk of prostate cancer in cohort studies, but not in case-control studies, findings that limit interpretation of our present results.

KEYWORDS:

Blood glucose; Longitudinal studies; Meta-analysis; Prostate cancer; Type 2 diabetes

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Comparative Risk of Cardiovascular Outcomes Between Topical and Oral Nonselective NSAIDs in Taiwanese Patients With Rheumatoid Arthritis.

Lin TC, Solomon DH, Tedeschi SK, Yoshida K, Kao Yang YH.

J Am Heart Assoc. 2017 Oct 27;6(11). pii: e006874. doi: 10.1161/JAHA.117.006874.

PMID: 29079568 Free Article

http://jaha.ahajournals.org/content/6/11/e006874.long

Abstract

BACKGROUND:

Topical NSAIDs have less systemic absorption than oral NSAIDs. We examined the risk of cardiovascular events associated with nonselective topical NSAIDs versus oral NSAIDs among patients with rheumatoid arthritis in Taiwan.

METHODS AND RESULTS:

We conducted a retrospective cohort study that included patients with incident rheumatoid arthritis who were newly starting therapy with nonselective topical NSAIDs or oral NSAIDs. We used the Taiwan National Health Insurance Research Database (NHIRD). The first date patients received either type of NSAID was defined as the index date. NSAID exposures continued until there was a treatment gap of >30 days. The main outcome was composite cardiovascular events, including myocardial infarction, unstable angina, heart failure, stroke, or revascularization. Follow-up was censored at treatment discontinuation, switch or addition of other NSAID category, cardiovascular outcome, death, or the end of the study. Propensity score weighted Cox regression models were used to compare the risk of cardiovascular events between topical NSAIDs and oral NSAIDs. There were 10 758 and 78 056 treatment episodes for topical and oral NSAIDs identified. After weighting by propensity score, the cohorts were well balanced over all covariates. The crude cardiovascular event rate was 1.87 per 100 person-years for topical NSAIDs and 2.14 per 100 person-years for oral NSAIDs. Results of propensity score weighted Cox regression found the topical NSAID group had 36% lower risk for cardiovascular events compared with the oral NSAID group (hazard ratio, 0.64; 95% confidence interval, 0.43-0.95).

CONCLUSIONS:

We found topical NSAID users experienced a reduced risk of cardiovascular events compared with oral NSAID users. If future studies with a larger sample size and longer follow-up confirm these results, NSAID prescribing might change accordingly.

KEYWORDS:

NSAIDs; cardiovascular outcomes; comparative effectiveness; pharmacoepidemiology; rheumatoid arthritis

 

Plasma Metabolites From Choline Pathway and Risk of Cardiovascular Disease in the PREDIMED (Prevention With Mediterranean Diet) Study

Marta Guasch‐Ferré, Frank B. Hu, Miguel Ruiz‐Canela, Mònica Bulló, Estefanía Toledo, Dong D. Wang, Dolores Corella, Enrique Gómez‐Gracia, Miquel Fiol, Ramon Estruch, José Lapetra, Montserrat Fitó, Fernando Arós, Lluís Serra‐Majem, Emilio Ros, Courtney Dennis, Liming Liang, Clary B. Clish, Miguel A. Martínez‐González, Jordi Salas‐Salvadó

Journal of the American Heart Association. 2017;6:e006524, originally published October 28, 2017

https://doi.org/10.1161/JAHA.117.006524

http://jaha.ahajournals.org/content/6/11/e006524

Abstract

Background The relationship between plasma concentrations of betaine and choline metabolism and major cardiovascular disease (CVD) end points remains unclear. We have evaluated the association between metabolites from the choline pathway and risk of incident CVD and the potential modifying effect of Mediterranean diet interventions.

Methods and Results We designed a case‐cohort study nested within the PREDIMED (Prevention With Mediterranean Diet) trial, including 229 incident CVD cases and 751 randomly selected participants at baseline, followed up for 4.8 years. We used liquid chromatography–tandem mass spectrometry to measure, at baseline and at 1 year of follow‐up, plasma concentrations of 5 metabolites in the choline pathway: trimethylamine N‐oxide, betaine, choline, phosphocholine, and α‐glycerophosphocholine. We have calculated a choline metabolite score using a weighted sum of these 5 metabolites. We used weighted Cox regression models to estimate CVD risk. The multivariable hazard ratios (95% confidence intervals) per 1‐SD increase in choline and α‐glycerophosphocholine metabolites were 1.24 (1.05–1.46) and 1.24 (1.03–1.50), respectively. The baseline betaine/choline ratio was inversely associated with CVD. The baseline choline metabolite score was associated with a 2.21‐fold higher risk of CVD across extreme quartiles (95% confidence interval, 1.36–3.59; P<0.001 for trend) and a 2.27‐fold higher risk of stroke (95% confidence interval, 1.24–4.16; P<0.001 for trend). Participants in the higher quartiles of the score who were randomly assigned to the control group had a higher risk of CVD compared with participants in the lower quartile and assigned to the Mediterranean diet groups (P=0.05 for interaction). No significant associations were observed for 1‐year changes in individual plasma metabolites and CVD.

Conclusions A metabolite score combining plasma metabolites from the choline pathway was associated with an increased risk of CVD in a Mediterranean population at high cardiovascular risk.

cardiovascular diseasecholinegut microbiotaMediterranean dietmetabolomics

Clinical Perspective

What Is New?

Baseline plasma concentrations of choline pathway metabolites (choline, phosphocholine, and α‐glycerophosphocholine) and a metabolite score combining choline pathway metabolites were associated with the risk of major cardiovascular events after 4.8 years of follow‐up in a Mediterranean population at high cardiovascular risk.

What Are the Clinical Implications?

Our findings suggest that metabolites from choline pathways may play a role in the development of cardiovascular disease.

The present work may have important public health implications for focusing on dietary interventions, such as adhering to a Mediterranean diet and reducing the intake of animal products, to improve metabolite profiles and, consequently, the risk of cardiovascular disease.

However, further research is needed to replicate these results in other populations and investigate the potential mechanisms underlying the associations between metabolite profiles and cardiovascular disease.

 

‘Fat but Fit’? The Controversy Continues

By RONI CARYN RABINOCT. 26, 2017

https://www.nytimes.com/2017/10/26/well/eat/fat-but-fit-the-controversy-continues.html?module=WatchingPortal&region=c-column-middle-span-region&pgType=Homepage&action=click&mediaId=thumb_square&state=standard&contentPlacement=10&version=internal&contentCollection=www.nytimes.com&contentId=https%3A%2F%2Fwww.nytimes.com%2F2017%2F10%2F26%2Fwell%2Feat%2Ffat-but-fit-the-controversy-continues.html&eventName=Watching-article-click

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

Metabolically Healthy Obese and Incident Cardiovascular Disease Events Among 3.5 Million Men and Women.

Caleyachetty R, Thomas GN, Toulis KA, Mohammed N, Gokhale KM, Balachandran K, Nirantharakumar K.

J Am Coll Cardiol. 2017 Sep 19;70(12):1429-1437. doi: 10.1016/j.jacc.2017.07.763.

PMID: 28911506

Abstract

BACKGROUND:

Previous studies have been unclear about the cardiovascular risks for metabolically healthy obese individuals.

OBJECTIVES:

This study examined the associations among metabolically healthy obese individuals and 4 different presentations of incident cardiovascular disease in a contemporary population.

METHODS:

We used linked electronic health records (1995 to 2015) in The Health Improvement Network (THIN) to assemble a cohort of 3.5 million individuals, 18 years of age or older and initially free of cardiovascular disease. We created body size phenotypes defined by body mass index categories (underweight, normal weight, overweight, and obesity) and 3 metabolic abnormalities (diabetes, hypertension, and hyperlipidemia). The primary endpoints were the first record of 1 of 4 cardiovascular presentations (coronary heart disease [CHD], cerebrovascular disease, heart failure, and peripheral vascular disease).

RESULTS:

During a mean follow-up of 5.4 years, obese individuals with no metabolic abnormalities had a higher risk of CHD (multivariate-adjusted hazard ratio {HR}: 1.49; 95% confidence interval [CI]: 1.45 to 1.54), cerebrovascular disease (HR: 1.07; 95% CI: 1.04 to 1.11), and heart failure (HR: 1.96; 95% CI: 1.86 to 2.06) compared with normal weight individuals with 0 metabolic abnormalities. Risk of CHD, cerebrovascular disease, and heart failure in normal weight, overweight, and obese individuals increased with increasing number of metabolic abnormalities.

CONCLUSIONS:

Metabolically healthy obese individuals had a higher risk of coronary heart disease, cerebrovascular disease, and heart failure than normal weight metabolically healthy individuals. Even individuals who are normal weight can have metabolic abnormalities and similar risks for cardiovascular disease events.

Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

cerebrovascular disease; coronary heart disease; heart failure; obesity; overweight; phenotype; weight

Edited by AlPater

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The Impact of Dietary Protein or Amino Acid Supplementation on Muscle Mass and Strength in Elderly People: Individual Participant Data and Meta-Analysis of RCT's.

Tieland M, Franssen R, Dullemeijer C, van Dronkelaar C, Kyung Kim H, Ispoglou T, Zhu K, Prince RL, van Loon LJC, de Groot LCPGM.

J Nutr Health Aging. 2017;21(9):994-1001. doi: 10.1007/s12603-017-0896-1.

PMID: 29083440

Abstract

OBJECTIVES:

Increasing protein or amino acid intake has been promoted as a promising strategy to increase muscle mass and strength in elderly people, however, long-term intervention studies show inconsistent findings. Therefore, we aim to determine the impact of protein or amino acid supplementation compared to placebo on muscle mass and strength in older adults by combining the results from published trials in a meta-analysis and pooled individual participant data analysis.

DESIGN:

We searched Medline and Cochrane databases and performed a meta-analysis on eight available trials on the effect of protein or amino acid supplementation on muscle mass and strength in older adults. Furthermore, we pooled individual data of six of these randomized double-blind placebo-controlled trials. The main outcomes were change in lean body mass and change in muscle strength for both the meta-analysis and the pooled analysis.

RESULTS:

The meta-analysis of eight studies (n=557) showed no significant positive effects of protein or amino acid supplementation on lean body mass (mean difference: 0.014 kg: 95% CI -0.152; 0.18), leg press strength (mean difference: 2.26 kg: 95% CI -0.56; 5.08), leg extension strength (mean difference: 0.75 kg: 95% CI: -1.96, 3.47) or handgrip strength (mean difference: -0.002 kg: 95% CI -0.182; 0.179). Likewise, the pooled analysis showed no significant difference between protein and placebo treatment on lean body mass (n=412: p=0.78), leg press strength (n=121: p=0.50), leg extension strength (n=121: p=0.16) and handgrip strength (n=318: p=0.37).

CONCLUSIONS:

There is currently no evidence to suggest that protein or amino acid supplementation without concomitant nutritional or exercise interventions increases muscle mass or strength in predominantly healthy elderly people.

KEYWORDS:

Sarcopenia; aging; dietary protein intake; lean body mass; performance

 

Intake of milk or fermented milk combined with fruit and vegetable consumption in relation to hip fracture rates: A cohort study of Swedish women.

Michaëlsson K, Wolk A, Lemming EW, Melhus H, Byberg L.

J Bone Miner Res. 2017 Oct 30. doi: 10.1002/jbmr.3324. [Epub ahead of print]

PMID: 29083056

Abstract

Milk products may differ in pro-oxidant properties and their effects on fracture risk could potentially be modified by the intake of foods with antioxidant activity. In the population-based Swedish Mammography Cohort study, we aimed to determine how milk and fermented milk combined with fruit and vegetable consumption are associated with hip fracture. Women born 1914-1948 (n=61 240) answered food frequency and lifestyle questionnaires in 1987-1990 and 38 071 women contributed with updated information in 1997. During a mean follow-up of 22 years, 5827 women had a hip fracture (ascertained via official register data). Compared with a low intake of milk (<1 glass/day) and a high intake of fruits and vegetables (≥5 servings/day), a high intake of milk (≥3 glasses/day) with a concomitant low intake of fruits and vegetables (<2 servings/day) resulted in a HR of 2.49 (95% CI, 2.03-3.05). This higher hip fracture rate among high consumers of milk was only modestly attenuated with a concomitant high consumption of fruit and vegetables (HR 2.14; 95% CI 1.69-2.71). The combination of fruits and vegetables with fermented milk (yogurt or soured milk) yielded a different pattern with lowest rates of hip fracture in high consumers: HR 0.81 (95% CI, 0.68-0.97) for ≥2 servings/day of fermented milk and ≥5 servings/day of fruits and vegetables compared with low consumption of both fruit and vegetables and fermented milk. We conclude that the amount and type of dairy products as well as fruit and vegetable intake are differentially associated with hip fracture rates in women.

KEYWORDS:

dairy; fruit; hip fracture; milk; vegetables

 

The Mediterranean Diet adherence by pregnant women delivering prematurely: association with size at birth and complications of prematurity.

Parlapani E, Agakidis C, Karagiozoglou-Lampoudi T, Sarafidis K, Agakidou E, Athanasiadis A, Diamanti E.

J Matern Fetal Neonatal Med. 2017 Oct 29:1-171. doi: 10.1080/14767058.2017.1399120. [Epub ahead of print]

PMID: 29082786

Abstract

BACKGROUND:

The Mediterranean diet (MD) is associated with decreased risk of metabolic syndrome and gestational diabetes due to the anti-inflammatory and antioxidative properties of its components. The aim was to investigate the potential association of MD adherence (MDA) during pregnancy by mothers delivering prematurely, with intrauterine growth as expressed by neonates' anthropometry at birth and complications of prematurity.

PARTICIPANTS AND METHODS:

This is a single-center, prospective, observational cohort study of 82 women who delivered preterm singletons at post conceptional age (PCA) ≤ 34 weeks and their live-born neonates. Maternal and neonatal demographic and clinical data were recorded. All mothers filled in a food frequency questionnaire, and the MDA score was calculated. Based on 50th centile of MD score, participants were classified into high-MDA and low-MDA groups.

RESULTS:

The low-MDA mothers had significantly higher pregestational BMI and rates of overweight/obesity (odd ratios (OR) 3.5) and gestational hypertension/preeclampsia (OR 3.8). Neonates in the low-MDA group had significantly higher incidence of intrauterine growth restriction (IUGR) (OR 3.3) and lower z-scores of birth weight and BMI. Regarding prematurity-related complications, the low MDA-group was more likely to develop necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity (OR 3.2, 1.3, and 1.6, respectively), while they were less likely to develop respiratory distress syndrome (OR 0.49), although the differences were not statistically significant. However, adjustment for confounders revealed MDA as a significant independent predictor of hypertension/preeclampsia, IUGR, birth weight z-score, necrotizing enterocolitis, and bronchopulmonary dysplasia.

CONCLUSIONS:

High MDA during pregnancy may favorably affect intrauterine growth and certain acute and chronic complications of prematurity as well as maternal hypertension/preeclampsia.

KEYWORDS:

Bronchopulmonary dysplasia; necrotizing enterocolitis; respiratory distress syndrome; retinopathy of prematurity

 

An early-customized low glycaemic-index diet prevents adverse pregnancy outcomes in overweight/obese women.

Petrella E, Tamborrino V, DI Cerbo L, Neri I, Facchinetti F.

Minerva Ginecol. 2017 Oct 27. doi: 10.23736/S0026-4784.17.04156-9. [Epub ahead of print]

PMID: 29083138

Abstract

OBJECTIVE:

To determine whether the prescription and follow-up of a behavioral program (customized nutritional advices and a constant physical activity) influences the occurrence of unfavorable maternal/neonatal outcomes among overweight/obese women.

METHODS:

A case-control study (1:3) included single pregnant women with BMI≥25, enrolled at 1st trimester. Cases (95) were prescribed (by both the dietitian and gynecologist) a low-glycemic index diet with an average intake of 1700/1800 Kcal/day plus 30 minutes walking at least 3 times/week (with four follow-up visits until delivery). Controls (275) received a nutritional booklet about a healthy lifestyle, than attended their scheduled visits until delivery by the obstetricians in charge.

RESULTS:

Gestational weight gain was similar between groups, despite obese women were higher in Cases (67.4%) than in Controls (54.5%, p=0.029). The occurrence of gestational diabetes mellitus (GDM) was lower in Cases (21.5%) than in Controls (32.7%; p=0.041). Such reduction remained related with the group of intervention (p=0.004) after correcting for confounders (BMI≥ 30, a family history of diabetes, age ≥ 35 and ethnicity). A higher number of Controls developed pregnancy induced hypertension (PIH) (11.6% vs 1.1% in cases, p<0.001). Preterm birth (PTB) occurred in one Case and in 28 Controls (10.2%; p=0.004). In the half of them, PTB was spontaneous while medically indicated for Intrauterine Growth Restriction, haemorrhage, PIH, GDM/macrosomia, Rh isoimmunisation in the remnant.

CONCLUSIONS:

An early behavioral intervention among overweight/obese pregnant women reduces unfavorable pregnancy outcomes.

 

Effect of dietary sodium restriction on arterial stiffness: systematic review and meta-analysis of the randomized controlled trials.

D'Elia L, Galletti F, La Fata E, Sabino P, Strazzullo P.

J Hypertens. 2017 Oct 27. doi: 10.1097/HJH.0000000000001604. [Epub ahead of print]

PMID: 29084085

Abstract

OBJECTIVE:

Arterial stiffness is an independent cardiovascular risk factor and sodium intake could be a determinant of arterial stiffness. Nevertheless, the studies that investigated the effect of reducing dietary sodium intake on arterial stiffness in humans provided inconsistent results. Therefore, we performed a systematic review and a meta-analysis of the available randomized controlled trials of salt restriction and arterial stiffness to try and achieve more definitive conclusions.

METHODS:

A systematic search of the online databases available (from 1996 through July 2017) was conducted including randomized controlled trials that reported arterial stiffness, expressed by carotid-femoral pulse wave velocity (PWV), as difference between the effects of two different sodium intake regimens. For each study, the mean difference and 95% confidence intervals were pooled using a random effect model. Sensitivity, heterogeneity, publication bias, subgroup and meta-regression analyses were performed.

RESULTS:

Eleven studies met the predefined inclusion criteria and provided 14 cohorts with 431 participants and 1-6 weeks intervention time. In the pooled analysis, an average reduction in sodium intake of 89.3 mmol/day was associated with a 2.84% (95% CI: 0.51-5.08) reduction in PWV. There was no significant heterogeneity among studies and no evidence of publication bias was detected. No single feature of the studies analyzed seemed to impact on the effect of salt restriction on PWV.

CONCLUSION:

The results of this meta-analysis indicate that restriction of dietary sodium intake reduces arterial stiffness. This effect seems be at least in part independent of the changes in blood pressure.

 

Initial level and rate of change in grip strength predict all-cause mortality in very old adults.

Granic A, Davies K, Jagger C, M Dodds R, Kirkwood TBL, Sayer AA.

Age Ageing. 2017 May 25:1-6. doi: 10.1093/ageing/afx087. [Epub ahead of print]

PMID: 28541466

Abstract

OBJECTIVE:

to investigate the associations between initial level and rate of change in grip strength (GS) and all-cause mortality in very old adults (≥85 years) over a 9.6-year follow-up.

METHODS:

prospective mortality data from 845 participants in the Newcastle 85+ Study were analysed for survival in relation to GS (kg, baseline and 5-year mean change) using Cox proportional hazards models.

RESULTS:

during the follow-up, 636 (75.3%) participants died. Higher baseline GS was associated with a decreased risk of mortality in all participants [hazard ratio (HR) = 0.95, 95% confidence interval (CI): 0.93-0.98, P < 0.001], men (HR = 0.97, 95% CI: 0.95-0.99, P = 0.009) and women (HR = 0.96, 95% CI: 0.94-0.99, P = 0.007) after adjustment for health, lifestyle and anthropometric factors. Overall GS slope had a downward trajectory and was determined in 602 participants: 451 experienced constant decline (negative slope) and 151 had increasing GS (positive slope) over time. Men and women with a negative slope had a 16 and 33% increased risk of mortality, respectively, with every kg/year decline in GS (P ≤ 0.005), and participants with a positive slope had a 31% decreased risk of mortality (P = 0.03) irrespective of baseline GS and key covariates.

CONCLUSION:

higher baseline GS and 5-year increase in GS were protective of mortality, whilst GS decline was associated with an increased risk of mortality in the very old over 9.6 years, especially in women. These results add to the biological and clinical importance of GS as a powerful predictor of long-term survival in late life.

KEYWORDS:

ageing; cohort study; grip strength; grip strength decline; mortality; older people.; risk factor

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Hypoxia tolerance, longevity and cancer-resistance in the mole rat Spalax - a liver transcriptomics approach.

Schmidt H, Malik A, Bicker A, Poetzsch G, Avivi A, Shams I, Hankeln T.

Sci Rep. 2017 Oct 30;7(1):14348. doi: 10.1038/s41598-017-13905-z.

PMID: 29084988

Update on riboflavin and multiple sclerosis: a systematic review.

Naghashpour M, Jafarirad S, Amani R, Sarkaki A, Saedisomeolia A.

Iran J Basic Med Sci. 2017 Sep;20(9):958-966. doi: 10.22038/IJBMS.2017.9257. Review.

PMID: 29085589

Abstract

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). Riboflavin plays an important role in myelin formation, and its deficiency is implicated as a risk factor for multiple sclerosis. Here, we systematically reviewed the literature concerning the health benefits of riboflavin on MS. The literature recorded within four main databases, including relevant clinical trials, experimental, and case-control studies from 1976 to 2017 were considered. Both human and animal studies were included for review, with no restrictions on age, gender, or ethnicity. Experimental studies demonstrated that riboflavin deficiency triggers neurologic abnormalities related to peripheral neuropathies such as demyelinating neuropathy. Moreover, randomized controlled trials (RCT) and case-control studies in which MS patients received riboflavin supplementation or had higher dietary riboflavin intake showed improvements in neurological motor disability. Riboflavin is a cofactor of xanthine oxidase and its deficiency exacerbates low uric acid caused by high copper levels, leading to myelin degeneration. The vitamin additionally plays a significant role in the normal functioning of glutathione reductase (GR) as an antioxidant enzyme, and conditions of riboflavin deficiency lead to oxidative damage. Riboflavin promotes the gene and protein levels of brain-derived neurotrophic factor (BDNF) in the CNS of an animal model of MS, suggesting that BDNF mediates the beneficial effect of riboflavin on neurological motor disability. Research to date generally supports the role of riboflavin in MS outcomes. However, further observational and interventional studies on human populations are warranted to validate the effects of riboflavin.

KEYWORDS:

Brain-derived- neurotrophic factor; Demyelinating disease; Multiple sclerosis; Riboflavin; Riboflavin deficiency

 

25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

Laddu DR, Rana JS, Murillo R, Sorel ME, Quesenberry CP Jr, Allen NB, Gabriel KP, Carnethon MR, Liu K, Reis JP, Lloyd-Jones D, Carr JJ, Sidney S.

Mayo Clin Proc. 2017 Oct 13. pii: S0025-6196(17)30577-3. doi: 10.1016/j.mayocp.2017.07.016. [Epub ahead of print]

PMID: 29050797

http://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/fulltext

http://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/pdf

Abstract

OBJECTIVE:

To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC).

PATIENTS AND METHODS:

This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age.

RESULTS:

We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants.

CONCLUSION:

White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.

 

[i did tink that more of the https://en.wikipedia.org/wiki/Restless_legs_syndrome#Causesshould have been considered as confounders.]

The potential impact of sleep-related movement disorders on stroke risk: a population-based longitudinal study.

Chou CH, Yin JH, Chen SY, Lin CC, Sung YF, Chung CH, Chien WC, Tsai CK, Tsai CL, Lin GY, Lin YK, Lee JT.

QJM. 2017 Oct 1;110(10):649-655. doi: 10.1093/qjmed/hcx097.

PMID: 28482057

https://academic.oup.com/qjmed/article/110/10/649/3805499

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/qjmed/110/10/10.1093_qjmed_hcx097/1/hcx097.pdf?Expires=1509579160&Signature=Jjf7te4rK97tVKvyCOJJJb3bqG3PtXyTxbPrJVNV1m8V8MPDFfRugNWUn46RUT6t2he7WqUpubam-25Z~4vN4MqT8kAWFJAUs0MOdopvYF1QNwQ2QI1IDuNc5bQ-O3po5Brq9DFeu65q6h3OJ~uLrZOwFjK~Dt6lIzXwiHTk3dcUL8F7HlBsUbPk1zYemXqnKERDiLNfEIsKlpGoqBUZHs8sVYdiIPAkYT7ohjYXlHZ9ySVVEteobd8jrIYDm0-eXr5PMZyrY8ZM4rFPpcFI8uVpszYXj73RxAqfPFbZwH4IwvIL8pJIE-2vPF1-hqsbd7w71r6~iqYZOHC6jU7mAg__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

BACKGROUND:

Sleep-related movement disorders (SRMD) have been shown to increase the risk of cardiovascular diseases. However, the relationship between SRMD and stroke remains unclear.

AIM:

To explore the relationship between SRMD and stroke in the general population.

DESIGN:

Two cohorts of patients with SRMD and without SRMD were followed up for the occurrence of hemorrhagic and ischemic stroke.

METHODS:

The study cohort enrolled 604 patients who were initially diagnosed as SRMD between 2000 and 2005. 2,416 age- and sex-matched patients without prior stroke were selected as the comparison cohort. A Cox-proportional hazard regression analysis was performed for multivariate adjustment.

RESULTS:

Patients with SRMD had a higher risk for developing all-cause stroke [adjusted hazard ratio (HR) = 2.29, 95% confidence interval (CI) = 1.42-3.80]. Patients of below 45 years old had the greatest stroke risk (HR = 4.03, 95% CI = 3.11-5.62), followed by patients aged ≥65 years (HR = 2.64, 95% CI = 1.12-3.44) and 45-64 years (HR = 1.07, 95% CI = 1.02-1.71). The age-stratified analysis suggested that the increased risk of hemorrhagic stroke was more significant than ischemic stroke among all age groups. Furthermore, males with SRMD were at greater risk to develop all-cause stroke (HR = 2.98, 95% CI = 1.74-4.50) than that of females (HR = 1.94, 95% CI = 1.01-3.77).

CONCLUSIONS:

Patients with SRMD were found to have an increased risk of all-cause stroke along with a higher possibility of hemorrhagic stroke over ischemic stroke.

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Fasting inhibits colorectal cancer growth by reducing M2 polarization of tumor-associated macrophages.

Sun P, Wang H, He Z, Chen X, Wu Q, Chen W, Sun Z, Weng M, Zhu M, Ma D, Miao C.

Oncotarget. 2017 Aug 16;8(43):74649-74660. doi: 10.18632/oncotarget.20301. eCollection 2017 Sep 26.

PMID: 29088814

http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=20301&path%5B%5D=64727

Abstract

Dietary restriction has been recognized as a healthy and natural therapy for cancer. It is reported that different forms of dietary restriction can promote anti-tumor immunity. However, it is not clear how fasting affects tumor-associated macrophages (TAMs). This study aims to investigate the relationship between fasting and antitumor immunity in terms of tumor-associated macrophages. In vivo, the results showed that alternate day fasting for 2 weeks inhibitted the tumor growth of mice without causing a reduction of body weight. Meanwhile, M2 polarization of tumor-associated macrophages in tumor tissues of alternate day fasting group was also decreased. In vitro, fasting induced the autophagy of CT26 cells, decreased the generation of extracellular adenosine by supressing the expression of CD73 in CT26 cells. Decreasing adenosine inhibitted M2 polarization of RAW264.7 cells through inactivating JAK1/STAT3 signal pathway in fasting condition. Eventually, the proliferation of CT26 cancer cells declined on account of fasting-facilitated antitumor immunity. These results suggested that fasting suppressed M2 polarization of tumor-associated macrophages to inhibit tumor growth through decreasing the level of adenosine in the tumor microenvironment both in vivo and in vitro. This process was associated with increasing autophagy of tumor cells.

KEYWORDS:

adenosine; autophagy; colorectal cancer; fasting; tumor-associated macrophages

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Low-protein diet for conservative management of chronic kidney disease: a systematic review and meta-analysis of controlled trials.

Rhee CM, Ahmadi SF, Kovesdy CP, Kalantar-Zadeh K.

J Cachexia Sarcopenia Muscle. 2017 Nov 2. doi: 10.1002/jcsm.12264. [Epub ahead of print]

PMID: 29094800

http://sci-hub.cc/10.1002/jcsm.12264

Abstract

BACKGROUND:

Recent data pose the question whether conservative management of chronic kidney disease (CKD) by means of a low-protein diet can be a safe and effective means to avoid or defer transition to dialysis therapy without causing protein-energy wasting or cachexia. We aimed to systematically review and meta-analyse the controlled clinical trials with adequate participants in each trial, providing rigorous contemporary evidence of the impact of a low-protein diet in the management of uraemia and its complications in patients with CKD.

METHODS:

We searched MEDLINE (PubMed) and other sources for controlled trials on CKD to compare clinical management of CKD patients under various levels of dietary protein intake or to compare restricted protein intake with other interventions. Studies with similar patients, interventions, and outcomes were included in the meta-analyses.

RESULTS:

We identified 16 controlled trials of low-protein diet in CKD that met the stringent qualification criteria including having 30 or more participants. Compared with diets with protein intake of >0.8 g/kg/day, diets with restricted protein intake (<0.8 g/kg/day) were associated with higher serum bicarbonate levels, lower phosphorus levels, lower azotemia, lower rates of progression to end-stage renal disease, and a trend towards lower rates of all-cause death. In addition, very-low-protein diets (protein intake <0.4 g/kg/day) were associated with greater preservation of kidney function and reduction in the rate of progression to end-stage renal disease. Safety and adherence to a low-protein diet was not inferior to a normal protein diet, and there was no difference in the rate of malnutrition or protein-energy wasting.

CONCLUSIONS:

In this pooled analysis of moderate-size controlled trials, a low-protein diet appears to enhance the conservative management of non-dialysis-dependent CKD and may be considered as a potential option for CKD patients who wish to avoid or defer dialysis initiation and to slow down the progression of CKD, while the risk of protein-energy wasting and cachexia remains minimal.

KEYWORDS:

All-cause death; Cachexia; Chronic kidney disease; Conservative management; End-stage renal disease; Glomerular filtration rate; Low-protein diet; Protein-energy wasting

 

The effects of a low-carbohydrate diet on oxygen saturation in heart failure patients: a randomized controlled clinical trial.

González-Islas D, Orea-Tejeda A, Castillo-Martínez L, Olvera-Mayorga G, Rodríguez-García WD, Santillán-Díaz C, Keirnes-Davis C, Vaquero-Barbosa N.

Nutr Hosp. 2017 Jul 28;34(4):792-798. doi: 10.20960/nh.784.

PMID: 29095000

http://www.nutricionhospitalaria.org/wp-content/uploads/2014/11/784.pdf

Abstract

INTRODUCTION:

Nutritional therapy in heart failure (HF) patients has been focused on fluid and sodium restriction with the aim of decreasing volume overload. However, these recommendations are not well established and sometimes controversial.

OBJECTIVE:

To evaluate the effect of the consumption of a low-carbohydrate diet on oxygen saturation, body composition and clinical variables during two months of follow-up in chronic, stable heart failure patients.

METHODS:

In a parallel group randomized controlled clinical trial, 88 ambulatory patients were randomly assigned to a low-carbohydrate diet group (40% carbohydrates, 20% protein and 40% fats [12% saturated, 18% monounsaturated and 10% polyunsaturated]) or a standard diet group (50% carbohydrates, 20% protein and 30% fats [10% saturated, 10% monounsaturated and 10% polyunsaturated]) for two months. Diets were normocaloric in both groups. At baseline and at two months of follow-up, the variables evaluated were: oxygen saturation, dietary intake, body composition and handgrip strength.

RESULTS:

After two months of follow-up, the low-carbohydrate diet group decreased the carbohydrate consumption and had improved oxygen saturation (93.0 ±4.4 to 94.6 ± 3.2, p = 0.02), while the standard diet group had decreased (94.90 ± 2.4 to 94.0 ± 2.9, p = 0.03). There were also differences between the groups at the end of the study (p = 0.04). No significant differences showed in handgrip strength in both groups, low-carbohydrate diet group (26.4 ± 8.3 to 27.2 ± 8.3 kg, p = 0.07) and standard diet group (25.4 ± 8.9 to 26.1 ± 9.5 kg, p = 0.14).

CONCLUSIONS:

Low-carbohydrate diet may improve the oxygen saturation in patients with chronic stable heart failure.

 

Effects of uric acid-lowering therapy in patients with chronic kidney disease: A meta-analysis.

Su X, Xu B, Yan B, Qiao X, Wang L.

PLoS One. 2017 Nov 2;12(11):e0187550. doi: 10.1371/journal.pone.0187550. eCollection 2017.

PMID: 29095953

Abstract

BACKGROUND AND OBJECTIVES:

The effects of uric acid-lowering therapy in patients with chronic kidney disease (CKD) remain uncertain. Therefore, we undertook a systematic review and meta-analysis to investigate the effects of uric acid-lowering agents on major clinical outcomes of CKD.

DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS:

According to the pre-specified protocol that was registered with PROSPERO (No. CRD42016038030), we searched systematically in MEDLINE, EMBASE, and the Cochrane Library for trials up to February 2016. Prospective, randomized, controlled trials assessing the effects of uric acid-lowering agents on cardiovascular and kidney outcomes in patients with CKD were included. Random-effects analytical methods were used.

RESULTS:

Sixteen eligible trials were identified, providing data for 1,211 patients with CKD, including 146 kidney failure events and 69 cardiovascular events. Uric acid-lowering therapy produced a 55% relative risk (RR) reduction (95% confidence interval [95% CI], 31-64) for kidney failure events (P < 0.001), and a 60% RR reduction (95% CI, 17-62) for cardiovascular events (P < 0.001), but had no significant effect on the risk of all-cause death (RR, 0.86; 95% CI, 0.50-1.46). The mean differences in rate of decline in the estimated glomerular filtration rate (4.10 mL/min/1.73 m2 per year slower in uric acid-lowering therapy recipients, 95% CI, 1.86-6.35) and the standardized mean differences in the change in proteinuria or albuminuria (-0.23 units of standard deviation greater in uric acid-lowering therapy recipients; 95% CI, -0.43 to -0.04) were also statistically significant.

CONCLUSIONS:

Uric acid-lowering therapy seemed to improve kidney outcomes and reduce the risk of cardiovascular events in adults with CKD.

https://www.karger.com/Article/Pdf/481460

 

Iodized salt intake and its association with urinary iodine, TPOAb and TgAb among urban Chinese.

Chen C, Xu H, Chen Y, Chen Y, Li Q, Hu J, Liang W, Cheng J, Xia F, Wang C, Han B, Zheng Y, Jiang B, Wang N, Lu Y.

Thyroid. 2017 Nov 1. doi: 10.1089/thy.2017.0385. [Epub ahead of print]

PMID: 29092685

Abstract

BACKGROUND:

Whether iodized salt increases the risk of thyroid diseases has been strongly debated in China, especially in the urban areas of coastal regions, in recent years. We aimed to investigate the status of iodized salt in terms of urinary and serum iodine concentration in urban coastal areas, and to further explore whether iodized salt or noniodized salt was associated with autoimmune thyroid disease (AITD).

METHODS:

Our data source was SPECT-China (ChiCTR-ECS-14005052, www.chictr.org.cn), a cross-sectional study in East China. We enrolled 1678 subjects from 12 communities in downtown Shanghai. The type of salt consumed, the urinary iodine concentration (UIC), serum iodine, thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) levels were obtained. AITD was defined as serum TPOAb and/or TgAb >60 kIU/L [TPO/TgAb (+)].

RESULTS:

The prevalence of AITD was 10.5% in men, and 21.4% in women. The median UIC and serum iodine concentration were 106.4μg/L and 60.9μg/L, respectively. Among all the subjects, 46.4% consumed non-iodized salt; the prevalence of iodine deficiency among those subjects was significantly higher than that of the subjects who consumed iodized salt (54.2% vs 40.1%, P<0.001). Consumption of non-iodized salt was positively associated with AITD in all participants (OR 1.49; 95%CI 1.15-1.95; P=0.003) and in women (OR 1.63; 95%CI 1.20-2.21; P<0.01) after multivariable adjustment. Additionally, the association between low UIC and AITD was observed among all subjects (OR 1.50; 95%CI 1.10-2.05; P=0.01) and in women (OR 1.45; 95%CI 1.02-2.07; P=0.038).

CONCLUSIONS:

In coastal areas that are believed rich in iodine, consuming non-iodized salt still led to lower UIC levels and a higher prevalence of iodine deficiency. The consumption of non-iodized salt and low UICs might be a risk factor for AITD, especially for women, which should be further confirmed by longitudinal studies.

 

A prospective study of dietary and supplemental zinc intake and risk of type 2 diabetes depending on genetic variation in <i>SLC30A8</i>.

Drake I, Hindy G, Ericson U, Orho-Melander M.

Genes Nutr. 2017 Oct 30;12:30. doi: 10.1186/s12263-017-0586-y. eCollection 2017.

PMID: 29093761

https://genesandnutrition.biomedcentral.com/articles/10.1186/s12263-017-0586-y

https://genesandnutrition.biomedcentral.com/track/pdf/10.1186/s12263-017-0586-y?site=genesandnutrition.biomedcentral.com

Abstract

BACKGROUND:

The solute carrier family 30 member 8 gene (SLC30A8) encodes a zinc transporter in the pancreatic beta cells and the major C-allele of a missense variant (rs13266634; C/T; R325W) in SLC30A8 is associated with an increased risk of type 2 diabetes (T2D). We hypothesized that the association between zinc intake and T2D may be modified by the SLC30A8 genotype.

RESULTS:

We carried out a prospective study among subjects with no history cardio-metabolic diseases in the Malmö Diet and Cancer Study cohort (N = 26,132, 38% men; 86% with genotype data). Zinc intake was assessed using a diet questionnaire and food record. During a median follow-up of 19 years, 3676 T2D cases occurred. A BMI-stratified Cox proportional hazards regression model with attained age as the time scale was used to model the association between total and dietary zinc intake, zinc supplement use, zinc to iron ratio, and risk of T2D adjusting for putative confounding factors.The median total zinc intake was 11.4 mg/day, and the median dietary zinc intake was 10.7 mg/day. Zinc supplement users (17%) had a median total zinc intake of 22.4 mg/day. Dietary zinc intake was associated with increased risk of T2D (Ptrend < 0.0001). In contrast, we observed a lower risk of T2D among zinc supplement users (HR = 0.79, 95% CI 0.70-0.89). The SLC30A8 CC genotype was associated with a higher risk of T2D (HR = 1.16, 95% CI 1.07-1.24), and the effect was stronger among subjects with higher BMI (Pinteraction = 0.007). We observed no significant modification of the zinc-T2D associations by SLC30A8 genotype. However, a three-way interaction between SLC30A8 genotype, BMI, and zinc to iron ratio was observed (Pinteraction = 0.007). A high zinc to iron ratio conferred a protective associated effect on T2D risk among obese subjects, and the effect was significantly more pronounced among T-allele carriers.

CONCLUSIONS:

Zinc supplementation and a high zinc to iron intake ratio may lower the risk of T2D, but these associations could be modified by obesity and the SLC30A8 genotype. The findings implicate that when considering zinc supplementation for T2D prevention, both obesity status and SLC30A8 genotype may need to be accounted for.

KEYWORDS:

Gene-nutrient interaction, Zinc, Solute carrier family 30 member 8 gene, Single nucleotide polymorphism, Cohort, Body mass index

 

[influence of habitual chocolate consumption over the Mini-Mental State Examination in Spanish older adults].

Orozco Arbelaez E, Banegas JR, Rodríguez Artalejo F, López García E.

Nutr Hosp. 2017 Jul 28;34(4):841-846. doi: 10.20960/nh.630. Spanish.

PMID: 29095007

Abstract

BACKGROUND:

There are associations described between dementia, mild cognitive impairment (MCI) and foods with a high content of polyphenols.

OBJECTIVE:

To assess the infl uence of habitual chocolate consumption over the MMSE in Spanish older adults.

METHODOLOGY:

Cross-sectional study, using data of the follow-up of the Seniors-Study on Nutrition and Cardiovascular Risk in Spain (ENRICA) cohort. Habitual chocolate consumption in the last year was assessed with a computerized dietary history; differences between dark chocolate and milk chocolate were recorded. Chocolate intake was classified into the following categories: no consumption, < 10 g/day, and ≥ 10 g/day. Validated MMSE scores for Spain were obtained during an interview and different cutoff points were used to define ≤ 25, ≤ 24 and ≤ 23. Linear and logistic regression models were used to calculate adjusted beta coefficients and odds ratios (OR).

RESULTS:

Compared to non-consumers, participants with a habitual chocolate consumption of ≥ 10 g/d had a better MMSE score (adjusted beta coefficient and 95% confidence interval: 0.26 (0.02-0.50; p trend = 0.05); for dark chocolate, the results were also statistically significant (0.48 [0.18-0.78]; p trend < 0.001). Total chocolate consumption was not associated with higher likelihood of having MCI. However, dark chocolate consumption was associated with less likelihood of MCI (OR and 95%CI for MMSE ≤ 25: 0.39 [0.20-0.77]; for MMSE ≤ 24: 0.26 [0.10-0.67]; and for MMSE ≤ 23: 0.25 [0.07-0.82]).

CONCLUSION:

Our results suggest that habitual dark chocolate consumption might improve cognitive function among the older population.

 

[The below paper is not pdf-availed.]

Reducing cholesterol and fat intake improves glucose tolerance by enhancing beta cell function in non-diabetic subjects.

Tricò D, Trifirò S, Mengozzi A, Morgantini C, Baldi S, Mari A, Natali A.

J Clin Endocrinol Metab. 2017 Oct 31. doi: 10.1210/jc.2017-02089. [Epub ahead of print]

PMID: 29095990

Abstract

CONTEXT:

A diet low in cholesterol and fat is commonly recommended to prevent metabolic and cardiovascular diseases; however, its effect on glucose tolerance is largely unknown.

OBJECTIVE:

We examined whether and through which mechanisms a chronic reduction of cholesterol and fat intake affects glucose tolerance in non-diabetic individuals, independently of weight changes.

DESIGN AND PARTICIPANTS:

In this cross-over, randomized clinical trial, thirty healthy subjects, including fifteen individuals with family history of T2D (T2D Offspring), underwent a 75-g oral glucose tolerance test (OGTT) after two 14-day isocaloric diets characterized by either high (HChF) or low (LChF) cholesterol and fat content.

MAIN OUTCOME MEASURES:

Changes in glucose tolerance, beta cell function, insulin clearance, and insulin sensitivity were evaluated by modeling plasma glucose, insulin, and C-peptide levels during the OGTT.

RESULTS:

The shift from the HChF to the LChF diet was neutral on body weight but enhanced glucose tolerance (mean glucose -5%, p=0.01) and three components of beta cell function, namely glucose sensitivity (+17%, p=0.01), insulin secretion at fasting glucose (+20%, p=0.02), and potentiation (+19%, p=0.03). The LChF diet improved insulin sensitivity (+7%, p=0.048) only in T2D Offspring, who tended to be more susceptible to the positive effect of the diet on glucose tolerance.

CONCLUSIONS:

A chronic and isocaloric decrease in dietary cholesterol and fat intake improves glucose tolerance by diffusely ameliorating beta cell function in non-diabetic subjects. Individuals genetically predisposed to develop T2D tend to be more susceptible to the positive effect of this dietary intervention on glucose tolerance and insulin sensitivity.

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Effect of pomegranate (Punica granatum L.) juice on kidney, liver, heart and testis histopathological changes, and the tissues lipid peroxidation and antioxidant status in lead acetate-treated rats.

Aksu DS, Sağlam YS, Yildirim S, Aksu T.

Cell Mol Biol (Noisy-le-grand). 2017 Oct 31;63(10):33-42. doi: 10.14715/cmb/2017.63.10.5.

PMID: 29096741

Abstract

Pomegranate juice (PJ) contains relevant amounts of active biological compounds which alleviate the detrimental effects of chronic heavy metal exposure. This study investigated the protective potential of PJ against lead-induced oxidative stress. A total of forty adult male Sprague Dawley rats were divided into four experimental groups. The animals were fed a standard pellet diet and tap water ad libitum. The rats were divided into four groups (n=10 for each group): control, lead asetat (2000 ppm), low-treated PJ- a daily dose of 2.000 ppm lead plus 30µl pomegranate juice (included 1.050 µmol total polyphenols, gallic acid equivalent), and high-treated PJ- a daily dose of 2.000 ppm lead plus 60µl pomegranate juice (included 2.100 µmol total polyphenols, gallic acid equivalent). The treatments were delivered for 5 weeks. After the treatment period, the tissues samples (kidney, liver, heart and testis) were collected. Tissue lead (Pb) and mineral amounts (copper, zinc, and iron), tissues lipid peroxidation level and antioxidant status, and tissues histopathological changes were determined. The results showed that the highest rate lead loading was in the kidney and the testis. Pomegranate juice was decreased the lead levels of soft tissues examined; increased Zn amounts in tissues of which the lead accumulation was higher (kidney and the testis); decreased the copper, zinc and the iron levels of the liver and heart tissues, without creating a weakness in antioxidant capacity of these tissues, restricted the oxidative stress by decreasing lipid peroxidation, improved both of the activities of antioxidant enzymes such as superoxide dismutase (SOD) and catalaz (CAT), and the level of glutathione (GSH) in all the tissues examined in lead-treated groups. As histopathological findings, the cellular damage induced by lead in the tissues of the kidney, liver and the heart were observed to have been partially prevented by PJ treatment. The protective effect of PJ was more pronounced in the testis compared to those others.

KEYWORDS:

Lead; Oxidative stress.; Phenolic compounds

 

Does Tooth Loss affect Dietary Intake and Nutritional Status? A Systematic Review of Longitudinal Studies.

Gaewkhiew P, Sabbah W, Bernabé E.

J Dent. 2017 Oct 30. pii: S0300-5712(17)30264-6. doi: 10.1016/j.jdent.2017.10.012. [Epub ahead of print] Review.

PMID: 29097121

Abstract

INTRODUCTION/OBJECTIVE:

A systematic review was conducted to explore whether tooth loss affects dietary intake and nutritional status among adults.

DATA:

Longitudinal studies of population-based or clinical samples of adults exploring the effect of tooth loss on food/dietary/nutrient intake and/or nutritional status were included for consideration. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies.

SOURCES:

A search strategy was designed to find published studies on MEDLINE, EMBASE and LILACS up to March 2017.

STUDY SELECTION:

Eight longitudinal studies in 4 countries (United States, Japan, Australia and Brazil) were included. Five of the six studies investigating the association between tooth loss and dietary intake showed significant results. The only consistent association, as reported in 2 studies, was for greater (self-reported) tooth loss and smaller reductions in dietary cholesterol. Three of the 4 studies investigating the association between tooth loss and nutritional status showed significant results. However, most results were contradicting. The quality of the evidence was weak.

CONCLUSION:

There is at present no strong evidence on the effect of tooth loss on diet and nutrition, with inconsistent results among the few studies identified. Additional high-quality longitudinal studies should address the limitations of previous studies identified in this review.

KEYWORDS:

Dental status; Dietary intake; Nutritional Status; Nutritional assessment; Systematic review; Tooth loss

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Treating laryngopharyngeal reflux: Evaluation of an anti-reflux program with comparison to medications.

Yang J, Dehom S, Sanders S, Murry T, Krishna P, Crawley BK.

Am J Otolaryngol. 2017 Oct 31. pii: S0196-0709(17)30699-3. doi: 10.1016/j.amjoto.2017.10.014. [Epub ahead of print]

PMID: 29100672

10.1016/j.amjoto.2017.10.014

Abstract

OBJECTIVE:

To determine if an anti-reflux induction program relieves laryngopharyngeal reflux (LPR) symptoms more effectively than medication and behavioral changes alone.

STUDY DESIGN:

Retrospective study.

SETTING:

Tertiary care academic center.

SUBJECTS AND METHODS:

A database was populated with patients treated for LPR. Patients were included in the study group if they completed a two-week anti-reflux program (diet, alkaline water, medications, behavioral modifications). Patients were included in the control group if they completed anti-reflux medications and behavioral modifications only. Patients completed the voice handicap index (VHI), reflux symptom index (RSI), cough severity index (CSI), dyspnea index (DI) and eating assessment tool (EAT-10) surveys and underwent laryngoscopy for examination and reflux finding score (RFS) quantification.

RESULTS:

Of 105 study group patients, 96 (91%) reported subjective improvement in their LPR symptoms after an average 32-day first follow-up and their RSI and CSI scores improved significantly. No significant differences were found in VHI, DI, or EAT-10 scores. Fifteen study patients who had previously failed adequate high-dose medication trials reported improvement and their CSI and EAT-10 scores improved significantly. Ninety-five percent of patients with a chief complaint of cough reported improvement and their CSI scores improved significantly from 12.3 to 8.2. Among 81 controls, only 39 (48%) patients reported improvement after an average 62-day first follow-up. Their RSI scores did not significantly change.

CONCLUSION:

The anti-reflux program yielded rapid and substantial results for a large cohort of patients with LPR. It compared favorably with medication and behavioral modification alone. It was effective in improving cough and treating patients who had previously failed medications alone.

KEYWORDS:

Cough; Induction diet; Laryngopharyngeal reflux; Proton pump inhibitors; Reflux symptom index

 

Dietary vitamin C intake and the risk of hip fracture: a dose-response meta-analysis.

Sun Y, Liu C, Bo Y, You J, Zhu Y, Duan D, Cui H, Lu Q.

Osteoporos Int. 2017 Nov 3. doi: 10.1007/s00198-017-4284-9. [Epub ahead of print]

PMID: 29101410

Abstract

The meta-analysis suggested that dietary vitamin C was statistically inversely associated with the risk of hip fracture (overall OR = 0.73, 95% CI = 0.55-0.97, I 2 = 69.1%) and with the increase of 50 mg/day vitamin C intake, the risk of hip fracture will reduce by 5% (OR = 0.95, 95% CI 0.91-1.00, P = 0.05).

INTRODUCTION:

Previous studies had inconsistent findings regarding the association between vitamin C intake and the risk of hip fracture. Therefore, we conducted a meta-analysis to evaluate the association of dietary vitamin C intake and the risk of hip fracture.

METHODS:

Relevant studies were identified by searching PubMed, Embase, and Web of Science up to December 2016. Additional articles were identified from reviewing the reference lists of relevant articles. The summary relative risks (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by random effects model. Funnel plot and Egger's test were used to test publication bias.

RESULTS:

The total six articles containing 7908 controls and 2899 cases of hip fracture were included in this meta-analysis. By comparing the highest versus the lowest categories of vitamin C intake, we found that dietary vitamin C was statistically correlated with the risk of hip fracture [overall OR = 0.73, 95% CI = 0.55-0.97, I 2 = 69.1%]. A linear dose-response association showed that the increase with vitamin C intake of 50 mg/day statistically reduced by 5% (OR = 0.95, 95% CI 0.91-1.00, P = 0.05) the risk of hip fracture.

CONCLUSIONS:

In conclusion, the results of current meta-analysis strongly support that increasing dietary vitamin C intake can decrease the risk of hip fracture. In order to verify the association of vitamin C intake and hip fracture risk, further well-designed largely randomized controlled trials (RCTs) are needed.

KEYWORDS:

Antioxidant; Dietary vitamin C; Dose-response; Hip fracture; Meta-analysis

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http://ajcn.nutrition.org/content/102/6/1416.full.pdf+html

 

Carrot intake and incidence of urothelial cancer: a systematic review and meta-analysis.

Luo X, Lu H, Li Y, Wang S.

Oncotarget. 2017 Aug 3;8(44):77957-77962. doi: 10.18632/oncotarget.19832. eCollection 2017 Sep 29.

PMID: 29100438

http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=19832&path%5B%5D=63318

Abstract

Previous studies regarding the relationship between carrot intake and risk of urothelial cancer have reported conflicting results. Hence we performed a meta-analysis of eligible studies to summarize evidence on this association. A comprehensive search up to January 2017 was performed in PubMed, Web of Science, Scopus, EMBASE, Cochrane register, and Chinese National Knowledge Infrastructure (CNKI) databases. The combined odds ratio (OR) with 95% confidence interval (CI) for the highest versus the lowest intake of carrot was calculated. A total of six epidemiological studies consisting of four case-control and two cohort studies were included. Overall analysis indicated a significantly reduced risk of urothelial cancer for high intake of carrot (OR = 0.63, 95% CI 0.44-0.90). Obvious significant heterogeneity was observed among included studies (P < 0.001 for heterogeneity; I2 = 79.6%). There was no significant publication bias by Begg's test (P = 0.348) or Egger's test (P = 0.130). In conclusion, this meta-analysis indicates that high intake of carrot is associated with a low incidence of urothelial cancer. Considering the limited included studies and huge heterogeneity, further large well-designed prospective cohort studies are warranted to confirm the findings from our meta-analysis.

KEYWORDS:

carrot; meta-analysis; risk; urothelial cancer

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Consumption of vegetables and fruits and urothelial cancer incidence: a prospective study.

Zeegers MP, Goldbohm RA, van den Brandt PA.

Cancer Epidemiol Biomarkers Prev. 2001 Nov;10(11):1121-8.

PMID: 11700259 Free Article

 

To vegan or not to vegan when pregnant, lactating or feeding young children.

Pawlak R.

Eur J Clin Nutr. 2017 Nov;71(11):1259-1262. doi: 10.1038/ejcn.2017.111. Epub 2017 Jul 26. No abstract available.

PMID: 28745335

http://sci-hub.cc/10.1038/ejcn.2017.111

 

Oral Supplementation of Glutamine Attenuates the Progression of Nonalcoholic Steatohepatitis in C57BL/6J Mice.

Sellmann C, Baumann A, Brandt A, Jin CJ, Nier A, Bergheim I.

J Nutr. 2017 Nov;147(11):2041-2049. doi: 10.3945/jn.117.253815. Epub 2017 Sep 20.

PMID: 28931589

Abstract

Background: Universally accepted therapeutic strategies for the treatment of nonalcoholic steatohepatitis (NASH) are still lacking. Studies suggest a preventive effect of oral Gln supplementation on the development of NASH; however, whether Gln also has therapeutic potential for pre-existing NASH has not yet been clarified.Objective: The aim of the present study was to determine whether Gln prevents the progression of diet-induced NASH in mice.Methods: For 8 wk, female C57BL/6J mice (6-8 wk old) were pair-fed a liquid Western-style diet [WSD, 25% of energy from fat, 50% wt:wt fructose, 0.16% wt:wt cholesterol] or control diet (C diet) to induce liver damage. From week 8 to 13, they were pair-fed the C diet or WSD alone or supplemented with l-Gln to provide 2.1 g/kg body weight (C diet + Gln or WSD + Gln). Energy intake was adjusted to the group with the lowest energy intake. Indexes of liver damage and inflammation, intestinal barrier function, and toll-like receptor 4 (Tlr4) signaling in the liver were determined.Results: The liver histology scores significantly increased from 8 to 13 wk (+31%) in WSD-fed mice and were significantly higher than in controls (P ≤ 0.05 for both time comparisons), whereas scores did not differ between C diet-fed and WSD + Gln-fed mice after 13 wk of feeding. The occludin protein concentrations in the small intestinal tissue were similarly reduced in both WSD-fed groups when compared with controls [WSD compared with C diet (-53%) and C diet + Gln (-42%), P ≤ 0.05; WSD + Gln compared with C diet + Gln (-34%), P ≤ 0.05] after 13 wk, whereas the expression of myeloid differentiation primary response gene 88 mRNA and concentration of inducible nitric oxide synthase and 4-hydroxynonenal protein adducts were significantly higher only in livers of WSD-fed mice (P ≤ 0.05 for the WSD group compared with all other groups; WSD + Gln group compared with the C diet groups: NS).Conclusion: Taken together, our data suggest that oral Gln supplementation protects mice from the progression of pre-existing, WSD-induced NASH.

KEYWORDS:

Western-style diet; hepatic inflammation; insulin resistance; lipid peroxidation; liver damage; neutrophils; toll-like receptor 4 signaling

 

A High-Carbohydrate, High-Fiber, Low-Fat Diet Results in Weight Loss among Adults at High Risk of Type 2 Diabetes.

Sylvetsky AC, Edelstein SL, Walford G, Boyko EJ, Horton ES, Ibebuogu UN, Knowler WC, Montez MG, Temprosa M, Hoskin M, Rother KI, Delahanty LM; Diabetes Prevention Program Research Group.

J Nutr. 2017 Nov;147(11):2060-2066. doi: 10.3945/jn.117.252395. Epub 2017 Sep 27.

PMID: 28954840

http://sci-hub.cc/10.3945/jn.117.252395

Abstract

Background: Weight loss is a key factor in reducing diabetes risk. The Diabetes Prevention Program (DPP) is a completed clinical trial that randomly assigned individuals at high risk of diabetes to a placebo (PLBO), metformin (MET), or intensive lifestyle intervention (ILS) group, which included physical activity (PA) and reduced dietary fat intake.Objective: We aimed to evaluate the associations between diet and weight at baseline and to identify specific dietary factors that predicted weight loss among DPP participants.Methods: Diet was assessed by a food frequency questionnaire. The associations between intakes of macronutrients and various food groups and body weight among DPP participants at baseline were assessed by linear regression, adjusted for race/ethnicity, age, sex, calorie intake, and PA. Models that predicted weight loss at year 1 were adjusted for baseline weight, change in calorie intake, and change in PA and stratified by treatment allocation (MET, ILS, and PLBO). All results are presented as estimates ± SEs.Results: A total of 3234 participants were enrolled in the DPP; 2924 had completed dietary data (67.5% women; mean age: 50.6 ± 10.7 y). Adjusted for calorie intake, baseline weight was negatively associated with carbohydrate intake (-1.14 ± 0.18 kg body weight/100 kcal carbohydrate, P < 0.0001) and, specifically, dietary fiber (-1.26 ± 0.28 kg/5 g fiber, P < 0.0001). Baseline weight was positively associated with total fat (1.25 ± 0.21 kg/100 kcal, P < 0.0001), saturated fat (1.96 ± 0.46 kg/100 kcal, P < 0.0001), and protein (0.21 ± 0.05 kg/100 kcal, P < 0.0001). For all groups, weight loss after 1 y was associated with increases in carbohydrate intake, specifically dietary fiber, and decreases in total fat and saturated fat intake.Conclusions: Higher carbohydrate consumption among DPP participants, specifically high-fiber carbohydrates, and lower total and saturated fat intake best predicted weight loss when adjusted for changes in calorie intake. Our results support the benefits of a high-carbohydrate, high-fiber, low-fat diet in the context of overall calorie reduction leading to weight loss, which may prevent diabetes in high-risk individuals.

KEYWORDS:

carbohydrate; diabetes; diet; macronutrient; weight

 

When to eat!

Dhurandhar NV, Binks M.

Am J Clin Nutr. 2017 Nov;106(5):1171-1172. doi: 10.3945/ajcn.117.167759. Epub 2017 Oct 11. No abstract available.

PMID: 29021284

http://sci-hub.cc/10.3945/ajcn.117.167759

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Later circadian timing of food intake is associated with increased body fat.

McHill AW, Phillips AJ, Czeisler CA, Keating L, Yee K, Barger LK, Garaulet M, Scheer FA, Klerman EB.

Am J Clin Nutr. 2017 Nov;106(5):1213-1219. doi: 10.3945/ajcn.117.161588. Epub 2017 Sep 6.

PMID: 28877894

http://sci-hub.cc/10.3945/ajcn.117.161588

Abstract

Background: Weight gain and obesity have reached alarming levels. Eating at a later clock hour is a newly described risk factor for adverse metabolic health; yet, how eating at a later circadian time influences body composition is unknown. Using clock hour to document eating times may be misleading owing to individual differences in circadian timing relative to clock hour.Objective: This study examined the relations between the timing of food consumption relative to clock hour and endogenous circadian time, content of food intake, and body composition.Design: We enrolled 110 participants, aged 18-22 y, in a 30-d cross-sectional study to document sleep and circadian behaviors within their regular daily routines. We used a time-stamped-picture mobile phone application to record all food intake across 7 consecutive days during a participant's regular daily routines and assessed their body composition and timing of melatonin release during an in-laboratory assessment.Results: Nonlean individuals (high body fat) consumed most of their calories 1.1 h closer to melatonin onset, which heralds the beginning of the biological night, than did lean individuals (low body fat) (log-rank P = 0.009). In contrast, there were no differences between lean and nonlean individuals in the clock hour of food consumption (P = 0.72). Multiple regression analysis showed that the timing of food intake relative to melatonin onset was significantly associated with the percentage of body fat and body mass index (both P < 0.05) while controlling for sex, whereas no relations were found between the clock hour of food intake, caloric amount, meal macronutrient composition, activity or exercise level, or sleep duration and either of these body composition measures (all P > 0.72).Conclusions: These results provide evidence that the consumption of food during the circadian evening and/or night, independent of more traditional risk factors such as amount or content of food intake and activity level, plays an important role in body composition.

KEYWORDS:

body composition; caloric intake; melatonin; metabolism; sleep duration

 

Time of day and eating behaviors are associated with the composition and function of the human gastrointestinal microbiota.

Kaczmarek JL, Musaad SM, Holscher HD.

Am J Clin Nutr. 2017 Nov;106(5):1220-1231. doi: 10.3945/ajcn.117.156380. Epub 2017 Sep 27.

PMID: 28971851 Free Article

http://ajcn.nutrition.org/content/106/5/1220.long

http://ajcn.nutrition.org/content/106/5/1220.full.pdf+html

Abstract

Background: Preclinical research has shown that the gastrointestinal microbiota exhibits circadian rhythms and that the timing of food consumption can affect the composition and function of gut microbes. However, there is a dearth of knowledge on these relations in humans.Objective: We aimed to determine whether human gastrointestinal microbes and bacterial metabolites were associated with time of day or behavioral factors, including eating frequency, percentage of energy consumed early in the day, and overnight-fast duration.Design: We analyzed 77 fecal samples collected from 28 healthy men and women. Fecal DNA was extracted and sequenced to determine the relative abundances of bacterial operational taxonomic units (OTUs). Gas chromatography-mass spectroscopy was used to assess short-chain fatty acid concentrations. Eating frequency, percentage of energy consumed before 1400, and overnight-fast duration were determined from dietary records. Data were analyzed by linear mixed models or generalized linear mixed models, which controlled for fiber intake, sex, age, body mass index, and repeated sampling within each participant. Each OTU and metabolite were tested as the outcome in a separate model.Results: Acetate, propionate, and butyrate concentrations decreased throughout the day (P = 0.006, 0.04, and 0.002, respectively). Thirty-five percent of bacterial OTUs were associated with time. In addition, relations were observed between gut microbes and eating behaviors, including eating frequency, early energy consumption, and overnight-fast duration.Conclusions: These results indicate that the human gastrointestinal microbiota composition and function vary throughout the day, which may be related to the circadian biology of the human body, the microbial community itself, or human eating behaviors. Behavioral factors, including timing of eating and overnight-fast duration, were also predictive of bacterial abundances. Longitudinal intervention studies are needed to determine causality of these biological and behavioral relations.

KEYWORDS:

adults; circadian rhythms; early energy consumption; eating frequency; eating patterns; humans; microbiome; overnight-fast duration; timing of eating

 

Effect of prior meal macronutrient composition on postprandial glycemic responses and glycemic index and glycemic load value determinations.

Meng H, Matthan NR, Ausman LM, Lichtenstein AH.

Am J Clin Nutr. 2017 Nov;106(5):1246-1256. doi: 10.3945/ajcn.117.162727. Epub 2017 Sep 13.

PMID: 28903959

http://sci-hub.cc/10.3945/ajcn.117.162727

Abstract

Background: The potential impact of prior meal composition on the postprandial glycemic response and glycemic index (GI) and glycemic load (GL) value determinations remains unclear.Objective: We determined the effect of meals that varied in macronutrient composition on the glycemic response and determination of GI and GL values of a subsequent standard test food.Design: Twenty healthy participants underwent 6 test sessions within 12 wk. The subjects received each of 3 isocaloric breakfast meals (i.e., high carbohydrate, high fat, or high protein) on separate days in a random order, which was followed by a standard set of challenges (i.e., white bread and a glucose drink) that were tested on separate days in a random order 4 h thereafter. Each challenge provided 50 g available carbohydrate. Arterialized venous blood was sampled throughout the 2-h postchallenge period. GI, GL, and insulin index (II) values were calculated with the use of the incremental area under the curve (AUCi) method, and serum lipids were determined with the use of standard assays.Results: The consumption of the high-protein breakfast before the white-bread challenge attenuated the rise in the postprandial serum glucose response (P < 0.0001) and resulted in lower glucose AUCi (P < 0.0001), GI (P = 0.0096), and GL (P = 0.0101) values than did the high-carbohydrate and high-fat breakfasts. The high-protein breakfast resulted in a lower insulin AUCi (P = 0.0146) for white bread than did the high-fat breakfast and a lower II value (P = 0.0285) than did the high-carbohydrate breakfast. The 3 breakfasts resulted in similar serum lipid responses to the white-bread challenge.Conclusions: These data indicate that the macronutrient composition of the prior meal influences the glycemic response and the determination of GI and GL values for white bread. Future studies are needed to determine whether the background food macronutrient composition influences mean dietary GI and GL values that are calculated for eating patterns, which may alter the interpretation of the associations between these values and chronic disease risk.

KEYWORDS:

glycemic index and glycemic load; glycemic response; healthy participants; macronutrient composition; nonesterified fatty acids

 

In the elderly, meat protein assimilation from rare meat is lower than that from meat that is well done.

Buffière C, Gaudichon C, Hafnaoui N, Migné C, Scislowsky V, Khodorova N, Mosoni L, Blot A, Boirie Y, Dardevet D, Santé-Lhoutellier V, Rémond D.

Am J Clin Nutr. 2017 Nov;106(5):1257-1266. doi: 10.3945/ajcn.117.158113. Epub 2017 Sep 13.

PMID: 28903955

http://sci-hub.cc/10.3945/ajcn.117.158113

Abstract

Background: Meat cooking conditions in in vitro and in vivo models have been shown to influence the rate of protein digestion, which is known to affect postprandial protein metabolism in the elderly.Objective: The present study was conducted to demonstrate the effect of cooking conditions on meat protein assimilation in the elderly. We used a single-meal protocol to assess the meat protein absorption rate and estimate postprandial meat protein utilization in elderly subjects.Design: The study recruited 10 elderly volunteers aged 70-82 y. Each received, on 2 separate occasions, a test meal exclusively composed of intrinsically 15N-labeled bovine meat (30 g protein), cooked at 55°C for 5 min [rare meat (RM)] or at 90°C for 30 min [fully cooked meat (FCM)], and minced. Whole-body fluxes of leucine, before and after the meal, were determined with the use of a [1-13C]leucine intravenous infusion. Meat protein absorption was recorded with the use of 15N enrichment of amino acids.Results: Postprandial time course observations showed a lower concentration in the plasma of indispensable amino acids (P < 0.01), a lower entry rate of meat leucine in the plasma (P < 0.01), and a lower contribution of meat nitrogen to plasma amino acid nitrogen (P < 0.001), evidencing lower peripheral bioavailability of meat amino acids with RM than with FCM. This was associated with decreased postprandial whole-body protein synthesis with RM than with FCM (40% compared with 56% of leucine intake, respectively; P < 0.01).Conclusions: Whereas meat cooking conditions have little effect on postprandial protein utilization in young adults, the present work showed that the bioavailability and assimilation of meat amino acids in the elderly is lower when meat is poorly cooked. In view to preventing sarcopenia, elderly subjects should be advised to favor the consumption of well-cooked meat.

KEYWORDS:

amino acid bioavailability; cooking; elderly; meat; protein metabolism

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Effect of Weight Losing on the Improving Clinical Statement of Patients With Knee Osteoarthritis.

Sadeghi A, Rad ZA, Sajedi B, Heydari AH, Akbarieh S, Jafari B.

Reumatol Clin. 2017 Nov 1. pii: S1699-258X(17)30176-6. doi: 10.1016/j.reuma.2017.06.016. [Epub ahead of print] English, Spanish.

PMID: 29102588

http://www.reumatologiaclinica.org/es/effect-weight-losing-on-improving/avance/S1699258X17301766/

Abstract

OBJECTIVE:

Osteoarthritis causes severe pain and disability in joints, one of the most prevalent involved joints is the knee joint. There are several therapeutics ways to control pain and disability, but almost none of them are definite treatment. In this article, we tried to reveal the effect of weight loss on improving symptoms of knee osteoarthritis as an effective and permanent therapeutic approach.

METHODS:

We chose 62 patients with grade 1-2 (mild to moderate) knee osteoarthritis and divided them equally into case and control groups. Patients should not had used NSAIDs at least for 6 months before study initiation. Symptoms severity was measured by WOMAC and VAS questionnaires before and after 3 months follow up. Weight and BMI were recorded too. Case group was suggested to have weight loss diet of less fat and carbohydrates and control group did not have any limitation.

RESULTS:

Comparison of variables' average of case and control groups was not logistically meaningful at the initiation and after the end of the study. But there was a meaningful correlation between variables' changes and lifestyle change in both groups, especially in WOMAC and VAS scores. All variables in case group had statistically meaningful differences between their amounts at the beginning and after the end of the study, on the contrary of the control group.

CONCLUSION:

In the comparison of our study with similar studies in the world. We deduced that weight loss can improve symptoms of knee osteoarthritis even in short time weight loss diet (3 months).

KEYWORDS:

Dolor de rodilla; Knee osteoarthritis; Knee pain; Knee stiffness; Osteoartritis de rodilla; Pérdida de peso; Rigidez de rodilla; Weight loss

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Dose ranging effects of Vitamin D3 on the Geriatric Depression Score: A Clinical Trial.

Yalamanchili V, Gallagher JC.

J Steroid Biochem Mol Biol. 2017 Nov 2. pii: S0960-0760(17)30325-4. doi: 10.1016/j.jsbmb.2017.10.025. [Epub ahead of print]

PMID: 29104103

Abstract

Depression is a common problem affecting millions, usually treated with selective serotonin uptake inhibitors. Interest in vitamin D as a co-therapy was stimulated by some association studies that correlated depression with low serum 25OHD levels. There are few longitudinal studies of vitamin D and depression and most are single doses of vitamin D. In this study we examined the effect of one-year treatment with several doses of vitamin D on the Geriatric depression score (GDS) in older Caucasian and African American women. The clinical trial was a study of seven daily oral doses of vitamin D (400-4800IU/d) in Black and White older women. The trial was a double blind, randomized and placebo controlled lasting 12-months. The main inclusion criterion was serum 25 hydroxyvitamin D (25OHD) ≤ 20ng/ml (50nmo/L). Calcium supplements were given to maintain calcium intake 1000mg in young people and 1200-1400mg/day in older women. Data on Geriatric depression (GDS) was collected using the validated long form at baseline and 12-months. The change in serum 25OHD was the primary outcome and GDS was one of the secondary outcomes. Adjustments were made for relevant covariates. Analysis of vitamin D effect was by dose low, medium and high compared to placebo or by quintiles. Serum 25OHD increased as a quadratic curve function to a mean of 46ng/ml (115nmol/l) in white women and 49ng/ml (122.5nmol/L) in black women on the highest dose of 4800 IU. In older women mean GDS scores changed from 3.8 (SD±4.2) at baseline to 3.6 (SD±4.1) at 12 months in whites and from 3.0 (SD±3.7) to 3.02 (SD±4.2) in Blacks. (p=0.790 in whites; p=0.958 in blacks). After 12-months there was no effect of dose on change in GDS score in women treated with different doses of vitamin D (p=0.507 in whites and p=0.340 in blacks). When both Caucasians and African Americans were divided into 3 dose groups, low (400-800 IU), medium (1600-3200 IU) and high (4000-4800 IU) doses, the change in score was 0.8 on low dose, -0.30 on medium dose and -0.31 on high dose compared to 0.11 on placebo (p=0.546). In summary, there was no improvement in GDS scores in Caucasians or African Americans on either increasing doses of vitamin D or quintiles of achieved response in serum 25OHD. The changes were small and not significant perhaps because of the relatively lower numbers of depressed women in the groups. Further studies should recruit larger numbers, 3 dose groups covering a serum25OHD range of 20-60ng/ml and more subjects with clinical depression in order to fully address the question of vitamin D effects on depression.

KEYWORDS:

depression; elderly; vitamin D insufficiency; vitamin D3; white and black women

 

Milk and other dairy foods in relation to prostate cancer recurrence: Data from the cancer of the prostate strategic urologic research endeavor (CaPSURE™).

Tat D, Kenfield SA, Cowan JE, Broering JM, Carroll PR, Van Blarigan EL, Chan JM.

Prostate. 2017 Nov 6. doi: 10.1002/pros.23441. [Epub ahead of print]

PMID: 29105845

http://sci-hub.cc/http://onlinelibrary.wiley.com/doi/10.1002/pros.23441/abstract;jsessionid=DDDDE83E3D0CC429320D045728E07F1E.f03t02

Abstract

BACKGROUND:

High-fat dairy, particularly whole milk, in healthy men may increase risk of aggressive prostate cancer. However, data are limited regarding dairy after prostate cancer diagnosis.

METHOD:

We conducted a prospective study among 1334 men with non-metastatic prostate cancer in the Cancer of the Prostate Strategic Urologic Research Endeavor. Men answered a food frequency questionnaire in 2004-2005 (median 2 years after diagnosis) and were followed until 2016 for recurrence, defined as: prostate cancer death, bone metastases, biochemical recurrence, or secondary treatment. Multivariate Cox proportional hazards regression was used to calculate hazards ratios (HR) and 95% confidence intervals (CI) for associations between whole and low-fat milk; total, high-fat, and low-fat dairy; and other dairy items and risk of recurrence.

RESULTS:

During a median follow-up of 8 years, we observed 137 events. Men who consumed >4 servings/week versus 0-3 servings/month of whole milk had an 80% increased risk of recurrence (HR: 1.73; 95%CI: 1.00, 2.98; P-value = 0.04). Body mass index (BMI) modified the association (P-interaction = 0.007). Among men with a BMI ≥27 kg/m2 , >4 servings/week versus 0-3 servings/month of whole milk was associated with a 3-fold higher risk of recurrence (HR: 2.96; 95%CI: 1.58, 5.54; P-value < 0.001). No association was seen in men with BMI <27 kg/m2 . Low-fat milk and other dairy foods were not associated with recurrence.

CONCLUSION:

In conclusion, whole milk consumption after prostate cancer diagnosis was associated with increased risk of recurrence, particularly among very overweight or obese men. Men with prostate cancer who choose to drink milk should select non-fat or low-fat options.

KEYWORDS:

cancer survivorship; nutrition; whole milk

 

Sports and HDL-Quality Reflected By Serum Amyloid A and Surfactant Protein B.

Sponder M, Kopecky C, Campean IA, Emich M, Fritzer-Szekeres M, Litschauer B, Graf S, Säemann MD, Strametz-Juranek J.

Int J Med Sci. 2017 Sep 3;14(11):1040-1048. doi: 10.7150/ijms.20388. eCollection 2017.

PMID: 29104456

http://www.medsci.org/v14p1040.htm

http://www.medsci.org/v14p1040.pdf

Abstract

Background: The aim of this prospective study was to investigate the influence of long-term physical activity on HDL quality, reflected by serum amyloid A (SAA) and surfactant protein B (SPB). Methods and results: 109 healthy subjects were recruited, 98 completed the study. Participants perform within the calculated training pulse for 8 months. The performance gain was measured/quantified by bicycle stress tests at the beginning and end of the observation period. SAA and SPB were measured at baseline and after 4 and 8 months by ELISA. In contrary to HDL-quantity, there was no sports-induced change in SAA or SPB observable. However, significant predictors for SPB-levels were smoking status, BMI and weekly alcohol consumption and for SAA weekly alcohol consumption together with sex and hsCRP-levels. Conclusions: Long-term physical activity increases HDL-quantity but has no impact on HDL-quality reflected by SAA and SPB. Smoking is associated with higher SPB-levels and the weekly alcohol intake is associated with both higher SAA and SPB-levels suggesting a damaging effect of smoking and drinking alcohol on the HDL-quality. We assume that HDL-quality is at least as important as HDL-quantity when investigating the role of HDL in (cardiovascular) disease and should receive attention in further studies dealing with HDL.

KEYWORDS:

HDL-quality.; high-density lipoprotein; physical activity; serum amyloid A; surfactant protein B

 

The role of mitochondrial ROS in the aging brain.

Stefanatos R, Sanz A.

FEBS Lett. 2017 Nov 6. doi: 10.1002/1873-3468.12902. [Epub ahead of print] Review.

PMID: 29106705

http://sci-hub.cc/10.1002/1873-3468.12902

Abstract

The brain is the most complex human organ, consuming more energy than any other tissue in proportion to its size. It relies heavily on mitochondria to produce energy and is made up of mitotic and post mitotic cells that need to closely coordinate their metabolism to maintain essential bodily functions. During aging, damaged mitochondria that produce less ATP and more reactive oxygen species (ROS) accumulate. The current consensus is that ROS cause oxidative stress, damaging mitochondria and resulting in an energetic crisis that triggers neurodegenerative diseases and accelerates aging. However, in model organisms, increasing mitochondrial ROS (mtROS) in the brain extends lifespan, suggesting that ROS may participate in signalling that protects the brain. Here, we summarize the mechanisms by which mtROS are produced at the molecular level, how different brain cells and regions produce different amounts of mtROS, and how mtROS levels change during aging. Finally, we critically discuss the possible roles of ROS in aging as signalling molecules and damaging agents, addressing whether age associated increases in mtROS are a cause or a consequence of aging.

KEYWORDS:

ROS ; Aging; Brain; Mitochondria; Signalling

 

[i find it strange that the subjects all ate the same amount of food but one group expended more energy and had more energy-consuming lean mass but weighed the same as the ad lib group.]

System-wide Benefits of Intermeal Fasting by Autophagy.

Martinez-Lopez N, Tarabra E, Toledo M, Garcia-Macia M, Sahu S, Coletto L, Batista-Gonzalez A, Barzilai N, Pessin JE, Schwartz GJ, Kersten S, Singh R.

Cell Metab. 2017 Oct 24. pii: S1550-4131(17)30608-3. doi: 10.1016/j.cmet.2017.09.020. [Epub ahead of print]

PMID: 29107505

http://sci-hub.cc/10.1016/j.cmet.2017.09.020

Abstract

Autophagy failure is associated with metabolic insufficiency. Although caloric restriction (CR) extends healthspan, its adherence in humans is poor. We established an isocaloric twice-a-day (ITAD) feeding model wherein ITAD-fed mice consume the same food amount as ad libitum controls but at two short windows early and late in the diurnal cycle. We hypothesized that ITAD feeding will provide two intervals of intermeal fasting per circadian period and induce autophagy. We show that ITAD feeding modifies circadian autophagy and glucose/lipid metabolism that correlate with feeding-driven changes in circulating insulin. ITAD feeding decreases adiposity and, unlike CR, enhances muscle mass. ITAD feeding drives energy expenditure, lowers lipid levels, suppresses gluconeogenesis, and prevents age/obesity-associated metabolic defects. Using liver-, adipose-, myogenic-, and proopiomelanocortin neuron-specific autophagy-null mice, we mapped the contribution of tissue-specific autophagy to system-wide benefits of ITAD feeding. Our studies suggest that consuming two meals a day without CR could prevent the metabolic syndrome.

KEYWORDS:

POMC; aging; autophagy; caloric restriction; circadian; fatty liver; gluconeogenesis; metabolic syndrome; myogenic progenitors; twice-a-day feeding

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Ketone Diester Ingestion Impairs Time-Trial Performance in Professional Cyclists.

Leckey JJ, Ross ML, Quod M, Hawley JA, Burke LM.

Front Physiol. 2017 Oct 23;8:806. doi: 10.3389/fphys.2017.00806. eCollection 2017.

PMID: 29109686

https://www.frontiersin.org/articles/10.3389/fphys.2017.00806/full

Abstract

We investigated the effect of pre- "race" ingestion of a 1,3-butanediol acetoacetate diester on blood ketone concentration, substrate metabolism and performance of a cycling time trial (TT) in professional cyclists. In a randomized cross-over design, 10 elite male cyclists completed a ~31 km laboratory-based TT on a cycling ergometer programmed to simulate the 2017 World Road Cycling Championships course. Cyclists consumed a standardized meal [2 g/kg body mass (BM) carbohydrate (CHO)] the evening prior to a trial day and a CHO breakfast (2 g/kg BM CHO) with 200 mg caffeine on the morning of a trial day. Cyclists were randomized to consume either the ketone diester (2 × 250 mg/kg) or a placebo drink, followed immediately by 200 mL diet cola, given ~ 30 min before and immediately prior to commencing a 20 min incremental warm-up. Blood samples were collected prior to and during the warm-up, pre- and post- TT and at regular intervals after the TT. Urine samples were collected pre- and post- warm-up, immediately post TT and 60 min post TT. Pre-exercise ingestion of the diester resulted in a 2 ± 1% impairment in TT performance that was associated with gut discomfort and higher perception of effort. Serum β-hydroxybutyrate, serum acetoacetate, and urine ketone concentrations increased from rest following ketone ingestion and were higher than placebo throughout the trial. Ketone ingestion induces hyperketonemia in elite professional cyclists when in a carbohydrate fed state, and impairs performance of a cycling TT lasting ~50 min.

KEYWORDS:

cycling; ketone ester; ketones; performance; time-trial

>>>>>>>

http://www.cell.com/cell-metabolism/fulltext/S1550-4131(16)30355-2?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1550413116303552%3Fshowall%3Dtrue

 

Chemoprevention with isothiocyanates - from bench to bedside.

Gründemann C, Huber R.

Cancer Lett. 2017 Oct 27. pii: S0304-3835(17)30670-5. doi: 10.1016/j.canlet.2017.10.033. [Epub ahead of print]

PMID: 29111351

https://sci-hub.cc/http://linkinghub.elsevier.com/retrieve/pii/S0304383517306705

Abstract

Intake of isothiocyanates (ITCs), naturally occurring as hydrolization products from glucosinolates (GLSs) in brassicaceae, has, in epidemiological studies, been weakly to moderately inversely correlated with the risk of colorectal cancer, prostate cancer and lung cancer. Numerous preclinical studies demonstrate chemopreventive mode of actions of ITCs, mainly related to a.) detoxification (induction of phase II enzymes), b.) anti-inflammatory properties by down-regulation of NFkappaB activity, c.) cyclin-mediated cell cycle arrest and d.) epigenetic modulation by inhibition of histone deacetylase activity. First prospective clinical trials were promising in patients with risk of prostate cancer recurrence. The glutathione-S-transferase gene expression seems to play a major role in the individual susceptibility towards ITCs. Safety issues are widely unclear and should be more addressed in future studies because ITCs can, in low concentrations, compromise the function of human immune cells and might impair genome stability.

KEYWORDS:

Brassicaceae; cancer; cruciferous vegetable; glucosinolates; mustard oil; safety

 

Effects of Egg Consumption on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Rouhani MH, Rashidi-Pourfard N, Salehi-Abargouei A, Karimi M, Haghighatdoost F.

J Am Coll Nutr. 2017 Nov 7:1-12. doi: 10.1080/07315724.2017.1366878. [Epub ahead of print]

PMID: 29111915

http://sci-hub.cc/10.1080/07315724.2017.1366878

Abstract

BACKGROUND:

It is widely agreed that egg consumption only modestly influences serum lipid concentrations. However, there is no meta-analysis summarizing existing randomized controlled trials.

OBJECTIVE:

The purpose of this study was to conduct a meta-analysis of published randomized controlled trials to explore the quantitative effect of egg consumption on serum lipid concentrations.

DESIGN:

Online databases including MEDLINE, Proquest and Google Scholar were systematically searched. Studies that were published after 2000 and compared serum lipids concentrations in egg-consumers and non egg-consumers were included. The data were obtained from 28 studies. Weighted mean differences were calculated as the ultimate effect using random effects model.

RESULTS:

Overall, egg consumption increased total cholesterol (TC) by 5.60 mg/dL (95% CI: 3.11, 8.09; P<0.0001), low density lipoprotein-cholesterol (LDL-C) by 5.55 mg/dL (95% CI: 3.14, 7.69; P<0.0001) and high density lipoprotein-cholesterol (HDL-C) by 2.13 mg/dL (95% CI: 1.10, 3.16; P<0.0001) compared with the control group. Heterogeneity found between studies was explained partly by study design and participant response to dietary cholesterol. No effect of increased egg consumption on LDL-C:HDL-C and TC:HDL-C ratios, and triglyceride (TG) concentrations were found. No association was observed between number of eggs consumed per day or study duration and any of the serum lipid markers.

CONCLUSION:

Consumption of egg increases total cholesterol, LDL-C and HDL-C, but not LDL-C:HDL-C, TC:HDL-C and TG compared with low egg control diets. To assess the risk of coronary events, future studies should focus on the postprandial effect of egg consumption and effects on coronary risk.

KEYWORDS:

Cholesterol; dyslipidemia; egg; high-density lipoprotein cholesterol; lipids

 

Adherence to a Healthy Lifestyle is Associated With a Lower Risk of Diverticulitis among Men.

Liu PH, Cao Y, Keeley BR, Tam I, Wu K, Strate LL, Giovannucci EL, Chan AT.

Am J Gastroenterol. 2017 Nov 7. doi: 10.1038/ajg.2017.398. [Epub ahead of print]

PMID: 29112202

http://sci-hub.cc/http://www.nature.com/articles/ajg2017398

Abstract

OBJECTIVES:

Diverticulitis is a common disease with high clinical burden. We evaluated the joint contribution of multiple lifestyle factors to risks of incident diverticulitis. We also estimated the proportion of diverticulitis preventable by lifestyle modifications.

METHODS:

We prospectively examined the association between lifestyle factors (red meat, dietary fiber intake, vigorous physical activity (activity with metabolic equivalent ≥6), body mass index (BMI), and smoking) and risk of diverticulitis among participants in the Health Professionals Follow-Up Study.

RESULTS:

We documented 907 incident cases of diverticulitis during 757,791 person-years. High intake of red meat, low intake of dietary fiber, low vigorous physical activity, high BMI, and smoking were independently associated with increased risks of diverticulitis (all P<0.05). Low-risk lifestyle was defined as average red meat intake <51 g per day, dietary fiber intake in the top 40% of the cohort (about 23 g per day), vigorous physical activity in the highest 50% among participants with non-zero vigorous physical activity (roughly 2 h of exercise weekly), normal BMI between 18.5-24.9 kg m-2, and never-smoker. There was an inverse linear relationship between number of low-risk lifestyle factors and diverticulitis incidence (P for trend<0.001). Compared with men with no low-risk lifestyle factors, the multivariable relative risks of diverticulitis were 0.71 (95% confidence interval (CI): 0.59-0.87) for men with 1 low-risk lifestyle factor; 0.66 (95% CI: 0.55-0.81) for 2 low-risk factors; 0.50 (95% CI: 0.40-0.62) for 3 low-risk factors; 0.47 (95% CI: 0.35-0.62) for 4 low-risk factors, and 0.27 (95% CI: 0.15-0.48) for 5 low-risk factors. Adherence to a low-risk lifestyle could prevent 50% (95% CI: 20-71%) of incident diverticulitis.

CONCLUSIONS:

Adherence to a low-risk lifestyle is associated with reduced incidence of diverticulitis.

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Amyloid β Deposition and Suspected Non-Alzheimer Pathophysiology and Cognitive Decline Patterns for 12 Years in Oldest Old Participants Without Dementia.

Zhao Y, Tudorascu DL, Lopez OL, Cohen AD, Mathis CA, Aizenstein HJ, Price JC, Kuller LH, Kamboh MI, DeKosky ST, Klunk WE, Snitz BE.

JAMA Neurol. 2017 Nov 6. doi: 10.1001/jamaneurol.2017.3029. [Epub ahead of print]

PMID: 29114732

Abstract

IMPORTANCE:

The prevalence of pathologic conditions of the brain associated with Alzheimer disease increases strongly with age. Little is known about the distribution and clinical significance of preclinical biomarker staging in the oldest old, when most individuals without dementia are likely to have positive biomarkers.

OBJECTIVE:

To compare the patterns of long-term cognitive decline in multiple domains by preclinical biomarker status in the oldest old without dementia.

DESIGN, SETTING, AND PARTICIPANTS:

A longitudinal observational study with a mean (SD) of 12.2 (2.2) years (range 7.2-15.1 years) of follow-up was conducted in an academic medical center from August 24, 2000, to January 14, 2016, including and extending observations from the Ginkgo Evaluation of Memory study. A total of 197 adults who had completed the Ginkgo Evaluation of Memory study, were free of dementia, and were able to undergo magnetic resonance imaging were eligible for a neuroimaging study in 2009. Of these patients, 175 were included in the present analyses; 140 (80%) were cognitively normal and 35 (20%) had mild cognitive impairment.

MAIN OUTCOMES AND MEASURES:

Biomarker groups included amyloid β negative (Aβ-)/neurodegeneration negative (ND-), amyloid β positive (Aβ+)/ND-, Aβ-/neurodegeneration positive (ND+), and Aβ+/ND+ based on Pittsburgh Compound B retention and hippocampal volume in 2009. Participants completed baseline neuropsychological testing from 2000 to 2002 and annual testing from 2004 to 2016. Domains included memory, executive function, language, visual-spatial reasoning, and attention and psychomotor speed. Slopes of decline were evaluated with linear mixed models adjusted for age, sex, and years of education.

RESULTS:

Of the 175 participants (71 women and 104 men), at imaging, mean (SD) age was 86.0 (2.9) years (range, 82-95 years). A total of 42 participants (24.0%) were Aβ-/ND-, 32 (18.3%) were Aβ+/ND-, 35 (20.0%) were Aβ-/ND+, and 66 (37.7%) were Aβ+/ND+. On all cognitive measures, the Aβ+/ND+ group showed the steepest decline. Compared with the Aβ-/ND- group, the amyloid deposition alone (Aβ+/ND-) group showed faster decline on tests of verbal and visual memory (-0.3513; 95% CI, -0.5269 to -0.1756), executive function (0.0158; 95% CI, 0.0013-0.0303), and language (-0.1934; 95% CI, -0.3520 to -0.0348). The Aβ-/ND+ group showed faster visual memory decline than the Aβ-/ND- reference group (-0.3007; 95% CI, -0.4736 to -0.1279).

CONCLUSIONS AND RELEVANCE:

In the oldest old without dementia, presence of either or both Aβ and hippocampal atrophy is typical (>75%). Isolated hippocampal volume atrophy is associated only with greater decline in memory. However, isolated Aβ is associated with decline in memory plus language and executive functions. These findings suggest different underlying pathophysiologic processes in the Aβ+/ND- and Aβ-/ND+ groups.

 

Dietary Zinc Acts as a Sleep Modulator.

Cherasse Y, Urade Y.

Int J Mol Sci. 2017 Nov 5;18(11). pii: E2334. doi: 10.3390/ijms18112334. Review.

PMID: 29113075

http://www.mdpi.com/1422-0067/18/11/2334/htm

Abstract

While zinc is known to be important for many biological processes in animals at a molecular and physiological level, new evidence indicates that it may also be involved in the regulation of sleep. Recent research has concluded that zinc serum concentration varies with the amount of sleep, while orally administered zinc increases the amount and the quality of sleep in mice and humans. In this review, we provide an exhaustive study of the literature connecting zinc and sleep, and try to evaluate which molecular mechanism is likely to be involved in this phenomenon. A better understanding should provide critical information not only about the way zinc is related to sleep but also about how sleep itself works and what its real function is.

KEYWORDS:

brain; nutrition; randomized controlled trial; sleep; zinc

 

[The below paper is pdf-availed.]

Changes in body mass index and incidence of diabetes: A longitudinal study of Alberta's Tomorrow Project Cohort.

Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA.

Prev Med. 2017 Nov 5. pii: S0091-7435(17)30418-8. doi: 10.1016/j.ypmed.2017.10.036. [Epub ahead of print]

PMID: 29117506

Abstract

Although obesity is a known risk factor for diabetes, the impact of body mass index (BMI) changes over time, especially BMI reduction, on diabetes development is less than clear. The objective of this study is to characterize the association between BMI changes over time and incidence of diabetes in a cohort of adults in Alberta. From 2000 to 2008, Alberta's Tomorrow Project (ATP) enrolled participants aged 35-69 to a population-based prospective cohort study. BMI was calculated from self-reported height and weight; change in BMI (∆BMI) was calculated as the difference between baseline and follow-up measurements. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm applied to linked administrative data (2000-2015). Multivariable Cox regression was used to examine the association between ∆BMI and incidence of diabetes. In a subset of the ATP cohort (n=19,164), 1168 incident cases of diabetes were identified during 198,853person-years of follow-up. Overall, BMI increase was associated with increased risk and BMI reduction was associated with reduced risk of diabetes. Particularly, compared to minimal BMI change (±5%), moderate (5%-10%) reduction in BMI was associated with 34% (95% CI: 12%-51%) reduction in risk of diabetes in participants with obesity; whereas 10% or greater increase in BMI was associated with an increased risk of diabetes of 64% or more in participants with overweight and obesity; in participants with normal and underweight, BMI changes was not apparently associated with risk of diabetes. Public health programs promoting weight loss, even at a moderate extent, would reduce risk of diabetes.

KEYWORDS:

Alberta's Tomorrow Project; Body mass index; Diabetes incidence; Longitudinal study

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

[subgroup 1: Normal/underweight at the baseline (n=5,487) HR *95% CI

∆BMI (absolute) per kg/m2 1.15 1.00–1.32

∆BMI (relative) per 10% 1.35 0.98–1.84

Relative ∆BMI (category)

>10% loss † – –

5-10% loss 1.43 0.56–3.67

± 5% 1 –

5-10% gain 1.53 0.80–2.90

>10% gain 1.42 0.64–3.12]

 

Association of Physical Activity With Risk of Major Cardiovascular Diseases in Chinese Men and Women.

Bennett DA, Du H, Clarke R, Guo Y, Yang L, Bian Z, Chen Y, Millwood I, Yu C, He P, Zheng X, Collins R, Chen J, Peto R, Li L, Chen Z; China Kadoorie Biobank Study Collaborative Group.

JAMA Cardiol. 2017 Nov 8. doi: 10.1001/jamacardio.2017.4069. [Epub ahead of print]

PMID: 29117341

https://jamanetwork.com/journals/jamacardiology/fullarticle/2661159

Abstract

IMPORTANCE:

In China, the patterns and levels of physical activity differed from those in high-income countries. Substantial uncertainty remains about the relevance, both qualitatively and quantitatively, of domain-specific physical activity for cardiovascular disease (CVD) subtypes in Chinese adults.

OBJECTIVE:

To assess the shape and strength of the associations of total, occupational, and nonoccupational physical activity with CVD subtypes in Chinese men and women.

DESIGN, SETTING, AND PARTICIPANTS:

This population-based prospective cohort study in 10 (5 urban, 5 rural) areas across China included 487 334 adults who were aged 30 to 79 (mean 51) years with no prior CVD history when enrolled from June 2004 to July 2008.

EXPOSURES:

Self-reported total, occupational, and nonoccupational physical activity, quantified as metabolic equivalent of task hours per day (MET-h/d) based on the type, frequency, and duration of specific activities.

MAIN OUTCOMES AND MEASURES:

Major vascular events (n = 36 184) and their components, including major coronary events (n = 5082), ischemic stroke (n = 25 647), intracerebral hemorrhage (n = 5252), and CVD death (n = 8437). Cox regression yielded adjusted hazard ratios for each disease that was associated with physical activity.

RESULTS:

Of the 487 334 study participants, 287 527 (59%) were women and the mean (SD) age was 51 (10.5) years. The overall mean (SD) total physical activity was 21.5 (12.8) MET-h/d, mainly from occupational activity, especially among men (75% vs 50% in women). Total physical activity was inversely associated with the risk of major vascular events, with the adjusted hazard ratio that compared the top vs bottom quintiles of physical activity being 0.77 (95% CI, 0.74-0.80). Throughout the range of total physical activity studied, the association with CVD with each 4 MET-h/d higher usual total physical activity (approximately 1 hour of brisk walking per day) associated with a 6% (95% CI, 5%-7%) lower risk of major vascular events, and a 9%, 5%, 6%, and 12% lower risk of major coronary events, ischemic stroke, intracerebral hemorrhage, and CVD death, respectively. The strength of the associations was similar and independent of each other for occupational and nonoccupational physical activity. However, for occupational physical activity, the associations with CVD subtypes were greatly attenuated above 20 MET-h/d, especially for intracerebral hemorrhage. The associations of total physical activity with major vascular events were similar among men and women and across different levels of sedentary leisure time but were much weaker among individuals with high blood pressure.

CONCLUSIONS AND RELEVANCE:

Among Chinese adults, higher occupational or nonoccupational physical activity was associated with significantly lower risks of major CVD.

 

Association between Fruit and Vegetable Consumption and Risk of Hypertension in Middle-Aged and Older Korean Adults.

Kim J, Kim J.

J Acad Nutr Diet. 2017 Nov 4. pii: S2212-2672(17)31394-1. doi: 10.1016/j.jand.2017.08.122. [Epub ahead of print]

PMID: 29113723

http://sci-hub.cc/10.1016/j.jand.2017.08.122

Abstract

BACKGROUND:

High fruit and vegetable (F/V) intake may be beneficial for hypertension prevention. However, a prospective association has not been investigated in a Korean population, and differences exist between typical diets in Korea and those of Western populations.

OBJECTIVE:

The aim of this prospective study was to investigate the association between F/V intake and risk of incident hypertension in middle-aged and older Korean adults using the data from the Korean Genome and Epidemiology Study (KoGES).

DESIGN:

The KoGES is a large community-based cohort study of Korean adults aged 40 to 69 years, which began in May 2001. Questionnaires on demographic information and lifestyle factors were completed at baseline. Anthropometrics and biochemical measurements were conducted biennially. Fruit and vegetable consumption was assessed with a semiquantitative food frequency questionnaire. Hypertension was defined as a systolic blood pressure≥140 mm Hg or diastolic blood pressure ≥90 mm Hg.

PARTICIPANTS AND SETTING:

A total of 4,257 participants (2,085 men, 2,172 women) without hypertension at baseline were evaluated.

MAIN OUTCOME MEASURES:

The primary outcome was incident hypertension.

STATISTICAL ANALYSIS PERFORMED:

Multivariate Cox proportional hazard models were used to examine hazard ratios (HRs) and 95% CIs for incident hypertension according to F/V consumption.

RESULTS:

During the 8-year follow-up, 1,158 participants (606 men and 552 women) developed hypertension. Among men, frequent fruit consumers (≥4 servings/day) had a 56% lower risk of incident hypertension than did infrequent consumers (<1 serving/day) (HR=0.44, 95% CI=0.32 to 0.60, P for trend <0.0001). Among women, frequent fruit consumers had a 67% lower risk of incident hypertension than did infrequent consumers (HR=0.33, 95% CI=0.24 to 0.45, P for trend <0.0001), after adjustment for potential confounders. However, there was no association between vegetable consumption and risk of incident hypertension in either men or women.

CONCLUSION:

A higher intake of fruit was prospectively associated with a lower risk of incident hypertension in middle-aged and older Korean adults, regardless of sex.

KEYWORDS:

Fruit and vegetable consumption; Hypertension; Korean Genome and Epidemiology Study

 

Gender differences in mortality among statin users aged 80 years or more.

Justo D, Tchernichovsky M, Kremer A, Joffe E, Sherman S, Ioffe M, Mayan H.

Z Gerontol Geriatr. 2017 Nov 7. doi: 10.1007/s00391-017-1335-y. [Epub ahead of print]

PMID: 29116376

http://sci-hub.cc/10.1007/s00391-017-1335-y

Abstract

BACKGROUND:

Little is known about the prognosis associated with statin therapy and its gender differences in older adults aged ≥80 years.

OBJECTIVE:

To study the mortality and survival associated with statin therapy and their gender differences in older adults aged ≥80 years.

METHOD:

This was a historical prospective study conducted at a tertiary medical center. The medical charts of all older adults aged ≥80 years who had been admitted to a single internal medicine department during 1 year were reviewed. All-cause 3‑year mortality and survival rates following hospital admission in men and in women using statins were investigated.

RESULTS:

The final cohort included 216 patients: 122 (56.5%) women, mean age 85.3 ± 3.9 years. Overall, 66 (53.2%) women and 58 (46.8%) men used statins for 3 years or more following hospital admission. During this time 48 (39.3%) women and 48 (51.1%) men died. The all-cause 3‑year mortality rates were significantly lower only in women who had used statins compared with women who had not used statins (24.2% vs. 57.1%; relative risk = 0.2; 95% confidence interval 0.1-0.5; p < 0.0001). The 3‑year cumulative survival rates were significantly higher in women who had used statins as part of primary as well as secondary cardiovascular prevention (p < 0.0001 and p = 0.014, respectively). A Cox regression analysis showed that statin therapy was independently associated with low 3‑year cumulative mortality rates in women (hazard ratio=0.3; 95% confidence interval=0.1-0.6; p = 0.001).

CONCLUSION:

In older adults aged ≥80 years, statin therapy is associated with high 3‑year cumulative survival rates only in women.

KEYWORDS:

Cardiovascular disease; Observational study; Polypharmacy; Prognosis; Survival

 

Transferability of the Mediterranean Diet to Non-Mediterranean Countries. What Is and What Is Not the Mediterranean Diet.

Martínez-González MÁ, Hershey MS, Zazpe I, Trichopoulou A.

Nutrients. 2017 Nov 8;9(11). pii: E1226. doi: 10.3390/nu9111226.

PMID: 29117146

http://www.mdpi.com/2072-6643/9/11/1226/htm

Abstract

Substantial evidence has verified the Mediterranean diet's (MedDiet) nutritional adequacy, long-term sustainability, and effectiveness for preventing hard clinical events from cardiovascular disease (CVD), as well as increasing longevity. This article includes a cumulative meta-analysis of prospective studies supporting a strong inverse association between closer adherence to the MedDiet and the incidence of hard clinical events of CVD. The MedDiet has become an increasingly popular topic of interest when focusing on overall food patterns rather than single nutrient intake, not only in Mediterranean countries, but also globally. However, several myths and misconceptions associated with the traditional Mediterranean diet should be clearly addressed and dispelled, particularly those that label as "Mediterranean" an eating pattern that is not in line with the traditional Mediterranean diet. The transferability of the traditional MedDiet to the non-Mediterranean populations is possible, but it requires a multitude of changes in dietary habits. New approaches for promoting healthy dietary behavior consistent with the MedDiet will offer healthful, sustainable, and practical strategies at all levels of public health. The following article presents practical resources and knowledge necessary for accomplishing these changes.

KEYWORDS:

Mediterranean diet; cardiovascular disease; dietary intervention; dietary patterns; dietary recommendations

 

Predicting Age by Mining Electronic Medical Records with Deep Learning Characterizes Differences between Chronological and Physiological Age.

Wang Z, Li L, Glicksberg BS, Israel A, Dudley JT, Ma'ayan A.

J Biomed Inform. 2017 Nov 4. pii: S1532-0464(17)30240-X. doi: 10.1016/j.jbi.2017.11.003. [Epub ahead of print]

PMID: 29113935

http://sci-hub.cc/10.1016/j.jbi.2017.11.003

Abstract

Determining the discrepancy between chronological and physiological age of patients is central to preventative and personalized care. Electronic medical records (EMR) provide rich information about the patient physiological state, but it is unclear whether such information can be predictive of chronological age. Here we present a deep learning model the uses vital signs and lab tests contained within the EMR of Mount Sinai Health System (MSHS) to predict chronological age. The model is trained on 377,686 EMR from patients of ages 18-85 years old. The discrepancy between the predicted and recorded chronological age is then used as a proxy to estimate physiological age. Overall, the model can predict the chronological age of patients with a standard deviation error of ∼7 years. The ages of the youngest and oldest patients were more accurately predicted, while patients of ages ranging between 40 and 60 years were the least accurately predicted. Patients with the largest discrepancy between their physiological and chronological age were further inspected. The patients predicted to be significantly older than their chronological age have higher systolic blood pressure, higher cholesterol, damaged liver, and anemia. In contrast, patients predicted to be younger than their chronological age have lower blood pressure and shorter stature among other indicators; both groups display lower weight than the population average. Using information from ∼10,000 patients from the entire cohort who have been also profiled with SNP arrays, genome-wide association study (GWAS) uncover several novel genetic variants associated with aging. In particular, significant variants were mapped to genes known to be associated with inflammation, hypertension, lipid metabolism, height, and increased lifespan in mice. Several genes with missense mutations were identified as novel candidate aging genes. In conclusion, we demonstrate how EMR data can be used to assess overall health via a scale that is based on deviation from the patient's predicted chronological age.

KEYWORDS:

Age prediction; Aging; Deep learning; Machine learning; Medical records

 

NATURE | NEWS & VIEWS

Neurobiology: A genetic cause of age-related decline

Patrick T. McGrath

Nature 551, 179–180 (09 November 2017) doi:10.1038/551179a

Published online 08 November 2017

Genetic variation in a neuropeptide signalling pathway regulates age-related declines in health in nematode worms. This discovery points to a mechanism that influences individual differences in ageing. See Article p.198

Subject terms: Ageing Genetics Neuroscience

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Genetic variation in glia–neuron signalling modulates ageing rate

Jiang-An Yin, Ge Gao, Xi-Juan Liu, Zi-Qian Hao, Kai Li, Xin-Lei Kang, Hong Li, Yuan-Hong Shan, Wen-Li Hu, Hai-Peng Li & Shi-Qing Cai

AffiliationsContributionsCorresponding author

Nature 551, 198–203 (09 November 2017) doi:10.1038/nature24463

Received 22 February 2017 Accepted 02 October 2017 Published online 08 November 2017

Abstract

The rate of behavioural decline in the ageing population is remarkably variable among individuals. Despite the considerable interest in studying natural variation in ageing rate to identify factors that control healthy ageing, no such factor has yet been found. Here we report a genetic basis for variation in ageing rates in Caenorhabditis elegans. We find that C. elegans isolates show diverse lifespan and age-related declines in virility, pharyngeal pumping, and locomotion. DNA polymorphisms in a novel peptide-coding gene, named regulatory-gene-for-behavioural-ageing-1 (rgba-1), and the neuropeptide receptor gene npr-28 influence the rate of age-related decline of worm mating behaviour; these two genes might have been subjected to recent selective sweeps. Glia-derived RGBA-1 activates NPR-28 signalling, which acts in serotonergic and dopaminergic neurons to accelerate behavioural deterioration. This signalling involves the SIR-2.1-dependent activation of the mitochondrial unfolded protein response, a pathway that modulates ageing. Thus, natural variation in neuropeptide-mediated glia–neuron signalling modulates the rate of ageing in C. elegans.

Subject terms: Behavioural genetics Neural ageing Ageing

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Effect of total, domain-specific, and intensity-specific physical activity on all-cause and cardiovascular mortality among hypertensive adults in China.

Fan M, Yu C, Guo Y, Bian Z, Li X, Yang L, Chen Y, Li M, Li X, Chen J, Chen Z, Lv J, Li L; China Kadoorie Biobank Collaborative Group.

J Hypertens. 2017 Nov 8. doi: 10.1097/HJH.0000000000001601. [Epub ahead of print]

PMID: 29120959

Abstract

OBJECTIVES:

We aimed to prospectively examine the associations of total, domain-specific, and intensity-specific physical activity with all-cause and cardiovascular mortality among Chinese hypertensive adults.

METHODS:

We performed a prospective cohort study in 150 391 hypertensive participants aged 30-79 years from the China Kadoorie Biobank study of 512 891 participants recruited from 10 diverse areas across China during 2004-2008. Participants with heart disease, stroke, chronic obstructive pulmonary disease, and cancer at baseline were excluded.

RESULTS:

During 1069 863 person-years of follow-up (median 7.1 years), a total of 5332 men and 4384 women died. Compared with hypertensive participants in the lowest level of total physical activity, the hazard ratios for all-cause mortality were 0.80 (0.76-0.84), 0.69 (0.65-0.73), and 0.67 (0.62-0.72) for those in quartiles 2-4 (Ptrend < 0.001), respectively. Inverse associations were also observed for cardiovascular mortality. Being active in occupational, domestic, and leisure time were associated with lower risk of all-cause and cardiovascular mortality. However, the adjusted ratio for active commuting was 1.08 (1.02-1.15) for all-cause mortality. High levels of low-intensity, moderate-intensity, and vigorous-intensity physical activity were consistently associated with lower risks of all-cause and cardiovascular mortality.

CONCLUSION:

Among Chinese hypertensive adults, a higher level of physical activity reduces all-cause and cardiovascular mortality, independent of intensities of physical activity. Not only leisure-time but also occupational and domestic physical activities were benefited.

 

Association between dietary intake and postlaparoscopic cholecystectomic symptoms in patients with gallbladder disease.

Shin Y, Choi D, Lee KG, Choi HS, Park Y.

Korean J Intern Med. 2017 Nov 10. doi: 10.3904/kjim.2016.223. [Epub ahead of print]

PMID: 29117670

http://kjim.org/upload/kjim-2016-223.pdf

Abstract

BACKGROUND/AIMS:

After cholecystectomy, patients have reported postcholecystectomic syndromes such as abdominal symptoms, dyspepsia, and diarrhea, which suggest a relationship between cholecystectomic symptoms and diet, although the details of this association remain unclear. The present study investigated the hypothesis that dietary intake of nutrients and foods was significantly associated with postcholecystectomic syndromes.

METHODS:

Gallstone patients (n = 59) who underwent laparoscopic cholecystectomy were enrolled, and dietary intake and clinical parameters were assessed immediately postcholecystectomy and 3 months later.

RESULTS:

There were no significant differences in biochemical measurements or characteristics between symptomatic and asymptomatic patients. Immediately postcholecystectomy, there were no significant differences in consumption of nutrients or foods between symptomatic and asymptomatic patients. However, 3 months after cholecystectomy, symptomatic patients consumed more animal protein, cholesterol, and eggs, and fewer vegetables than did asymptomatic patients. Multivariable-adjusted regression analyses also indicated that the risk for symptoms was positively associated with intake of animal protein, cholesterol, and eggs, but negatively associated with intake of vegetables after adjusting for confounders. In addition, symptomatic patients consumed more bread-based breakfast foods, while asymptomatic patients consumed more rice.

CONCLUSIONS:

Postcholecystectomic syndromes were positively associated with intake of cholesterol, animal protein, and eggs, and negatively associated with intake of vegetables, suggesting that diet was plays a role in postcholecystectomic syndromes.

KEYWORDS:

Diet; Follow-up studies; Gallstone; Postcholecystectomy syndrome

 

Immunological and Clinical Effect of Diet Modulation of the Gut Microbiome in Multiple Sclerosis Patients: A Pilot Study.

Saresella M, Mendozzi L, Rossi V, Mazzali F, Piancone F, LaRosa F, Marventano I, Caputo D, Felis GE, Clerici M.

Front Immunol. 2017 Oct 25;8:1391. doi: 10.3389/fimmu.2017.01391. eCollection 2017.

PMID: 29118761

Abstract

Pathogenesis of autoimmune disorders, including multiple sclerosis (MS), has been linked to an alteration of the resident microbial commensal community and of the interplay between the microbiota and the immune system. Dietary components such as fiber, acting on microbiota composition, could, in principle, result in immune modulation and, thus, could be used to obtain beneficial outcomes for patients. We verified this hypothesis in a pilot study involving two groups of clinically similar relapsing-remitting (RR) MS patients who had undergone either a high-vegetable/low-protein diet (HV/LP diet group; N = 10) or a "Western Diet" (WD group; N = 10) for at least 12 months. Gut microbiota composition, analyzed by 16 S V4 rRNA gene sequencing and immunological profiles, was examined after a minimum of 12 months of diet. Results showed that, in the HV/LP diet group compared to the WD group: (1) Lachnospiraceae family was significantly more abundant; (2) IL-17-producing T CD4+ lymphocytes (p = 0.04) and PD-1 expressing T CD4+ lymphocytes (p = 0.0004) were significantly decreased; and (3) PD-L1 expressing monocytes (p = 0.009) were significantly increased. In the HV/LP diet group, positive correlations between Lachnospiraceae and both CD14+/IL-10+ and CD14+/TGFβ+monocytes (RSp = 0.707, p = 0.05, and RSp = 0.73, p = 0.04, respectively), as well as between Lachnospiraceae and CD4+/CD25+/FoxP3+ T lymphocytes (RSp = 0.68, p = 0.02) were observed. Evaluation of clinical parameters showed that in the HV/LP diet group alone the relapse rate during the 12 months follow-up period and the Expanded Disability Status Scale score at the end of the study period were significantly reduced. Diet modulates dysbiosis and improves clinical parameters in MS patients by increasing anti-inflammatory circuits. Because Lachnospiraceae favor Treg differentiation as well as TGFβ and IL-10 production this effect could be associated with an increase of these bacteria in the microbiota.

KEYWORDS:

cytokine; diet; dysbiosis; immunology; inflammation; microbiome; multiple sclerosis

 

Hyperlipidemia is associated with an increased risk of clinical benign prostatic hyperplasia.

Shih HJ, Huang CJ, Lin JA, Kao MC, Fan YC, Tsai PS.

Prostate. 2017 Nov 9. doi: 10.1002/pros.23451. [Epub ahead of print]

PMID: 29119583

http://sci-hub.cc/10.1002/pros.23451

Abstract

BACKGROUND:

A high fat diet is associated with risk of benign prostatic hyperplasia (BPH). However, whether hyperlipidemia is associated with BPH remains unclear. This population-based cohort study elucidated whether hyperlipidemia is associated with an increased risk of BPH.

METHODS:

We used a new-exposure design and analyzed data retrieved from the Taiwan National Health Insurance Database between January 1, 2000 and December 31, 2013. The cohort of men with newly diagnosed hyperlipidemia and the age- and index-date-matched (1:3) nonhyperlipidemia cohort were tracked for incidence of BPH during a 1- to 14-year follow-up. Diagnosis of BPH using the International Classification of Diseases, Ninth Revision, Clinical Modification codes, and the occurrence of BPH diagnosis plus the use of alpha-blockers or 5-alpha reductase inhibitors or receipt of transurethral resection of the prostate were the primary and secondary endpoints, respectively. The confounders in this study were diabetes mellitus, hypertension, coronary heart disease, obesity, liver cirrhosis, nonsteroidal anti-inflammatory drugs, metformin, aspirin, and number of urologist visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a multivariate Cox proportional hazards regression model adjusted for the propensity score.

RESULTS:

A total of 35 860 subjects (aged 40-99 years)-including the hyperlipidemia cohort (n = 8,965) and nonhyperlipidemia cohort (n = 26 895)-were identified. Our data revealed that the hyperlipidemia cohort had significantly higher incidences of developing BPH (24.6% vs 12.3%, P < 0.001) and treated BPH (13% vs 5.7%, P < 0.001) compared with the nonhyperlipidemia cohort. The risk of developing BPH in the hyperlipidemia cohort was significantly higher than that in the nonhyperlipidemia cohort (HR = 1.73, 95% CI = 1.63-1.83, P < 0.001) after adjustment for the propensity score.

CONCLUSIONS:

Hyperlipidemia is associated with an increased risk of clinical BPH.

KEYWORDS:

hyperlipidemia; hyperplasia; lipid; prostate

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Associations of Calcium and Dairy Products with All-Cause and Cause-Specific Mortality in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Prospective Cohort Study.

Um CY, Judd SE, Flanders WD, Fedirko V, Bostick RM.

Nutr Cancer. 2017 Nov 10:1-11. doi: 10.1080/01635581.2017.1367946. [Epub ahead of print]

PMID: 29125314

https://sci-hub.cc/https://www.tandfonline.com/doi/full/10.1080/01635581.2017.1367946

Abstract

Associations of calcium and dairy product intakes with cardiovascular disease risk and cancer mortality are controversial. We investigated associations of calcium and dairy product intakes with mortality in the prospective REasons for Geographic and Racial Differences in Stroke study (n = 30,239). Of 2,966 total deaths, 32.3% were from CVD and 28.8% from cancer. For those in the upper relative to the lowest quintile of intakes, from Cox proportional hazards regression models, the multivariable-adjusted hazard ratios (HRs) for all-cause mortality were 1.13 (95% confidence intervals [CI] 0.95-1.35; P-trend 0.004) for whole milk, and 0.75 (CI 0.61-0.93; P-trend 0.001) for nonfat milk; for CVD mortality the corresponding HRs were 0.80 (CI 0.55-1.16; P-trend 0.80) and 0.72 (CI 0.49-1.05; P-trend 0.06); and for cancer mortality they were 1.56 (CI 1.17-2.08; P-trend 0.006) and 0.89 (CI 0.62-1.28; P-trend 0.86). Calcium (total, dietary, supplemental) and total dairy product intakes were not associated with all-cause, cardiovascular, or cancer mortality. These results suggest that whole milk consumption may be directly associated with cancer mortality; non-fat milk consumption may be inversely associated with all-cause and cardiovascular- and cancer-specific mortality; and calcium intake independent of milk product intakes may not be associated with mortality.

"calcium-adjusted residuals would represent

a possible indirect indicator of the noncalcium, nonfat

components of milk (such as IGF-1)."

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The double mutation of cytochrome P450's and fatty acid desaturases affect lipid regulation and longevity in <i>C. elegans</i>.

Imanikia S, Hylands P, Stürzenbaum SR.

Biochem Biophys Rep. 2015 Jun 25;2:172-178. doi: 10.1016/j.bbrep.2015.06.007. eCollection 2015 Jul.

PMID: 29124160

http://www.sciencedirect.com/science/article/pii/S2405580815000382?via%3Dihub

https://ac.els-cdn.com/S2405580815000382/1-s2.0-S2405580815000382-main.pdf?_tid=20bbef92-c7cd-11e7-a050-00000aacb35f&acdnat=1510507129_a75d5518bb8e304a0cce9a9821e62a85

Abstract

An imbalance between energy uptake and energy expenditure can lead to obesity and increase the risk of coronary heart disease, high blood pressure, stroke, type II diabetes and some cancers. Given that key elements of the energy pathway are evolutionary conserved, invertebrate research is an attractive alternative that overcomes the many legislative, financial and experimental hurdles typical of research with higher metazoan animals. Recent studies have suggested that some members of the cytochrome P450 superfamily are involved in lipid metabolism in addition to the traditional xenobiotic activity. To investigate this notion in more detail, the present study aimed to pinpoint phenotypic, genetic and genomic-level responses of Caenorhabditis elegans using selected deletion mutants including fat-5 (a member of the Δ9 desaturases) and cyp-35A2 (a member of the cytochrome P450 family). The creation of a fat-5(tm420);cyp-35A2(gk317) mutant uncovered that the deletion of both genes resulted in a strain which is marked by an extended lifespan. Furthermore, it diminished the overall level of Nile Red positive compartments, which is indicative of a change in lipid metabolism. Comprehensive transcriptomics revealed that several genes involved in aging and lipid transport/homeostasis were modulated following the double deletion of fat-5 and cyp-35A2. Taken together, the results suggest the presence of a putative correlation between longevity and lipid regulation and given that both genes have human homologs, this finding may offer a new lead to investigate in higher organisms.

KEYWORDS:

C. elegans; Cytochrome P450; Fatty acid desaturase; Life-span; Nematode

 

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Science, this issue p. 813

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SAMTOR is an <i>S</i>-adenosylmethionine sensor for the mTORC1 pathway.

Gu X, Orozco JM, Saxton RA, Condon KJ, Liu GY, Krawczyk PA, Scaria SM, Harper JW, Gygi SP, Sabatini DM.

Science. 2017 Nov 10;358(6364):813-818. doi: 10.1126/science.aao3265.

PMID: 29123071

http://sci-hub.cc/10.1126/science.aao3265

SAMTOR is a SAM sensor that links methionine and one-carbon metabolism to mTORC1 signaling.

Abstract

mTOR complex 1 (mTORC1) regulates cell growth and metabolism in response to multiple environmental cues. Nutrients signal via the Rag guanosine triphosphatases (GTPases) to promote the localization of mTORC1 to the lysosomal surface, its site of activation. We identified SAMTOR, a previously uncharacterized protein, which inhibits mTORC1 signaling by interacting with GATOR1, the GTPase activating protein (GAP) for RagA/B. We found that the methyl donor S-adenosylmethionine (SAM) disrupts the SAMTOR-GATOR1 complex by binding directly to SAMTOR with a dissociation constant of approximately 7 μM. In cells, methionine starvation reduces SAM levels below this dissociation constant and promotes the association of SAMTOR with GATOR1, thereby inhibiting mTORC1 signaling in a SAMTOR-dependent fashion. Methionine-induced activation of mTORC1 requires the SAM binding capacity of SAMTOR. Thus, SAMTOR is a SAM sensor that links methionine and one-carbon metabolism to mTORC1 signaling.

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editor's summary.

Stella M. Hurtley

Science 10 Nov 2017:

Vol. 358, Issue 6364, pp. 758-760

DOI: 10.1126/science.358.6364.758-m

http://sci-hub.cc/10.1126/science.358.6364.758-m

The amino acid methionine is widely appreciated to have interesting effects on animal physiology. Diets low in methionine increase longevity and overall health, particularly glucose homeostasis. Gu et al. describe a potential molecular link between the effects of methionine restriction and the growth controller mTOR complex 1 (mTORC1), a well-validated regulator of life span and health span in many organisms. They identify a protein that they named SAMTOR as a component of the nutrient-sensing pathway upstream of mTORC1. SAMTOR directly binds S-adenosylmethionine (SAM), a metabolite made from methionine, and is necessary for regulating mTORC1 in response to methionine.

 

NEUROENDOCRINOLOGY

Connecting smell to metabolism

Gemma Alderton

There is accumulating evidence, particularly in rodents, that odor perception and olfactory neurons can regulate metabolism. For instance, ablating the sense of smell can lead to resistance to obesity induced by a high-fat diet. In a Perspective, Garrison and Knight discuss the potential mechanisms and implications of these findings with regard to the regulation of metabolism and how this may also affect longevity in mammals.

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Science, this issue p. 718

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Linking smell to metabolism and aging

BY JENNIFER L. GARRISON, ZACHARY A. KNIGHT

Science 10 Nov 2017:

Vol. 358, Issue 6364, pp. 718-719

DOI: 10.1126/science.aao5474

The olfactory system can have direct effects on energy homeostasis

Summary

The sense of smell, or olfaction, allows animals to survey the chemical landscape of the outside world and use this information to guide behavior. Olfactory cues are particularly important for the regulation of feeding, but how odor perception influences other aspects of energy homeostasis remains poorly understood. Recent work has begun to uncover some of these connections, revealing an unexpected role for olfaction in the control of metabolism and longevity.

>>>>>>>>>>

2. The Sense of Smell Impacts Metabolic Health and Obesity.

Riera CE, Tsaousidou E, Halloran J, Follett P, Hahn O, Pereira MMA, Ruud LE, Alber J, Tharp K, Anderson CM, Brönneke H, Hampel B, Filho CDM, Stahl A, Brüning JC, Dillin A.

Cell Metab. 2017 Jul 5;26(1):198-211.e5. doi: 10.1016/j.cmet.2017.06.015.

PMID: 28683287

http://sci-hub.cc/10.1016/j.cmet.2017.06.015

Abstract

Olfactory inputs help coordinate food appreciation and selection, but their role in systemic physiology and energy balance is poorly understood. Here we demonstrate that mice upon conditional ablation of mature olfactory sensory neurons (OSNs) are resistant to diet-induced obesity accompanied by increased thermogenesis in brown and inguinal fat depots. Acute loss of smell perception after obesity onset not only abrogated further weight gain but also improved fat mass and insulin resistance. Reduced olfactory input stimulates sympathetic nerve activity, resulting in activation of β-adrenergic receptors on white and brown adipocytes to promote lipolysis. Conversely, conditional ablation of the IGF1 receptor in OSNs enhances olfactory performance in mice and leads to increased adiposity and insulin resistance. These findings unravel a new bidirectional function for the olfactory system in controlling energy homeostasis in response to sensory and hormonal signals.

KEYWORDS:

diet-induced obesity; energy balance; hyperosmia; hyposmia; insulin resistance; insulin-like growth factor 1 receptor; lipolysis; olfactory sensory neuron; thermogenesis

 

Life equations for the senescence process.

Liu X.

Biochem Biophys Rep. 2015 Oct 1;4:228-233. doi: 10.1016/j.bbrep.2015.09.020. eCollection 2015 Dec.

PMID: 29124208

http://www.sciencedirect.com/science/article/pii/S2405580815001004?via%3Dihub

https://ac.els-cdn.com/S2405580815001004/1-s2.0-S2405580815001004-main.pdf?_tid=d1cb9bfe-c7d0-11e7-bd34-00000aab0f6c&acdnat=1510508714_ec276e3e33565dcdb20d58ac03cbf8aa

Abstract

The Gompertz law of mortality quantitatively describes the mortality rate of humans and almost all multicellular animals. However, its underlying kinetic mechanism is unclear. The Gompertz law cannot explain the mortality plateau at advanced ages and cannot give an explicit relationship between temperature and mortality. In this study a reaction kinetics model with a time dependent rate coefficient is proposed to describe the survival and senescence processes. A temperature-dependent mortality function was derived. The new mortality function becomes the Gompertz mortality function with the same relationship of parameters prescribed by the Strehler-Mildvan correlation when age is smaller than a characteristic value δ, and reaches the mortality plateau when age is greater than δ. A closed-form analytical expression for describing the relationship of average lifespan with temperature and other equations are derived from the new mortality function. The derived equations can be used to estimate the limit of average lifespan, predict the maximal longevity, calculate the temperature coefficient of lifespan, and explain the tendency of the survival curve. This prediction is consistent with the most recently reported mortality trajectories for single-year birth cohorts. This study suggests that the senescence process results from the imbalance between damaging energy and protecting energy for the critical chemical substance in the body. The rate of senescence of the organism increases while the protecting energy decreases. The mortality plateau is reached when the protecting energy decreases to its minimal levels. The decreasing rate of the protecting energy is temperature-dependent. This study is exploring the connection between the biochemical mechanism and demography.

KEYWORDS:

Lifespan; Mortality kinetics; Mortality plateau; Survival curve

 

Influence of abdominal obesity and habitual behaviors on incident atrial fibrillation in Japanese.

Hamada R, Lee JS, Mori K, Watanabe E, Muto S.

J Cardiol. 2017 Nov 7. pii: S0914-5087(17)30201-0. doi: 10.1016/j.jjcc.2017.07.008. [Epub ahead of print]

PMID: 29126781

http://sci-hub.cc/10.1016/j.jjcc.2017.07.008

Abstract

BACKGROUND:

As atrial fibrillation (AF) increases with the aging of the population, it is urgently required to clarify modifiable factors to prevent AF. However, evidence regarding the independent influence of abdominal-obesity and habitual behaviors on incident AF is limited among Japanese.

METHODS AND RESULTS:

Those aged 40-79 years undergoing periodic health checkups during 2008-2014 were followed-up in 2015 (n=96,841) and the independent risk of incident AF was estimated using multivariate Cox proportional hazards regression models after adjustment for potential covariates. Participants were classified into four groups according to the baseline body mass index (BMI: kg/m2) (normal-BMI or overweight: < or ≥25) and waist circumference (WC: cm) (normal-WC or abdominal-obesity: < or ≥85 for male, ≥90 for female). Baseline habitual behaviors, smoking status, alcohol intake, and physical activity, were also included as modifiable factors. Among 65,984 eligible participants, 349 developed AF over mean follow-up of 5.5±1.6 years. Increase of both BMI and WC significantly elevated the risk of AF. Compared to the normal-BMI and normal-WC group, the normal-BMI but abdominal-obesity and the overweight and abdominal-obesity groups in males and the overweight and abdominal-obesity group in females had significantly elevated risk of AF. Among modifiable behavioral factors including abdominal-obesity, alcohol intake (≥40g/day) and abdominal-obesity significantly elevated the risk of AF in males, and abdominal-obesity was the strongest risk factor in both sexes, but smoking and physical activity were not significant. However, an aggregation of these four behavioral factors increased the risk of AF more than 2.5 times in both sexes.

CONCLUSIONS:

Abdominal-obesity could be a crucial risk factor in prediction of AF in Japanese, and an aggregation of four behavioral factors increased the risk of AF almost three times. To prevent incident AF, practicing healthy habitual behaviors is recommended.

KEYWORDS:

Abdominal obesity; Atrial fibrillation; Habitual behaviors; Lifestyle; Waist circumference

 

Whole Grain Consumption and Risk of Ischemic Stroke: Results From 2 Prospective Cohort Studies.

Juan J, Liu G, Willett WC, Hu FB, Rexrode KM, Sun Q.

Stroke. 2017 Nov 10. pii: STROKEAHA.117.018979. doi: 10.1161/STROKEAHA.117.018979. [Epub ahead of print]

PMID: 29127271

http://sci-hub.cc/10.1161/strokeaha.117.018979

Abstract

BACKGROUND AND PURPOSE:

Higher intake of whole grains may exert cardiometabolic benefits, although findings on stroke risk are inconclusive. The potentially differential effects of individual whole grain foods on ischemic stroke have not been examined.

METHODS:

We analyzed whole grain consumption in relation to ischemic stroke among 71 750 women from the Nurses' Health Study and 42 823 men from the Health Professionals Follow-up Study who were free of cardiovascular disease, diabetes mellitus, and cancer at baseline (1984 and 1986, respectively) through 2010 using a Cox proportional hazards model. Validated semiquantitative food frequency questionnaires were used to assess consumption of whole grain intake, including whole grain cold breakfast cereal, dark bread, oatmeal, brown rice, popcorn, bran, and germ. Self-reported incident cases of ischemic stroke were confirmed through medical record review.

RESULTS:

During 2820 128 person-years of follow-up in the 2 cohorts, 2458 cases of ischemic stroke were identified and confirmed. Intake of total whole grains was not associated with risk of ischemic stroke after adjustment for covariates: the pooled hazard ratio (95% confidence interval) comparing extreme intake levels was 1.04 (0.91-1.19). However, intake of whole grain cold breakfast cereal and total bran was inversely associated with ischemic stroke after multivariate adjustment: the pooled hazard ratios (95% confidence intervals) were 0.88 (0.80-0.96; Ptrend=0.008) and 0.89 (0.79-1.00; Ptrend=0.004), respectively. Other whole grain foods were not associated with a lower risk of ischemic stroke.

CONCLUSIONS:

Although overall consumption of whole grains was not associated with lower risk of ischemic stroke, greater consumption of whole grain cold breakfast cereal and bran was significantly associated with a lower risk of ischemic stroke. More studies are needed to replicate these associations between individual whole grain foods and risk of ischemic stroke among other populations.

KEYWORDS:

breakfast; cohort studies; meta-analysis; stroke; whole grains

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Accelerometer-measured sedentary time and physical activity-A 15 year follow-up of mortality in a Swedish population-based cohort.

Dohrn IM, Sjöström M, Kwak L, Oja P, Hagströmer M.

J Sci Med Sport. 2017 Nov 7. pii: S1440-2440(17)31748-6. doi: 10.1016/j.jsams.2017.10.035. [Epub ahead of print]

PMID: 29128418

http://www.jsams.org/article/S1440-2440(17)31748-6/fulltext

http://www.jsams.org/article/S1440-2440(17)31748-6/pdf

Abstract

OBJECTIVES:

To investigate the associations of objectively assessed sedentary time, light intensity physical activity (PA), moderate to vigorous intensity PA (MVPA), and total PA with all-cause mortality and mortality from cardiovascular disease (CVD) or cancer in a Swedish population-based cohort with 15 years follow-up time.

DESIGN:

Longitudinal prospective cohort study.

METHODS:

Data from 851 persons (56% women) ≥35 years at baseline were included. Primary exposure variables were time (min/day) spent sedentary, in light intensity PA and in MVPA, and total counts from an Actigraph 7164 accelerometer. Data on all-cause mortality and mortality from CVD or cancer were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI).

RESULTS:

Compared with the least sedentary participants, those in the most sedentary tertile had an increased risk of all-cause mortality, HR: 2.7 (1.4, 5.3), CVD mortality, HR: 5.5 (1.4, 21.2) and cancer mortality, HR: 4.3 (1.2, 16.0). For all-cause mortality, those in the highest light intensity PA tertile had a HR 0.34 (0.17, 0.67) compared with the lowest tertile. A similar pattern was found for CVD and cancer mortality. More time spent in MVPA was associated with the largest risk reduction for CVD mortality, with an almost 90% lower risk in the tertile with the most time in MVPA.

CONCLUSIONS:

This study confirms a strong inverse relationship between MVPA and mortality, and adds new insight for the understanding of the associations between sedentary time and light intensity PA and mortality.

KEYWORDS:

Accelerometry; Epidemiology; Mortality; Physical activity; Prospective; Sedentary behaviour

 

Moderate physical activity reduces 10-year diabetes incidence: the mediating role of oxidative stress biomarkers.

Koloverou E, Tambalis K, Panagiotakos DB, Georgousopoulou E, Chrysohoou C, Skoumas I, Tousoulis D, Stefanadis C, Pitsavos C; ATTICA study group.

Int J Public Health. 2017 Nov 11. doi: 10.1007/s00038-017-1052-8. [Epub ahead of print]

PMID: 29128918

http://sci-hub.cc/10.1007/s00038-017-1052-8

Abstract

OBJECTIVES:

To evaluate the effect of physical activity levels on 10-year diabetes incidence and investigate the potential mechanism.

METHODS:

In 2001-2002, a random sample of apparently healthy 3042 men and women (18-89 years) was selected to participate in the ATTICA study. Several socio-demographic, clinical and lifestyle characteristics were recorded. Physical activity level was recorded through a translated, validated, version of International Physical Activity Questionnaire (IPAQ); MET min/week was calculated and quartiles constructed. Diabetes diagnosis was defined according to the ADA criteria. During 2011-2012, a 10-year follow-up was performed.

RESULTS:

n = 191 cases were recorded, yielding an incidence of 12.9%. In multivariable analysis, moderate physical activity level (331-1484 MET min/week) was found to decrease 10-year diabetes incidence by 53% compared to very low physical activity (< 150 MET min/week) (OR = 0.47; 95% CI 0.24, 0.93). For high physical activity level (> 1484 MET min/week), the results were not significant. The antidiabetic effect was found to be mediated by oxidized LDL and total antioxidant capacity.

CONCLUSIONS:

The current work revealed the significant beneficial role of moderate physical activity against diabetes development, potentially through attenuating oxidative stress.

KEYWORDS:

Diabetes incidence; Oxidative stress; Physical activity

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Impact of Alcohol Intake and Drinking Patterns on Mortality From All Causes and Major Causes of Death in a Japanese Population.

Saito E, Inoue M, Sawada N, Charvat H, Shimazu T, Yamaji T, Iwasaki M, Sasazuki S, Mizoue T, Iso H, Tsugane S.

J Epidemiol. 2017 Nov 11. doi: 10.2188/jea.JE20160200. [Epub ahead of print]

PMID: 29129895

Abstract

BACKGROUND:

We examined the associations of alcohol consumption and liver holidays with all-cause mortality and with mortality due to cancer, heart disease, cerebrovascular disease, respiratory disease, and injury using a large-scale prospective study in Japan.

METHODS:

We followed 102,849 Japanese who were aged between 40 and 69 years at baseline for 18.2 years on average, during which 15,203 deaths were reported. Associations between alcohol intake and mortality risk were assessed using a Cox proportional hazards model, with analysis by the number of liver holidays (in which a person abstains from drinking for several days a week).

RESULTS:

A J-shaped association was observed between alcohol intake and total mortality in men (nondrinkers: reference; occasional drinkers: hazard ratio {HR} 0.74; 95% confidence interval [CI], 0.68-0.80; 1-149 g/week: HR 0.76; 95% CI, 0.71-0.81; 150-299 g/week: HR 0.75; 95% CI, 0.70-0.80; 300-449 g/week: HR 0.84; 95% CI, 0.78-0.91; 450-599 g/week: HR 0.92; 95% CI, 0.83-1.01; and ≥600 g/week: HR 1.19; 95% CI, 1.07-1.32) and in women (nondrinkers: reference; occasional: HR 0.75; 95% CI, 0.70-0.82; 1-149 g/week: HR 0.80; 95% CI, 0.73-0.88; 150-299 g/week: HR 0.91; 95% CI, 0.74-1.13; 300-449 g/week: HR 1.04; 95% CI, 0.73-1.48; and ≥450 g/week: HR 1.59; 95% CI, 1.07-2.38). In current drinkers, alcohol consumption was associated with a linear, positive increase in mortality risk from all causes, cancer, and cerebrovascular disease in both men and women, but not heart disease in men. Taking of liver holidays was associated with a lower risk of cancer and cerebrovascular disease mortality in men.

CONCLUSIONS:

Alcohol intake showed J-shaped associations with the risk of total mortality and three leading causes of death. However, heavy drinking increases the risk of mortality, which highlights the necessity of drinking in moderation coupled with liver holidays.

KEYWORDS:

Japan/epidemiology; adult; alcohol; cardiovascular diseases/mortality; follow-up studies; mortality; neoplasms/mortality; proportional hazards models

 

HEALTH

The Secret to Long Life? It May Lurk in the DNA of the Oldest Among Us

James Clement has scoured the globe for

supercentenarians, aged 110 and older, willing to

contribute their genomes to a rare scientific cache.

By AMY HARMON

NOV. 13, 2017

https://www.nytimes.com/2017/11/13/health/supercentenarians-genetics-longevity.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region&region=top-news&WT.nav=top-news

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

Identifying genetic variants that affect viability in large cohorts.

Mostafavi H, Berisa T, Day FR, Perry JRB, Przeworski M, Pickrell JK.

PLoS Biol. 2017 Sep 5;15(9):e2002458. doi: 10.1371/journal.pbio.2002458. eCollection 2017 Sep.

PMID: 28873088 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584811/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584811/pdf/pbio.2002458.pdf

Abstract

A number of open questions in human evolutionary genetics would become tractable if we were able to directly measure evolutionary fitness. As a step towards this goal, we developed a method to examine whether individual genetic variants, or sets of genetic variants, currently influence viability. The approach consists in testing whether the frequency of an allele varies across ages, accounting for variation in ancestry. We applied it to the Genetic Epidemiology Research on Adult Health and Aging (GERA) cohort and to the parents of participants in the UK Biobank. Across the genome, we found only a few common variants with large effects on age-specific mortality: tagging the APOE ε4 allele and near CHRNA3. These results suggest that when large, even late-onset effects are kept at low frequency by purifying selection. Testing viability effects of sets of genetic variants that jointly influence 1 of 42 traits, we detected a number of strong signals. In participants of the UK Biobank of British ancestry, we found that variants that delay puberty timing are associated with a longer parental life span (P~6.2 × 10-6 for fathers and P~2.0 × 10-3 for mothers), consistent with epidemiological studies. Similarly, variants associated with later age at first birth are associated with a longer maternal life span (P~1.4 × 10-3). Signals are also observed for variants influencing cholesterol levels, risk of coronary artery disease (CAD), body mass index, as well as risk of asthma. These signals exhibit consistent effects in the GERA cohort and among participants of the UK Biobank of non-British ancestry. We also found marked differences between males and females, most notably at the CHRNA3 locus, and variants associated with risk of CAD and cholesterol levels. Beyond our findings, the analysis serves as a proof of principle for how upcoming biomedical data sets can be used to learn about selection effects in contemporary humans.

>>>>>>>>>>>

https://www.crsociety.org/topic/11801-als-papers-citations-and-possibly-links-and-excerpts-or-my-synopses/page-15?hl=chrna3&do=findComment&comment=23590

 

[The below paper is pdf-availed. To me, it looked like they wanted the Med diet to be better, it was not, so they fudged the data to suggest it was better. The low-fat diet's LPS was lower fasted, it increased to that of the other two diets post-prandially, and so they said only the low-fat diet increased significantly as a fold change.]

Endotoxemia is modulated by quantity and quality of dietary fat in older adults.

Lopez-Moreno J, Garcia-Carpintero S, Gomez-Delgado F, Jimenez-Lucena R, Vals-Delgado C, Alcala-Diaz JF, Roncero-Ramos I, Rangel-Zuñiga OA, Yubero-Serrano EM, Malagon MM, Ordovas JM, Perez-Martinez P, Lopez-Miranda J, Camargo A.

Exp Gerontol. 2017 Nov 9. pii: S0531-5565(17)30652-6. doi: 10.1016/j.exger.2017.11.006. [Epub ahead of print]

PMID: 29129737

Abstract

BACKGROUND:

Aging is an important determinant of the rate of atherosclerosis development, mainly through low-grade inflammation. Diet, and particularly its fat content, modulates the inflammatory response in fasting and postprandial states.

OBJECTIVE:

We aimed to study the effects of dietary fat on endotoxemia in healthy older adults.

MATERIALS AND METHODS:

Twenty healthy older adults were randomized to three diets, lasting three-weeks each, using a crossover design: 1. A Mediterranean diet enriched in MUFA with virgin olive oil. 2. An SFA-rich diet. 3. A low-fat high-carbohydrate diet enriched in n-3 PUFA (α-linolenic acid of plant origin) (CHO-PUFA diet). At the end of each period, after a 12-h fast, the subjects received a meal with a composition similar to the dietary period just completed. We determined the fasting and the postprandial plasma levels of lipopolysaccharide (LPS) and LPS-binding protein (LBP).

RESULTS:

In the fasting state, we observed lower LPS plasma levels after the consumption of the CHO-PUFA diet (P=0.046) in comparison with the consumption of the Med and SFA-rich diets. In the postprandial measurements, we observed a statistically significant increase in plasma levels of LPS (P=0.044) and a decrease in LBP (P=0.003) after the intake of the CHO-PUFA meal, whereas no postprandial changes were observed after the ingestion of the Med and SFA-rich meals.

CONCLUSION:

Our results, together with those obtained in a previous study, support the concept that the consumption of the Med Diet, in contrast to a low-fat PUFA diet, constitutes a more suitable dietary lifestyle for preventing the development of atherosclerosis in a population at risk, such as older adults.

KEYWORDS:

Aging; Atherosclerosis; Diet; Inflammation; Lipopolysaccharide

"The n-3

PUFA enrichment of the high-CHO and low-fat diet was achieved via the use of natural

food components rich in α-linolenic acid of plant origin (mainly walnuts (Juglans regia

L.)). The carbohydrate intake from the CHO-PUFA diet was based on the consumption

of biscuits, jam and bread. Eighty percent of the MUFA from the Med Diet was

provided by virgin olive oil, which was used for cooking, salad dressing and as a spread.

Butter was used as the main source of SFAs in the SFA-rich diet."

 

Diet and Physical Activity Behaviors in Primary Care Patients with Recent Intentional Weight Loss.

Gibbs BB, Tudorascu D, Bryce CL, Comer D, Fischer GS, Hess R, Huber KA, McTigue KM, Simkin-Silverman LR, Conroy MB.

Transl J Am Coll Sports Med. 2017;2(18):114-121. Epub 2017 Sep 15.

PMID: 29130068

Abstract

PURPOSE:

Lifestyle habits of primary care patients with recent, intentional weight loss are unclear and need to be better understood to aid in translational health promotion efforts. We aimed to characterize diet and exercise habits in primary care patients with recent, intentional weight loss, comparing those with greater (≥10%) vs. lesser (5 to <10%) weight loss.

METHODS:

This was a cross-sectional analysis of baseline data from a randomized trial comparing weight loss maintenance interventions. The study included primary care patients, 18-75 years old, with ≥5% intentional weight loss via lifestyle change in the past 2 years. Participants (74% female, 87% white) had mean age 53 (12) years, body mass index 30.4 (5.9) kg/m2, and recent weight loss of 11 (8)%. Dietary habits were measured by the Diet Habits Survey. Physical activity and sedentary behavior were measured by self-report and objectively by pedometer.

RESULTS:

On average, participants reported high fruits and vegetables intake (5 servings/day), and low intake of fried foods (1 serving/week), desserts (1 serving/week) and sugar-sweetened beverages (0 servings/week). Those with greater vs. lesser weight loss had higher intake of fruits and vegetables (p=0.037) and low fat foods or recipes (p=0.019). Average self-reported moderate-vigorous physical activity was 319 (281) minutes/week, with significant differences between greater (374 (328) minutes/week) vs. lesser (276 (230) minutes/week) weight loss groups (p=0.017). By pedometer, 30% had ≥7,500 steps/day; the proportion was higher in greater (43%) vs. lesser (19%) weight loss groups (p=0.005).

CONCLUSIONS:

For weight loss, clinical patients typically employ simple strategies such as 5+ fruits and vegetables per day, fried foods and desserts ≤1 per week, elimination of sugary drinks, choosing low fat foods/recipes, and physical activity 45-60 min/day.

KEYWORDS:

diet; physical activity; primary care; sedentary behavior; weight loss

 

Chylomicronemia risk factors ranked by importance for the individual and community in 108,711 women and men.

Pedersen SB, Varbo A, Langsted A, Nordestgaard BG.

J Intern Med. 2017 Nov 11. doi: 10.1111/joim.12713. [Epub ahead of print]

PMID: 29130593

http://sci-hub.cc/10.1111/joim.12713

Abstract

BACKGROUND:

Hypertriglyceridemia prevalence is increasing as more individuals become obese, and chylomicronemia risk factors for the individual and community have not been described previously.

OBJECTIVE:

To describe chylomicronemia risk factors in the general population for individuals and community.

METHODS:

108,711 individuals from the Copenhagen General Population Study were grouped as unlikely chylomicronemia (nonfasting triglycerides <2mmol/L(177 mg/dL)), possible chylomicronemia (2-4.99mmol/L(177-442mg/dL)), probable chylomicronemia (5-9.99mmol/L(443-885mg/dL)), and definite chylomicronemia (≥10mmol/L(≥886mg/dL)). Relative risk(RR) from Poisson regression ranked dichotomized chylomicronemia risk factors for individuals, and population attributable fractions(PAF) for the community: type 2 diabetes, alcohol intake, obesity, fat intake, hypothyroidism, kidney function, education, sedentary lifestyle, menopause and hormone replacement (women).

RESULTS:

For women and men, chylomicronemia was unlikely in 81% and 64%, possible in 18% and 33%, probable in 1% and 3%, and definite in 0.03% and 0.14%, respectively. For the individual, the three top-ranked risk factors for probable/definite versus unlikely chylomicronemia in women were type 2 diabetes (RR:4.21;95%confidence interval:3.30-5.36), menopause (RR:3.74;2.62-5.36), and obesity (RR:3.44;2.81-4.21). Corresponding top-ranked risk factors in men were obesity (RR:3.86;3.46-4.30), type 2 diabetes (RR:1.88;1.61-2.19), and reduced kidney function (RR:1.86;1.48-2.34). For the community, top-ranked risk factors in women were menopause (PAF:63%), obesity (PAF:29%), and type 2 diabetes (PAF:15%). Corresponding top-ranked risk factors in men were obesity (PAF:29%), type 2 diabetes (PAF:6.4%), and sedentary lifestyle (PAF:6.0%).

CONCLUSIONS:

Obesity and type 2 diabetes were the most important modifiable chylomicronemia risk factors in women and men, both for the individual and community. This could influence chylomicronemia prevention and help design randomized trials aimed at reducing triglycerides.

KEYWORDS:

cardiovascular risk factor; diabetes; obesity; remnant cholesterol; triglyceride-rich lipoproteins; triglycerides

Edited by AlPater

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[The below paper is pdf-availed.]

The role of artificial and natural sweeteners in reducing the consumption of table sugar: A narrative review.

Mooradian AD, Smith M, Tokuda M.

Clin Nutr ESPEN. 2017 Apr;18:1-8. doi: 10.1016/j.clnesp.2017.01.004. Epub 2017 Feb 4. Review.

PMID: 29132732

Abstract

The rapid increase in the prevalence of obesity worldwide has been partially attributed to the overconsumption of added sugars. Recent guidelines call for limiting the consumption of simple sugars to less than 10% of daily caloric consumption. High intensity sweeteners are regulated as food additives and include aspartame, acesulfame-k, neotame, saccharin, sucralose, cyclamate and alitame. Steviol glycosides and Luo Han Guo fruit extracts are high intensity sweeteners that are designated as generally recognized as safe (GRAS). Commonly used non-caloric artificial sweeteners may have unfavorable effect on health including glucose intolerance and failure to cause weight reduction. The nutritive sweeteners include sugar alcohols such as sorbitol, xylitol, lactitol, mannitol, erythritol, trehalose and maltitol. Naturally occurring rare sugars have recently emerged as an alternative category of sweeteners. These monosaccharides and their derivatives are found in nature in small quantities and lack significant calories. This category includes d-allulose (d-psicose), d-tagatose, d-sorbose and d-allose. Limiting consumption of any sweetener may well be the best health advice. Identifying natural sweeteners that have favorable effects on body weight and metabolism may help achieving the current recommendations of restricting simple sugar consumption.

KEYWORDS:

Artificial sweeteners

"1.3. Concerns with current artificial sweeteners

Several large cohort studies have found positive correlation

between artificial sweetener use and weight gain [67e69]. The San

Antonio Heart Study of 3682 adults over a seven to eight-year

period showed that consuming more than 21 artificially sweetened

beverages per week (vs. none) was associated with almostdoubled

the risk of being overweight or obese [odds ratio

(OR) ¼ 1.93, P ¼ 0.007 among 1250 baseline normal weight individuals,

and OR ¼ 2.03, P ¼ 0.0005 among 2571 individuals with

baseline body mass index (BMI) of less than 30 kg/m2

] [67]. The

American Cancer Society study of 78,694 women ages 50e69 years

found that at one-year follow-up, artificial sweetener users were

significantly more likely than non-users to gain weight, regardless

of initial BMI. Among those who gained weight, the average body

weight gain by users of artificial sweetener was higher by 0.5e1.5 lb

than the weight gained by non-users. The weight changes were not

explicable by differences in food consumption patterns [68].

However, in the Health Professionals Follow-Up Study, whereas

sugar-sweetened beverage consumption was associated with a

significantly elevated risk of type 2 diabetes, the association between

artificially sweetened beverages and type 2 diabetes was

largely explained by health status, pre-enrollment weight change,

dieting, and BMI [69].

The association between self-reported sugar sweetened beverages

(SSB), artificially sweetened beverages (ASB), and 100% fruit

juice consumption and type 2 diabetes risk over 14 years of followup

was examined in a French prospective study of 66,118 women

[70]. Compared with nonconsumers, women in the highest quartiles

of SSB and ASB consumers were at increased risk of diabetes

with HRs (95% CIs) of 1.34 (1.05, 1.71) and 2.21 (1.56, 3.14) for

women who consumed >359 and > 603 ml/week of SSBs and ASBs,

respectively [70].

Beverage consumption of 25,639 British adults without diabetes

at baseline in the European Prospective Investigation into Cancer

and Nutrition (EPIC)-Norfolk study was assessed using 7-day food

diaries [71]. There were positive associations (HR [95% CI] per

serving/day]) for soft drinks 1.21 (1.05, 1.39), sweetened-milk

beverages 1.22 (1.05, 1.43) and ASB 1.22 (1.11, 1.33), but not for

sweetened tea/coffee 0.98 (0.94, 1.02) or fruit juice 1.01 (0.88, 1.15).

Further adjustment for adiposity attenuated the association of ASB,

HR 1.06 (0.93, 1.20) [71]. Systemic reviews and metanalysis have

concluded that consumption of sugar sweetened beverages was

associated with a greater incidence of type 2 diabetes, independently

of adiposity (Table 1). Although artificially sweetened beverages

and fruit juice also showed positive associations with

incidence of type 2 diabetes, the findings were probably biased

[27].

It is postulated that sweetness decoupled from caloric content

offers partial, but incomplete activation of the food reward pathways,

which may further fuel food seeking behavior [72]. Artificial

sweeteners may encourage sweet cravings and sugar dependence

from other foods.

In a controlled experiment, aspartame-sweetened water

increased subjective appetite rating in normal weight adult males

[73]. Aspartame, acesulfame potassium, and saccharin were all

associated with heightened motivation to eat [74]. Similar observations

were made in rats where saccharin supplementation, but

not addition of glucose, significantly increased total energy consumption

and weight gain [75].

In a recent study it was found that commonly used non-caloric

artificial sweeteners cause glucose intolerance through changes in

the intestinal microbiota [76]. These effects were abrogated by

antibiotic treatment, and were fully transferrable to germ-free mice

upon fecal transplantation of microbiota from non-caloric artificial

sweetener -consuming mice. These observations raise new concerns

about the widespread consumption of non-caloric artificial

sweeteners."

 

Effect of Lactobacillus on body weight and body fat in overweight subjects: a systematic review of randomized controlled clinical trials.

Crovesy L, Ostrowski M, Ferreira DMTP, Rosado EL, Soares-Mota M.

Int J Obes (Lond). 2017 Nov;41(11):1607-1614. doi: 10.1038/ijo.2017.161. Epub 2017 Jul 10. Review.

PMID: 28792488

Abstract

Gut microbiota is important for maintaining body weight. Modulation of gut microbiota by probiotics may result in weight loss and thus help in obesity treatment. The aim of this systematic review was to evaluate the effects of Lactobacillus on weight loss and/or fat mass in overweight adults. A search was performed on the Medline (PubMed) and Scopus electronic databases using the search terms: 'probiotics', 'Lactobacillus, 'obesity', 'body weight changes', 'weight loss', 'overweight', 'abdominal obesity', 'body composition', 'body weight', 'body fat' and 'fat mass'. In the total were found 1567 articles, but only 14 were included in this systematic review. Of these nine showed decreased body weight and/or body fat, three did not find effect and two showed weight gain. Results suggest that the beneficial effects are strain dependent. It can highlight that Lactobacillus plantarum and Lactobacillus rhamnosus when combined with a hypocaloric diet, L. plantarum with Lactobacillus curvatus, Lactobacillus gasseri, Lactobacillus amylovorus, Lactobacillus acidophilus and Lactobacillus casei with phenolic compounds, and multiple species of Lactobacillus.

 

[And a lean-looking man who became a centenarian at that.]

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

"During his youth, he left high school to pursue odd jobs, such as shoveling bat guano in Arizona, working as a powder monkey in a Colorado mine, working in a lumber camp,[3] and working as a crewmember on a ship to China.[2]" https://en.wikipedia.org/wiki/Ancel_Keys#Early_life

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

Ancel Benjamin Keys (1904-2004): His early works and the legacy of the modern Mediterranean diet.

Aboul-Enein BH, Puddy WC, Bernstein J.

J Med Biogr. 2017 Jan 1:967772017727696. doi: 10.1177/0967772017727696. [Epub ahead of print]

PMID: 29134858

https://sci-hub.cc/http://journals.sagepub.com/doi/10.1177/0967772017727696

Abstract

Culturally congruent dietary patterns have evolved with geographic and societal traditions and can be traced as far back as pre-Hellenistic Greece. Today, the modern Mediterranean diet (MDiet) is recognized internationally as an anti-obesogenic cardioprotective dietary model consisting of plant-based foods native to the Mediterranean basin, fish, olive oil, and an active lifestyle. With the assumption that obesity and heart disease rates adversely affected life expectancy, the MDiet was identified by Dr Ancel Keys as a primary characteristic among people-groups largely immune to these trends. Following extensive research on how food quality affected human performance, Keys engineered the largest ecologic investigation of dietary habits and their effects on heart disease and longevity known as the Seven Countries Study. A new understanding of how regionally and culturally specific diets affected entire populations led to the introduction of the MDiet to the global public health community. This historiographic portrait of Dr Keys describes his humble beginnings, highlights critical points in his career, discusses his seminal research into diet and culture as protective agents, and details his legacy as the pioneer of the modern MDiet.

KEYWORDS:

Ancel keys; Mediterranean diet; cardiovascular disease; obesity

"Keys showed an early interest in science as

evidenced by his attempt at chloroforming a fly at his

eighth birthday party. Keys enrolled at the University

of California at Berkeley (UC-Berkeley) majoring in

chemistry but became dissatisfied and took a short

trip to China on board the S.S President Wilson working

as an oiler."

 

Leisure-Time, Domestic, and Work-Related Physical Activity and Their Prospective Associations With All-Cause Mortality in Patients With Cardiovascular Disease.

Ku PW, Chen LJ, Fox KR, Chen YH, Liao Y, Lin CH.

Am J Cardiol. 2017 Oct 19. pii: S0002-9149(17)31610-7. doi: 10.1016/j.amjcard.2017.10.003. [Epub ahead of print]

PMID: 29132648

http://sci-hub.cc/10.1016/j.amjcard.2017.10.003

Abstract

This study aimed to examine the prospective associations between total physical activity, leisure-time physical activity (LTPA), and domestic and work-related physical activity (DWPA) involving heavy physical labor, with all-cause mortality in patients with cardiovascular disease (CVD). A 7-year follow-up cohort design was used based on the data from the Taiwan 2005 National Health Interview Survey, which was linked to the 2005 to 2012 Taiwan National Health Insurance claims data. Multivariable Cox proportional hazard models were utilized to assess the associations between physical activity and all-cause mortality in 2,370 patients with CVD. Participants who achieved a volume of all physical activities of ≥1,000 kcal/week experienced lower risks of all-cause mortality than those who achieved less. Additionally, an inverse relation between LTPA and all-cause mortality was observed. Furthermore, participants who reported exertions (1 to 999 kcal/week) in DWPA had the lowest risk of all-cause mortality. This study provides evidence that patients with CVD who achieve at least a moderate volume of physical activity reduce their mortality risk. It also reveals that both LTPA and DWPA may be important contributors to the reduced risk of premature death among this clinical population.

 

Uric Acid and the Risks of Kidney Failure and Death in Individuals With CKD.

Srivastava A, Kaze AD, McMullan CJ, Isakova T, Waikar SS.

Am J Kidney Dis. 2017 Nov 10. pii: S0272-6386(17)30948-4. doi: 10.1053/j.ajkd.2017.08.017. [Epub ahead of print]

PMID: 29132945

http://sci-hub.cc/10.1053/j.ajkd.2017.08.017

Abstract

BACKGROUND:

Serum uric acid concentrations increase in chronic kidney disease (CKD) and may lead to tubular injury, endothelial dysfunction, oxidative stress, and intrarenal inflammation. Whether uric acid concentrations are associated with kidney failure and death in CKD is unknown.

STUDY DESIGN:

Prospective observational cohort study.

SETTINGS & PARTICIPANTS:

3,885 individuals with CKD stages 2 to 4 enrolled in the Chronic Renal Insufficiency Cohort (CRIC) between June 2003 and September 2008 and followed up through March 2013.

PREDICTOR:

Baseline uric acid concentrations.

OUTCOMES:

Kidney failure (initiation of dialysis therapy or transplantation) and all-cause mortality.

RESULTS:

During a median follow-up of 7.9 years, 885 participants progressed to kidney failure and 789 participants died. After adjustment for demographic, cardiovascular, and kidney-specific covariates, higher uric acid concentrations were independently associated with risk for kidney failure in participants with estimated glomerular filtration rates (eGFRs) ≥ 45mL/min/1.73m2 (adjusted HR per 1-standard deviation greater baseline uric acid, 1.40; 95% CI, 1.12-1.75), but not in those with eGFRs<30mL/min/1.73m2. There was a nominally higher HR in participants with eGFRs of 30 to 44mL/min/1.73m2 (adjusted HR, 1.13; 95% CI, 0.99-1.29), but this did not reach statistical significance. The relationship between uric acid concentration and all-cause mortality was J-shaped (P=0.007).

LIMITATIONS:

Potential residual confounding through unavailable confounders; lack of follow-up measurements to adjust for changes in uric acid concentrations over time.

CONCLUSIONS:

Uric acid concentration is an independent risk factor for kidney failure in earlier stages of CKD and has a J-shaped relationship with all-cause mortality in CKD. Adequately powered randomized placebo-controlled trials in CKD are needed to test whether urate lowering may prove to be an effective approach to prevent complications and progression of CKD.

KEYWORDS:

CKD progression; Chronic Renal Insufficiency Cohort (CRIC); Uric acid; chronic kidney disease (CKD); death; eGFR decline; end-stage renal disease (ESRD); hyperuricemia; kidney failure

 

Gender differences in the impact of anemia on subclinical myocardial damage and cardiovascular mortality in the general population: The Yamagata (Takahata) study.

Honda Y, Watanabe T, Otaki Y, Tamura H, Nishiyama S, Takahashi H, Arimoto T, Shishido T, Miyamoto T, Shibata Y, Konta T, Kawasaki R, Daimon M, Ueno Y, Kato T, Kayama T, Kubota I.

Int J Cardiol. 2017 Nov 10. pii: S0167-5273(17)34127-X. doi: 10.1016/j.ijcard.2017.11.019. [Epub ahead of print]

PMID: 29133274

http://sci-hub.cc/10.1016/j.ijcard.2017.11.019

Abstract

BACKGROUND:

Anemia has been shown to worsen cardiovascular diseases. However, it is unclear whether there is a gender difference in the impact of anemia on subclinical myocardial damage and cardiovascular mortality in the general population.

METHODS:

A prospective cohort study was conducted in a community based on annual health checks. Serum heart-type fatty acid binding protein (H-FABP) levels, which is a marker for myocardial damage, and blood counts were measured at baseline in subjects without previous cardiovascular diseases (n=3111).

RESULTS:

There were 343 subjects (11.0%) with anemia at baseline. H-FABP levels were inversely correlated with hemoglobin concentrations in male subjects, whereas there was no such correlation in female subjects, irrespective of the status of menopause. Prevalence of myocardial damage (H-FABP ≥4.3ng/ml) was significantly higher in male subjects with anemia than those without, irrespective of the type of anemia (microcytic, normocytic, and macrocytic). Multivariate logistic regression analysis revealed that anemia was an independent predictor of myocardial damage after adjusting for confounders. During 10years of follow-up, there were 204 all-cause deaths including 57 cardiovascular deaths. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in male subjects with anemia than in those without. However, anemia was not associated with cardiovascular mortality in female subjects. Multivariate Cox proportional hazard analysis revealed that anemia was an independent predictor of all-cause and cardiovascular mortalities after adjusting for confounders.

CONCLUSION:

Anemia was an independent predictor of all-cause and cardiovascular mortalities, and subclinical myocardial damage in male subjects, but not in female subjects.

KEYWORDS:

Anemia; Cardiovascular mortality; General population; H-FABP; Subclinical myocardial damage

 

Folic acid intake and folate status and colorectal cancer risk: A systematic review and meta-analysis.

Moazzen S, Dolatkhah R, Tabrizi JS, Shaarbafi J, Alizadeh BZ, de Bock GH, Dastgiri S.

Clin Nutr. 2017 Oct 28. pii: S0261-5614(17)31383-3. doi: 10.1016/j.clnu.2017.10.010. [Epub ahead of print]

PMID: 29132834

http://sci-hub.cc/10.1016/j.clnu.2017.10.010

Abstract

BACKGROUND & AIMS:

To evaluate the controversies among the studies assessing the association between folic acid intake or folate status and colorectal cancer risk.

METHODS:

PubMed, Cochrane library and references of related articles were searched from January 2000 to September 2016. Studies on folic acid intake or folate status and colorectal cancer or adenoma risk were included. Full text review was conducted for potentially eligible studies. Quality assessment was performed. Random-effects meta-analysis was used to estimate risk ratio and 95% Confidence Intervals. Analysis was conducted by Comprehensive Meta-Analysis software.

RESULTS:

Folic acid supplement intake showed no significant effect on colorectal cancer risk in meta-analysis of randomized controlled trials, RR: 1.07 (95% CI: 0.86-1.43). The effect on risk was not significant in cohort studies either; RR = 0.96 (95% CI: 0.76-1.21). However, there was significant reduced colorectal cancer risk in total folate intake in cohort studies; 0.71 (95% CI: 0.59-0.86). Odds Ratio was also significantly reduced in case control studies; 0.77 (95% CI: 0.62-0.95). Nevertheless once folate status was measured as Red Blood Cell folate content, no significant effect on colorectal cancer risk was observed; 1.05 (95% CI: 0.85-1.30).

CONCLUSION:

The differences in bioavailability and metabolism of synthetic folic acid and natural dietary folate as well as variation in the baseline characteristics of subjects and various methods of folate status assessment might be the main reasons for these controversies. Findings of present study highlight the importance of individualized folic acid supplement intake given the fact that the beneficiary effects of long term folic acid supplementation is not confirmed.

KEYWORDS:

Colorectal cancer; Folate status; Folic acid; Meta-analysis; Systematic review

 

Malnutrition and its association with readmission and death within 7 days and 8-180 days postdischarge in older patients: a prospective observational study.

Sharma Y, Miller M, Kaambwa B, Shahi R, Hakendorf P, Horwood C, Thompson C.

BMJ Open. 2017 Nov 12;7(11):e018443. doi: 10.1136/bmjopen-2017-018443.

PMID: 29133331

http://bmjopen.bmj.com/content/7/11/e018443

http://bmjopen.bmj.com/content/bmjopen/7/11/e018443.full.pdf

Abstract

OBJECTIVE:

The relationship between admission nutritional status and clinical outcomes following hospital discharge is not well established. This study investigated whether older patients' nutritional status at admission predicts unplanned readmission or death in the very early or late periods following hospital discharge.

DESIGN, SETTING AND PARTICIPANTS:

The study prospectively recruited 297 patients ≥60 years old who were presenting to the General Medicine Department of a tertiary care hospital in Australia. Nutritional status was assessed at admission by using the Patient-Generated Subjective Global Assessment (PG-SGA) tool, and patients were classified as either nourished (PG-SGA class A) or malnourished (PG-SGA classes B and C). A multivariate logistic regression model was used to adjust for other covariates known to influence clinical outcomes and to determine whether malnutrition is a predictor for early (0-7 days) or late (8-180 days) readmission or death following discharge.

OUTCOME MEASURES:

The impact of nutritional status was measured on a combined endpoint of any readmission or death within 0-7 days and between 8 and 180 days following hospital discharge.

RESULTS:

Within 7 days following discharge, 29 (10.5%) patients had an unplanned readmission or death whereas an additional 124 (50.0%) patients reached this combined endpoint within 8-180 days postdischarge. Malnutrition was associated with a significantly higher risk of combined endpoint of readmissions or death both within 7 days (OR 4.57, 95% CI 1.69 to 12.37, P<0.001) and within 8-180 days (OR 1.98, 95% CI 1.19 to 3.28, P=0.007) following discharge and this risk remained significant even after adjustment for other covariates.

CONCLUSIONS:

Malnutrition in older patients at the time of hospital admission is a significant predictor of readmission or death both in the very early and in the late periods following hospital discharge. Nutritional state should be included in future risk prediction models.

KEYWORDS:

general medicine (see internal medicine); geriatric medicine; quality in health care

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HEALTH

How to Lower Your Blood Pressure

By GINA KOLATANOV. 15, 2017

https://www.nytimes.com/2017/11/15/health/blood-pressure-answers.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region&region=top-news&WT.nav=top-news

 

Under New Guidelines, Millions More Americans Will Need to Lower Blood Pressure

By GINA KOLATANOV. 13, 2017

https://www.nytimes.com/2017/11/13/health/blood-pressure-treatment-guidelines.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=7&pgtype=sectionfront

 

Not performing an OGTT results in significant underdiagnosis of (pre)diabetes in a high risk adult Caucasian population.

Meijnikman AS, De Block CEM, Dirinck E, Verrijken A, Mertens I, Corthouts B, Van Gaal LF.

Int J Obes (Lond). 2017 Nov;41(11):1615-1620. doi: 10.1038/ijo.2017.165. Epub 2017 Jul 19.

PMID: 28720876

Abstract

OBJECTIVE:

Type 2 diabetes (T2DM) is known to be underdiagnosed. Tests for diagnosis include fasting plasma glucose (FPG), oral glucose tolerance test (OGTT) and HbA1c. HbA1c can be tested in non-fasting conditions. Therefore, general practitioners almost no longer execute OGTT's. We evaluated the performance of OGTT versus HbA1c in a population consisting of overweight and obese subjects, which can be considered a 'high risk' population.

RESEARCH DESIGN AND METHODS:

A total of, 1241 overweight and obese subjects without a history of diabetes (male/female: 375/866, age 44±13 years, body mass index 38.0±6.1 kg m-2) were tested for glucose tolerance status using FPG, OGTT and HbA1c.

RESULTS:

Exactly, 46.8% were found to have prediabetes and 11.9% were newly diagnosed with T2DM (male/female=18.9/8.9%) using ADA criteria. Testing only HbA1c would have resulted in 78 subjects being diagnosed with T2DM, but 47.3% of newly diagnosed patients would have been missed if OGTT would not have been done. Exactly 581 subjects were diagnosed with prediabetes, 1.4% subjects had impaired fasting glucose (IFG) 30.5% had impaired glucose tolerance (IGT), 5.1% subjects had a combined IFG+IGT, and 9.8% had an isolated elevated HbA1c (5.7-6.4%). Of the 581 subjects with prediabetes, 257 had an HbA1c <5.7%. Therefore, 44.2% subjects would have been missed when OGTT would not have been done.

CONCLUSION:

In a population with only overweight and obese adult subjects, 46.8% were diagnosed with prediabetes and 11.9% were newly diagnosed with diabetes. Exactly, 5.6 and 20.7% of total population met the diagnostic criteria of the OGTT for diabetes and prediabetes, respectively, but did not meet the diagnostic criteria of the HbA1c. These data suggest that not performing an OGTT results in significant underdiagnose of T2DM in an overweight and obese adult population.

 

Association of metabolic syndrome and its components with all-cause and cardiovascular mortality in the elderly: A meta-analysis of prospective cohort studies.

Ju SY, Lee JY, Kim DH.

Medicine (Baltimore). 2017 Nov;96(45):e8491. doi: 10.1097/MD.0000000000008491.

PMID: 29137039

http://journals.lww.com/md-journal/Fulltext/2017/11100/Association_of_metabolic_syndrome_and_its.35.aspx

Abstract

There is increasing evidence regarding the relationship between metabolic syndrome and mortality. However, previous research examining metabolic syndrome and mortality in older populations has produced mixed results. In addition, there is a clear need to identify and manage individual components of metabolic syndrome to decrease cardiovascular disease (CVD) mortality. In this meta-analysis, we searched the MEDLINE databases using PubMed, Cochrane Library, and EMBASE databases. Based on 20 prospective cohort studies, metabolic syndrome was associated with a higher risk of all-cause mortality [relative risk (RR), 1.23; 95% confidence interval (CI), 1.15-1.32; I = 55.9%] and CVD mortality (RR, 1.24; 95% CI, 1.11-1.39; I = 58.1%). The risk estimates of all-cause mortality for single components of metabolic syndrome were significant for higher values of waist circumference or body mass index (RR, 0.94; 95% CI, 0.88-1.00), higher values of blood glucose (RR, 1.19; 95% CI, 1.05-1.34), and lower values of high-density lipoprotein (HDL) cholesterol (RR, 1.11; 95% CI, 1.02-1.21). In the elderly population, metabolic syndrome was associated with an increased risk of all-cause and CVD mortality. Among the individual components of metabolic syndrome, increased blood glucose and HDL cholesterol levels were significantly associated with increased mortality. However, older obese or overweight individuals may have a decreased mortality risk. Thus, the findings of the current meta-analysis raise questions about the utility of the definition of metabolic syndrome in predicting all-cause mortality and CVD mortality in the elderly population.

 

Effect of aerobic training on peak oxygen uptake among seniors aged 70 or over: A meta-analysis of randomized controlled trials.

Bouaziz W, Kanagaratnam L, Vogel T, Schmitt E, Dramé M, Kaltenbach G, Geny B, Lang PO.

Rejuvenation Res. 2017 Nov 14. doi: 10.1089/rej.2017.1988. [Epub ahead of print]

PMID: 29137544

https://sci-hub.cc/http://online.liebertpub.com/doi/10.1089/rej.2017.1988

Abstract

Older adults undergo a progressive decline in cardiorespiratory fitness and functional capacity. This lower peak oxygen uptake (VO2peak) level is associated with increased risk of frailty, dependency, loss of autonomy, and mortality from all causes. Regular physical activity and particularly aerobic training (AT) has been shown to contribute to better and healthy ageing. We conducted a meta-analysis in order to measure the exact benefit of AT on VO2peak in seniors aged 70 years or over. A comprehensive, systematic database search for manuscripts was performed in Embase, Medline, PubMed Central, ScienceDirect, Scopus, and Web of Science using key words. Two reviewers independently assessed interventional studies for potential inclusion. Ten randomized controlled trials (RCTs) were included totaling 348 seniors aged 70 years or over. Across the trials, no high risk of bias was measured and all considered open-label arms for controls. With significant heterogeneity between the RCTs (all P <0.001), pooled analyses were computed for VO2peak. Not only VO2peak was found significantly higher in the training group compared to controls (mean difference - MD = 1.56; 95% confidence interval - CI: 0.90 - 2.23) in pooled analysis of the 10 RCTs, but also when the analysis was adjusted on the participants' health status. MD among healthy and unhealthy seniors were respectively 1.72 (95% CI: 0.34 - 3.10) and 1.47 (95% CI: 0.60 - 2.34). This meta-analysis confirms the AT-associated benefits on VO2peak in healthy and unhealthy seniors.

 

Uric acid predicts adverse outcomes in chronic kidney disease: a novel insight from trajectory analyses.

Tsai CW, Chiu HT, Huang HC, Ting IW, Yeh HC, Kuo CC.

Nephrol Dial Transplant. 2017 Nov 10. doi: 10.1093/ndt/gfx297. [Epub ahead of print]

PMID: 29140472

Abstract

BACKGROUND:

Very little is known about longitudinal trajectories of serum uric acid (SUA) over the course of chronic kidney disease (CKD). We aimed to determine whether longitudinal SUA trajectories are associated with the risk of end-stage renal disease (ESRD) and all-cause mortality among CKD patients.

METHODS:

We conducted a prospective cohort study from a 13-year multidisciplinary pre-ESRD care registry. The final study population consisted of 5090 CKD patients aged 20-90 years between 2003 and 2015. An individual's SUA trajectory was defined by group-based trajectory modeling in four distinct patterns: high, moderate-high, moderate and low. Time to ESRD and death was analyzed by multiple Cox regression.

RESULTS:

A total of 948 ESRD events and 472 deaths occurred with incidence rates of 57.9 and 28.7 per 1000 person-years, respectively. Compared with those with a low SUA trajectory, the adjusted hazard ratio of patients for incident ESRD was in a dose-response manner as follows: moderate, 1.89 [95% confidence interval (CI), 1.37-2.60]; moderate-high, 2.49 (1.75-3.55); and high, 2.84 (1.81-4.47); after considering the competing risk of death. For all-cause mortality, the corresponding risk estimate of the same SUA trajectory was 1.38 (95% CI, 0.89-2.12), 1.95 (1.22-3.10) and 4.52 (2.48-8.26), respectively. The unfavorable effect of elevated SUA trajectories on progression to ESRD was differentially higher among CKD patients without using urate-lowering agents at baseline (P for interaction = 0.018).

CONCLUSIONS:

Elevated SUA trajectories are associated with accelerated kidney failure and all-cause mortality in CKD patients. Adequate experimental evidence is urgently needed to inform when and how to optimize SUA in this population.

KEYWORDS:

chronic kidney disease; dialysis; mortality; trajectory; uric acid

 

Circulating long-chain n-3 polyunsaturated fatty acid and incidence of stroke: a meta-analysis of prospective cohort studies.

Yang B, Ren XL, Huang H, Guo XJ, Ma AG, Li D.

Oncotarget. 2017 Jul 25;8(48):83781-83791. doi: 10.18632/oncotarget.19530. eCollection 2017 Oct 13.

PMID: 29137382

Abstract

BACKGROUND:

Circulating long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) can provide objective measures that reflect both dietary consumption and relevant biological processes. Nevertheless, prospective cohort studies on circulating LC n-3 PUFA in relation to incidence of stroke have yielded inconsistent results. We therefore conducted a meta-analysis to quantitatively evaluate the association.

RESULTS:

A total of 2,836 stroke events occurred among 20,460 individuals aged 35-79 yr from 10 prospective cohort studies. Circulating LC n-3 PUFA was significantly associated with reduced risk of stroke (RR: 0.86; 95% CI: 0.76, 0.98; I2 = 0.00%), especially 22:5n-3 (RR: 0.74; 95% CI: 0.60, 0.92) and 22:6n-3 (RR: 0.78; 95% CI: 0.65, 0.94). The associations were more pronounced with ischemic stroke (RR: 0.81; 95% CI: 0.68, 0.96), but not with hemorrhagic stroke (RR: 0.95; 95% CI: 0.60, 1.49). A 1% increment of 22:5n-3 and 22:6n-3 proportions in circulating blood was associated with 25% (RR: 0.75; 95% CI: 0.64, 0.87) and 11% (RR: 0.89; 95% CI: 0.83, 0.95) reduced risk of stroke, respectively.

MATERIALS AND METHODS:

Pertinent studies were identified from Cochrane Library, PubMed and EMBASE database through June 2017. Multivariate-adjusted risk ratios (RRs) with 95% confidence interval (CI) for incident stroke when comparing the top with the bottom tertiles of baseline LC n-3 PUFA proportions in blood were pooled using a random-effect model.

CONCLUSIONS:

Circulating LC n-3 PUFAs were linearly associated with reduced risk of stroke, especially 22:5n-3 and 22:6n-3. Such findings highlight the importance of circulating LC n-3 PUFA in the development of ischemic stroke.

KEYWORDS:

PUFA; biomarker; circulation; meta-analysis; stroke

 

Dietary fiber intake and risk of metabolic syndrome: A meta-analysis of observational studies.

Wei B, Liu Y, Lin X, Fang Y, Cui J, Wan J.

Clin Nutr. 2017 Oct 31. pii: S0261-5614(17)31392-4. doi: 10.1016/j.clnu.2017.10.019. [Epub ahead of print]

PMID: 29137803

Abstract

BACKGROUND & AIMS:

Epidemiological studies show inconsistent findings on the association of dietary fiber intake with risk of metabolic syndrome (MetS). Herein, we aim to conduct a meta-analysis of published studies to determine the role of dietary fiber in prevention of MetS.

METHODS:

A systematical search in PubMed and Embase databases through December 2016, together with reference scrutiny of relevant literature, was performed to identify studies for inclusion. We aggregated the odds ratios (ORs) with 95% confidence intervals (CIs) of MetS using a random effect model. Dose-response relationship between fiber intake and MetS was also evaluated.

RESULTS:

This meta-analysis included 8 cross-sectional and 3 cohort studies, totaling 28,241 participants and 9140 MetS cases. The highest versus lowest fiber intake was associated with a reduced risk of MetS (OR: 0.85, 95% CI: 0.79-0.92; P = 0.005), with moderate heterogeneity (I2 = 64%, P = 0.001) across studies. The benefit of fiber intake was significant among cross-sectional studies (OR: 0.85, 95% CI: 0.78-0.92; P < 0.001) but not among cohort studies (OR: 0.86, 95% CI: 0.70-1.06; P = 0.16). In dose-response analysis, we found a curvilinear relationship between fiber consumption and prevalence of MetS. Compared with non-fiber intake, the ORs (95% CIs) of MetS across fiber intake levels were 0.85 (0.79-0.91), 0.76 (0.67-0.85), 0.73 (0.65-0.83), and 0.73 (0.65-0.82) for 10, 20, 30, and 40 g/d, respectively.

CONCLUSIONS:

Dietary fiber intake is associated with less likelihood of having MetS. Additional large, prospective studies are warranted to enhance our findings.

KEYWORDS:

Dietary fiber; Meta-analysis; Metabolic syndrome; Prevention

 

Effects of weight loss interventions for adults who are obese on mortality, cardiovascular disease, and cancer: systematic review and meta-analysis.

Ma C, Avenell A, Bolland M, Hudson J, Stewart F, Robertson C, Sharma P, Fraser C, MacLennan G.

BMJ. 2017 Nov 14;359:j4849. doi: 10.1136/bmj.j4849.

PMID: 29138133

Abstract

Objective To assess whether weight loss interventions for adults with obesity affect all cause, cardiovascular, and cancer mortality, cardiovascular disease, cancer, and body weight.Design Systematic review and meta-analysis of randomised controlled trials (RCTs) using random effects, estimating risk ratios, and mean differences. Heterogeneity investigated using Cochran's Q and I2 statistics. Quality of evidence assessed by GRADE criteria.Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials, and full texts in our trials' registry for data not evident in databases. Authors were contacted for unpublished data.Eligibility criteria for selecting studies RCTs of dietary interventions targeting weight loss, with or without exercise advice or programmes, for adults with obesity and follow-up ≥1 year.Results 54 RCTs with 30 206 participants were identified. All but one trial evaluated low fat, weight reducing diets. For the primary outcome, high quality evidence showed that weight loss interventions decrease all cause mortality (34 trials, 685 events; risk ratio 0.82, 95% confidence interval 0.71 to 0.95), with six fewer deaths per 1000 participants (95% confidence interval two to 10). For other primary outcomes moderate quality evidence showed an effect on cardiovascular mortality (eight trials, 134 events; risk ratio 0.93, 95% confidence interval 0.67 to 1.31), and very low quality evidence showed an effect on cancer mortality (eight trials, 34 events; risk ratio 0.58, 95% confidence interval 0.30 to 1.11). Twenty four trials (15 176 participants) reported high quality evidence on participants developing new cardiovascular events (1043 events; risk ratio 0.93, 95% confidence interval 0.83 to 1.04). Nineteen trials (6330 participants) provided very low quality evidence on participants developing new cancers (103 events; risk ratio 0.92, 95% confidence interval 0.63 to 1.36).Conclusions Weight reducing diets, usually low in fat and saturated fat, with or without exercise advice or programmes, may reduce premature all cause mortality in adults with obesity.

 

Does the impact of a plant-based diet during pregnancy on birth weight differ by ethnicity? A dietary pattern analysis from a prospective Canadian birth cohort alliance.

Zulyniak MA, de Souza RJ, Shaikh M, Desai D, Lefebvre DL, Gupta M, Wilson J, Wahi G, Subbarao P, Becker AB, Mandhane P, Turvey SE, Beyene J, Atkinson S, Morrison KM, McDonald S, Teo KK, Sears MR, Anand SS; NutriGen Alliance investigators.

BMJ Open. 2017 Nov 14;7(11):e017753. doi: 10.1136/bmjopen-2017-017753.

PMID: 29138203

Abstract

OBJECTIVE:

Birth weight is an indicator of newborn health and a strong predictor of health outcomes in later life. Significant variation in diet during pregnancy between ethnic groups in high-income countries provides an ideal opportunity to investigate the influence of maternal diet on birth weight.

SETTING:

Four multiethnic birth cohorts based in Canada (the NutriGen Alliance).

PARTICIPANTS:

3997 full-term mother-infant pairs of diverse ethnic groups who had principal component analysis-derived diet pattern scores-plant-based, Western and health-conscious-and birth weight data.

RESULTS:

No associations were identified between the Western and health-conscious diet patterns and birth weight; however, the plant-based dietary pattern was inversely associated with birth weight (β=-67.6 g per 1-unit increase; P<0.001), and an interaction with non-white ethnicity and birth weight was observed. Ethnically stratified analyses demonstrated that among white Europeans, maternal consumption of a plant-based diet associated with lower birth weight (β=-65.9 g per 1-unit increase; P<0.001), increased risk of small-for-gestational age (SGA; OR=1.46; 95% CI 1.08 to 1.54;P=0.005) and reduced risk of large-for-gestational age (LGA; OR=0.71; 95% CI 0.53 to 0.95;P=0.02). Among South Asians, maternal consumption of a plant-based diet associated with a higher birth weight (β=+40.5 g per 1-unit increase; P=0.01), partially explained by cooked vegetable consumption.

CONCLUSIONS:

Maternal consumption of a plant-based diet during pregnancy is associated with birth weight. Among white Europeans, a plant-based diet is associated with lower birth weight, reduced odds of an infant born LGA and increased odds of SGA, whereas among South Asians living in Canada, a plant-based diet is associated with increased birth weight.

KEYWORDS:

PCA; birth weight; diet pattern; nutrition

 

Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis.

Chilibeck PD, Kaviani M, Candow DG, Zello GA.

Open Access J Sports Med. 2017 Nov 2;8:213-226. doi: 10.2147/OAJSM.S123529. eCollection 2017. Review.

PMID: 29138605

https://sci-hub.cc/http://link.springer.com/10.1007/s10552-017-0981-0

Abstract

The loss of muscle mass and strength with aging results in significant functional impairment. Creatine supplementation has been used in combination with resistance training as a strategy for increasing lean tissue mass and muscle strength in older adults, but results across studies are equivocal. We conducted a systematic review and meta-analysis of randomized controlled trials of creatine supplementation during resistance training in older adults with lean tissue mass, chest press strength, and leg press strength as outcomes by searching PubMed and SPORTDiscus databases. Twenty-two studies were included in our meta-analysis with 721 participants (both men and women; with a mean age of 57-70 years across studies) randomized to creatine supplementation or placebo during resistance training 2-3 days/week for 7-52 weeks. Creatine supplementation resulted in greater increases in lean tissue mass (mean difference =1.37 kg [95% CI =0.97-1.76]; p<0.00001), chest press strength (standardized mean difference [sMD] =0.35 [0.16-0.53]; p=0.0002), and leg press strength (SMD =0.24 [0.05-0.43]; p=0.01). A number of mechanisms exist by which creatine may increase lean tissue mass and muscular strength. These are included in a narrative review in the discussion section of this article. In summary, creatine supplementation increases lean tissue mass and upper and lower body muscular strength during resistance training of older adults, but potential mechanisms by which creatine exerts these positive effects have yet to be evaluated extensively.

KEYWORDS:

age; bench press; exercise; leg press; muscle; nutrition; sarcopenia

 

Dietary glutamine, glutamate and mortality: two large prospective studies in US men and women.

Ma W, Heianza Y, Huang T, Wang T, Sun D, Zheng Y, Hu FB, Rexrode KM, Manson JE, Qi L.

Int J Epidemiol. 2017 Nov 13. doi: 10.1093/ije/dyx234. [Epub ahead of print]

PMID: 29140419

Abstract

BACKGROUND:

Emerging studies have related circulating glutamine metabolites to various chronic diseases such as cardiovascular disease and cancer; diet is the major source of nutrients involved in glutamine metabolism. However, it remains unknown whether dietary intakes of glutamine, glutamate,and their ratio are related to total and cause-specific mortality.

METHODS:

We followed 74 082 women from the Nurses' Health Study (1984-2012) and 42 303 men from the Health Professionals Follow-up Study (1986-2012), who were free of cardiovascular disease and cancer at baseline. Diet was updated every 2 to 4 years by using validated food frequency questionnaires. The content of glutamine and glutamate in foods was calculated based on protein fractions generated from gene sequencing methods and adjusted for total energy intake.

RESULTS:

We documented 30 424 deaths during 2 878 344 person-years of follow-up. After adjustment for potential confounders including lifestyle and dietary factors, higher intakes of glutamine and glutamine-to-glutamate ratio were associated with significantly lower risk of total and cause-specific mortality. Compared with people in the lowest quintile of dietary glutamine-to-glutamate ratio, the pooled hazard ratio (HR) in the highest quintile was 0.87 [95% confidence interval (CI): 0.84, 0.91; P for trend < 0.001) for total mortality, 0.81 (95% CI: 0.75, 0.88; P for trend < 0.001) for cardiovascular mortality, and 0.93 (95% CI: 0.87, 0.99; P for trend = 0.01) for cancer mortality.

CONCLUSIONS:

We found dietary glutamine and glutamine-to-glutamate ratio were inversely related to risk of mortality, particularly cardiovascular mortality, independent of other dietary and lifestyle factors, in US men and women.

KEYWORDS:

Glutamine; diet; epidemiology; mortality

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Epistasis, physical capacity-related genes and exceptional longevity: FNDC5 gene interactions with candidate genes FOXOA3 and APOE.

Fuku N, Díaz-Peña R, Arai Y, Abe Y, Zempo H, Naito H, Murakami H, Miyachi M, Spuch C, Serra-Rexach JA, Emanuele E, Hirose N, Lucia A.

BMC Genomics. 2017 Nov 14;18(Suppl 8):803. doi: 10.1186/s12864-017-4194-4.

PMID: 29143599

https://bmcgenomics.biomedcentral.com/articles/10.1186/s12864-017-4194-4

https://bmcgenomics.biomedcentral.com/track/pdf/10.1186/s12864-017-4194-4?site=bmcgenomics.biomedcentral.com

Abstract

BACKGROUND:

Forkhead box O3A (FOXOA3) and apolipoprotein E (APOE) are arguably the strongest gene candidates to influence human exceptional longevity (EL, i.e., being a centenarian), but inconsistency exists among cohorts. Epistasis, defined as the effect of one locus being dependent on the presence of 'modifier genes', may contribute to explain the missing heritability of complex phenotypes such as EL. We assessed the potential association of epistasis among candidate polymorphisms related to physical capacity, as well as antioxidant defense and cardiometabolic traits, and EL in the Japanese population. A total of 1565 individuals were studied, subdivided into 822 middle-aged controls and 743 centenarians.

RESULTS:

We found a FOXOA3 rs2802292 T-allele-dependent association of fibronectin type III domain-containing 5 (FDNC5) rs16835198 with EL: the frequency of carriers of the FOXOA3 rs2802292 T-allele among individuals with the rs16835198 GG genotype was significantly higher in cases than in controls (P < 0.05). On the other hand, among non-carriers of the APOE 'risk' ε4-allele, the frequency of the FDNC5 rs16835198 G-allele was higher in cases than in controls (48.4% vs. 43.6%, P < 0.05). Among carriers of the 'non-risk' APOE ε2-allele, the frequency of the rs16835198 G-allele was higher in cases than in controls (49% vs. 37.3%, P < 0.05).

CONCLUSIONS:

The association of FDNC5 rs16835198 with EL seems to depend on the presence of the FOXOA3 rs2802292 T-allele and we report a novel association between FNDC5 rs16835198 stratified by the presence of the APOE ε2/ε4-allele and EL. More research on 'gene*gene' and 'gene*environment' effects is needed in the field of EL.

KEYWORDS:

APOE; Ageing; Centenarians; Exceptional longevity; FNDC5; FOXO3A

 

MARKETPLACE

Health Canada toughens green tea extract warnings

'Cases of liver injury continue to be reported in Canada and worldwide,' safety review says

By David Common, CBC News Posted: Nov 15, 2017

http://www.cbc.ca/news/health/health-canada-green-tea-extract-cbc-marketplace-1.4404054

 

Accelerometer-Measured Physical Activity and Mortality in Women Aged 63 to 99.

LaMonte MJ, Buchner DM, Rillamas-Sun E, Di C, Evenson KR, Bellettiere J, Lewis CE, Lee IM, Tinker LF, Seguin R, Zaslovsky O, Eaton CB, Stefanick ML, LaCroix AZ.

J Am Geriatr Soc. 2017 Nov 16. doi: 10.1111/jgs.15201. [Epub ahead of print]

PMID: 29143320

http://sci-hub.cc/10.1111/jgs.15201

Abstract

OBJECTIVES:

To prospectively examine associations between accelerometer-measured physical activity (PA) and mortality in older women, with an emphasis on light-intensity PA.

DESIGN:

Prospective cohort study with baseline data collection between March 2012 and April 2014.

SETTING:

Women's Health Initiative cohort in the United States.

PARTICIPANTS:

Community-dwelling women aged 63 to 99 (N = 6,382).

MEASUREMENTS:

Minutes per day of usual PA measured using hip-worn triaxial accelerometers, physical functioning measured using the Short Physical Performance Battery, mortality follow-up for a mean 3.1 years through September 2016 (450 deaths).

RESULTS:

When adjusted for accelerometer wear time, age, race-ethnicity, education, smoking, alcohol, self-rated health, and comorbidities, relative risks (95% confidence intervals) for all-cause mortality across PA tertiles were 1.00 (referent), 0.86 (0.69, 1.08), 0.80 (0.62, 1.03) trend P = .07, for low light; 1.00, 0.57 (0.45, 0.71), 0.47 (0.35, 0.61) trend P < .001, for high light; and, 1.00, 0.63 (0.50, 0.79), 0.42 (0.30, 0.57) trend P < .001, for moderate-to-vigorous PA (MVPA). Associations remained significant for high light-intensity PA and MVPA (P < .001) after further adjustment for physical function. Each 30-min/d increment in light-intensity (low and high combined) PA and MVPA was associated, on average, with multivariable relative risk reductions of 12% and 39%, respectively (P < .01). After further simultaneous adjusting for light intensity and MVPA, the inverse associations remained significant (light-intensity PA: RR = 0.93, 95% CI = 0.89-0.97; MVPA: RR = 0.67, 95% CI = 0.58-0.78). These relative risks did not differ between subgroups for age or race and ethnicity (interaction, P ≥ .14, all).

CONCLUSION:

When measured using accelerometers, light-intensity and MVPA are associated with lower mortality in older women. These findings suggest that replacing sedentary time with light-intensity PA is a public health strategy that could benefit an aging society and warrants further investigation.

KEYWORDS:

aging; epidemiology; longevity; physical activity; women's health

 

Effects of Sodium Reduction and the DASH Diet in Relation to Baseline Blood Pressure.

Juraschek SP, Miller ER 3rd, Weaver CM, Appel LJ.

J Am Coll Cardiol. 2017 Nov 4. pii: S0735-1097(17)41098-9. doi: 10.1016/j.jacc.2017.10.011. [Epub ahead of print]

PMID: 29141784

Abstract

BACKGROUND:

Both sodium reduction and the DASH (Dietary Approaches to Stop Hypertension) diet, a diet rich in fruits, vegetables, and low-fat dairy products, and reduced in saturated fat and cholesterol, lower blood pressure. The separate and combined effects of these dietary interventions by baseline blood pressure (BP) has not been reported.

OBJECTIVES:

The authors compared the effects of low versus high sodium, DASH versus control, and both (low sodium-DASH vs. high sodium-control diets) on systolic BP (SBP) by baseline BP.

METHODS:

In the DASH-Sodium (Dietary Patterns, Sodium Intake and Blood Pressure) trial, adults with pre- or stage 1 hypertension and not using antihypertensive medications, were randomized to either DASH or a control diet. On either diet, participants were fed each of 3 sodium levels (50, 100, and 150 mmol/day at 2,100 kcal) in random order over 4 weeks separated by 5-day breaks. Strata of baseline SBP were <130, 130 to 139, 140 to 149, and ≥150 mm Hg.

RESULTS:

Of 412 participants, 57% were women, and 57% were black; mean age was 48 years, and mean SBP/diastolic BP was 135/86 mm Hg. In the context of the control diet, reducing sodium (from high to low) was associated with mean SBP differences of -3.20, -8.56, -8.99, and -7.04 mm Hg across the respective baseline SBP strata listed (p for trend = 0.004). In the context of high sodium, consuming the DASH compared with the control diet was associated with mean SBP differences of -4.5, -4.3, -4.7, and -10.6 mm Hg, respectively (p for trend = 0.66). The combined effects of the low sodium-DASH diet versus the high sodium-control diet on SBP were -5.3, -7.5, -9.7, and -20.8 mm Hg, respectively (p for trend < 0.001).

CONCLUSIONS:

The combination of reduced sodium intake and the DASH diet lowered SBP throughout the range of pre- and stage 1 hypertension, with progressively greater reductions at higher levels of baseline SBP. SBP reductions in adults with the highest levels of SBP (≥150 mm Hg) were striking and reinforce the importance of both sodium reduction and the DASH diet in this high-risk group. Further research is needed to determine the effects of these interventions among adults with SBP ≥160 mm Hg.

KEYWORDS:

DASH; blood pressure; diet; sodium; trial

 

[The below paper is not pdf-availed.]

Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies.

Schwingshackl L, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, Andriolo V, Bechthold A, Schlesinger S, Boeing H.

Adv Nutr. 2017 Nov 15;8(6):793-803. doi: 10.3945/an.117.017178. Print 2017 Nov. Review.

PMID: 29141965

Abstract

The aim of this systematic review and meta-analysis was to summarize the evidence on the relation of the intakes of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSBs) with the risk of hypertension. PubMed, Scopus, and Web of Science were searched systematically until June 2017 for prospective studies having quantitatively investigated the above-mentioned foods. We conducted meta-analysis on the highest compared with the lowest intake categories and linear and nonlinear dose-response meta-analyses to analyze the association. Summary RRs and 95% CIs were estimated by using a random-effects model. Overall, 28 reports were included in the meta-analysis. An inverse association for the risk of hypertension was observed for 30 g whole grains/d (RR: 0.92; 95% CI: 0.87, 0.98), 100 g fruits/d (RR: 0.97; 95% CI: 0.96, 0.99), 28 g nuts/d (RR: 0.70; 95% CI: 0.45, 1.08), and 200 g dairy/d (RR: 0.95; 95% CI: 0.94, 0.97), whereas a positive association for 100 g red meat/d (RR: 1.14; 95% CI: 1.02, 1.28), 50 g processed meat/d (RR: 1.12; 95% CI: 1.00, 1.26), and 250 mL SSB/d (RR: 1.07; 95% CI: 1.04, 1.10) was seen in the linear dose-response meta-analysis. Indication for nonlinear relations of the intakes of whole grains, fruits, fish, and processed meats with the risk of hypertension was detected. In summary, this comprehensive dose-response meta-analysis of 28 reports identified optimal intakes of whole grains, fruits, nuts, legumes, dairy, red and processed meats, and SSBs related to the risk of hypertension. These findings need to be seen under the light of very-low to low quality of meta-evidence. However, the findings support the current dietary guidelines in the prevention of hypertension.

KEYWORDS:

diet; dose-response; food groups; hypertension; meta-analysis

 

DHA supplementation improves cognitive function via enhancing Aβ-mediated autophagy in Chinese elderly with mild cognitive impairment: a randomised placebo-controlled trial.

Zhang YP, Lou Y, Hu J, Miao R, Ma F.

J Neurol Neurosurg Psychiatry. 2017 Nov 15. pii: jnnp-2017-316176. doi: 10.1136/jnnp-2017-316176. [Epub ahead of print]

PMID: 29142143

Abstract

BACKGROUND:

Higher docosahexaenoic acid (DHA) intake is inversely correlated with relative risk of Alzheimer's disease. The potential benefits of DHA supplementation in people with mild cognitive impairment (MCI) have not been fully examined.

OBJECTIVE:

Our study aimed to assess the effect of a 24-month DHA supplementation on cognitive function and amyloid beta (Aβ)-mediated autophagy in elderly subjects with MCI.

METHODS:

This was a randomised, double-blind, placebo-controlled trial in Tianjin, China. A total of 240 individuals with MCI were identified and randomly divided into intervention (DHA 2 g/day, n=120) and control (corn oil as placebo, n=120) groups. Cognitive function and blood Aβ-related biomarkers were measured at baseline, 6, 12, 18 and 24 months. Data were analysed using generalised estimating equation.

RESULTS:

A total of 217 participants (DHA: 109, placebo: 108) completed the trial. During the follow-up, scores of full-scale IQ, verbal IQ and subdomains of information and digit span were significantly higher in the intervention group than the convention group (p<0.05). In the intervention group, blood Aβ-42 level and expression of Aβ protein precursor mRNA were decreased (p<0.05), while Beclin-1 and LC3-II levels and expression of LC3-II mRNA were increased (p<0.05).

CONCLUSION:

Daily oral DHA supplementation (2 g/day) for 24 months may improve cognitive function and change blood biomarker-related Aβ-mediated autophagy in people with MCI. Larger longer-term confirmatory studies are warranted.

KEYWORDS:

alzheimer’s disease; cognition; epidemiology; neurobiology; randomised trials

 

Stroke and food groups: an overview of systematic reviews and meta-analyses.

Deng C, Lu Q, Gong B, Li L, Chang L, Fu L, Zhao Y.

Public Health Nutr. 2017 Nov 16:1-11. doi: 10.1017/S1368980017003093. [Epub ahead of print]

PMID: 29143697

Abstract

OBJECTIVE:

Numerous systematic reviews of prospective studies on the association of stroke risk with the consumption of various food groups have been published. A review of the evidence across the existing systematic reviews and meta-analyses of prospective studies was conducted to provide an overview of the range and validity of the reported associations of food groups with stroke risk.

DESIGN:

The PubMed, EMBASE and Cochrane Library databases were searched for articles published up to September 2015 to identify systematic reviews of prospective studies.

RESULTS:

A total of eighteen studies published from 2008 to 2015 were eligible for analysis. Overall, thirteen specific foods were studied for an association with stroke outcome, including nuts, legumes, fruits and vegetables, refined grains, whole grains, dairy products, eggs, chocolate, red and/or processed meat, fish, tea, sugar-sweetened beverages and coffee. Whereas a high consumption of nuts, fruits, vegetables, dairy foods, fish and tea, and moderate consumption of coffee and chocolate demonstrated a protective effect, a high consumption of red and/or processed meat was associated with increased stroke risk. Refined grain, sugar-sweetened beverage, legume, egg and whole grain intake showed no effect on stroke outcome.

CONCLUSIONS:

The current overview provided a high level of evidence to support the beneficial effect of specific foods on stroke outcome. Clinicians and policy makers could inform clinical practice and policy based on this overview.

KEYWORDS:

Food; Overview; Stroke

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