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Hemoglobin, Albuminuria, and Kidney Function in Cardiovascular Risk: The ARIC (Atherosclerosis Risk in Communities) Study.

Ishigami J, Grams ME, Naik RP, Caughey MC, Loehr LR, Uchida S, Coresh J, Matsushita K.

J Am Heart Assoc. 2018 Jan 12;7(2). pii: e007209. doi: 10.1161/JAHA.117.007209.

PMID: 29330257 Free Article

http://jaha.ahajournals.org/content/7/2/e007209.long

Abstract

BACKGROUND:

Reduced estimated glomerular filtration rate (eGFR) and elevated urinary albumin-to-creatinine ratio (ACR) individually increase risk of cardiovascular disease (CVD). We hypothesized that these associations are stronger among people with abnormal (both low and high) hemoglobin levels.

METHODS AND RESULTS:

Using 5801 participants with available hemoglobin measures of the ARIC (Atherosclerosis Risk in Community) study in 1996-1998, we explored the cross-sectional association of eGFR and ACR with hemoglobin levels and their longitudinal associations with CVD (heart failure, coronary heart disease, and stroke) risk through 2013. At baseline, 8.8% had anemia (<13 g/dL in men and <12 g/dL in women) and 7.2% had high hemoglobin (≥16 g/dL in men and ≥15 g/dL in women). The adjusted prevalence ratio of anemia was 2.12 (95% confidence interval, 1.59-2.82) for eGFR 30 to 59 compared with ≥90 mL/min per 1.73 m2 and 1.45 (1.07-1.95) for ACR ≥30 compared with <10 mg/g. ACR ≥30 mg/g was also associated with high hemoglobin (prevalence ratio, 1.57 [1.12-2.19] compared with <10 mg/g). During follow-up, there were 1069 incident CVDs among 5098 CVD-free participants at baseline. In multivariable Cox models, lower eGFR, higher ACR, and anemia were each independently associated with CVD risk, with the association of low eGFR being slightly stronger in anemia (P-for-interaction, 0.072). There was no hemoglobin-ACR interaction; however, when CVD subtypes were analyzed separately, risk of coronary heart disease and stroke associated with high ACR was slightly stronger in high hemoglobin (P-for-interaction, 0.074).

CONCLUSIONS:

Kidney function, albuminuria, and anemia were correlated and independently associated with CVD risk. Correlation and potential interaction for atherosclerotic CVD between albuminuria and high hemoglobin deserve further investigation.

KEYWORDS:

anemia; anemia and chronic kidney disease; cardiovascular disease; chronic kidney disease

 

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community-Dwelling Japanese Elderly: The Hisayama Study.

Takae K, Hata J, Ohara T, Yoshida D, Shibata M, Mukai N, Hirakawa Y, Kishimoto H, Tsuruya K, Kitazono T, Kiyohara Y, Ninomiya T.

J Am Heart Assoc. 2018 Jan 20;7(2). pii: e006693. doi: 10.1161/JAHA.117.006693.

PMID: 29353232

http://jaha.ahajournals.org/content/7/2/e006693

Abstract

BACKGROUND:

Epidemiologic evidence has emerged to reveal an association of albuminuria and low estimated glomerular filtration rate (eGFR) with dementia, but the findings are inconsistent. In addition, there are limited studies addressing the association between albuminuria and Alzheimer disease (AD).

METHODS AND RESULTS:

A total of 1562 community-dwelling Japanese subjects aged ≥60 years without dementia were followed up for 10 years. The outcomes were incidence of all-cause dementia and its subtypes, namely, AD and vascular dementia (VaD). The hazard ratios for the outcomes were estimated according to urine albumin-creatinine ratio (UACR) and eGFR levels using a Cox proportional hazards model. During the follow-up, 358 subjects developed all-cause dementia (238 AD and 93 VaD). Higher UACR level was significantly associated with greater multivariable-adjusted risks of all-cause dementia (hazard ratios [95% confidence intervals]: 1.00 [reference], 1.12 [0.78-1.60], 1.65 [1.18-2.30], and 1.56 [1.11-2.19] for UACR of ≤6.9, 7.0-12.7, 12.8-29.9, and ≥30.0 mg/g, respectively), AD (1.00 [reference], 1.20 [0.77-1.86], 1.75 [1.16-2.64], and 1.58 [1.03-2.41], respectively), and VaD (1.00 [reference], 1.03 [0.46-2.29], 1.94 [0.96-3.95], and 2.19 [1.09-4.38], respectively). On the other hand, lower eGFR level was marginally associated with greater risk of VaD, but not AD. Subjects with UACR ≥12.8 mg/g and eGFR of <60 mL/min per 1.73 m2 had 3.3-fold greater risk of VaD than those with UACR <12.8 mg/g and eGFR of ≥60 mL/min per 1.73 m2.

CONCLUSIONS:

Albuminuria is a significant risk factor for the development of both AD and VaD in community-dwelling Japanese elderly. Moreover, albuminuria and low eGFR are mutually associated with a greater risk of VaD.

KEYWORDS:

Alzheimer disease; albuminuria; estimated glomerular filtration rate; prospective cohort study; vascular dementia

 

Relationship of Arterial Stiffness Index and Pulse Pressure With Cardiovascular Disease and Mortality

M. Abdullah Said, Ruben N. Eppinga, Erik Lipsic, Niek Verweij, Pim van der Harst

Journal of the American Heart Association. 2018;7:e007621, originally published January 22, 2018

https://doi.org/10.1161/JAHA.117.007621

http://jaha.ahajournals.org/content/7/2/e007621

Abstract

Background Vascular aging results in stiffer arteries and may have a role in the development of cardiovascular disease (CVD). Arterial stiffness index (ASI), measured by finger photoplethysmography, and pulse pressure (PP) are 2 independent vascular aging indices. We investigated whether ASI or PP predict new‐onset CVD and mortality in a large community‐based population.

Methods and Results We studied 169 613 UK Biobank participants (mean age 56.8 years; 45.8% males) who underwent ASI measurement and blood pressure measurement for PP calculation. Mean±SD ASI was 9.30±3.1 m/s and mean±SD PP was 50.98±13.2 mm Hg. During a median disease follow‐up of 2.8 years (interquartile range 1.4–4.0), 18 190 participants developed CVD, of which 1587 myocardial infarction (MI), 4326 coronary heart disease, 1192 heart failure, and 1319 stroke. During a median mortality follow‐up of 6.1 years (interquartile range 5.8–6.3), 3678 participants died, of which 1180 of CVD. Higher ASI was associated with increased risk of overall CVD (unadjusted hazard ratio 1.27; 95% confidence interval [CI], 1.25–1.28), myocardial infarction (1.38; 95% CI, 1.32–1.44), coronary heart disease (1.31; 95% CI, 1.27–1.34), and heart failure (1.31; 95% CI 1.24–1.37). ASI also predicted mortality (all‐cause, CVD, other). Higher PP was associated with overall CVD (1.57; 95% CI, 1.55–1.59), myocardial infarction (1.48; 95% CI, 1.42–1.54), coronary heart disease (1.47; 95% CI, 1.43–1.50), heart failure (1.47; 95% CI, 1.40–1.55), and CVD mortality (1.47; 95% CI, 1.40–1.55). PP improved risk reclassification of CVD in a non–laboratory‐based Framingham Risk Score by 5.4%, ASI by 2.3%.

Conclusions ASI and PP are independent predictors of CVD and mortality outcomes. Although both improved risk prediction for new‐onset disease, PP appears to have a larger clinical value than ASI.

arterial stiffnesscardiovascular diseasecardiovascular outcomesmortalitypulse pressureUK Biobank

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Testosterone a key factor in gender related metabolic syndrome.

Bianchi VE, Locatelli V.

Obes Rev. 2018 Jan 21. doi: 10.1111/obr.12633. [Epub ahead of print] Review.

PMID: 29356299

Abstract

Metabolic syndrome (MetS) is highly correlated with cardiovascular diseases. Although an excess of body fat is a determinant factor for MetS development, a reduced level of testosterone plays a fundamental role in its regulation. Low testosterone level is highly related to insulin resistance, visceral obesity and MetS. We have searched in Pubmed clinical trial with the password: testosterone and insulin resistance, and testosterone and MetS. We found 19 studies on the correlation between testosterone level with insulin resistance and 18 on the effect of testosterone therapy on MetS. A high correlation between low testosterone and insulin resistance has been found in men, but not in women. Testosterone administration in hypogonadal men improved MetS and reduced the mortality risk. Androgen and oestrogen receptors are expressed in adipocytes, muscle and liver tissue, and their activation is necessary to improve metabolic control. Normalization of testosterone level should be the primary treatment in men, along with caloric restriction and physical exercise. These findings come mainly from correlative data, and there remains a need for randomized trials to strengthen this evidence. This review will consider the effects of testosterone on the regulation and development of MetS in men and women.

KEYWORDS:

17β-estradiol; insulin resistance; metabolic syndrome; obesity; testosterone; visceral fat

 

Heart rate as a predictor of cardiovascular risk.

Tadic M, Cuspidi C, Grassi G.

Eur J Clin Invest. 2018 Jan 22. doi: 10.1111/eci.12892. [Epub ahead of print] Review.

PMID: 29355923

Abstract

BACKGROUND:

Heart rate (HR) is a predictor of cardiovascular, cerebrovascular and all-cause mortality in the general population, as well as in patients with cardio- and cerebrovascular diseases. We aimed to summarize current knowledge regarding the influence of HR on cardio- and cerebrovascular morbidity and mortality.

MATERIALS AND METHODS:

PubMed, MEDLINE, Ovid and Embase databases was searched for large follow-up studies or meta-analysis published between January 1990 and September 2017 in the English language using the following keyword "heart rate", "resting heart rate", "mortality", "outcome", "hypertension", "heart failure", "ischemic heart disease", "coronary heart disease", "stroke".

RESULTS:

The relationship between increased HR and cardio- and cerebrovascular morbidity and mortality has been reported in a large number of studies, and the results regarding this association are concurrent. This connection is generally stronger in men than in women. The increase in HR usually occurs in parallel with elevation of blood pressure and metabolic disturbances (insulin resistance, dyslipidemia). However, even after adjustment for the most important cardiovascular risk factors, HR remained an independent predictor of adverse events in global population or in patients with cardio- and cerebrovascular diseases.

CONCLUSION:

HR has an important negative effect on cardio- and cerebrovascular morbidity and mortality. Future longitudinal investigations should clarify HR significance and optimal HR reduction for primary and secondary prevention in cardio- and cerebrovascular events.

KEYWORDS:

heart failure; heart rate; hypertension; ischemic heart disease; mortality; stroke

 

Eating behavior traits of successful weight losers during 12 months of alternate-day fasting: An exploratory analysis of a randomized controlled trial.

Kroeger CM, Trepanowski JF, Klempel MC, Barnosky A, Bhutani S, Gabel K, Varady KA.

Nutr Health. 2018 Jan 1:260106017753487. doi: 10.1177/0260106017753487. [Epub ahead of print]

PMID: 29353535

Abstract

BACKGROUND:

Alternate-day fasting (ADF) has gained popularity in recent years. The diet consists of a "fast day" where an individual consumes 0-25% of their energy needs, alternated with a "feast day" where a person is permitted to eat ad libitum.

AIM:

This study examined eating behavior traits of successful weight losers during alternate day fasting.

METHODS:

Obese participants ( n = 34) took part in 12 months of ADF and were grouped into a high (≥5%) or low-weight-loss (<5%) group post-treatment.

RESULTS:

The high-weight-loss group demonstrated increased ( p = 0.04) fullness, decreased ( p = 0.03) hunger, increased dietary protein intake (15% to 20% of kcal, p = 0.04), and better adherence to fast-day calorie goals.

CONCLUSIONS:

Thus, individuals who achieve clinically significant weight loss with ADF demonstrate improved satiety, increased protein intake, and better adherence to fast-day calorie goals.

KEYWORDS:

Weight loss success; alternate day fasting; body weight; eating behavior traits; obese adults

 

Dietary Consumption of Antioxidant Vitamins and Subsequent Lung Cancer Risk: The Japan Public Health Center-based Prospective Study.

Narita S, Saito E, Sawada N, Shimazu T, Yamaji T, Iwasaki M, Ishihara J, Takachi R, Shibuya K, Inoue M, Tsugane S; JPHC Study Group.

Int J Cancer. 2018 Jan 22. doi: 10.1002/ijc.31268. [Epub ahead of print]

PMID: 29355932

Abstract

While many epidemiological studies have studied the association between lung cancer risk and fruits and vegetable consumption, the major sources of antioxidant vitamins, only a few have investigated the direct association with antioxidants in consideration of cancer subtypes and smoking status. Here, we examined the association between consumption of antioxidant vitamins and lung cancer risk in one of the largest prospective cohort studies in Japan. We investigated the association of dietary antioxidant vitamins intake, namely retinol, vitamin C, vitamin E, α-carotene, and β-carotene, and subsequent incidence of lung cancer among 38,207 men and 41,498 women in the Japan Public Health Center-based Prospective Study. Cox proportional hazard regression was performed with adjustment for potential confounders and by strata of cancer subtypes and smoking status. Antioxidant and other dietary intakes were assessed using a food frequency questionnaire (FFQ). During 1,233,096 person-years of follow-up between 1995 and 2013, a total of 1,690 lung cancer cases were newly diagnosed. In a multivariate regression model, while higher retinol intake was positively associated with overall lung cancer risk in men (HR 1.26; 95% CI 1.05-1.51; ptrend 0.003), the estimates were more evident with small cell carcinoma (HR 1.92; 95% CI 1.13-3.24; ptrend <0.001). Null associations were observed for other antioxidant vitamins. Our prospective study suggests that higher consumption of retinol may be associated with an increased risk of lung cancer in men, especially with small cell carcinoma, although confirmation is required.

KEYWORDS:

Antioxidant vitamins; epidemiology; lung cancer; prospective cohort study

 

Associations of the serum long-chain n-3 PUFA and hair mercury with resting heart rate, peak heart rate during exercise and heart rate recovery after exercise in middle-aged men.

Tajik B, Kurl S, Tuomainen TP, Savonen K, Virtanen JK.

Br J Nutr. 2018 Jan;119(1):66-73. doi: 10.1017/S0007114517003191. Epub 2017 Dec 6.

PMID: 29208059

Abstract

Long-chain n-3 PUFA from fish have been associated with lower risk of CVD. Fish may also contain methylmercury, which may attenuate the inverse associations of the long-chain n-3 PUFA. However, the mechanisms underlying these associations are not fully known. We evaluated the associations of the serum long-chain n-3 PUFA (EPA, DPA and DHA) and hair Hg with resting heart rate (HR), peak HR during cycle ergometer exercise and HR recovery after exercise. A total of 1008 men from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study, aged 42-60 years and free of CVD, were studied. After multivariate-adjustments in ANCOVA, higher serum total long-chain n-3 PUFA concentration was associated with lower resting HR (extreme-quartile difference 2·2 beats/min; 95 % CI 0·2, 4·1, P trend across quartiles=0·02), but not with peak HR or HR recovery. Associations were generally similar when EPA, DPA and DHA were evaluated individually, except for DPA, which was also associated with better HR recovery after exercise (extreme-quartile difference 2·1 beats/min; 95 % CI 0·1, 4·2, P trend=0·06). Higher hair Hg content had a trend towards lower peak HR after adjusting for the long-chain n-3 PUFA (P trend=0·05), but it only slightly attenuated the associations of the serum long-chain n-3 PUFA with HR. These findings suggest that higher serum long-chain n-3 PUFA concentrations are associated with lower resting HR in middle-aged men from Eastern Finland, which may partially explain the potential cardioprotective effect of fish intake.

KEYWORDS:

HR heart rate; KIHD Kuopio Ischaemic Heart Disease Risk Factor Study; Cohort studies; Cross-sectional studies; Exercise tests; Fatty acids; Heart rate

 

The association and dose-response relationship between dietary intake of α-linolenic acid and risk of CHD: a systematic review and meta-analysis of cohort studies.

Wei J, Hou R, Xi Y, Kowalski A, Wang T, Yu Z, Hu Y, Chandrasekar EK, Sun H, Ali MK.

Br J Nutr. 2018 Jan;119(1):83-89. doi: 10.1017/S0007114517003294.

PMID: 29355094

Abstract

Previous studies show inconsistent associations between α-linolenic acid (ALA) and risk of CHD. We aimed to examine an aggregate association between ALA intake and risk of CHD, and assess for any dose-response relationship. We searched the PubMed, EMBASE and Web of Science databases for prospective cohort studies examining associations between ALA intake and CHD, including composite CHD and fatal CHD. Data were pooled using random-effects meta-analysis models, comparing the highest category of ALA intake with the lowest across studies. Subgroup analysis was conducted based on study design, geographic region, age and sex. For dose-response analyses, we used two-stage random-effects dose-response models. In all, fourteen studies of thirteen cohorts were identified and included in the meta-analysis. The pooled results showed that higher ALA intake was associated with modest reduced risk of composite CHD (risk ratios (RR)=0·91; 95 % CI 0·85, 0·97) and fatal CHD (RR=0·85; 95 % CI 0·75, 0·96). The analysis showed a J-shaped relationship between ALA intake and relative risk of composite CHD (χ 2=21·95, P<0·001). Compared with people without ALA intake, only people with ALA intake <1·4 g/d showed reduced risk of composite CHD. ALA intake was linearly associated with fatal CHD - every 1 g/d increase in ALA intake was associated with a 12 % decrease in fatal CHD risk (95 % CI -0·21, -0·04). Though a higher dietary ALA intake was associated with reduced risk of composite and fatal CHD, the excess composite CHD risk at higher ALA intakes warrants further investigation, especially through randomised controlled trials.

KEYWORDS:

α-Linolenic acid; ALA α-linolenic acid; RR risk ratio; CHD; Dose–response relationships; Meta-analyses

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Total nut, tree nut, peanut, and peanut butter consumption and the risk of pancreatic cancer in the Netherlands Cohort Study.

Nieuwenhuis L, van den Brandt PA.

Cancer Epidemiol Biomarkers Prev. 2018 Jan 22. pii: cebp.0448.2017. doi: 10.1158/1055-9965.EPI-17-0448. [Epub ahead of print]

PMID: 29358224

Abstract

BACKGROUND:

Nut intake has been associated with decreased cancer-related mortality, but few studies have examined the potential of nuts in the chemoprevention of pancreatic cancer. We prospectively investigated the association of total nut, tree nut, peanut, and peanut butter consumption with pancreatic cancer risk.

METHODS:

In the Netherlands Cohort Study, 120,852 men and women completed a baseline questionnaire, including a food frequency questionnaire, in 1986. After 20.3 years of follow-up, 583 incident pancreatic cancer cases, including 349 microscopically confirmed pancreatic cancer (MCPC) cases, were included in multivariable case-cohort analyses.

RESULTS:

Increased total nut consumption was associated with a non-significantly decreased MCPC risk in men (HR (95% CI) for 10+ g/day vs. nonconsumers = 0.72 (0.47-1.11), P-trend = 0.163). No clear association was found in women. For tree nut and peanut consumption, non-significant inverse associations were observed in men. In women, no or unclear associations were found for tree nut and peanut consumption. Peanut butter intake was related to a significantly reduced risk of MCPC in men (HR (95% CI) for 5+ g/day vs. nonconsumers = 0.53 (0.28-1.00), P-trend = 0.047), but this relation was not clear in women. Evidence for a nonlinear dose-response relation with MCPC was found for tree nut intake only. The associations were weaker when looking at total pancreatic cancer.

CONCLUSIONS:

Our results suggest that nuts and peanut butter might reduce pancreatic cancer risk in men. In women, no or unclear associations were found.

IMPACT:

Nut consumption might reduce the risk of pancreatic cancer in men.

 

Coffee Intake Decreases Risk of Postmenopausal Breast Cancer: A Dose-Response Meta-Analysis on Prospective Cohort Studies.

Lafranconi A, Micek A, De Paoli P, Bimonte S, Rossi P, Quagliariello V, Berretta M.

Nutrients. 2018 Jan 23;10(2). pii: E112. doi: 10.3390/nu10020112.

PMID: 29360766

Abstract

Aim: A dose-response meta-analysis was conducted in order to summarize the evidence from prospective cohort studies regarding the association between coffee intake and breast cancer risk. Methods: A systematic search was performed in electronic databases up to March 2017 to identify relevant studies; risk estimates were retrieved from the studies and linear and non-linear dose-response analysis modelled by restricted cubic splines was conducted. A stratified and subgroup analysis by menopausal and estrogen/progesterone receptor (ER/PR) status, smoking status and body mass index (BMI) were performed in order to detect potential confounders. Results: A total of 21 prospective studies were selected either for dose-response, the highest versus lowest category of consumption or subgroup analysis. The dose-response analysis of 13 prospective studies showed no significant association between coffee consumption and breast cancer risk in the non-linear model. However, an inverse relationship has been found when the analysis was restricted to post-menopausal women. Consumption of four cups of coffee per day was associated with a 10% reduction in postmenopausal cancer risk (relative risk, RR 0.90; 95% confidence interval, CI 0.82 to 0.99). Subgroup analyses showed consistent results for all potential confounding factors examined. Conclusions: Findings from this meta-analysis may support the hypothesis that coffee consumption is associated with decreased risk of postmenopausal breast cancer.

KEYWORDS:

breast cancer; caffeine; coffee; dose-response; meta-analysis; postmenopausal; receptor

 

A prospective study of frequency of eating restaurant prepared meals and subsequent 9-year risk of all-cause and cardiometabolic mortality in US adults.

Kant AK, Graubard BI.

PLoS One. 2018 Jan 23;13(1):e0191584. doi: 10.1371/journal.pone.0191584. eCollection 2018.

PMID: 29360850

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0191584

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0191584&type=printable

Abstract

Restaurant prepared foods are known to be energy-dense and high in fat and sodium, but lower in protective nutrients. There is evidence of higher risk of adiposity, type II diabetes, and heart disease in frequent consumers of restaurant meals. However, the risk of mortality as a long-term health consequence of frequent consumption of restaurant meals has not been examined. We examined the prospective risk of all-cause and coronary heart disease, cerebrovascular disease and diabetes (cardiometabolic) mortality in relation to frequency of eating restaurant prepared meals in a national cohort. We used frequency of eating restaurant prepared meals information collected in the National Health and Nutrition Examination Surveys, conducted from 1999-2004, with mortality follow-up completed through Dec. 31, 2011 (baseline age ≥ 40y; n = 9107). We estimated the relative hazard of all-cause and cardiometabolic mortality associated with weekly frequency of eating restaurant meals using Cox-proportional hazards regression methods to adjust for multiple covariates. All analyses accounted for complex survey design and included sample weights. Over 33% of all respondents reported eating ≥3 restaurant prepared meals/week. In this cohort, 2200 deaths due to all causes and 665 cardiometabolic deaths occurred over a median follow-up of 9 years. The covariate-adjusted hazard ratio of all cause or cardiometabolic mortality in men and women reporters of <1 or 1-2 restaurant prepared meals did not differ from those reporting ≥3 meals/week (P>0.05). The results were robust to effect modification by baseline BMI, years of education, and baseline morbidity. Expectedly, the 24-h dietary intakes of whole grains, fruits, dietary fiber, folate, vitamin C, potassium and magnesium at baseline were lower, but energy, energy density, and energy from fat were higher in more frequent restaurant meal reporters (P<0.05). Baseline serum HDL cholesterol, folate, and some carotenoids were inversely associated with the frequency of eating restaurant prepared meals (P<0.05); however, serum concentrations of total cholesterol, triglycerides, fasting glucose, insulin, glycated hemoglobin, and c-reactive protein were unrelated (P<0.05). The weekly frequency of eating restaurant prepared meals and prospective risk of mortality after 9 years were not related in this cohort.

 

Pharmacologic Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review.

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

Ann Intern Med. 2018 Jan 2;168(1):39-51. doi: 10.7326/M17-1529. Epub 2017 Dec 19.

PMID: 29255847

Abstract

BACKGROUND:

Optimal treatment to prevent or delay cognitive decline, mild cognitive impairment (MCI), or dementia is uncertain.

PURPOSE:

To summarize current evidence on the efficacy and harms of pharmacologic interventions to prevent or delay cognitive decline, MCI, or dementia in adults with normal cognition or MCI.

DATA SOURCES:

Several electronic databases from January 2009 to July 2017, bibliographies, and expert recommendations.

STUDY SELECTION:

English-language trials of at least 6 months' duration enrolling adults without dementia and comparing pharmacologic interventions with placebo, usual care, or active control on cognitive outcomes.

DATA EXTRACTION:

Two reviewers independently rated risk of bias and strength of evidence; 1 extracted data, and a second checked accuracy.

DATA SYNTHESIS:

Fifty-one unique trials were rated as having low to moderate risk of bias (including 3 that studied dementia medications, 16 antihypertensives, 4 diabetes medications, 2 nonsteroidal anti-inflammatory drugs [NSAIDs] or aspirin, 17 hormones, and 7 lipid-lowering agents). In persons with normal cognition, estrogen and estrogen-progestin increased risk for dementia or a combined outcome of MCI or dementia (1 trial, low strength of evidence); high-dose raloxifene decreased risk for MCI but not for dementia (1 trial, low strength of evidence); and antihypertensives (4 trials), NSAIDs (1 trial), and statins (1 trial) did not alter dementia risk (low to insufficient strength of evidence). In persons with MCI, cholinesterase inhibitors did not reduce dementia risk (1 trial, low strength of evidence). In persons with normal cognition and those with MCI, these pharmacologic treatments neither improved nor slowed decline in cognitive test performance (low to insufficient strength of evidence). Adverse events were inconsistently reported but were increased for estrogen (stroke), estrogen-progestin (stroke, coronary heart disease, invasive breast cancer, and pulmonary embolism), and raloxifene (venous thromboembolism).

LIMITATION:

High attrition, short follow-up, inconsistent cognitive outcomes, and possible selective reporting and publication.

CONCLUSION:

Evidence does not support use of the studied pharmacologic treatments for cognitive protection in persons with normal cognition or MCI.

 

Over-the-Counter Supplement Interventions to Prevent Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer-Type Dementia: A Systematic Review.

Butler M, Nelson VA, Davila H, Ratner E, Fink HA, Hemmy LS, McCarten JR, Barclay TR, Brasure M, Kane RL.

Ann Intern Med. 2018 Jan 2;168(1):52-62. doi: 10.7326/M17-1530. Epub 2017 Dec 19.

PMID: 29255909

Abstract

BACKGROUND:

Optimal interventions to prevent or delay cognitive decline, mild cognitive impairment (MCI), or dementia are uncertain.

PURPOSE:

To summarize the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, MCI, or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis.

DATA SOURCES:

Multiple electronic databases from 2009 to July 2017 and bibliographies of systematic reviews.

STUDY SELECTION:

English-language trials of at least 6 months' duration that enrolled adults without dementia and compared cognitive outcomes with an OTC supplement versus placebo or active controls.

DATA EXTRACTION:

Extraction performed by a single reviewer and confirmed by a second reviewer; dual-reviewer assessment of risk of bias; consensus determination of strength of evidence.

DATA SYNTHESIS:

Thirty-eight trials with low to medium risk of bias compared ω-3 fatty acids, soy, ginkgo biloba, B vitamins, vitamin D plus calcium, vitamin C or β-carotene, multi-ingredient supplements, or other OTC interventions with placebo or other supplements. Few studies examined effects on clinical Alzheimer-type dementia or MCI, and those that did suggested no benefit. Daily folic acid plus vitamin B12 was associated with improvements in performance on some objectively measured memory tests that were statistically significant but of questionable clinical significance. Moderate-strength evidence showed that vitamin E had no benefit on cognition. Evidence about effects of ω-3 fatty acids, soy, ginkgo biloba, folic acid alone or with other B vitamins, β-carotene, vitamin C, vitamin D plus calcium, and multivitamins or multi-ingredient supplements was either insufficient or low-strength, suggesting that these supplements did not reduce risk for cognitive decline. Adverse events were rarely reported.

LIMITATION:

Studies had high attrition and short follow-up and used a highly variable set of cognitive outcome measures.

CONCLUSION:

Evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.

 

Prevention of Late-Life Dementia: No Magic Bullet.

Larson EB.

Ann Intern Med. 2018 Jan 2;168(1):77-79. doi: 10.7326/M17-3026. Epub 2017 Dec 19. No abstract available.

PMID: 29255884

In describing the biodemography of human aging, noted demographer James Vaupel wrote that half of the children alive in 2010 in countries with the highest life expectancies may live to celebrate their 100th birthday. He also wrote about a related public health imperative: the high rates of Alzheimer disease and related dementias (ADRD) in persons older than 85 years. Quoting Shakespeare's As You Like It (“sans teeth, sans eyes, sans taste, sans everything”), Vaupel called cognitive impairment and sensory deprivation, especially vision and hearing loss, the “two scourges of senescence” (1).

Since the early to mid-1980s, scientific attention and support for research on ADRD have increased. Although symptoms generally occur in late life, the underlying brain pathology probably develops many years earlier. Care and management of people with ADRD are improving, but we have no cures or even disease-modifying treatments; in any case, prevention is more attractive. Even delaying ADRD onset would have a profound effect on public health and individual lives.

The 4 evidence-based reviews (2–5) from the Minnesota Evidence-based Practice Center (EPC) published in Annals summarize findings from randomized controlled trials (RCTs) on the effectiveness of interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia. Because EPC systematic reviews inform the U.S. Preventive Services Task Force (USPSTF) and public health messaging, the process to generate them is stringent and standardized. These reviews were supported by the Agency for Healthcare Research and Quality and the National Institute on Aging to provide the evidence base for a recent National Academy of Medicine (NAM) report on preventing cognitive decline and dementia (6).

I served on the NAM committee that developed the report based on the Minnesota EPC reviews. I was also one of 24 international researchers involved in a Lancet Commission report (7), released at the same time as the NAM report, that covers “effective dementia prevention, intervention, and care.” Aging patients and friends who expect to live to age 90 or older, when the prevalence of dementia increases to 50% or more, often say to me, “I sure hope I don't get Alzheimer's.” How do the 4 EPC papers and the NAM and Lancet reports answer the questions these people have about preventing or delaying the onset of ADRD?

To put it simply, all evidence indicates that there is no magic bullet. Our NAM committee searched in vain for convincing evidence of effective preventive interventions from the RCTs reviewed by the EPC. Although we found some intriguing positive results for physical activity (8) (reviewed in Brasure and colleagues [2]), cognitive training (9) (reviewed in Butler and colleagues [5]), and possibly multifactorial interventions (10), nothing even approached the evidence level required for a USPSTF recommendation. The 2 other EPC papers, from Fink and colleagues (3) and Butler and coworkers (4), also found insufficient evidence to support medications or supplements for cognitive protection. Of the papers cited in the 4 reviews, the vast majority did not meet strength-of-evidence standards, offered little evidence of effectiveness, or both. For all the potential treatments considered during the past decades on the basis of observational studies or hypotheses about reducing neurodegeneration—from prescription medicines, to over-the-counter drugs, to vitamins—the evidence is insufficient to make EPC-based clinical recommendations.

Why is this so? In part, the lack of evidence reflects the challenge of studying prevention of a common chronic disease that originates well before symptoms occur. To see effectiveness, trials on preventive interventions may need to begin when participants are in midlife. Such lengthy trials would have huge logistic challenges, be costly, and be difficult to interpret because of probable selective attrition. Equally challenging, as pointed out in the NAM report, is that many of the most promising interventions, such as controlling hypertension, avoiding smoking, exercising, and treating diabetes and other vascular risk factors, are already goals of standard medical care. The need for randomization to control treatments would create ethical dilemmas.

Another reason for the disheartening findings of the EPC papers is that they reviewed only RCTs. The Lancet Commission on dementia took a different tactic in its prevention section. The report notes 2 interesting recent observational findings. First, the overall number of people with dementia is rising rapidly, primarily because of aging populations and an increase in dementia incidence in China and prevalence in Japan. However, some countries, including the United States, the United Kingdom, Sweden, the Netherlands, and Canada, have had an unexpected decline in age-specific incidence or prevalence of ADRD (7). The commission noted that this reduced dementia risk is probably related to lifetime exposure to more favorable socioeconomic, health, and lifestyle factors for persons born later in the 20th century. Second, the report acknowledged that dementia neuropathology is complex, and community-based autopsy studies have shown that plaques and tangles of Alzheimer disease often occur with other degenerative findings, including microvascular infarcts and Lewy bodies, which probably contribute to cognitive decline. Of even more importance, the report cites surprising results from community-based U.S. studies showing that some persons with advanced neuropathologic signs of Alzheimer disease do not have dementia but are resilient to showing its symptoms, even into very late life (11).

These 2 findings led the Lancet Commission to conclude that our best chance for preventing dementia is a “life course” approach, particularly toward suspected modifiable risk factors (Figure). This strategy acknowledges that factors throughout life influence ADRD development but may be modifiable and probably are susceptible to public health interventions and clinical care. In addition, improving risk factors will contribute to better general health and well-being.

FIGURE.

Risk factors for dementia.

The Lancet Commission's new life-course model, showing potentially modifiable—and nonmodifiable—risk factors for dementia. ApoE = apolipoprotein E. (Reprinted from The Lancet, 19 July 2017, Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, et al, Dementia prevention, intervention, and care, Copyright 2017, with permission from Elsevier).

Image: M173026ff1_Figure_Risk_factors_for_dementia

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Dementia prevention, intervention, and care.

Livingston G, Sommerlad A, Orgeta V, Costafreda SG, Huntley J, Ames D, Ballard C, Banerjee S, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gitlin LN, Howard R, Kales HC, Larson EB, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N.

Lancet. 2017 Dec 16;390(10113):2673-2734. doi: 10.1016/S0140-6736(17)31363-6. Epub 2017 Jul 20. Review. No abstract available.

PMID: 28735855

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The NAM report concluded that classes of interventions supported by encouraging, although inconclusive, evidence are cognitive training, blood pressure management, and increased physical activity. The Lancet Commission had a broader but overlapping list. The commission recommended promoting universal education to improve socioeconomic well-being, increasing physical activity, reducing or stopping smoking, and maintaining social engagement, as well as managing hypertension, obesity, hearing loss, depression, and diabetes. Like the 4 EPC papers, both reports highlight the scant data from RCTs. Both groups were encouraged that more evidence may come from ongoing research, such as studies of “combination therapies” that address several individual, modifiable risk factors.

When people ask me how to prevent dementia, they often want a simple answer, such as vitamins, dietary supplements, or the latest hyped idea. I tell them that they can take many common-sense actions that promote health throughout life and may help to avoid or delay ADRD, namely regular physical activity; control of vascular risk factors, including preventing or effectively managing diabetes; not smoking; and maintaining a healthy diet and weight. Engaging in cognitively stimulating activities and avoiding social isolation also are probably beneficial. As our patients age, we should do what we can to correct their vision and hearing loss and stay aware of drugs that harm the brain and increase dementia risk, such as chronic high doses of anticholinergics (12). Note that none of these recommendations has harmful side effects.

Thus, although we do not have a magic bullet to prevent ADRD, 2 recent, comprehensive reports emphasize that we have made progress in understanding the biology of the aging brain. Promising trials on dementia prevention are under way. The EPC papers and the NAM and Lancet reports provide a measured assessment of our current knowledge and a motivation to learn more ways to build resilience for a healthier late life (13).

 

Pooled RCTs: Reanalysis accounting for screening intensity suggests that screening reduces prostate cancer mortality.

Stockler MR.

Ann Intern Med. 2018 Jan 16;168(2):JC5. doi: 10.7326/ACPJC-2018-168-2-005. No abstract available.

PMID: 29335717

Abstract

Question

In men ≥ 55 years of age, does screening reduce mortality from prostate cancer?

Scope

Included randomized controlled trials (RCTs) (Prostate, Lung, Colorectal, and Ovarian [PLCO] Cancer Screening Trial, ClinicalTrials.gov NCT00002540, and European Randomized Study of Screening for Prostate Cancer [ERSPC], Current Controlled Trials ISRCTN49127736) compared prostate screening (annual prostate-specific antigen [PSA] testing for 6 years {then annual digital rectal examination for 4 y}* [PLCO] or PSA testing every 2 to 4 years [ERSPC]) with usual care in men 55 to 74 (PLCO) or 55 to 69 (ERSPC) years of age. Outcome was prostate cancer mortality.

Methods

Meta analysis of individual patient data of 238 077 men (median age 59 to 62 y), with follow-up to 11 years. Data were analyzed according to randomized group (screening vs usual care) and by mean lead time (MLT) per group. MLT is a proxy for screening/diagnosis intensity and accounts for screening frequency, attendance rates, criteria for biopsy referral, and biopsy frequency.

Main results

Meta-analysis by randomized group showed a modest effect on prostate cancer mortality (Table). Meta-analysis adjusting for MLT showed a reduction in mortality/year of MLT that did not vary across the trials (Table).

Conclusion

In men ≥ 55 years of age, accounting for screening intensity via mean lead time revealed a reduction in prostate cancer mortality compared with no screening.

===========================

Effect of prostate cancer screening vs no screening on prostate cancer mortality at 11 y in men ≥ 55 y†

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

Methods of comparison Rate ratio (95% CI)

--------

Intention-to-treat‡ 0.84 (0.73 to 0.96)

Hazard ratio/y of MLT (CI)

MLT§ 0.92 (0.87 to 0.97)

Hazard ratio on screened arms (CI)||

MLT§ 0.71 (0.56 to 0.91)

----------

†MLT = mean lead time; CI defined in Glossary. Results integrating data from 2 large screening trials using an empirical approach for MLT estimation. Additional analyses provided by authors.

‡Intention-to-treat, fixed-effect, individual patient data meta-analysis of PLCO and ERSPC trials.

§A continuous variable that represents intensity of screening. Derived by comparing empirical incidence in each group with incidence in an unscreened population (US, before introduction of PSA screening).

||Comparator is a no-screening setting (MLT = 0).

==========================

Commentary

It was reasonable to hope that PLCO and ERSCP, 2 RCTs that included nearly a quarter of a million men, would resolve a controversy that has raged for more than 20 years since clinicians began screening for prostate cancer with PSA blood testing. However, differences between the screening regimens, settings, compliance, and results of these trials have fueled, rather than doused, the controversy.

MLT, the average number of years earlier that cancer is diagnosed because of screening, is a good proxy for differences between screening regimens that might affect their outcomes. Tsodikov and colleagues used sound and innovative methods first to estimate a version of MLT in the 2 trials and then to account for differences in MLT after analysis of the effects of screening on prostate cancer mortality. Their analyses suggest that the results of the 2 pivotal trials were complementary rather than contradictory and that the screening in these trials reduced prostate cancer mortality by approximately 25% to 33% over 11 years in relative terms, compared with a policy of no screening. However, this benefit needs to be considered carefully, both in absolute terms and weighed against the harms of PSA-based screening.

An infographic prepared by the US Preventive Services Task Force (USPSTF) explains what PSA-based testing means to men considering this screening approach (1). For every 1000 men offered PSA-based screening over 10 to 15 years, they estimate that about 240 will have elevated PSA levels and be recommended a prostate biopsy, 100 will have cancer detected, 80 will choose treatment with surgery or radiation (65 immediately and 15 after a period of active surveillance), 60 will experience impotence or incontinence because of their treatment, and only 1 or 2 will avoid death from prostate cancer. Of note, prostate cancer accounted for < 3% of deaths in PLCO and ERSCP, and the reduction in prostate cancer mortality did not improve overall survival.

Draft recommendations from the USPSTF accurately reflect the delicate balance of benefits versus harms over 10 to 15 years, our current empirical horizon. Doctors should discuss the possible consequences, benefits, and harms of PSA screening before taking blood for a PSA test in men aged 55 to 69 years. This is necessary to enable each man to make a decision about PSA screening that is both well-informed and consistent with his preferences.

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Mortality results from a randomized prostate-cancer screening trial.

Andriole GL, Crawford ED, Grubb RL 3rd, Buys SS, Chia D, Church TR, Fouad MN, Gelmann EP, Kvale PA, Reding DJ, Weissfeld JL, Yokochi LA, O'Brien B, Clapp JD, Rathmell JM, Riley TL, Hayes RB, Kramer BS, Izmirlian G, Miller AB, Pinsky PF, Prorok PC, Gohagan JK, Berg CD; PLCO Project Team.

N Engl J Med. 2009 Mar 26;360(13):1310-9. doi: 10.1056/NEJMoa0810696. Epub 2009 Mar 18. Erratum in: N Engl J Med. 2009 Apr 23;360(17):1797.

PMID: 19297565 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2944770/

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Diets with a low glycaemic load have favourable effects on prediabetes progression and regression: a prospective cohort study.

He F.

J Hum Nutr Diet. 2018 Jan 23. doi: 10.1111/jhn.12539. [Epub ahead of print]

PMID: 29363199

Abstract

BACKGROUND:

To date, no study assessing the associations among glycaemic index (GI), glycaemic load (GL) and progression to diabetes has focused specifically on prediabetes. Moreover, the available data on the association between these variables and regression to normal glucose regulation (NGR) are insufficient. Therefore, the present study aimed to evaluate the longitudinal associations among GI, GL and prediabetes outcomes.

METHODS:

This prospective study included 640 adults aged 40-79 years with prediabetes at baseline. Dietary data were assessed using a previously validated 3-day food record. The participants were divided into three groups according to GI and GL tertiles. Outcomes were defined based on annual oral glucose tolerance test results.

RESULTS:

During a median of 5 years of follow-up, 127 incident cases of diabetes and 249 incident cases of NGR were identified. Dietary GL was positively associated with the risk of developing diabetes and negatively associated with the likelihood of reaching NGR at least once. Comparing the highest and lowest tertiles of GL, the multivariable-adjusted hazard ratios (95% confidence intervals) were 1.85 (1.07-3.21) for progression and 0.65 (0.44-0.96) for regression. No association was observed between GI and prediabetes outcomes in the fully adjusted models.

CONCLUSIONS:

Among patients with prediabetes, high dietary GL was positively associated with diabetes risk. Furthermore, a low-GL diet contributed to an increased incidence of reaching NGR.

KEYWORDS:

glycaemic index; glycaemic load; prediabetes; prospective study; regression

 

Effects of ascorbic acid on anxiety state and affect in a non-clinical sample.

Moritz B, Schwarzbold ML, Guarnieri R, Diaz AP, S Rodrigues AL, Dafre AL.

Acta Neurobiol Exp (Wars). 2017;77(4):362-372.

PMID: 29369301

Abstract

Objective Given that the literature data indicates that ascorbic acid may have an anxiolytic effect, we hypothesized that a single oral administration of ascorbic acid could acutely affect emotional states. Methods The effects of acid ascorbic supplementation on anxiety and other emotional states were evaluated by the State‑Trait Anxiety Inventory (STAI), and Visual Analogue Mood Scale (VAMS). Immediately before, and 2 hours after receiving a single ascorbic acid dose (1000 mg) or placebo, 142 graduate students were evaluated by the STAI and VAMS in a randomized, double‑blind, placebo‑controlled trial. Results No changes from basal levels were observed in the STAI state‑anxiety or VAMS scores. However, the ingestion of ascorbic acid by the 25% more anxious healthy subjects (women; 14 control and 23 ascorbic acid), as defined by the STAI trait‑anxiety scale, produced a significant reduction from baseline anxiety scores in the STAI state‑anxiety scale and VAMS anxiety subscale. The study evaluated a small sample with narrow sociodemographic characteristics, composed mainly of healthy young females (> 94%) enrolled in post‑graduation courses, without controlling diet, physical activity, and formal psychiatric diagnosis.

CONCLUSIONS:

Despite the sample size limitation, this study provides the first evidence of an acute anxiolytic effect of ascorbic acid. Broader population studies are required to evaluate the clinical relevance of presented data.

 

Pre-Meal Effect of Whey Proteins on Metabolic Parameters in Subjects with and without Type 2 Diabetes: A Randomized, Crossover Trial.

Bjørnshave A, Holst JJ, Hermansen K.

Nutrients. 2018 Jan 25;10(2). pii: E122. doi: 10.3390/nu10020122.

PMID: 29370144

Abstract

Diabetic dyslipidemia with elevated postprandial triglyceride (TG) responses is characteristic in type 2 diabetes (T2D). Diet and meal timing can modify postprandial lipemia (PPL). The impact of a pre-meal of whey proteins (WP) on lipid metabolism is unidentified. We determined whether a WP pre-meal prior to a fat-rich meal influences TG and apolipoprotein B-48 (ApoB-48) responses differentially in patients with and without T2D. Two matched groups of 12 subjects with and without T2D accomplished an acute, randomized, cross-over trial. A pre-meal of WP (20 g) or water (control) was consumed 15 min before a fat-rich meal (supplemented with 20 g WP in case of water pre-meal). Postprandial responses were examined during a 360-min period. A WP pre-meal significantly increased postprandial concentrations of insulin (P < 0.0001), glucagon (P < 0.0001) and glucose-dependent insulinotropic peptide (GIP) (P < 0.0001) in subjects with and without T2D. We detected no effects of the WP pre-meal on TG, ApoB-48, or non-esterified fatty acids (NEFA) responses to the fat-rich meal in either group. Paracetamol absorption i.e. gastric emptying was delayed by the WP pre-meal (P = 0.039). In conclusion, the WP pre-meal induced similar hormone and lipid responses in subjects with and without T2D. Thus, the WP pre-meal enhanced insulin, glucagon and GIP responses but did not influence lipid or glucose responses. In addition, we demonstrated that a WP pre-meal reduced gastric emptying in both groups.

KEYWORDS:

postprandial lipemia; pre-meal; type 2 diabetes; whey proteins

 

Dietary nitrate-induced increases in human muscle power: high versus low responders.

Coggan AR, Broadstreet SR, Mikhalkova D, Bole I, Leibowitz JL, Kadkhodayan A, Park S, Thomas DP, Thies D, Peterson LR.

Physiol Rep. 2018 Jan;6(2). doi: 10.14814/phy2.13575.

PMID: 29368802

Abstract

Maximal neuromuscular power is an important determinant of athletic performance and also quality of life, independence, and perhaps even mortality in patient populations. We have shown that dietary nitrate (NO3- ), a source of nitric oxide (NO), improves muscle power in some, but not all, subjects. The present investigation was designed to identify factors contributing to this interindividual variability. Healthy men (n = 13) and women (n = 7) 22-79 year of age and weighing 52.1-114.9 kg were studied using a randomized, double-blind, placebo-controlled, crossover design. Subjects were tested 2 h after ingesting beetroot juice (BRJ) either containing or devoid of 12.3 ± 0.8 mmol of NO3- . Plasma NO3- and nitrite (NO2- ) were measured as indicators of NO bioavailability and maximal knee extensor speed (Vmax ), power (Pmax ), and fatigability were determined via isokinetic dynamometry. On average, dietary NO3- increased (P < 0.05) Pmax by 4.4 ± 8.1%. Individual changes, however, ranged from -9.6 to +26.8%. This interindividual variability was not significantly correlated with age, body mass (inverse of NO3- dose per kg), body mass index (surrogate for body composition) or placebo trial Vmax or fatigue index (in vivo indicators of muscle fiber type distribution). In contrast, the relative increase in Pmax was significantly correlated (r = 0.60; P < 0.01) with the relative increase in plasma NO2- concentration. In multivariable analysis female sex also tended (P = 0.08) to be associated with a greater increase in Pmax. We conclude that the magnitude of the dietary NO3- -induced increase in muscle power is dependent upon the magnitude of the resulting increase in plasma NO2- and possibly female sex.

KEYWORDS:

Fiber type; isokinetic dynamometry; nitric oxide; sex differences

 

Anaemia and depletion of iron stores as risk factors for postpartum depression: a literature review.

Wassef A, Nguyen QD, St-André M.

J Psychosom Obstet Gynaecol. 2018 Jan 24:1-10. doi: 10.1080/0167482X.2018.1427725. [Epub ahead of print]

PMID: 29363366

Abstract

PURPOSE:

Iron-deficiency and anaemia are common in pregnant and postpartum women because of increasing iron demand and blood loss. Many women also enter pregnancy with pre-depleted iron stores. We reviewed the evidence linking anaemia and/or iron-deficiency to postpartum depression (PPD).

METHODS:

We identified seventeen studies in four databases including randomized-controlled trials (RCTs) and observational studies assessing the impact of anaemia, iron-deficiency and iron supplementation on the risk of PPD. We extracted data on sample size, geographical region, obstetrical complications, measures of depression, haemoglobin, iron levels and intake of iron supplementation and critically appraised the results from the studies.

RESULTS:

Eight out of ten studies found higher risk for PPD (r - 0.19 to -0.43 and ORs 1.70-4.64) in anaemic women. Low ferritin in the postpartum period but not during pregnancy was associated with increased risk of PPD. Iron supplementation in the postpartum period decreased risk of PPD in four out of five studies, whereas it did not protect from PPD if given during pregnancy. Limitations include study heterogeneity, discrepancy of prevalence of PPD and usage of a screening tool for evaluation of PPD.

CONCLUSION:

Anaemia and/or iron-deficiency may contribute to PPD in at-risk women. Further studies should elucidate the association between these entities.

KEYWORDS:

Anaemia; ferritin; haemoglobin; iron; postpartum depression

 

Flu could raise heart attack risk, Canadian study says

Researchers also find greater risk with other respiratory viruses

The Canadian Press Posted: Jan 24, 2018

http://www.cbc.ca/news/health/flu-heart-attack-risk-canadian-study-1.4502537

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Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection

nejm

Vitamin D: missing link between hypertension and muscle mass.

Baretić M, Matovinović M, Vukić T, Ranilović D.

J Hum Hypertens. 2017 Dec;32(1):1-2. doi: 10.1038/s41371-017-0004-3. Epub 2017 Nov 20. No abstract available.

PMID: 29158563

https://www.nature.com/articles/s41371-017-0004-3

We have read ‘Effects of calcium plus vitamin D supplementation on blood pressure: a systematic review and meta-analysis of randomised controlled trials’ and have shared our experiences with vitamin D and hypertension [1]. We retrospectively analysed data of 33 obese patients attending a structural educational programme at the Department of Endocrinology, Internal Medicine Clinic, University Hospital Centre Zagreb, Croatia. Two groups were included. Group 1: 16 patients with hypertension (3 males; 13 females; average body mass index (BMI), 38 kg/m2; median age, 40 years) and Group 2: 17 patients without hypertension (4 males; 13 females; average BMI, 45 kg/m2; median age, 45 years). Secondary causes of obesity were excluded (normal values of thyroid-stimulating hormone and cortisol after overnight suppression with 1 mg dexamethasone), and no participant took vitamin D supplements. Body composition was estimated by bioelectrical impedance analysis (fat percentage, fat mass, muscle mass and visceral fat rating). Statistical analysis was performed on the age, sex, BMI, body composition, glucose, lipid profile and vitamin D level. Both groups had low vitamin D levels. In Group 1, the median vitamin D level was 40 nmol/l (20–69) and in Group 2, it was 36 nmol/l (12–76). A two-sided t-test revealed no significant difference in vitamin D levels between the two groups (P = 0.343). In Group 1, vitamin D levels positively correlated with muscle mass (Spearman’s correlation coefficient, r = 0.68); however, this correlation was insignificant in Group 2 (r = −0.32). Whether this finding was accidental or some pathophysiological explanation existed, i.e., were there connectors linking vitamin D action, hypertension and muscle mass remains unknown.

Vitamin D influences muscles by the following pathways: (a) genetic, mediated by a receptor present in muscle cells and (b) nontranscriptional, which cannot be explained by a slow genetic pathway. Vitamin D promotes mitogen-activated protein kinase (MAPK) signalling pathway activation, resulting in myogenesis initiation, cell proliferation, differentiation and apoptosis [2]. MAPK is activated by various stimuli, including angiotensin II [3]. MAPK signalling plays a bigger role in adipogenesis; after stimulation, transcriptional pathways are initiated to ensure terminal differentiation of precursors into adult white or brown adipocytes [4]. Vitamin D is associated with metabolic syndrome, hypertension and muscle mass, probably by MAPK signalling pathway. Postreceptor pathways mediated by vitamin D influence both metabolic syndrome and body composition elements (hypertension and muscle mass). For obese hypertensive patients, assessing only BMI is not enough because it does not reveal sarcopenic obesity. Hitherto, the type of patients with hypertension and low vitamin D level who would benefit from vitamin D substitution therapy has not been determined. In an analysis of 92 subjects with low baseline vitamin D levels (<79.9 nmol/l), significant decreases in 24-h systolic and diastolic blood pressures occurred during cholecalciferol supplementation [5]. Since our group of hypertensive obese patients had much lower baseline vitamin D levels, they should certainly be given substitution therapy. Further research is warranted to confirm the effect magnitude of calcium and vitamin D supplementation on blood pressure changes, as stated in the article published in your journal [1].

References

1. Effects of calcium plus vitamin D supplementation on blood pressure: a systematic review and meta-analysis of randomized controlled trials.

Wu L, Sun D.

J Hum Hypertens. 2017 Sep;31(9):547-554. doi: 10.1038/jhh.2017.12. Epub 2017 Feb 23. Review.

PMID: 28230063

Abstract

The effect of calcium or vitamin D supplement on blood pressure (BP) has been explored in previous meta-analyses, but the results are conflicting. The combined efficacy of calcium and vitamin D on BP has not been systematically assessed. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) to explore the effect of calcium plus vitamin D (CaD) supplementation on changes of systolic blood pressure (SBP) and diastolic blood pressure among male and female participants (with and without diagnosed hypertension) aged 18 years or older. The PubMed, the Embase and the Cochrane Central Register of controlled trials were searched. A random effects model was used to calculate the pooled weighted mean differences (WMDs) with 95% confidence intervals (CIs) for the continuous outcome data. Cochrane Collaboration tool was used to assess the study quality of each trial. We further performed subgroup analysis and meta-regression by ethnicity, gender, age, health status, supplement dose, co-interventions, supplement duration and quality assessment. Eight RCTs involving 36 806 participants were assessed. The follow-up time ranged from 15 weeks to a maximum of 7 years. No meaningful effect on daytime office BP was detected in the present study, with evidence of significant heterogeneity. Subgroup analysis by gender indicated some evidence of elevated SBP in male participants, and the WMD (95% CI) was 1.49 mm Hg (1.03, 1.95). Further high-quality research is still warranted to confirm the magnitude of the effect of CaD supplementation on the changes of BP among participants with different ethnicity, gender, health status and CaD supplements.

Edited by AlPater

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Spermidine in health and disease.

Madeo F, Eisenberg T, Pietrocola F, Kroemer G.

Science. 2018 Jan 26;359(6374). pii: eaan2788. doi: 10.1126/science.aan2788. Review.

PMID: 29371440

Abstract

Interventions that delay aging and protect from age-associated disease are slowly approaching clinical implementation. Such interventions include caloric restriction mimetics, which are defined as agents that mimic the beneficial effects of dietary restriction while limiting its detrimental effects. One such agent, the natural polyamine spermidine, has prominent cardioprotective and neuroprotective effects and stimulates anticancer immunosurveillance in rodent models. Moreover, dietary polyamine uptake correlates with reduced cardiovascular and cancer-related mortality in human epidemiological studies. Spermidine preserves mitochondrial function, exhibits anti-inflammatory properties, and prevents stem cell senescence. Mechanistically, it shares the molecular pathways engaged by other caloric restriction mimetics: It induces protein deacetylation and depends on functional autophagy. Because spermidine is already present in daily human nutrition, clinical trials aiming at increasing the uptake of this polyamine appear feasible.

 

Almond Consumption and Processing Affects the Composition of the Gastrointestinal Microbiota of Healthy Adult Men and Women: A Randomized Controlled Trial.

Holscher HD, Taylor AM, Swanson KS, Novotny JA, Baer DJ.

Nutrients. 2018 Jan 26;10(2). pii: E126. doi: 10.3390/nu10020126.

PMID: 29373513

http://www.mdpi.com/2072-6643/10/2/126/htm

Abstract

BACKGROUND:

Almond processing has been shown to differentially impact metabolizable energy; however, the effect of food form on the gastrointestinal microbiota is under-investigated.

OBJECTIVE:

We aimed to assess the interrelationship of almond consumption and processing on the gastrointestinal microbiota.

DESIGN:

A controlled-feeding, randomized, five-period, crossover study with washouts between diet periods was conducted in healthy adults (n = 18). Treatments included: (1) zero servings/day of almonds (control); (2) 1.5 servings (42 g)/day of whole almonds; (3) 1.5 servings/day of whole, roasted almonds; (4) 1.5 servings/day of roasted, chopped almonds; and (5) 1.5 servings/day of almond butter. Fecal samples were collected at the end of each three-week diet period.

RESULTS:

Almond consumption increased the relative abundances of Lachnospira, Roseburia, and Dialister (p ≤ 0.05). Comparisons between control and the four almond treatments revealed that chopped almonds increased Lachnospira, Roseburia, and Oscillospira compared to control (p < 0.05), while whole almonds increased Dialister compared to control (p = 0.007). There were no differences between almond butter and control.

CONCLUSIONS:

These results reveal that almond consumption induced changes in the microbial community composition of the human gastrointestinal microbiota. Furthermore, the degree of almond processing (e.g., roasting, chopping, and grinding into butter) differentially impacted the relative abundances of bacterial genera.

KEYWORDS:

fat; fermentation; fiber; microbiome; nuts

 

Fibre intake and the development of inflammatory bowel disease: A European prospective multi-centre cohort study (EPIC-IBD).

Andersen V, Chan S, Luben R, Khaw KT, Olsen A, Tjonneland A, Kaaks R, Grip O, Bergmann MM, Boeing H, Hultdin J, Karling P, Overvad K, Oldenburg B, Opstelten J, Boutron-Ruault MC, Carbonnel F, Racine A, Key T, Masala G, Palli D, Tumino R, Trichopoulou A, Riboli E, Hart A.

J Crohns Colitis. 2018 Jan 24;12(2):129-136. doi: 10.1093/ecco-jcc/jjx136.

PMID: 29373726

https://academic.oup.com/ecco-jcc/article/12/2/129/4372232

Abstract

BACKGROUND AND AIMS:

Population-based prospective cohort studies investigating fibre intake and development of inflammatory bowel disease are lacking. Our aim was to investigate the association between fibre intake and the development of Crohn's disease [CD] and ulcerative colitis [uC] in a large European population.

METHODS:

In total, 401326 participants, aged 20-80 years, were recruited in eight countries in Europe between 1991 and 1998. At baseline, fibre intake [total fibres, fibres from fruit, vegetables and cereals] was recorded using food frequency questionnaires. The cohort was monitored for the development of inflammatory bowel disease. Each case was matched with four controls and odds ratios [ORs] for the exposures were calculated using conditional logistic regression. Sensitivity analyses according to smoking status were computed.

RESULTS:

In total, 104 and 221 participants developed incident CD and UC, respectively. For both CD and UC, there were no statistically significant associations with either quartiles, or trends across quartiles, for total fibre or any of the individual sources. The associations were not affected by adjusting for smoking and energy intake. Stratification according to smoking status showed null findings apart from an inverse association with cereal fibre and CD in non-smokers [Quartile 4 vs 1 OR = 0.12, 95% confidence interval = 0.02-0.75, p = 0.023, OR trend across quartiles = 0.50, 95% confidence interval = 0.29-0.86, p = 0.017].

CONCLUSION:

The results do not support the hypothesis that dietary fibre is involved in the aetiology of UC, although future work should investigate whether there may be a protective effect of specific types of fibre according to smoking status in CD.

KEYWORDS:

Dietary fibre; diet; epidemiology; fibre food; inflammatory bowel disease; prospective study

 

Association of Low-Moderate Arsenic Exposure and Arsenic Metabolism with Incident Diabetes and Insulin Resistance in the Strong Heart Family Study.

Grau-Perez M, Kuo CC, Gribble MO, Balakrishnan P, Jones Spratlen M, Vaidya D, Francesconi KA, Goessler W, Guallar E, Silbergeld EK, Umans JG, Best LG, Lee ET, Howard BV, Cole SA, Navas-Acien A.

Environ Health Perspect. 2017 Dec 20;125(12):127004. doi: 10.1289/EHP2566.

PMID: 29373862

https://ehp.niehs.nih.gov/wp-content/uploads/2017/12/EHP2566.alt_.pdf

Abstract

BACKGROUND:

High arsenic exposure has been related to diabetes, but at low-moderate levels the evidence is mixed. Arsenic metabolism, which is partly genetically controlled and may rely on certain B vitamins, plays a role in arsenic toxicity.

OBJECTIVE:

We evaluated the prospective association of arsenic exposure and metabolism with type 2 diabetes and insulin resistance.

METHODS:

We included 1,838 American Indian men and women free of diabetes (median age, 36 y). Arsenic exposure was assessed as the sum of inorganic arsenic (iAs), monomethylarsonate (MMA), and dimethylarsinate (DMA) urine concentrations (ΣAs). Arsenic metabolism was evaluated by the proportions of iAs, MMA, and DMA over their sum (iAs%, MMA%, and DMA%). Homeostasis model assessment for insulin resistance (HOMA2-IR) was measured at baseline and follow-up visits. Incident diabetes was evaluated at follow-up.

RESULTS:

Median ΣAs, iAs%, MMA%, and DMA% was 4.4μg/g creatinine, 9.5%, 14.4%, and 75.6%, respectively. Over 10,327 person-years of follow-up, 252 participants developed diabetes. Median HOMA2-IR at baseline was 1.5. The fully adjusted hazard ratio [95% confidence interval (CI)] for incident diabetes per an interquartile range increase in ΣAs was 1.57 (95% CI: 1.18, 2.08) in participants without prediabetes at baseline. Arsenic metabolism was not associated with incident diabetes. ΣAs was positively associated with HOMA2-IR at baseline but negatively with HOMA2-IR at follow-up. Increased MMA% was associated with lower HOMA2-IR when either iAs% or DMA% decreased. The association of arsenic metabolism with HOMA2-IR differed by B-vitamin intake and AS3MT genetics variants.

CONCLUSIONS:

Among participants without baseline prediabetes, arsenic exposure was associated with incident diabetes. Low MMA% was cross-sectional and prospectively associated with higher HOMA2-IR. Research is needed to confirm possible interactions of arsenic metabolism with B vitamins and AS3MT variants on diabetes risk.

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Walking to a pathway for cardiovascular effects of air pollution.

Thurston GD, Newman JD.

Lancet. 2017 Dec 5. pii: S0140-6736(17)33078-7. doi: 10.1016/S0140-6736(17)33078-7. [Epub ahead of print] No abstract available.

PMID: 29221647 Free Article

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33078-7/fulltext

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Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study.

Sinharay R, Gong J, Barratt B, Ohman-Strickland P, Ernst S, Kelly F, Zhang JJ, Collins P, Cullinan P, Chung KF.

Lancet. 2017 Dec 5. pii: S0140-6736(17)32643-0. doi: 10.1016/S0140-6736(17)32643-0. [Epub ahead of print]

PMID: 29221643 Free Article

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32643-0/fulltext

Abstract

BACKGROUND:

Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults.

METHODS:

In this randomised, crossover study, we recruited men and women aged 60 years and older with angiographically proven stable ischaemic heart disease or stage 2 Global initiative for Obstructive Lung Disease (GOLD) COPD who had been clinically stable for 6 months, and age-matched healthy volunteers. Individuals with ischaemic heart disease or COPD were recruited from existing databases or outpatient respiratory and cardiology clinics at the Royal Brompton & Harefield NHS Foundation Trust and age-matched healthy volunteers using advertising and existing databases. All participants had abstained from smoking for at least 12 months and medications were taken as recommended by participants' doctors during the study. Participants were randomly assigned by drawing numbered disks at random from a bag to do a 2 h walk either along a commercial street in London (Oxford Street) or in an urban park (Hyde Park). Baseline measurements of participants were taken before the walk in the hospital laboratory. During each walk session, black carbon, particulate matter (PM) concentrations, ultrafine particles, and nitrogen dioxide (NO2) concentrations were measured.

FINDINGS:

Between October, 2012, and June, 2014, we screened 135 participants, of whom 40 healthy volunteers, 40 individuals with COPD, and 39 with ischaemic heart disease were recruited. Concentrations of black carbon, NO2, PM10, PM2.5, and ultrafine particles were higher on Oxford Street than in Hyde Park. Participants with COPD reported more cough (odds ratio [OR] 1·95, 95% CI 0·96-3·95; p<0·1), sputum (3·15, 1·39-7·13; p<0·05), shortness of breath (1·86, 0·97-3·57; p<0·1), and wheeze (4·00, 1·52-10·50; p<0·05) after walking down Oxford Street compared with Hyde Park. In all participants, irrespective of their disease status, walking in Hyde Park led to an increase in lung function (forced expiratory volume in the first second [FEV1] and forced vital capacity [FVC]) and a decrease in pulse wave velocity (PWV) and augmentation index up to 26 h after the walk. By contrast, these beneficial responses were attenuated after walking on Oxford Street. In participants with COPD, a reduction in FEV1 and FVC, and an increase in R5-20 were associated with an increase in during-walk exposure to NO2, ultrafine particles and PM2.5, and an increase in PWV and augmentation index with NO2 and ultrafine particles. In healthy volunteers, PWV and augmentation index were associated both with black carbon and ultrafine particles.

INTERPRETATION:

Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects.

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Age, Race, and Gender Factors in Incident Disability.

Jacob ME, Marron MM, Boudreau RM, Odden MC, Arnold AM, Newman AB.

J Gerontol A Biol Sci Med Sci. 2018 Jan 16;73(2):194-197. doi: 10.1093/gerona/glx194.

PMID: 29045556

Abstract

BACKGROUND:

Incident disability rates enable the comparison of risk across populations. Understanding these by age, sex, and race is important for planning for the care of older adults and targeting prevention.

METHODS:

We calculated incident disability rates among older adults in the Cardiovascular Health Study, a study of 5,888 older adults aged ≥ 65 years over 6 years of follow-up. Disability was defined in the following two ways: (i) self-report of disability (severe difficulty or inability) in any of six Activities of Daily Living (ADL), and (ii) mobility difficulty (any difficulty walking half a mile or climbing 10 steps). Incident disability rates were calculated as events per 100 person years for age, gender, and race groups.

RESULTS:

The incidence of ADL disability, and mobility difficulty were 2.7 (2.5-2.8), and 9.8 (9.4-10.3) events per 100 person years. Women, older participants, and blacks had higher rates in both domains.

CONCLUSION:

Incidence rates are considerably different based on the domain examined as well as age, race, and gender composition of the population. Prevention efforts should focus on high risk populations and attempt to ameliorate factors that increase risk in these groups.

KEYWORDS:

Disablement process; Health disparities; Minority aging; Physical function

 

Body Mass Index and Decline in Cognitive Function in Older Black and White Persons.

Arvanitakis Z, Capuano AW, Bennett DA, Barnes LL.

J Gerontol A Biol Sci Med Sci. 2018 Jan 16;73(2):198-203. doi: 10.1093/gerona/glx152.

PMID: 28961897

Abstract

BACKGROUND:

While body mass index (BMI) is higher in black compared to white persons, little is known about BMI and change in cognition in cohorts with a large proportion of blacks. We examine relations of BMI with decline in global cognition and five cognitive domains, in older blacks and whites, and determine whether relations differ by race.

METHODS:

Participants were 2,134 persons without baseline dementia (33% black; 75% women; mean age =77.9 [range 53-100] and education = 14.7 years, Mini-Mental State Examination = 28.0), enrolled in one of two longitudinal, community-based cohort studies of aging (Minority Aging Research Study; Rush Memory and Aging Project). Summary scores of global cognition and five domains were based on 19 neuropsychological tests administered annually. Mixed-effects models, controlling for age, sex, education, and race, were used to examine the relation of baseline BMI to change in cognition.

RESULTS:

Baseline BMI = 28.4 units (30.3 in blacks [95% confidence interval (CI): 27.2-27.7]; 27.4 in whites [95% CI: 29.8-30.7]). During a mean annual follow-up of 6 years (SD = 4), lower baseline BMI was related to faster decline in global cognition (p = .002), and semantic memory (p < .001) and episodic memory (p = .004), but not working memory, perceptual speed, or visuospatial ability (all p > .08). The relationship of BMI with change in cognition was not modified by race (all p > .09).

CONCLUSIONS:

Late-life lower BMI relates to faster rates of decline in cognition, specifically semantic memory and episodic memory, in both blacks and whites. The effect of BMI on cognition appears to be similar in both racial groups.

KEYWORDS:

Body mass index; Cognitive decline; Cohort; Memory; Race

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Sulfur amino acid restriction-induced changes in redox-sensitive proteins are associated with slow protein synthesis rates.

Nichenametla SN, Mattocks DAL, Malloy VL, Pinto JT.

Ann N Y Acad Sci. 2018 Jan 29. doi: 10.1111/nyas.13556. [Epub ahead of print]

PMID: 29377163

Abstract

The mechanisms underlying life span extension by sulfur amino acid restriction (SAAR) are unclear. Cysteine and methionine are essential for the biosynthesis of proteins and glutathione (GSH), a major redox buffer in the endoplasmic reticulum (ER). We hypothesized that SAAR alters protein synthesis by modulating the redox milieu. Male F344-rats were fed control (CD: 0.86% methionine without cysteine) and SAAR diets (0.17% methionine without cysteine) for 12 weeks. Growth rates, food intake, cysteine and GSH levels, proteins associated with redox status and translation, and fractional protein synthesis rates (FSRs) were determined in liver. Despite a 40% higher food intake, growth rates for SAAR rats were 27% of those fed CD. Hepatic free cysteine in SAAR rats was 55% compared with CD rats. SAAR altered tissue distribution of GSH, as hepatic and erythrocytic levels were 56% and 196% of those in CD rats. Lower GSH levels did not induce ER stress (i.e., unchanged expression of Xbp1s , Chop, and Grp78), but activated PERK and its substrates eIF2-α and NRF2. SAAR-induced changes in translation-initiation machinery (higher p-eIF2-α and 4E-BP1, and lower eIF4G-1) resulted in slower protein synthesis rates (53% of CD). Proteins involved in the antioxidant response (NRF2, KEAP1, GCLM, and NQO1) and protein folding (PDI and ERO1-α) were increased in SAAR. Lower FSR and efficient protein folding might be improving proteostasis in SAAR.

KEYWORDS:

NRF2; cysteine; endoplasmic reticulum; life span; protein turnover

 

Cardioprotective effects of dietary rapamycin on adult female C57BLKS/J-Lepr<sup>db</sup> mice.

Reifsnyder PC, Ryzhov S, Flurkey K, Anunciado-Koza RP, Mills I, Harrison DE, Koza RA.

Ann N Y Acad Sci. 2018 Jan 29. doi: 10.1111/nyas.13557. [Epub ahead of print]

PMID: 29377150

Abstract

Rapamycin (RAPA), an inhibitor of mTORC signaling, has been shown to extend life span in mice and other organisms. Recently, animal and human studies have suggested that inhibition of mTORC signaling can alleviate or prevent the development of cardiomyopathy. In view of this, we used a murine model of type 2 diabetes (T2D), BKS-Leprdb , to determine whether RAPA treatment can mitigate the development of T2D-induced cardiomyopathy in adult mice. Female BKS-Leprdb mice fed diet supplemented with RAPA from 11 to 27 weeks of age showed reduced weight gain and significant reductions of fat and lean mass compared with untreated mice. No differences in plasma glucose or insulin levels were observed between groups; however, RAPA-treated mice were more insulin sensitive (P < 0.01) than untreated mice. Urine albumin/creatinine ratio was lower in RAPA-treated mice, suggesting reduced diabetic nephropathy and improved kidney function. Echocardiography showed significantly reduced left ventricular wall thickness in mice treated with RAPA compared with untreated mice (P = 0.02) that was consistent with reduced heart weight/tibia length ratios, reduced myocyte size and cardiac fibrosis measured by histomorphology, and reduced mRNA expression of Col1a1, a marker for cardiomyopathy. Our results suggest that inhibition of mTORC signaling is a plausible strategy for ameliorating complications of obesity and T2D, including cardiomyopathy.

KEYWORDS:

cardiomyopathy; diabetes; mTORC; obesity; rapamycin

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Coffee or Tea? A prospective cohort study on the associations of coffee and tea intake with overall and cause-specific mortality in men versus women.

van den Brandt PA.

Eur J Epidemiol. 2018 Jan 27. doi: 10.1007/s10654-018-0359-y. [Epub ahead of print]

PMID: 29380105

Abstract

Coffee and tea intake have been associated with reduced mortality, but no studies have investigated possible substitution effects. The relationship of mortality with coffee, tea, and substituting coffee with tea was investigated in the Netherlands Cohort Study. In 1986, 120,852 men and women aged 55-69 years provided information on dietary and lifestyle habits. Mortality follow-up until 1996 consisted of linkage to Statistics Netherlands. Multivariate case-cohort analyses were based on 8665 deaths and 3166 subcohort members with complete data on coffee, tea and confounders. Higher coffee intake was significantly, nonlinearly related to lower overall and cause-specific mortality in women. In men, coffee was significantly positively related to cancer and cardiovascular mortality, and inversely to respiratory and other causes of death. Tea intake was significantly, nonlinearly related to lower overall, cancer and cardiovascular mortality in men, but showed no association with mortality in women. In substitution analyses, increasing the proportion tea (replacing coffee with tea) was significantly and nonlinearly related to lower overall, cancer and cardiovascular mortality in men, but in women higher tea proportions were positively associated with overall mortality (and most causes of death). This study suggests that for men, compared to exclusive coffee drinkers, those drinking 30-50% tea showed the lowest mortality; any tea drinking seemed better than only coffee. For women, those who drank exclusively coffee or drinking up to 40% tea had the lowest mortality, but those drinking higher percentages of tea were at increased mortality risk [hr 1.41 (95% CI 1.01-1.99) for 80-100% tea compared to exclusive coffee drinkers].

KEYWORDS:

Cardiovascular diseases; Coffee; Cohort studies; Mortality; Neoplasms; Tea

 

Dietary sodium to potassium ratio and the incidence of hypertension and cardiovascular disease: A population-based longitudinal study.

Mirmiran P, Bahadoran Z, Nazeri P, Azizi F.

Clin Exp Hypertens. 2018 Jan 30:1-8. doi: 10.1080/10641963.2018.1431261. [Epub ahead of print]

PMID: 29381403

Abstract

OBJECTIVE:

There is an interaction between dietary sodium/potassium intake in the pathogenesis of hypertension (HTN) and cardiovascular disease (CVD). The aim of this study was to investigate the association of dietary sodium to potassium (Na/K) ratio and the risk of HTN and CVD in a general population of Iranian adults.

METHODS:

In this prospective cohort study, adults men and women with complete baseline data were selected from among participants of the Tehran Lipid and Glucose Study and were followed up for 6.3 years for incidence of HTN and CVD outcomes. Dietary sodium and potassium were assessed using a valid and reliable 168-item food frequency questionnaire. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between dietary sodium, potassium and their ratio and risk of outcomes.

RESULTS:

During the study follow-up, 291 (15.1%) and 79 (5.0%) new cases of HTN and CVD were identified, respectively. No significant association was observed between usual intakes of sodium, potassium and dietary Na/K ratio with the incidence of HTN. There was no significant association between dietary intakes of sodium and potassium per se and the risk of CVD, whereas when dietary sodium to potassium ratio was considered as exposure in the fully-adjusted Cox regression model, and participants in the highest compared to lowest tertile had a significantly increased risk of CVD (HR = 2.19, 95% CI = 1.16-4.14).

CONCLUSIONS:

Our findings suggest that high dietary Na/K ratio could contribute to increased risk of CVD events.

KEYWORDS:

Dietary sodium; cardiovascular disease; dietary potassium; hypertension

 

Sex-specific differences in hypertension and associated cardiovascular disease.

Colafella KMM, Denton KM.

Nat Rev Nephrol. 2018 Jan 30. doi: 10.1038/nrneph.2017.189. [Epub ahead of print] Review.

PMID: 29380817

Abstract

Although intrinsic mechanisms that regulate arterial blood pressure (BP) are similar in men and women, marked variations exist at the molecular, cellular and tissue levels. These physiological disparities between the sexes likely contribute to differences in disease onset, susceptibility, prevalence and treatment responses. Key systems that are important in the development of hypertension and cardiovascular disease (CVD), including the sympathetic nervous system, the renin-angiotensin-aldosterone system and the immune system, are differentially activated in males and females. Biological age also contributes to sexual dimorphism, as premenopausal women experience a higher degree of cardioprotection than men of similar age. Furthermore, sex hormones such as oestrogen and testosterone as well as sex chromosome complement likely contribute to sex differences in BP and CVD. At the cellular level, differences in cell senescence pathways may contribute to increased longevity in women and may also limit organ damage caused by hypertension. In addition, many lifestyle and environmental factors - such as smoking, alcohol consumption and diet - may influence BP and CVD in a sex-specific manner. Evidence suggests that cardioprotection in women is lost under conditions of obesity and type 2 diabetes mellitus. Treatment strategies for hypertension and CVD that are tailored according to sex could lead to improved outcomes for affected patients.

 

Masked hypertension and cardiovascular outcomes: an updated systematic review and meta-analysis.

Palla M, Saber H, Konda S, Briasoulis A.

Integr Blood Press Control. 2018 Jan 5;11:11-24. doi: 10.2147/IBPC.S128947. eCollection 2018. Review.

PMID: 29379316

https://www.dovepress.com/masked-hypertension-and-cardiovascular-outcomes-an-updated-systematic--peer-reviewed-fulltext-article-IBPC

Abstract

BACKGROUND:

As many as one-third of individuals with normal office blood pressure (BP) are diagnosed with masked hypertension (HTN) based on ambulatory BP measurements (ABPM). Masked HTN is associated with higher risk of sustained HTN (SH) and increased cardiovascular morbidity.

METHODS:

The present study was designed to systematically review cohort studies and assess the effects of masked HTN compared to normotension and SH on cardiovascular events and all-cause mortality. We systematically searched the electronic databases, such as MEDLINE, PubMed, Embase, and Cochrane for prospective cohort studies, which evaluated participants with office and ambulatory and/or home BP.

RESULTS:

We included nine studies with a total number of 14729 participants (11245 normotensives, 3484 participants with masked HTN, 1984 participants with white-coat HTN, and 5143 participants with SH) with a mean age of 58 years and follow-up of 9.5 years. Individuals with masked HTN had significantly increased rates of cardiovascular events and all-cause mortality than normotensives and white-coat HTN and had lower rates of cardiovascular events than those with SH (odds ratio 0.61, 95% confidence interval 0.42-0.89; P=0.010; I2=84%). Among patients on antihypertensive treatment, masked HTN was associated with higher rates of cardiovascular events than in those with normotension and white-coat HTN and similar rates of cardiovascular events in those with treated SH.

CONCLUSION:

Prompt screening of high-risk individuals with home BP measurements and ABPM, the diagnosis of masked HTN, and the initiation of treatment, may mitigate the adverse cardiovascular effects of masked HTN.

KEYWORDS:

cardiovascular outcomes; masked hypertension; meta-analysis

 

Association between Body Mass Index and All-Cause Mortality among Oldest Old Chinese.

Wang J, Taylor AW, Zhang T, Appleton S, Shi Z.

J Nutr Health Aging. 2018;22(2):262-268. doi: 10.1007/s12603-017-0907-2.

PMID: 29380854

Abstract

OBJECTIVES:

To examine the association between BMI and all-cause mortality in the oldest old (≥80 years).

DESIGN:

The study used a prospective cohort study design.

SETTING:

Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011.

POPULATION:

8026 participants aged 80 years and older were followed every two to three years.

MEASUREMENTS:

Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up.

RESULTS:

The mean BMI was 19.8 (SD 4.5) kg/m2. The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality.

CONCLUSION:

Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese.

KEYWORDS:

Body mass index; Chinese; all-cause mortality; cohort study; older adults

 

Boosting Sirt4 gene activity extends healthy lifespan in fruit flies

January 29, 2018, Brown University

https://phys.org/news/2018-01-boosting-sirt4-gene-healthy-lifespan.html

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Sirt4 is a mitochondrial regulator of metabolism and lifespan in <i>Drosophila melanogaster</i>.

Wood JG, Schwer B, Wickremesinghe PC, Hartnett DA, Burhenn L, Garcia M, Li M, Verdin E, Helfand SL.

Proc Natl Acad Sci U S A. 2018 Jan 29. pii: 201720673. doi: 10.1073/pnas.1720673115. [Epub ahead of print]

PMID: 29378963

Abstract

Sirtuins are an evolutionarily conserved family of NAD+-dependent deacylases that control metabolism, stress response, genomic stability, and longevity. Here, we show the sole mitochondrial sirtuin in Drosophila melanogaster, Sirt4, regulates energy homeostasis and longevity. Sirt4 knockout flies have a short lifespan, with increased sensitivity to starvation and decreased fertility and activity. In contrast, flies overexpressing Sirt4 either ubiquitously or specifically in the fat body are long-lived. Despite rapid starvation, Sirt4 knockout flies paradoxically maintain elevated levels of energy reserves, including lipids, glycogen, and trehalose, while fasting, suggesting an inability to properly catabolize stored energy. Metabolomic analysis indicates several specific pathways are affected in Sirt4 knockout flies, including glycolysis, branched-chain amino acid metabolism, and impaired catabolism of fatty acids with chain length C18 or greater. Together, these phenotypes point to a role for Sirt4 in mediating the organismal response to fasting, and ensuring metabolic homeostasis and longevity.

KEYWORDS:

Sirt4; aging; metabolism; mitochondria; sirtuins

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Endogenous testosterone and mortality risk.

Meyer EJ, Wittert G.

Asian J Androl. 2018 Jan 30. doi: 10.4103/aja.aja_70_17. [Epub ahead of print] Review.

PMID: 29384142

Abstract

In men, obesity and metabolic complications are associated with lower serum testosterone (T) and dihydrotestosterone (DHT) and an increased risk of, and mortality from, multiple chronic diseases in addition to cardiovascular disease (CVD). The causal interrelationships between these factors remain a matter of debate. In men with untreated congenital and lifelong forms of hypogonadotropic hypogonadism, there appears to be no increased risk. Men with Klinefelter's syndrome have an increased risk of various types of cancers, as well as CVD, which persist despite T therapy. In the absence of pathology of the hypothalamic-pituitary-gonadal axis, the effect of modest reductions in serum T in aging men is unclear. The prevalence of low serum T concentrations is high in men with cancer, renal disease, and respiratory disease and is likely to be an indicator of severity of systemic disease, not hypogonadism. Some population-based studies have found low serum T to be associated with a higher risk of deaths attributed to cancer, renal disease, and respiratory disease, while others have not. Although a meta-analysis of longitudinal studies has shown an association between low serum T and all-cause mortality, marked heterogeneity between studies limited a firm conclusion. Therefore, while a decrease in T particularly occurring later in life may be associated with an increase in all-cause and specific types of mortality in men, the differential effects, if any, of T and other sex steroids as compared to health and lifestyle factors are unknown at the current time.

 

Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort.

Hatch EE, Wesselink AK, Hahn KA, Michiel JJ, Mikkelsen EM, Sorensen HT, Rothman KJ, Wise LA.

Epidemiology. 2018 Jan 30. doi: 10.1097/EDE.0000000000000812. [Epub ahead of print]

PMID: 29384791

Abstract

Dietary factors, including sugar-sweetened beverages, may have adverse effects on fertility. Sugar-sweetened beverages have been associated with poor semen quality in cross-sectional studies, and female soda intake has been associated with lower fecundability in some, but not all, studies. We evaluated the association of female and male sugar-sweetened beverage intake with fecundability among 3828 women planning pregnancy and 1045 of their male partners in a North American prospective cohort study. We followed participants enrolled between June 2013 and May 2017 until pregnancy or for up to twelve menstrual cycles. Eligible women were aged 21-45 years (male partners ≥21), attempting conception for ≤6 cycles, and not using fertility treatments. Participants completed a comprehensive baseline questionnaire, including questions on soda (sugar-sweetened and diet), fruit juice, energy, and sports drink consumption during the previous 4 weeks. We estimated time-to-pregnancy from follow-up questionnaires completed every 2 months by the female partner. We calculated adjusted fecundability ratios (FR) and 95% confidence intervals (CIs) according to intake of sugar-sweetened beverages using proportional probabilities regression. Both female and male intakes of sugar-sweetened beverages were associated with reduced fecundability (FR= 0.81; 95% CI: 0.70, 0.94 and 0.78; 95% CI: 0.63, 0.95 for ≥ 7 sugar-sweetened beverages per week compared with none, for females and males, respectively). Fecundability was further reduced among those who drank ≥7 servings per week of sugar-sweetened sodas (FR= 0.75, 95% CI: 0.59, 0.95 for females and 0.67, 95% CI: 0.51, 0.89 for males). Diet soda had little association with fecundability.

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The effects of diurnal intermittent fasting on the wake-promoting neurotransmitter orexin-A.

Almeneessier AS, Alzoghaibi M, BaHammam AA, Ibrahim MG, Olaish AH, Nashwan SZ, BaHammam AS.

Ann Thorac Med. 2018 Jan-Mar;13(1):48-54. doi: 10.4103/atm.ATM_181_17.

PMID: 29387256

Abstract

BACKGROUND:

Food restriction has been demonstrated to increase the alertness in different species and to increase the levels of the wake-promoting neurotransmitter orexin. We hypothesized that diurnal intermittent fasting (DIF) increases orexin-A levels during fasting. Therefore, we conducted this study to assess the effects of DIF, during the month of Ramadan, on orexin, while controlling for lifestyle changes that may accompany Ramadan such as sleep duration, bedtime and wake time, energy expenditure, light exposure, and food.

METHODS:

Eight young healthy volunteers (mean age, 25.4 ± 3.5 years) reported to the laboratory on three occasions: (1) 4 weeks before Ramadan while performing DIF for 1 week outside the month of Ramadan (fasting outside Ramadan); (2) 1 week before Ramadan (nonfasting baseline) (BL); and (3) during the 2nd week of Ramadan while performing DIF (Ramadan). Plasma levels of orexin-A were measured using an enzyme immunoassay five times at 22:00, 02:00, 04:00, 06:00, and 11:00. Caloric intake, light exposure, and sleep schedule were maintained during the participants' stays in the laboratory in the three study periods.

RESULTS:

Orexin-A levels increased in the daytime during fasting and decreased at night compared to BL. The differences in orexin-A levels between DIF and BL were significant at 06:00, 11:00, 22:00, and 02:00.

CONCLUSIONS:

DIF increases orexin-A levels in the plasma during fasting hours. This finding supports findings from animal studies showing that fasting increases alertness.

KEYWORDS:

Hypocretin; Ramadan; intermittent fasting; orexin; sleep; vigilance

 

Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study.

Cho J, Lee I, Park SH, Jin Y, Kim D, Kong JY, Kang H.

Biomed Res Int. 2017;2017:1903589. doi: 10.1155/2017/1903589. Epub 2017 Dec 14.

PMID: 29387717

https://www.hindawi.com/journals/bmri/2017/1903589/

Abstract

BACKGROUND:

Little is known regarding the effects of socioeconomic status (SES) and frailty on mortality in Korea.

OBJECTIVE:

This study investigated the combined impact of low SES and frailty on all-cause mortality in Korean older adults.

METHODS:

Study sample at baseline comprised 7,960 community-dwelling adults (56.8% women) aged 65 years and older. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of low SES and frailty for all-cause mortality.

RESULTS:

Overall, low SES plus frailty resulted in an increased risk of all-cause mortality (HR = 1.56, 95% CI = 1.09-2.23, P = 0.015) even after adjustments for all the measured covariates, as compared with high SES plus nonfrailty (HR = 1). Among older adults aged 65-75 years, the increased mortality risk of either low SES plus nonfrailty (HR = 1.37, 95% CI = 1.02-1.84, P = 0.038) or high SES plus frailty (HR = 2.09, 95% CI = 1.12-3.91, P = 0.021) remained significant even after adjustments for all the covariates, as compared with high SES plus nonfrailty (HR = 1).

CONCLUSION:

The current findings suggest that either low SES or frailty is significantly associated with increased all-cause mortality in Korean older adults.

 

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks: Meta-analysis of 10 Trials Involving 77 917 Individuals.

Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P, Chew EY, Bosch J, Collins R, Lewington S, Armitage J, Clarke R; Omega-3 Treatment Trialists’ Collaboration.

JAMA Cardiol. 2018 Jan 31. doi: 10.1001/jamacardio.2017.5205. [Epub ahead of print]

PMID: 29387889

Abstract

IMPORTANCE:

Current guidelines advocate the use of marine-derived omega-3 fatty acids supplements for the prevention of coronary heart disease and major vascular events in people with prior coronary heart disease, but large trials of omega-3 fatty acids have produced conflicting results.

OBJECTIVE:

To conduct a meta-analysis of all large trials assessing the associations of omega-3 fatty acid supplements with the risk of fatal and nonfatal coronary heart disease and major vascular events in the full study population and prespecified subgroups.

DATA SOURCES AND STUDY SELECTION:

This meta-analysis included randomized trials that involved at least 500 participants and a treatment duration of at least 1 year and that assessed associations of omega-3 fatty acids with the risk of vascular events.

DATA EXTRACTION AND SYNTHESIS:

Aggregated study-level data were obtained from 10 large randomized clinical trials. Rate ratios for each trial were synthesized using observed minus expected statistics and variances. Summary rate ratios were estimated by a fixed-effects meta-analysis using 95% confidence intervals for major diseases and 99% confidence intervals for all subgroups.

MAIN OUTCOMES AND MEASURES:

The main outcomes included fatal coronary heart disease, nonfatal myocardial infarction, stroke, major vascular events, and all-cause mortality, as well as major vascular events in study population subgroups.

RESULTS:

Of the 77 917 high-risk individuals participating in the 10 trials, 47 803 (61.4%) were men, and the mean age at entry was 64.0 years; the trials lasted a mean of 4.4 years. The associations of treatment with outcomes were assessed on 6273 coronary heart disease events (2695 coronary heart disease deaths and 2276 nonfatal myocardial infarctions) and 12 001 major vascular events. Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with coronary heart disease death (rate ratio [RR], 0.93; 99% CI, 0.83-1.03; P = .05), nonfatal myocardial infarction (RR, 0.97; 99% CI, 0.87-1.08; P = .43) or any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = .12). Neither did randomization to omega-3 fatty acid supplementation have any significant associations with major vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = .10), overall or in any subgroups, including subgroups composed of persons with prior coronary heart disease, diabetes, lipid levels greater than a given cutoff level, or statin use.

CONCLUSIONS AND RELEVANCE:

This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.

 

Serum Metabolomic Profiling of All-Cause Mortality: A Prospective Analysis in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study Cohort.

Huang J, Weinstein SJ, Moore SC, Derkach A, Hua X, Liao LM, Gu F, Mondul AM, Sampson JN, Albanes D.

Am J Epidemiol. 2018 Jan 30. doi: 10.1093/aje/kwy017. [Epub ahead of print]

PMID: 29390044

Abstract

Tobacco use, hypertension, hyperglycemia, overweight, and inactivity are leading causes of overall and cardiovascular disease (CVD) mortality worldwide, yet the relevant metabolic alterations responsible are largely unknown. We conducted a serum metabolomic analysis of 620 men in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1985-2013). During 28 years of follow-up, there were 435 deaths (197 CVD and 107 cancer). The analysis included 406 known metabolites measured with ultra-high performance liquid chromatography/mass spectrometry-gas chromatography/mass spectrometry. Cox regression estimated mortality hazard ratios (HR) for a one standard-deviation difference in metabolite-signals, and we divided the data into training and test-sets, creating a metabolite risk score of the strongest metabolites in the former to test in the latter. The strongest associations with overall mortality were N-acetylvaline (HR=1.28; P<4.1×10-5, below Bonferroni statistical threshold), and dimethylglycine, 7-methylguanine, C-glycosyltryptophan, taurocholate, and N-acetyltryptophan (1.23≤HR≤1.32; 5×10-5≤P≤1×10-4). C-Glycosyltryptophan, 7-methylguanine, and 4-androsten-3beta,17beta-diol disulfate were statistically significantly associated with CVD mortality (1.49≤HR≤1.62, P<4.1×10-5). No metabolite was associated with cancer mortality at false discovery rate<0.1. Individuals with a one standard-deviation higher metabolite risk score had increased all-cause and CVD mortality in the test-set (HR=1.4, P=0.05; HR=1.8, P=0.003, respectively). The several serum metabolites and their composite risk score independently associated with all-cause and CVD mortality may provide potential leads regarding the molecular basis of mortality.

KEYWORDS:

7-methylguanine; C-glycosyltryptophan; N-acetylvaline; all-cause mortality; bile acids; cardiovascular disease mortality; dimethylglycine; serum metabolomics

 

Adherence to diet recommendations and risk of abdominal aortic aneurysm in the Malmö Diet and Cancer Study.

Nordkvist S, Sonestedt E, Acosta S.

Sci Rep. 2018 Jan 31;8(1):2017. doi: 10.1038/s41598-018-20415-z.

PMID: 29386636

Abstract

The research examining the association between quality of diet and abdominal aortic aneurysm (AAA) is scarce. The aim of the present study was to explore the association between diet quality and development of AAA for middle-aged individuals in the Malmö Diet and Cancer Study (MDCS), a prospective cohort study with baseline data collection carried out between 1991 and 1996. At baseline, the study participants who were eligible for this study (n = 26133) documented their dietary habits in a food diary and questionnaire. Incident AAA cases during an average of 20.7 years of follow-up were identified by using registers. A diet quality index consisting of six components, saturated fat, polyunsaturated fat, fibre, sucrose, fruits and vegetables and fish and shellfish, was used to assess the diet quality. After adjusting for potential confounders, the diet quality index was not associated with incident AAA. However, a tendency of decreased risk was observed among individuals adhering to recommendations for fruit and vegetables compared with non-adherence. When comparing the risk of more extreme intake groups, high intakes of both fruits and vegetables were associated with decreased risk.

 

Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies.

Rosique-Esteban N, Guasch-Ferré M, Hernández-Alonso P, Salas-Salvadó J.

Nutrients. 2018 Feb 1;10(2). pii: E168. doi: 10.3390/nu10020168. Review.

PMID: 29389872

Abstract

Magnesium (Mg) is an essential dietary element for humans involved in key biological processes. A growing body of evidence from epidemiological studies, randomized controlled trials (RCTs) and meta-analyses have indicated inverse associations between Mg intake and cardiovascular diseases (CVD). The present review aims to summarize recent scientific evidence on the topic, with a focus on data from epidemiological studies assessing the associations between Mg intake and major cardiovascular (CV) risk factors and CVD. We also aimed to review current literature on circulating Mg and CVD, as well as potential biological processes underlying these observations. We concluded that high Mg intake is associated with lower risk of major CV risk factors (mainly metabolic syndrome, diabetes and hypertension), stroke and total CVD. Higher levels of circulating Mg are associated with lower risk of CVD, mainly ischemic heart disease and coronary heart disease. Further, RCTs and prospective studies would help to clarify whether Mg intake and Mg circulating levels may also protect against other CVDs and CVD death.

KEYWORDS:

cardiovascular; death; epidemiological studies; inflammation; magnesium; metabolic syndrome; mortality; oxidation; type 2 diabetes

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Does dietary fluid intake affect skin hydration in healthy humans? A systematic literature review.

Akdeniz M, Tomova-Simitchieva T, Dobos G, Blume-Peytavi U, Kottner J.

Skin Res Technol. 2018 Feb 2. doi: 10.1111/srt.12454. [Epub ahead of print]

PMID: 29392767

Abstract

BACKGROUND:

Associations between daily amounts of drinking water and skin hydration and skin physiology receive increasingly attention in the daily life and in clinical practice. However, there is a lack of evidence of dermatological benefits from drinking increased amounts of water.

MATERIALS AND METHODS:

Pubmed and Web of Science were searched without any restrictions of publication dates. References of included papers and related reviews were checked. Eligibility criteria were primary intervention and observational studies investigating the effects of fluid intake on skin properties in English, German, Spanish or Portuguese language, including subjects being healthy and 18+ years.

RESULTS:

Searches resulted in 216 records, 23 articles were read in full text, and six were included. The mean age of the samples ranged from 24 to 56 years. Overall the evidence is weak in terms of quantity and methodological quality. Disregarding the methodological limitations a slight increase in stratum corneum and "deep" skin hydration was observed after additional water intake, particularly in individuals with lower prior water consumption. Reductions of clinical signs of dryness and roughness were observed. The extensibility and elasticity of the skin increased slightly. Unclear associations were shown between water intake and transepidermal water loss, sebum content, and skin surface pH.

CONCLUSIONS:

Additional dietary water intake may increase stratum corneum hydration. The underlying biological mechanism for this possible relationship is unknown. Whether this association also exists in aged subjects is unclear. Research is needed to answer the question whether increased fluid intake decreases signs of dry skin.

KEYWORDS:

drinking; fluid intake; skin barrier; skin hydration; skin physiology; transepidermal water loss; water

 

Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umeå85+/GERDA.

Weidung B, Toots A, Nordström P, Carlberg B, Gustafson Y.

Medicine (Baltimore). 2017 Dec;96(51):e9161. doi: 10.1097/MD.0000000000009161.

PMID: 29390448

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5758150/

Abstract

Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umeå85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and ≥95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umeå85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean change ± standard deviation in SBP was -12 ± 25 mm Hg. SBP decline was associated independently with later investigation year (P = .009), higher baseline SBP (P < .001), baseline antidepressant prescription (P = .011), incident acute myocardial infarction during follow-up (P = .003), new diuretic prescription during follow-up (P = .044), and a decline in the Barthel Activities of Daily Living index at follow-up (P < .001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors.

 

High plasma adiponectin levels are associated with frailty in a general old-old population: The Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study.

Nagasawa M, Takami Y, Akasaka H, Kabayama M, Maeda S, Yokoyama S, Fujimoto T, Nozato Y, Imaizumi Y, Takeda M, Itoh N, Takeya Y, Yamamoto K, Sugimoto K, Nakagawa T, Masui Y, Arai Y, Ishizaki T, Ikebe K, Gondo Y, Kamide K, Rakugi H.

Geriatr Gerontol Int. 2018 Feb 2. doi: 10.1111/ggi.13258. [Epub ahead of print]

PMID: 29392822

Abstract

AIM:

The objective of the present study was to investigate the association between frailty and plasma adiponectin levels in a general population of Japanese older adults.

METHODS:

The volunteer older adults, aged approximately 83 years, were recruited randomly from a general population in the Japanese Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians study. We used the modified Cardiovascular Health Study criteria to assess the frailty status of the study participants. The study participants were classified as non-frail, pre-frail and frail according to their physical activities. We compared plasma adiponectin levels among these three groups and applied a multivariate logistic regression analysis including plasma adiponectin levels to clarify the factors associated with frailty status in the cross-sectional design.

RESULTS:

The mean age of the participants was 83.1 ± 0.9 years, and 51.8% were men. The frailty index was available to assess 353 participants, of whom 24.6% were classified as non-frail, 62.3% as prefrail and 13.0% as frail. The log-transformed plasma adiponectin levels increased stepwise in the following order: non-frail, pre-frail and frail. A multivariate logistic regression analysis showed that higher plasma adiponectin levels, a higher estimated glomerular filtration rate and lower hemoglobin levels were independent determinants for pre-frail/frail status compared with non-frail status.

CONCLUSIONS:

The present study showed that higher plasma adiponectin levels were associated with frailty status in older Japanese adults in the general population. Further longitudinal study is essential to clarify the role of plasma adiponectin in the progression of frailty.

KEYWORDS:

Japanese; adiponectin; cross-sectional study; elderly; frailty

 

Sleep lengthening in late adulthood signals increased risk of mortality.

Soh AZ, Chee MWL, Yuan JM, Koh WP.

Sleep. 2018 Feb 1. doi: 10.1093/sleep/zsy005. [Epub ahead of print]

PMID: 29394410

Abstract

STUDY OBJECTIVES:

Epidemiological evidence indicates that both short and long sleep at midlife increase mortality risk, but few studies have examined how change in sleep duration between midlife and later life affects this risk. We examined the association between change in sleep duration and mortality risk.

METHODS:

The Singapore Chinese Health Study is a prospective cohort of 63257 Chinese in Singapore aged 45-74 years at recruitment (1993-1998). Self-reported sleep duration was collected from 39523 participants who completed both baseline (mean age 54.8 years) and follow-up II (mean age 67.9 years; 2006-2010) interviews, which were on average 12.7 years apart. Mortality data were obtained via linkage with national death registry up to December 31, 2015.

RESULTS:

Compared with participants who reported sleeping the recommended duration (7 hr) at both interviews, those with persistently short sleep (≤5 hr) had increased risk of all-cause mortality (hazard ratio {HR} 1.27, 95% confidence interval [CI] 1.06-1.53). Similarly, those with persistently long sleep (≥9 hr) had increased risk of all-cause (HR 1.47, 95% CI 1.24-1.73) and cardiovascular (HR 1.40, 95% CI 1.04-1.89) mortality. The proportion of long-sleepers increased with aging (6%-23.7%). Progression to long sleep from short (HR 1.50, 95% CI 1.24-1.81) or recommended (HR 1.43, 95% CI 1.25-1.64) duration was associated with increased all-cause mortality, especially for cardiovascular mortality. Change in sleep duration was not linked to cancer mortality.

CONCLUSIONS:

Persistent short or long sleep or increasing sleep duration in late adulthood was associated with increased risk of all-cause mortality, especially from cardiovascular causes.

KEYWORDS:

mortality; sleep change; sleep duration

 

Intake of trace metals and the risk of incident kidney stones.

Ferraro PM, Gambaro G, Curhan GC, Taylor EN.

J Urol. 2018 Jan 29. pii: S0022-5347(18)30152-6. doi: 10.1016/j.juro.2018.01.077. [Epub ahead of print]

PMID: 29391176

Abstract

PURPOSE:

The association between intakes of trace metals and risk of incident stones has not been longitudinally investigated.

MATERIALS AND METHODS:

We performed a prospective analysis of 193,551 participants of the Health Professionals Follow-up Study (HPFS), Nurses' Health Study (NHS) I and II. During a follow-up of 3,316,580 person-years, there were 6,576 incident stones. We used multivariate regression models to identify associations between intakes of zinc, iron, copper and manganese and risk of stones. In a subset of participants with 24-hour urine collections, we examined the association between intake of trace metals and urine composition.

RESULTS:

After multivariate adjustment, total and dietary intakes of zinc and iron were not significantly associated with incident stones. Higher intake of manganese was associated with lower risk of stones; the pooled hazard ratio (HR) for the highest quintile of total manganese intake compared with the lowest was 0.82 (95% confidence interval [CI] 0.68, 0.98; p=0.02). Total but not dietary copper intake was marginally associated with higher risk of stones (pooled HR 1.14, 95% CI 1.02, 1.28; p=0.01). There were no statistically significant associations between total intakes of manganese and copper and urinary supersaturations.

CONCLUSIONS:

Intakes of zinc and iron were not associated with risk of stones. Copper intake may be associated with higher risk in some individuals. Higher total manganese intake was associated with lower risk of stones but not with traditional 24h urinary composite markers of stone risk. Further research is needed to elucidate mechanisms whereby manganese may reduce kidney stone formation.

 

Independent and combined effect of bilirubin and smoking on the progression of chronic kidney disease.

Wang J, Wang B, Liang M, Wang G, Li J, Zhang Y, Huo Y, Cui Y, Xu X, Qin X.

Clin Epidemiol. 2018 Jan 15;10:121-132. doi: 10.2147/CLEP.S150687. eCollection 2018.

PMID: 29391834

Abstract

OBJECTIVE:

Whether serum bilirubin and cigarette smoking affect the risk of renal function decline remains inconclusive. We aimed to test the independent and combined effects of bilirubin and cigarette smoking on the progression of chronic kidney disease (CKD) in hypertensive adults.

METHODS:

The study population consisted of 12,633 patients in the renal sub-study of the China Stroke Primary Prevention Trial. The primary outcome was progression of CKD, defined as a decrease in estimated glomerular filtration rate (eGFR) of ≥30% and to a level of <60 mL/min/1.73 m2 if baseline eGFR was ≥60 mL/min/1.73 m2, or a decrease in eGFR of ≥50% if baseline eGFR was <60 mL/min/1.73 m2, or end-stage renal disease. The secondary outcomes included 1) rapid decline in renal function and 2) annual rate of eGFR decline.

RESULTS:

The median follow-up duration was 4.4 years. Cigarette smoking had no significant effect on the progression of CKD (odds ratio [OR]: 1.11, 95% confidence interval [95% CI]: 0.78-1.57). However, a significantly lower risk of the primary event (OR: 0.72, 95% CI: 0.55-0.95) was found in participants in tertile 3 compared to those in tertiles 1-2 for total bilirubin (TBiL) levels. More importantly, there was an interaction between TBiL and smoking status on the primary outcome (P for interaction =0.013). Among ever smokers, TBiL levels had no significant effect on the primary outcome. However, among never smokers, higher TBiL levels were significantly associated with a lower risk of the primary outcome (tertile 3 vs 1-2; OR: 0.53, 95% CI: 0.36-0.78). Similar trends were observed for direct bilirubin and secondary outcomes.

CONCLUSION:

Among hypertensive patients, bilirubin was inversely associated with the progression of CKD in never smokers, but not in ever smokers.

KEYWORDS:

annual rate of eGFR decline; chronic kidney disease; cigarette smoking; hypertensive adults; rapid renal function decline; serum bilirubin

 

Oral Contraceptive Use and Risks of Cancer in the NIH-AARP Diet and Health Study.

Michels KA, Brinton LA, Pfeiffer RM, Trabert B.

Am J Epidemiol. 2018 Jan 31. doi: 10.1093/aje/kwx388. [Epub ahead of print]

PMID: 29394309

Abstract

Although use of oral contraceptives (OC) is common, their influence on carcinogenesis is not fully understood. We used Cox proportional hazards models to examine OC use (never/<1 year (reference), 1-4, 5-9, 10+ years) and development of incident cancers across body sites within the same base population: women in the prospective NIH-AARP Diet and Health Study (enrolled 1995-1996, followed until 2011). Adjustment for confounding varied by outcome; all models accounted for age, race, body mass index, and smoking status and included ≥100,000 women. Any OC use conferred a 3% reduction in the risk for any cancer (hazard ratio = 0.97, 95% confidence interval: 0.95, 0.99). Expected risk reductions that strengthened with duration of use were identified for ovarian and endometrial cancers and were suggested for kidney cancer (P-trends < 0.05). We noted reduced risk for non-Hodgkin lymphoma (hazard ratio = 0.79, confidence interval: 0.64, 0.97) with 10+ years of use. We observed a 37% reduced risk for bladder cancer and 46% increased risk for pancreatic cancer among long-term users who were ≤60 at baseline. OC use did not influence risks for most other cancers evaluated. Given the high prevalence of use and changing formulations, future studies are warranted to fully understand the chemopreventive effects of these medications.

KEYWORDS:

cancer; chemoprevention; epidemiology; oral contraceptives; prospective studies

Edited by AlPater

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AGING RESEARCH

Forever young? Naked mole rats may know the secret

Kai Kupferschmidt

Science 02 Feb 2018:

Vol. 359, Issue 6375, pp. 506-507

DOI: 10.1126/science.359.6375.506

Summary

A new paper claims that there may be no such thing as a maximum life span for naked mole rats. As these burrowing, sausage-shaped rodents grow older, their risk of dying does not seem to increase, defying a mathematical equation called the Gompertz law that describes aging in all known mammalian species. The new finding comes from the lab of Rochelle Buffenstein at Google biotech spinoff Calico in San Francisco, California, who has studied the animals since 1980. Other researchers say it's too early to say that naked mole rats don't age, but they agree something very unusual happens in the animals and welcome the treasure trove of life history data revealed in the paper.

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Naked Mole-Rat mortality rates defy gompertzian laws by not increasing with age.

Ruby JG, Smith M, Buffenstein R.

Elife. 2018 Jan 24;7. pii: e31157. doi: 10.7554/eLife.31157.

PMID: 29364116 Free PMC Article

Abstract

The longest-lived rodent, the naked mole-rat (Heterocephalus glaber), has a reported maximum lifespan of >30 years and exhibits delayed and/or attenuated age-associated physiological declines. We questioned whether these mouse-sized, eusocial rodents conform to Gompertzian mortality laws by experiencing an exponentially increasing risk of death as they get older. We compiled and analyzed a large compendium of historical naked mole-rat lifespan data with >3000 data points. Kaplan-Meier analyses revealed a substantial portion of the population to have survived at 30 years of age. Moreover, unlike all other mammals studied to date, and regardless of sex or breeding-status, the age-specific hazard of mortality did not increase with age, even at ages 25-fold past their time to reproductive maturity. This absence of hazard increase with age, in defiance of Gompertz's law, uniquely identifies the naked mole-rat as a non-aging mammal, confirming its status as an exceptional model for biogerontology.

KEYWORDS:

Gompertz; Heterocephalus glaber; aging; ecology; naked mole-rat

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Disease prevention and delayed aging by dietary sulfur amino acid restriction: translational implications.

Dong Z, Sinha R, Richie JP Jr..

Ann N Y Acad Sci. 2018 Feb 5. doi: 10.1111/nyas.13584. [Epub ahead of print] Review.

PMID: 29399808

Abstract

Sulfur amino acids (SAAs) play numerous critical roles in metabolism and overall health maintenance. Preclinical studies have demonstrated that SAA-restricted diets have many beneficial effects, including extending life span and preventing the development of a variety of diseases. Dietary sulfur amino acid restriction (SAAR) is characterized by chronic restrictions of methionine and cysteine but not calories and is associated with reductions in body weight, adiposity and oxidative stress, and metabolic changes in adipose tissue and liver resulting in enhanced insulin sensitivity and energy expenditure. SAAR-induced changes in blood biomarkers include reductions in insulin, insulin-like growth factor-1, glucose, and leptin and increases in adiponectin and fibroblast growth factor 21. On the basis of these preclinical data, SAAR may also have similar benefits in humans. While little is known of the translational significance of SAAR, its potential feasibility in humans is supported by findings of its effectiveness in rodents, even when initiated in adult animals. To date, there have been no controlled feeding studies of SAAR in humans; however, there have been numerous relevant epidemiologic and disease-based clinical investigations reported. Here, we summarize observations from these clinical investigations to provide insight into the potential effectiveness of SAAR for humans.

KEYWORDS:

aging; cysteine; metabolism; methionine; sulfur amino acid restriction

 

Fruit and vegetable consumption and risk of endometriosis.

Harris HR, Eke AC, Chavarro JE, Missmer SA.

Hum Reprod. 2018 Feb 1. doi: 10.1093/humrep/dey014. [Epub ahead of print]

PMID: 29401293

Abstract

STUDY QUESTION:

Is there an association between intake of fruits and vegetables and risk of laparoscopically confirmed endometriosis?

SUMMARY ANSWER:

Higher intake of fruits, particularly citrus fruits, is associated with a lower risk of endometriosis.

WHAT IS KNOWN ALREADY:

Two case-control studies have examined the associations between fruit and vegetable intake and endometriosis risk with contrasting results. Diets rich in fruits and vegetables include higher levels of pro-vitamin A nutrients (alpha-carotene, beta-carotene, beta-cryptoxanthin) and women with endometriosis have been reported to have lower intake of vitamin A than women without endometriosis.

STUDY DESIGN SIZE, DURATION:

A prospective cohort study using data collected from 70 835 premenopausal women from 1991 to 2013 as part of the Nurses' Health Study II cohort.

PARTICIPANTS/MATERIALS, SETTING, METHODS:

Diet was assessed with a validated food frequency questionnaire (FFQ) every 4 years. Cases were restricted to laparoscopically confirmed endometriosis. Cox proportional hazards models were used to calculate rate ratios (RR) and 95% CI.

MAIN RESULTS AND THE ROLE OF CHANCE:

During 840 012 person-years of follow-up, 2609 incident cases of laparoscopically confirmed endometriosis were reported (incidence rate = 311 per 100 000 person-years). We observed a non-linear inverse association between higher fruit consumption and risk of laparoscopically confirmed endometriosis (Psignificance of the curve = 0.005). This inverse association was particularly evident for citrus fruits. Women consuming ≥1 servings of citrus fruits/day had a 22% lower endometriosis risk (95% CI = 0.69-0.89; Ptrend = 0.004) compared to those consuming <1 serving/week. No association was observed between total vegetable intake and endometriosis risk. However, women consuming ≥1 servings/day cruciferous vegetables had a 13% higher risk of endometriosis (95% CI = 0.95-1.34; Ptrend = 0.03) compared to those consuming <1 serving/week. Of the nutrients examined, only beta-cryptoxanthin intake was significantly associated with lower endometriosis risk (RR fifth quintile = 0.88; 95% CI = 0.78-1.00; Ptrend = 0.02).

LIMITATIONS REASONS FOR CAUTION:

Some error in the self-reporting of dietary intake is expected, however, use of a validated FFQ and examining diet prospectively across multiple time points, make it unlikely that this non-differential misclassification strongly influenced the results.

WIDER IMPLICATIONS OF THE FINDINGS:

Our findings suggest that a higher intake of fruits, particularly citrus fruits, is associated with a lower risk of endometriosis, and beta-cryptoxanthin in these foods may partially explain this association. In contrast to what we hypothesized, consumption of some vegetables increased endometriosis risk which may indicate a role of gastrointestinal symptoms in both the presentation and exacerbation of endometriosis-related pain; however, it is not clear what components of these foods might underlie the observed associations. Future studies examining dietary patterns that consider different combinations of food intake may help clarify these associations.

KEYWORDS:

beta-cryptoxanthinIntroduction; diet; endometriosis; fruits; vegetables

 

Effects of weight changes in the autonomic nervous system: A systematic review and meta-analysis.

Costa J, Moreira A, Moreira P, Delgado L, Silva D.

Clin Nutr. 2018 Jan 9. pii: S0261-5614(18)30006-2. doi: 10.1016/j.clnu.2018.01.006. [Epub ahead of print]

PMID: 29395374

Abstract

BACKGROUND:

Obesity has been linked to autonomic dysfunction, which is thought to be one of the main contributors for hypertension, cardiac remodelling and death. Exercise and diet-based weight loss are the mainstay therapy for obesity, but there is a paucity of data regarding the effect of weight changes in autonomic nervous system (ANS) activity.

OBJECTIVE:

To describe the impact of weight changes in autonomic nervous system.

METHODS:

A systematic literature search of four biomedical databases was performed evaluating effects of weight changes, thorough diet and/or exercise-based interventions, in the following ANS outcomes: heart rate variability, namely low frequency (LF)/high frequency (HF) ratio (LF/HF ratio), normalized units of LF (LFnu) and HF (HFnu), muscle sympathetic nerve activity (MSNA), noradrenaline spillover rate (NA-SR), standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), baroreflex sensitivity and pupillometry. Quality appraisal was performed using the GRADE methodology and, where fitting, studies with comparable outcomes were pooled for meta-analysis.

RESULTS:

Twenty-seven studies - 7 controlled clinical trials and 20 observational studies - were included. Weight gain was reported in 4 studies and weight loss in all the other studies. Interventions inducing weight changes included: hypocaloric or hypercaloric diets, exercise (strength, endurance or aerobic training) and hypocaloric diet coupled with exercise programs. Most studies which resulted in weight loss reported decreases in LF/HF ratio, LFnu, MSNA burst frequency and incidence, NA-SR, and an increase of baroreflex sensitivity, HF, HFnu and RMSSD, pointing to a parasympathetic nervous system activation. Meta-analysis regarding weight loss interventions showed a significant pooled effect size (95% CI) with a decreased of MSNA burst frequency -5.09 (-8.42, -1.75), MSNA incidence -6.66 (-12.40, -0.62), however this was not significant for SDNN 14.32 (-4.31, 32.96). Weight gain was associated with an increase in LF/HF, LFnu, MSNA burst frequency and incidence. The weight loss effects were potentiated by the association of hypocaloric diet with exercise. Nevertheless, weight changes effects in these outcomes were based in low or very low quality of evidence.

CONCLUSIONS:

Diet and exercise based weight loss appears to increase parasympathetic and decrease sympathetic activity, the opposing effects being observed with weight gain. These findings are not uniformly reported in the literature, possibly due to differences in study design, methodology, characteristics of the participants and techniques used to estimate autonomic nervous activity.

KEYWORDS:

Autonomic nervous system; Baroreflex sensitivity; Heart rate variability; Muscle sympathetic nerve activity; Noradrenaline spillover rate; Weight change

 

Nonlinear dose-response association between body mass index and risk of all-cause and cardiovascular mortality in patients with hypertension: A meta-analysis.

Jayedi A, Shab-Bidar S.

Obes Res Clin Pract. 2018 Jan 30. pii: S1871-403X(18)30002-4. doi: 10.1016/j.orcp.2018.01.002. [Epub ahead of print] Review.

PMID: 29396230

Abstract

OBJECTIVE:

The present study examined the dose-response association of body mass index (BMI) and risk of all-cause and cardiovascular mortality in patients with existing hypertension.

METHOD:

A systematic search was done using PubMed and Scopus, from their inception up to January 25, 2017. Prospective and retrospective cohort studies reporting risk estimates of all-cause and cardiovascular mortality for three or more quantitative categories of BMI were included. Studies which reported results as continuous also were included. Pooled relative risks (RRs) were calculated using random effects models.

RESULTS:

Of initial 34,938 identified studies, 14 studies with a total of 489,222 hypertensive patients, involving 41,872 cases of all-cause mortality and 2,123 cases of cardiovascular mortality were included. A five-unit increment in BMI was associated with an 8% reduction in the risk of all-cause mortality (Pooled RR: 0.92, 95% CI: 0.87, 0.97, P=0.003; I2=95.7%, n=13), and marginally and inversely associated with the risk of cardiovascular mortality (Pooled RR: 0.95, 95% CI: 0.88, 1.02, P=0.15; I2=90.3%, n=5). Nonlinear dose-response meta-analysis suggested a reverse J-shaped association between BMI and risk of all-cause and cardiovascular mortality, with a nadir at BMI of ∼27.5-30kg/m2. Subgroup analysis indicated that the strength and shape of the association between BMI and all-cause mortality might be influenced by age.

CONCLUSION:

There is strong evidence which confirms existence of obesity paradox in patients with hypertension. However, owing to the observational nature of included studies, these findings should be interpreted with caution.

KEYWORDS:

Body mass index; Hypertension; Mortality; Obesity

 

Hormone Replacement Therapy and Colorectal Cancer Incidence and Mortality in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

Symer MM, Wong NZ, Abelson JS, Milsom JW, Yeo HL.

Clin Colorectal Cancer. 2018 Jan 12. pii: S1533-0028(17)30284-0. doi: 10.1016/j.clcc.2018.01.003. [Epub ahead of print]

PMID: 29398422

Abstract

INTRODUCTION:

Hormone replacement therapy has been shown to reduce colorectal cancer incidence, but its effect on colorectal cancer mortality is controversial. The objective of this study was to determine the effect of hormone replacement therapy on survival from colorectal cancer.

PATIENTS AND METHODS:

We performed a secondary analysis of data from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, a large multicenter randomized trial run from 1993 to 2001, with follow-up data recently becoming mature. Participants were women aged 55 to 74 years, without recent colonoscopy. Data from the trial were analyzed to evaluate colorectal cancer incidence, disease-specific mortality, and all-cause mortality based on subjects' use of hormone replacement therapy at the time of randomization: never, current, or former users.

RESULTS:

A total of 75,587 women with 912 (1.21%) incident colorectal cancers and 239 associated deaths were analyzed, with median follow-up of 11.9 years. Overall, 88.6% were non-Hispanic white, and < 10% had not completed high school. The never-user group was slightly older than the current or former user groups (average, 63.8 vs. 61.4 vs. 63.3 years; P < .001). Almost one-half (47.1%) of the current users had undergone hysterectomy, compared with 21.6% of never-users and 34.0% of former users (P < .001). Adjusted colorectal cancer incidence in current users compared to never-users was lower (hazard ratio {HR}, 0.81; 95% confidence interval [CI], 0.69-0.94; P = .005), as was death from colorectal cancer (HR, 0.63; 95% CI, 0.47-0.85; P = .002) and all-cause mortality (HR, 0.76; 95% CI, 0.72-0.80; P < .001).

CONCLUSIONS:

Hormone replacement therapy is associated with a reduced risk of colorectal cancer incidence and improved colorectal cancer-specific survival, as well as all-cause mortality.

KEYWORDS:

Colon; Colorectal neoplasms; Colorectal surgery; Early detection of cancer; Estrogen replacement therapy

 

A high whey protein, vitamin D and E supplement preserves muscle mass, strength, and quality of life in sarcopenic older adults: A double-blind randomized controlled trial.

Bo Y, Liu C, Ji Z, Yang R, An Q, Zhang X, You J, Duan D, Sun Y, Zhu Y, Cui H, Lu Q.

Clin Nutr. 2018 Jan 9. pii: S0261-5614(18)30007-4. doi: 10.1016/j.clnu.2017.12.020. [Epub ahead of print]

PMID: 29395372

Abstract

OBJECTIVE:

Sarcopenia, an age-related decline of muscle mass, strength, and physical function, was associated with falls, frailty, and poor quality of life. The aim of the current study is to examine the effect of nutritional supplement containing whey protein, vitamin D and E on measures of sarcopenia.

METHODS:

A total of 60 sarcopenic older adult subjects participated in the current randomized, double-blind, placebo-controlled (iso-caloric control product) trial for 6 months. Muscle mass [Relative skeletal mass index (RSMI) measured by bioimpedance analysis (BIA)], muscle strength (handgrip strength), physical function (6-m gait speed, chair stand test, and timed-up-and-go test, TUG), quality of life (measured by Short-Form 36-Item Health Survey, SF-36), and blood biochemical indexes were measured before and after the 6-month intervention.

RESULTS:

Compared to placebo group, nutritional supplementation improves RSMI (mean difference: 0.18 kg/m2, 95%CI: 0.01-0.35, P = 0.040), handgrip strength (mean difference: 2.68 kg, 95%CI: 0.71-4.65, P = 0.009), SF-36 mental component summary (SF-36 MCS) (mean difference: 11.26, 95%CI: 3.86-18.65, P = 0.004), SF-36 physical component summary (SF-36 PCS) (mean difference: 20.21, 95%CI: 11.30-29.12, P < 0.001), serum IGF-1 (mean difference: 14.34 ng/mL, 95%CI: 2.06-26.73), IL-2 (mean difference: -575.32 pg/mL, 95%CI: -1116.94 ∼ -33.70, P = 0.038), serum vitamin D3 (mean difference: 11.01 ng/mL, 95%CI: 6.44-15,58, P < 0.001), and serum vitamin E (mean difference: 4.17 ng/L, 95%CI: 1.89-6.45, P = 0.001).

CONCLUSION:

The current study demonstrated that the combined supplementation of whey protein, vitamin D and E can significantly improve RSMI, muscle strength, and anabolic markers such as IGF-I and IL-2 in older adults with sarcopenia. Further larger well-designed studies are warranted to evaluate whether long-term whey protein supplementation can blunt the declines of muscle function and mass in older adults with sarcopenia.

KEYWORDS:

Older adults; Sarcopenia; Vitamin D; Vitamin E; Whey protein

 

Persistent light to moderate alcohol intake and lung function: A longitudinal study.

Vasquez MM, Sherrill DL, LeVan TD, Morgan WJ, Sisson JH, Guerra S.

Alcohol. 2017 Sep 1;67:65-71. doi: 10.1016/j.alcohol.2017.08.013. [Epub ahead of print]

PMID: 29396309

Abstract

Alcohol intake has been inconsistently associated with lung function levels in cross-sectional studies. The goal of our study was to determine whether longitudinally assessed light-to-moderate alcohol intake is associated with levels and decline of lung function. We examined data from 1333 adult participants in the population-based Tucson Epidemiological Study of Airway Obstructive Disease. Alcohol intake was assessed with four surveys between 1972 and 1992. Subjects who completed at least two surveys were classified into longitudinal drinking categories ("never", "inconsistent", or "persistent drinker"). Spirometric lung function was measured in up to 11 surveys between 1972 and 1992. Random coefficient models were used to test for differences in lung function by drinking categories. After adjustment for sex, age, height, education, BMI categories, smoking status, and pack-years, as compared to never-drinkers, persistent drinkers had higher FVC (coefficient: 157 mL, p < 0.001), but lower FEV1/FVC ratio (-2.3%, p < 0.001). Differences were due to a slower decline of FVC among persistent than among never-drinkers (p = 0.003), and these trends were present independent of smoking status. Inconsistent drinking showed similar, but weaker associations. After adjustment for potential confounders, light-to-moderate alcohol consumption was associated with a significantly decreased rate of FVC decline over adult life.

KEYWORDS:

Alcohol; Lung function; Obstruction; Restriction

Edited by AlPater

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Association between average daily television viewing time and the incidence of ovarian cancer: findings from the Japan Collaborative Cohort Study.

Ukawa S, Tamakoshi A, Mori M, Ikehara S, Shirakawa T, Yatsuya H, Iso H; JACC study group.

Cancer Causes Control. 2018 Feb;29(2):213-219. doi: 10.1007/s10552-018-1001-8. Epub 2018 Jan 16.

PMID: 29340890

Abstract

PURPOSE:

Seventy-five percent of epidemiological studies have reported that sedentary behavior is associated with ovarian cancer incidence. Although Japan has one of the most sedentary populations, with median sitting times of 7 h/day, this association has not been investigated. This study aimed to elucidate the association between average daily television (TV) viewing time, which is a major sedentary behavior, and the incidence of ovarian cancer in a large-scale nationwide cohort study in Japan.

METHODS:

A total of 34,758 female participants aged 40-79 years without a history of cancer at baseline were included in the study. The inverse probability weighted competing risk model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the incidence of ovarian cancer.

RESULTS:

During a median follow-up of 19.4 years, 59 participants developed ovarian cancer (ICD-10: C56), 2,706 participants developed other types of cancer, and 4,318 participants died. Participants who watched TV for ≥ 5 h/day were more likely to develop ovarian cancer than those who watched TV for < 2 h/day (HR 2.15; 95% CI 1.54-2.99).

CONCLUSION:

Our findings suggest that reducing the amount of time spent sedentarily may be beneficial for preventing ovarian cancer.

KEYWORDS:

Cohort study; Epidemiology; Ovarian neoplasms; Risk assessment; Sedentary behavior

 

Short-term methionine deprivation improves metabolic health via sexually dimorphic, mTORC1-independent mechanisms.

Yu D, Yang SE, Miller BR, Wisinski JA, Sherman DS, Brinkman JA, Tomasiewicz JL, Cummings NE, Kimple ME, Cryns VL, Lamming DW.

FASEB J. 2018 Jan 30:fj201701211R. doi: 10.1096/fj.201701211R. [Epub ahead of print]

PMID: 29401631

Abstract

Obesity and diabetes are major challenges to global health, and there is an urgent need for interventions that promote weight loss. Dietary restriction of methionine promotes leanness and improves metabolic health in mice and humans. However, poor long-term adherence to this diet limits its translational potential. In this study, we develop a short-term methionine deprivation (MD) regimen that preferentially reduces fat mass, restoring normal body weight and glycemic control to diet-induced obese mice of both sexes. The benefits of MD do not accrue from calorie restriction, but instead result from increased energy expenditure. MD promotes increased energy expenditure in a sex-specific manner, inducing the fibroblast growth factor (Fgf)-21-uncoupling protein (Ucp)-1 axis only in males. Methionine is an agonist of the protein kinase mechanistic target of rapamycin complex (mTORC)-1, which has been proposed to play a key role in the metabolic response to amino acid-restricted diets. In our study, we used a mouse model of constitutive hepatic mTORC1 activity and demonstrate that suppression of hepatic mTORC1 signaling is not required for the metabolic effects of MD. Our study sheds new light on the mechanisms by which dietary methionine regulates metabolic health and demonstrates the translational potential of MD for the treatment of obesity and type 2 diabetes.

KEYWORDS:

Fgf21; amino acids; diabetes; dietary protein; obesity

 

Vitamin D Status and Intakes and Their Association with Cognitive Trajectory in A Longitudinal Study of Urban Adults.

Beydoun MA, Hossain S, Fanelli-Kuczmarski MT, Beydoun HA, Canas JA, Evans MK, Zonderman AB.

J Clin Endocrinol Metab. 2018 Feb 1. doi: 10.1210/jc.2017-02462. [Epub ahead of print]

PMID: 29409006

Abstract

CONTEXT:

Serum 25-hydroxyvitamin D [25(OH)D], dietary and supplemental vitamin D may influence cognitive outcomes.

OBJECTIVES:

Sex/age-specific and race-specific associations of vitamin D status and intake were examined with longitudinal change in various cognitive domains in a large sample of ethnically and socio-economically diverse US urban adults.

DESIGN:

Two prospective waves of data from Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used. Setting: Baltimore City, MD, 2004-2013.

PARTICIPANTS:

U.S. adults aged 30-64y at baseline visit, length of follow-up between visits 1 (2004-2009) and 2 (2009-2013) with mean follow-up time±SD: 4.64±0.93y. Final analytic sample sizes ranged from 1,231-1,803 participants with 1.5-2.0 visits/participant.

MAIN OUTCOME AND EXPOSURE MEASURES:

Cognitive performance was assessed using 11 test scores covering domains of global cognition, attention, learning/memory, executive function, visuo-spatial/visuo-construction ability, psychomotor speed and language/verbal. Serum 25(OH)D, vitamin D intake and use of supplements containing vitamin D were the key exposures.

RESULTS:

Based on multiple mixed-effects linear regression models, there was a consistent relationship between vitamin D status (overall) and supplemental intake (older women and African-Americans) with a slower rate of decline in the domain of verbal fluency. Higher dietary intake of vitamin D was linked to slower rate of decline in verbal memory among younger women, and a slower rate of decline in visual memory/visuo-constructive abilities among Whites. All other associations were inconsistent.

CONCLUSIONS:

Vitamin D status and intakes were inversely related to domain-specific cognitive decline in US urban adults. Larger population studies are needed to replicate our findings.

 

Folic Acid in Stroke Prevention in Countries without Mandatory Folic Acid Food Fortification: A Meta-Analysis of Randomized Controlled Trials.

Hsu CY, Chiu SW, Hong KS, Saver JL, Wu YL, Lee JD, Lee M, Ovbiagele B.

J Stroke. 2018 Jan;20(1):99-109. doi: 10.5853/jos.2017.01522. Epub 2018 Jan 31.

PMID: 29402063

http://j-stroke.org/journal/view.php?doi=10.5853/jos.2017.01522

http://j-stroke.org/upload/pdf/jos-2017-01522.pdf

Abstract

BACKGROUND AND PURPOSE:

Additional folic acid (FA) treatment appears to have a neutral effect on reducing vascular risk in countries that mandate FA fortification of food (e.g., USA and Canada). However, it is uncertain whether FA therapy reduces stroke risk in countries without FA food fortification. The purpose of this study was to comprehensively evaluate the efficacy of FA therapy on stroke prevention in countries without FA food fortification.

METHODS:

PubMed, EMBASE, and clinicaltrials.gov from January 1966 to August 2016 were searched to identify relevant studies. Relative risk (RR) with 95% confidence interval (CI) was used as a measure of the association between FA supplementation and risk of stroke, after pooling data across trials in a random-effects model.

RESULTS:

The search identified 13 randomized controlled trials (RCTs) involving treatment with FA that had enrolled 65,812 participants, all of which stroke was reported as an outcome measure. After all 13 RCTs were pooled, FA therapy versus control was associated with a lower risk of any future stroke (RR, 0.85; 95% CI, 0.77 to 0.95). FA alone or combination of FA and minimal cyanocobalamin (≤0.05 mg/day) was associated with a lower risk of future stroke (RR, 0.75; 95% CI, 0.66 to 0.86) whereas combination of FA and cyanocobalamin (≥0.4 mg/day) was not associated with a lower risk of future stroke (RR, 0.95; 95% CI, 0.86 to 1.05).

CONCLUSIONS:

FA supplement reduced stroke in countries without mandatory FA food fortification. The benefit was found mostly in patients receiving FA alone or combination of FA and minimal cyanocobalamin.

KEYWORDS:

Folic acid; Food, fortified; Meta-analysis; Prevention; Stroke

 

Postprandial saturated fatty acids increase the risk of type 2 diabetes: a cohort study in a Chinese population.

Wang Y, Meng X, Deng X, Okekunle AP, Wang P, Zhang Q, Ding L, Guo X, Lv M, Sun C, Li Y.

J Clin Endocrinol Metab. 2018 Feb 1. doi: 10.1210/jc.2017-01904. [Epub ahead of print]

PMID: 29409024

Abstract

CONTEXT:

Experimental evidence suggests saturated fatty acids (SFA) are associated with insulin resistance (IR), but results from epidemiological studies on fasting SFA-diabetes risk are inconsistent.

OBJECTIVE:

We investigated SFA (fasting and 2h postprandial) profiles and diabetes risk.

DESIGN SETTING:

A total of 8,940 subjects were recruited for the Harbin People's Health Study in 2008. Serum SFA (fasting and 2h postprandial) at baseline in Chinese men and women without diabetes were profiled while type 2 diabetes was ascertained using WHO criteria after 4-7 years of follow-up.

OUTCOME:

Associations between 2h postprandial SFA (2h-SFA) and diabetes.

RESULTS:

At baseline, incident cases of diabetes were older with higher body mass index (BMI) and waist circumference (WC). After a mean follow-up of 6.7 years, 658 incident cases of diabetes occurred. After propensity score (PS) computation and inverse probability of treatment weighting (IPTW) estimation, fasting-SFA were unrelated to diabetes risk but IPTW-adjusted odds ratio (OR) and 95% confidence interval (CI) for the highest tertile of postprandial stearic acid (2h-SA), postprandial palmitic acid (2h-PA) and 2h-SFA for diabetes risk were 2.50 (2.08, 3.16), 1.56 (1.23, 2.02) and 1.70 (1.34, 2.17) respectively P-trend<0.0001. Similarly, 2h-SA/fasting-SA, 2h-PA/fasting-PA and 2h-SFA/fasting-SFA ratios [iPTW-adjusted OR (95%CI): 2.94 (2.39, 3.58), 2.31 (1.80, 2.93), and 2.42 (1.91, 3.11), respectively P-trend<0.0001] predicted the diabetes risk.

CONCLUSIONS:

Higher serum 2h-SFA (but not fasting-SFA) independently predicted diabetes risk.

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Asparagine bioavailability governs metastasis in a model of breast cancer.

Knott SRV, Wagenblast E, Khan S, Kim SY, Soto M, Wagner M, Turgeon MO, Fish L, Erard N, Gable AL, Maceli AR, Dickopf S, Papachristou EK, D'Santos CS, Carey LA, Wilkinson JE, Harrell JC, Perou CM, Goodarzi H, Poulogiannis G, Hannon GJ.

Nature. 2018 Feb 7. doi: 10.1038/nature25465. [Epub ahead of print]

PMID: 29414946

Abstract

Using a functional model of breast cancer heterogeneity, we previously showed that clonal sub-populations proficient at generating circulating tumour cells were not all equally capable of forming metastases at secondary sites. A combination of differential expression and focused in vitro and in vivo RNA interference screens revealed candidate drivers of metastasis that discriminated metastatic clones. Among these, asparagine synthetase expression in a patient's primary tumour was most strongly correlated with later metastatic relapse. Here we show that asparagine bioavailability strongly influences metastatic potential. Limiting asparagine by knockdown of asparagine synthetase, treatment with l-asparaginase, or dietary asparagine restriction reduces metastasis without affecting growth of the primary tumour, whereas increased dietary asparagine or enforced asparagine synthetase expression promotes metastatic progression. Altering asparagine availability in vitro strongly influences invasive potential, which is correlated with an effect on proteins that promote the epithelial-to-mesenchymal transition. This provides at least one potential mechanism for how the bioavailability of a single amino acid could regulate metastatic progression.

 

Dietary fat stimulates development of NAFLD more potently than dietary fructose in Sprague-Dawley rats.

Jensen VS, Hvid H, Damgaard J, Nygaard H, Ingvorsen C, Wulff EM, Lykkesfeldt J, Fledelius C.

Diabetol Metab Syndr. 2018 Jan 24;10:4. doi: 10.1186/s13098-018-0307-8. eCollection 2018.

PMID: 29410708

Abstract

BACKGROUND:

In humans and animal models, excessive intake of dietary fat, fructose and cholesterol has been linked to the development of non-alcoholic fatty liver disease (NAFLD). However, the individual roles of the dietary components remain unclear. To investigate this further, we compared the effects of a high-fat diet, a high-fructose diet and a combination diet with added cholesterol on the development of NAFLD in rats.

METHODS:

Forty male Sprague-Dawley rats were randomized into four groups receiving either a control-diet (Control: 10% fat); a high-fat diet (HFD: 60% fat, 20% carbohydrate), a high-fructose diet [HFr: 10% fat, 70% carbohydrate (mainly fructose)] or a high-fat/high-fructose/high-cholesterol-diet (NASH: 40% fat, 40% carbohydrate (mainly fructose), 2% cholesterol) for 16 weeks.

RESULTS:

After 16 weeks, liver histology revealed extensive steatosis and inflammation in both NASH- and HFD-fed rats, while hepatic changes in HFr-rats were much more subtle. These findings were corroborated by significantly elevated hepatic triglyceride content in both NASH- (p < 0.01) and HFD-fed rats (p < 0.0001), elevated hepatic cholesterol levels in NASH-fed rats (p < 0.0001), but no changes in HFr-fed rats, compared to Control. On the contrary, only HFr-fed rats developed dyslipidemia as characterized by higher levels of plasma triglycerides compared to all other groups (p < 0.0001). Hepatic dysfunction and inflammation was confirmed in HFD-fed rats by elevated levels of hepatic MCP-1 (p < 0.0001), TNF-alpha (p < 0.001) and plasma β-hydroxybutyrate (p < 0.0001), and in NASH-fed rats by elevated levels of hepatic MCP-1 (p < 0.01), increased hepatic macrophage infiltration (p < 0.001), and higher plasma levels of alanine aminotransferase (p < 0.0001) aspartate aminotransferase (p < 0.05), haptoglobin (p < 0.001) and TIMP-1 (p < 0.01) compared to Control.

CONCLUSION:

These findings show that dietary fat and cholesterol are the primary drivers of NAFLD development and progression in rats, while fructose mostly exerts its effect on the circulating lipid pool.

KEYWORDS:

Animal models; Cholesterol; Diet; Fat; Fructose; NAFLD; NASH; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Rat

 

Current Level of Fish Consumption is Associated with Mortality in Chinese but not US Adults: New Findings From Two Nationwide Cohort Studies With 14 and 9.8 years of Follow-Up.

Zhuang P, Wang W, Wang J, Zhang Y, Jiao J.

Mol Nutr Food Res. 2018 Feb 7. doi: 10.1002/mnfr.201700898. [Epub ahead of print]

PMID: 29412509

Abstract

SCOPE:

Whether dietary fish consumption is linked to mortality remains unclear. We aim to investigate the association of fish consumption with mortality in Chinese and US nationwide populations.

METHODS AND RESULTS:

We utilized data from China Health and Nutrition Survey (CHNS, n = 14,117) and National Health and Nutrition Examination Survey (NHANES, n = 33,221) including NHANES III conducted in 1988-1994 and continuous NHANES 1999-2010. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 14 and 9.8 years for CHNS and NHANES, 1007 and 5209 deaths were documented, respectively. Among Chinese adults, increased fish intake was significantly associated with decreased total mortality. The multivariable-adjusted HRs (95% CIs) across increasing categories of fish intake were 0.45 (0.36-0.56), 0.72 (0.60-0.86) and 0.70 (0.59-0.85) (P trend < 0.0001). However, fish intake was not associated with total mortality among US adults (P trend = 0.21). We only detected a borderline inverse association between fish intake and stroke mortality (P trend = 0.05), whereas a positive association with diabetes mortality in the third category of fish intake in NHANES.

CONCLUSION:

In these two nationwide cohort studies, fish consumption is associated with a reduced risk of total mortality for Chinese but not US populations. This article is protected by copyright. All rights reserved.

KEYWORDS:

China Health and Nutrition Survey; National Health and Nutrition Examination Survey; fish consumption; mortality; nationwide cohort

 

Early pregnancy maternal trace mineral status and the association with adverse pregnancy outcome in a cohort of Australian women.

Wilson RL, Bianco-Miotto T, Leemaqz SY, Grzeskowiak LE, Dekker GA, Roberts CT.

J Trace Elem Med Biol. 2018 Mar;46:103-109. doi: 10.1016/j.jtemb.2017.11.016. Epub 2017 Dec 5.

PMID: 29413099

Abstract

Maternal micronutrient deficiencies in pregnancy can have profound effects on fetal development and pregnancy outcome. Plasma trace minerals including copper, zinc, selenium and iron have been shown to be extremely important in supporting reproduction. We sought to determine whether there is an association between maternal trace mineral status in early pregnancy and pregnancy complications using a prospective cohort study of 1065 pregnant Australian women who were recruited as part of the Screening for Pregnancy Endpoints (SCOPE) study in Adelaide. Copper, zinc, selenium and iron present in the plasma were measured using mass spectrometry in samples collected at 15±1 weeks' gestation. After adjusting for covariates, women with lower plasma copper (<27.9μmol/L and 27.9-32.5μmol/L) had decreased risk for any pregnancy complication when compared with women with high plasma copper (>32.5μmol/L) (aRR=0.87; 95% CI=0.76, 0.99 and aRR=0.88; 95% CI=0.78, 1.00, respectively). This was also observed when adjusting for plasma zinc and selenium status (<27.9μmol/L: aRR=0.81; 95% CI=0.69, 0.96 and 27.9-32.5μmol/L: aRR=0.84; 95% CI=0.72, 0.98). Combined low copper and zinc status was also associated with a reduced risk of any pregnancy complication as compared with high copper and zinc status (aRR=0.80; 95% CI=0.70, 0.93). These results provide justification for further work into elucidating the mechanistic role of trace elements in early pregnancy, as well as their interactions in supporting successful pregnancy outcomes.

KEYWORDS:

Copper; Micronutrients; Pregnancy; Pregnancy complications; Zinc

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Comparison of blood lipid-lowering effects of olive oil and other plant oils: a systematic review and meta-analysis of 27 randomized placebo-controlled clinical trials.

Ghobadi S, Hassanzadeh-Rostami Z, Mohammadian F, Nikfetrat A, Ghasemifard N, Raeisi Dehkordi H, Faghih S.

Crit Rev Food Sci Nutr. 2018 Feb 8:0. doi: 10.1080/10408398.2018.1438349. [Epub ahead of print]

PMID: 29420053

Abstract

OBJECTIVE:

We aim to report a systematic review and meta-analysis of randomized controlled trials (RCTs) on effects of olive oil consumption compared with other plant oils on blood lipids.

METHODS:

PubMed, web of science, Scopus, ProQuest, and Embase were systematically searched until September 2017, with no age, language and design restrictions. Weighed mean difference (WMD) and 95% confidence interval (CI) were expressed as effect size. Sensitivity analyses and pre specified subgroup was conducted to evaluate potential heterogeneity. Meta-regression analyses were performed to investigate association between blood lipid-lowering effects of olive oil and duration of treatment.

RESULTS:

Twenty-seven trials, comprising 1089 participants met the eligibility criteria. Results of this study showed that compared to other plant oils, high-density lipoprotein level increased significantly more for OO (1.37 mg/dl: 95% CI: 0.4, 2.36). Also OO consumption reduced total cholesterol (TC) (6.27 mg/dl, 95% CI: 2.8, 10.6), Low-density lipoprotein (LDL-c) (4.2 mg/dl, 95% CI: 1.4, 7.01), and triglyceride (TG) (4.31 mg/dl, 95% CI: 0.5, 8.12) significantly less than other plant oils. There were no significant effects on Apo lipoprotein A1 and Apo lipoprotein B.

CONCLUSION:

This meta-analysis suggested that OO consumption decreased serum TC, LDL-c, and TG less but increased HDL-c more than other plant oils.

KEYWORDS:

Dyslipidemia; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Olive oil; Total cholesterol; Triacylglycerol

 

Maternal obesity, fish intake and recurrent spontaneous preterm birth.

Smid MC, Stuebe AM, Manuck TA, Sen S.

J Matern Fetal Neonatal Med. 2018 Feb 7:1-141. doi: 10.1080/14767058.2018.1439008. [Epub ahead of print]

PMID: 29415593

Abstract

OBJECTIVE:

Moderate fish intake in early pregnancy is associated with decreased risk of preterm birth (PTB). Obesity during pregnancy is characterized by inflammation and insufficiency of essential fatty acids. The objective of this study was to measure the association between fish intake during pregnancy and risk of recurrent spontaneous (s)PTB among lean, overweight and obese women.

DESIGN:

This is secondary analysis of a randomized controlled trial of omega-3 fatty acid supplementation for recurrent PTB prevention, 2005-2006. The primary exposure was fish intake at time of enrollment (16-22.9-week gestation). The primary outcomes were sPTB < 37 weeks and sPTB < 35 weeks. Maternal prepregnancy body mass index was treated as an effect modifier.

SUBJECTS:

852 women were included, 47% were lean, 25% overweight and 28% obese.

RESULTS:

In this cohort, among lean, but not overweight or obese women, ≥ 1 serving of fish per week was associated with decreased frequency of sPTB < 37 weeks compared with < 1 serving of fish per week (45.1 versus 27.5%, p = 0.001) and spontaneous PTB < 35 (21.4 versus 11.6%, p = 0.01). In adjusted models, as fish intake increased, the predicted probability of sPTB decreased in lean women but increased in overweight and obese women (p for interaction < 0.10).

CONCLUSION:

Fish intake was associated with lower probability of sPTB in lean women and higher probability in obese women. These findings warrant further investigation to understand the dietary or metabolic factors associated with obesity that may modulate benefit of fish intake during pregnancy.

KEYWORDS:

Fish intake; maternal obesity; omega 3 fatty acids; preterm birth

 

Replacing sedentary time with physical activity: a 15-year follow-up of mortality in a national cohort.

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

Clin Epidemiol. 2018 Jan 25;10:179-186. doi: 10.2147/CLEP.S151613. eCollection 2018.

PMID: 29416378

https://www.dovepress.com/replacing-sedentary-time-with-physical-activity-a-15-year-follow-up-of-peer-reviewed-fulltext-article-CLEP

Abstract

BACKGROUND:

Sedentary behavior is associated with health risks in adults. The potential benefits of reducing sedentary time may be dependent not only on decrease per se, but also on the type of activity it replaces. Few longitudinal studies have investigated the effects on mortality when replacing objectively assessed sedentary time with another physical activity (PA) behavior.

OBJECTIVE:

To investigate the effects of replacing objectively assessed sedentary time with time in light-intensity PA or moderate-vigorous PA (MVPA) on all-cause mortality, cardiovascular disease (CVD) mortality or cancer mortality in a cohort with 15 years follow-up time.

METHODS:

In total, 851 women and men from the population-based Sweden Attitude Behaviour and Change study were included. Time spent sedentary, in light-intensity PA and in MVPA were assessed using an Actigraph 7164 accelerometer. Mortality data were obtained from Swedish registers. Cox proportional hazards models estimated hazard ratios (HR) of mortality with 95% confidence intervals (CI) and isotemporal substitution models were used to estimate the effect of replacing sedentary behavior with PA for the same amount of time.

RESULTS:

Over a follow-up of 14.2 years (SD 1.9) with 12,117 person-years at risk, 79 deaths occurred, 24 deaths from CVD, 27 from cancer, and 28 from other causes. Replacing 30 minutes/day of sedentary time with light-intensity PA was associated with significant reduction in all-cause mortality risk (HR: 0.89, 95% CI: 0.81-0.98) and CVD mortality risk (HR: 0.76, 95% CI: 0.63-0.92). Replacing 10 minutes of sedentary time with MVPA was associated with reduction in CVD mortality risk (HR: 0.62, 95% CI: 0.42-0.91). No statistically significant reductions were found for cancer mortality.

CONCLUSION:

This statistical modelling study suggests that replacing sedentary time with light-intensity PA could have beneficial effect on both all-cause mortality and CVD mortality. Replacing sedentary time with MVPA could reduce CVD mortality.

KEYWORDS:

accelerometry; isotemporal substitution; light intensity; moderate-to-vigorous intensity; prospective; sedentary behavior

 

Weight change in older adults and mortality: the Multiethnic Cohort Study.

Park SY, Wilkens LR, Maskarinec G, Haiman CA, Kolonel LN, Marchand LL.

Int J Obes (Lond). 2018 Feb;42(2):205-212. doi: 10.1038/ijo.2017.188. Epub 2017 Aug 14.

PMID: 28885999

Abstract

OBJECTIVE:

To investigate the association between weight change in older adults and mortality in a multiethnic population.

METHODS:

We performed a prospective analysis using data on weight change between the baseline (1993-1996) and the 10-year follow-up (2003-2007) surveys in relation to subsequent mortality among 63 040 participants in the Multiethnic Cohort Study in Hawaii and California. The participants were African American, Native Hawaiian, Japanese American, Latino and white, aged 45-75 years at baseline, and did not report heart disease or cancer at either survey.

RESULTS:

During an average of 7.3 years of follow-up after the 10-year survey, 6623 deaths were identified. Compared with individuals whose weight remained stable (±2.5 kg), those who lost weight and those with the highest weight gain (>10 kg) were at increased risk of all-cause mortality, with the risks greater for the weight loss (hazard ratios (HR): 2.86; 95% confidence interval (95% CI): 2.62-3.11 for >10 kg) than the weight-gain group (HR: 1.25; 95% CI: 1.11-1.41 for >10 kg), thus resulting in a reverse J-shaped curve. Japanese Americans and Latinos had stronger associations of weight loss >10 kg with mortality than did African Americans, Native Hawaiians and whites. The increase in risk with weight gain >10 kg was greater for older (⩾55 years at baseline) than younger individuals, whereas the increase in mortality associated with weight loss was greater for the normal weight (<25 kg m-2 at baseline) participants and never smokers, compared with overweight/obese persons and current smokers, respectively.

CONCLUSIONS:

Our findings confirm the association between weight change and a higher mortality in a healthy, multiethnic population, with higher risks for weight loss than weight gain. On the basis of these observations, public health recommendation should focus on the prevention of weight loss, as well as weight stability within the non-obese range, for middle-aged and older adults.

 

Meal timing effects on insulin sensitivity and intrahepatic triglycerides during weight loss.

Versteeg RI, Ackermans MT, Nederveen AJ, Fliers E, Serlie MJ, la Fleur SE.

Int J Obes (Lond). 2018 Feb;42(2):156-162. doi: 10.1038/ijo.2017.199. Epub 2017 Aug 16.

PMID: 28811653

Abstract

BACKGROUND:

Several human and rodent studies suggest that in addition to the amount of energy consumed, timing of food intake contributes to body weight regulation. Consuming most energy in the morning has favorable effects on weight loss and weight maintenance. Whether this also affects glucose metabolism and liver fat independently from weight loss is unknown.

OBJECTIVE:

We hypothesized that during weight loss, consuming most energy in the morning improves insulin sensitivity and reduces hepatic fat content more than consuming most energy in the evening.

METHODS:

Twenty-three obese insulin resistant men (age 59.9±7.9 years, body mass index 34.4±3.8 kg m-2) followed a 4-week hypocaloric diet intervention with either 50% of daily energy consumed in the morning (BF group) or evening (D group). Insulin sensitivity, measured with a two-step hyperinsulinemic euglycemic clamp using a glucose tracer, intrahepatic triglycerides (IHTG), measured using magnetic resonance spectroscopy, and resting energy expenditure (REE) were assessed before and after the diet intervention.

RESULTS:

Meal macronutrient composition and weight loss (6.5±1.5% vs 6.2±1.9%, respectively, P=0.70) did not differ between the BF and D groups. Endogenous glucose production (P⩽0.001), hepatic and peripheral insulin sensitivity (P=0.002; P=0.001, respectively) as well as IHTG content (P⩽0.001) all significantly improved with weight loss, but were not different between the BF and D groups. In addition, both groups decreased REE and respiratory quotient equally.

CONCLUSIONS:

During weight loss, consuming most energy in the morning instead of the evening does not have additional beneficial effects on insulin sensitivity and IHTG content. These results do not support weight independent effects of meal timing on glucose metabolism and IHTG in hypocaloric conditions in obese men.

 

Redefining Hypertension — Assessing the New Blood-Pressure Guidelines

G. Bakris and M. Sorrentino

N Engl J Med 2018;378:497-499 | Published Online January 17, 2018

http://www.nejm.org/doi/full/10.1056/NEJMp1716193?query=TOC

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2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

Whelton PK, Carey RM, Aronow WS, Casey DE Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC Jr, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA Sr, Williamson JD, Wright JT Jr.

J Am Coll Cardiol. 2017 Nov 7. pii: S0735-1097(17)41519-1. doi: 10.1016/j.jacc.2017.11.006. [Epub ahead of print] No abstract available.

PMID: 29146535

 

Effect of long-term nutraceutical and dietary supplement use on cognition in the elderly: a 10-year systematic review of randomised controlled trials.

D'Cunha NM, Georgousopoulou EN, Dadigamuwage L, Kellett J, Panagiotakos DB, Thomas J, McKune AJ, Mellor DD, Naumovski N.

Br J Nutr. 2018 Feb;119(3):280-298. doi: 10.1017/S0007114517003452. Epub 2018 Jan 9.

PMID: 29310724

Abstract

Nutraceuticals have generated interest as a way to mitigate the cognitive decline in older adults. The aim of this systematic review was to determine the evidence for these claims from the scientific literature in randomised, double-blinded, controlled trials (duration: ≥1 year; participants: n≥100; age(mean): ≥65 years). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched four electronic databases (PubMed, Scopus, CINAHL and Web of Science) and identified twenty-five studies published between the 15·June·2006 and 14·June·2016. Interventions included B-vitamins, n-3 fatty acids, antioxidant vitamins and herbs. Of the B-vitamin studies, four found benefits to cognition with supplementation. The first of these B-vitamin studies, in individuals with mild cognitive impairment (n 266; duration=2 years), included benefit to executive function (P=0·015) and improvements in the Mini-Mental State Examination (MMSE) among participants with baseline homocysteine above 11·3 µmol/l (P<0·001). In the same sample, the second study found cognitive benefits of B-vitamins dependent on the higher baseline plasma n-3 fatty acid status. The third B-vitamin study (n 900; duration=2 years) reported improved performance in immediate (P=0·046) and delayed recall (P=0·013), whereas the fourth study (n 856; duration=2 years) reported slower rate of cognitive decline in the MMSE (P=0·05). One study investigating DHA treatment (n 402; duration=1·5 years) revealed the slower rate of cognitive change in apoE e4 non-carriers (P=0·03). As only five included studies revealed notable benefits, presently based on the specific compounds explored here, there is not compelling evidence to support the use nutraceuticals to improve cognition in the elderly. Future long-term trials of nutraceuticals should investigate interactions with lifestyle, blood biomarkers and genetic risk factors.

KEYWORDS:

AD Alzheimer’s disease; ADAS-cog cognitive subscale of Alzheimer’s Disease Assessment Scale; APOE4 apoE e4; CDR Clinical Dementia Rating Scale; CSF cerebrospinal fluid; FADS fatty acid desaturase; Hcy homocysteine; MCI mild cognitive impairment; MMSE Mini-Mental State Examination; QoL quality of life; RCT randomised controlled trial; TICS Telephone Interview of Cognitive Status; Cognition; Dementia; Dietary supplements; Elderly; Mild cognitive impairment; Nutraceuticals; Vitamins

 

Prenatal vitamin D status and offspring's growth, adiposity and metabolic health: a systematic review and meta-analysis.

Santamaria C, Bi WG, Leduc L, Tabatabaei N, Jantchou P, Luo ZC, Audibert F, Nuyt AM, Wei SQ.

Br J Nutr. 2018 Feb;119(3):310-319. doi: 10.1017/S0007114517003646. Epub 2018 Jan 11.

PMID: 29321080

Abstract

In this systematic review and meta-analysis of observational studies, we aimed to estimate the associations between prenatal vitamin D status and offspring growth, adiposity and metabolic health. We searched the literature in human studies on prenatal vitamin D status and offspring growth in PubMed, up to July 2017. Studies were selected according to their methodological quality and outcomes of interest (anthropometry, fat mass and diabetes in offspring). The inverse variance method was used to calculate the pooled mean difference (MD) with 95 % CI for continuous outcomes, and the Mantel-Haenszel method was used to calculate the pooled OR with 95 % CI for dichotomous outcomes. In all, thirty observational studies involving 35 032 mother-offspring pairs were included. Vitamin D status was evaluated by circulating 25-hydroxyvitamin D (25(OH)D) level. Low vitamin D status was based on each study's cut-off for low 25(OH)D levels. Low prenatal vitamin D levels were associated with lower birth weight (g) (MD -100·69; 95 % CI -162·25, -39·13), increased risk of small-for-gestational-age (OR 1·55; 95 % CI 1·16, 2·07) and an elevated weight (g) in infant at the age of 9 months (g) (MD 119·75; 95 % CI 32·97, 206·52). No associations were observed between prenatal vitamin D status and other growth parameters at birth, age 1 year, 4-6 years or 9 years, nor with diabetes type 1. Prenatal vitamin D may play a role in infant adiposity and accelerated postnatal growth. The effects of prenatal vitamin D on long-term metabolic health outcomes in children warrant future studies.

KEYWORDS:

25(OH)D 25-hydroxyvitamin D; MD mean difference; SGA small-for-gestational-age; 25-Hydrovitamin D; Adiposity; Infant growth; Metabolic health; Pregnancy

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Lancet Volume 391, No. 10120, p518–519, 10 February 2018

Comment

Rising incidence of heart failure demands action

Faiez Zannad

Published: 21 November 2017

Open Access

DOI: https://doi.org/10.1016/S0140-6736(17)32873-8

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32873-8/fulltext

Summary

References

Heart failure is a life-threatening syndrome with substantial morbidity and mortality and is a burden to patients, their carers, and health systems. Estimates of heart failure incidence and prevalence are difficult to generate. Accurate epidemiological estimates of heart failure, however, are crucial to ensure resources are appropriately and adequately allocated to treat patients with existing disease, and to inform prevention methods among those at risk.

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Conrad, N, Judge, A, Tran, J et al.

Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals.

Lancet. 2017; (published online Nov 21.)

http://dx.doi.org/10.1016/S0140-6736(17)32520-5.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32520-5/fulltext

Background

Large-scale and contemporary population-based studies of heart failure incidence are needed to inform resource planning and research prioritisation but current evidence is scarce. We aimed to assess temporal trends in incidence and prevalence of heart failure in a large general population cohort from the UK, between 2002 and 2014.

Methods

For this population-based study, we used linked primary and secondary electronic health records of 4 million individuals from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex. Eligible patients were aged 16 years and older, had contributed data between Jan 1, 2002, and Dec 31, 2014, had an acceptable record according to CPRD quality control, were approved for CPRD and Hospital Episodes Statistics linkage, and were registered with their general practice for at least 12 months. For patients with incident heart failure, we extracted the most recent measurement of baseline characteristics (within 2 years of diagnosis) from electronic health records, as well as information about comorbidities, socioeconomic status, ethnicity, and region. We calculated standardised rates by applying direct age and sex standardisation to the 2013 European Standard Population, and we inferred crude rates by applying year-specific, age-specific, and sex-specific incidence to UK census mid-year population estimates. We assumed no heart failure for patients aged 15 years or younger and report total incidence and prevalence for all ages (>0 years).

Findings

From 2002 to 2014, heart failure incidence (standardised by age and sex) decreased, similarly for men and women, by 7% (from 358 to 332 per 100 000 person-years; adjusted incidence ratio 0·93, 95% CI 0·91–0·94). However, the estimated absolute number of individuals with newly diagnosed heart failure in the UK increased by 12% (from 170 727 in 2002 to 190 798 in 2014), largely due to an increase in population size and age. The estimated absolute number of prevalent heart failure cases in the UK increased even more, by 23% (from 750 127 to 920 616). Over the study period, patient age and multi-morbidity at first presentation of heart failure increased (mean age 76·5 years [sD 12·0] to 77·0 years [12·9], adjusted difference 0·79 years, 95% CI 0·37–1·20; mean number of comorbidities 3·4 [sD 1·9] vs 5·4 [2·5]; adjusted difference 2·0, 95% CI 1·9–2·1). Socioeconomically deprived individuals were more likely to develop heart failure than were affluent individuals (incidence rate ratio 1·61, 95% CI 1·58–1·64), and did so earlier in life than those from the most affluent group (adjusted difference −3·51 years, 95% CI −3·77 to −3·25). From 2002 to 2014, the socioeconomic gradient in age at first presentation with heart failure widened. Socioeconomically deprived individuals also had more comorbidities, despite their younger age.

Interpretation

Despite a moderate decline in standardised incidence of heart failure, the burden of heart failure in the UK is increasing, and is now similar to the four most common causes of cancer combined. The observed socioeconomic disparities in disease incidence and age at onset within the same nation point to a potentially preventable nature of heart failure that still needs to be tackled.

 

Cadmium Body Burden and Gestational Diabetes Mellitus: A Prospective Study.

Liu W, Zhang B, Huang Z, Pan X, Chen X, Hu C, Liu H, Jiang Y, Sun X, Peng Y, Xia W, Xu S, Li Y.

Environ Health Perspect. 2018 Feb 8;126(2):027006. doi: 10.1289/EHP2716.

PMID: 29425094

https://ehp.niehs.nih.gov/wp-content/uploads/2018/02/EHP2716.alt_.pdf

Abstract

BACKGROUND:

Several studies have reported that cadmium (Cd) is associated with type 2 diabetes. However, little is known about Cd exposure and the risk of gestational diabetes mellitus (GDM).

OBJECTIVE:

We examined the association between Cd body burden in early pregnancy and the risk of GDM.

METHODS:

We conducted a prospective study of 2,026 pregnant women from a single tertiary medical center between 2013 and 2016 in Wuhan, China. Cd body burden was reflected by Cd concentrations in urine samples collected between gestational weeks 8 and 14. GDM was diagnosed according to International Association of Diabetes and Pregnancy Study Groups Consensus Panel (IADPSG) recommendations.

RESULTS:

The geometric mean of Cd concentrations in maternal urine of all pregnant women was 0.59μg/L. A total of 198 (9.8%) women were diagnosed with GDM. After adjustment for potential confounders, the risk ratios (RRs) of GDM were 1.04 (95% CI: 0.74, 1.44) for the middle tertile of Cd levels and 1.36 (95%: CI: 0.98, 1.90) for the top tertile compared with the bottom tertile. In addition, we found a significant interaction between fetal sex and maternal Cd levels on the risk of GDM (p for interaction=0.03). Among women carrying male fetuses, the RR of GDM was 1.86 (95% CI: 1.14, 2.93) for the top tertile of Cd levels compared with the bottom tertile.

CONCLUSIONS:

To our knowledge, this is the first report of an association between urinary Cd levels in early pregnancy and GDM. Our findings suggest that Cd body burden increases the risk of GDM and that the association may be modified by fetal sex.

 

Hormonal factors and pancreatic cancer risk in women: The Malmö Diet and Cancer Study.

Andersson G, Borgquist S, Jirström K.

Int J Cancer. 2018 Feb 9. doi: 10.1002/ijc.31302. [Epub ahead of print]

PMID: 29424426

Abstract

The incidence of pancreatic cancer is levelling between sexes. Smoking, high age and heredity are established risk factors, but evidence regarding the influence of hormonal factors is unclear. In this study, we investigated the associations of reproductive factors, use of oral contraceptives (OC) and hormone replacement therapy (HRT) with pancreatic cancer risk in the Malmö Diet and Cancer Study, a prospective, population-based cohort encompassing 17 035 women. Up until December 31st 2015, 110 women were identified with incident pancreatic cancer through the Swedish Cancer Registry. Higher age at menarche was significantly associated with pancreatic cancer risk (age-adjusted [hazard ratio] HR=1.17; 95% confidence interval [CI] 1.04-1.32, and fully adjusted HR=1.17; 95% CI 1.04-1.32). Ever use of OC was not significantly associated with pancreatic cancer risk but ever use of HRT was significantly associated with a decreased risk of pancreatic cancer (age-adjusted HR=0.47, 95% CI 0.23-0.97, and fully adjusted HR=0.48, 95% CI 0.23-1.00), in particular use of estrogen-only regimen (age-adjusted HR=0.21; 95% CI 0.05-0.87 and fully adjusted HR=0.22; 95% CI 0.05-0.90). Age at menopause or first childbirth, parity, and breastfeeding history were not significantly associated with pancreatic cancer risk. Collectively, these findings suggest a protective role of female hormones against pancreatic cancer. Further studies are needed, and potential modifying genetic factors and indirect hazardous effects of smoking should also be considered.

KEYWORDS:

Reproductive factors; hormone replacement therapy; oral contraceptives; pancreatic cancer risk

 

The Scientist » The Nutshell

Study: Telomeres Don’t Shorten with Age in Longest-Lived Bats

Researchers find that while bats in the Myotis genus don’t produce telomerase, the enzyme that lengthens telomeres, they possess 21 telomere maintenance–related genes.

By Diana Kwon | February 8, 2018

https://www.the-scientist.com/?articles.view/articleNo/51595/title/Study--Telomeres-Don-t-Shorten-with-Age-in-Longest-Lived-Bats/&utm_campaign=TS_DAILY%20NEWSLETTER_2018&utm_source=hs_email&utm_medium=email&utm_content=60546591&_hsenc=p2ANqtz-9KwOXrBvq54zWhhA1FvFfYKLae1Li2tHzvtZcWe8TONuj6eIl0X7-dS8LiALaOJrXHDPMnKpML0ME3ZSbJOcpTjWDL7Q&_hsmi=60546591

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Growing old, yet staying young: The role of telomeres in bats’ exceptional longevity

Nicole M. Foley1, Graham M. Hughes1, Zixia Huang1, Michael Clarke1, David Jebb1, Conor V. Whelan1, Eric J. Petit2, Frédéric Touzalin3, Olivier Farcy4, Gareth Jones5, Roger D. Ransome5, Joanna Kacprzyk1, Mary J. O’Connell6, Gerald Kerth7, Hugo Rebelo5,8,9, Luísa Rodrigues10, Sébastien J. Puechmaille1,7 and Emma C. Teeling1,*

Science Advances 07 Feb 2018:

Vol. 4, no. 2, eaao0926

DOI: 10.1126/sciadv.aao0926

http://advances.sciencemag.org/content/4/2/eaao0926.full

Abstract

Understanding aging is a grand challenge in biology. Exceptionally long-lived animals have mechanisms that underpin extreme longevity. Telomeres are protective nucleotide repeats on chromosome tips that shorten with cell division, potentially limiting life span. Bats are the longest-lived mammals for their size, but it is unknown whether their telomeres shorten. Using >60 years of cumulative mark-recapture field data, we show that telomeres shorten with age in Rhinolophus ferrumequinum and Miniopterus schreibersii, but not in the bat genus with greatest longevity, Myotis. As in humans, telomerase is not expressed in Myotis myotis blood or fibroblasts. Selection tests on telomere maintenance genes show that ATM and SETX, which repair and prevent DNA damage, potentially mediate telomere dynamics in Myotis bats. Twenty-one telomere maintenance genes are differentially expressed in Myotis, of which 14 are enriched for DNA repair, and 5 for alternative telomere-lengthening mechanisms. We demonstrate how telomeres, telomerase, and DNA repair genes have contributed to the evolution of exceptional longevity in Myotis bats, advancing our understanding of healthy aging.

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Effect of whole milk compared with skimmed milk on fasting blood lipids in healthy adults: a 3-week randomized crossover study.

Engel S, Elhauge M, Tholstrup T.

Eur J Clin Nutr. 2018 Feb;72(2):249-254. doi: 10.1038/s41430-017-0042-5. Epub 2017 Dec 11.

PMID: 29229955

https://www.nature.com/articles/s41430-017-0042-5

https://www.nature.com/articles/s41430-017-0042-5.pdf

Abstract

BACKGROUND/OBJECTIVES:

Dietary guidelines have for decades recommended choosing low-fat dairy products due to the high content of saturated fat in dairy known to increase blood concentration of LDL cholesterol. However, meta-analyses including observational studies show no association between overall dairy intake and risk of cardiovascular disease and even point to an inverse association with type 2 diabetes. The objective was to compare the effects of whole milk (3.5% fat) with skimmed milk (0.1% fat) on fasting serum blood lipids, insulin, and plasma glucose in healthy subjects.

SUBJECT/METHODS:

A randomized, controlled 2 × 3-week crossover dietary intervention in 18 healthy adults randomly assigned to a sequence of treatments consisting of 0.5 L/d of whole milk and skimmed milk as part of their habitual diet. A total of 17 subjects completed the intervention.

RESULTS:

Whole milk increased HDL cholesterol concentrations significantly compared to skimmed milk (P < 0.05). There were no significant differences between whole milk and skimmed milk in effects on total and LDL cholesterol, triacylglycerol, insulin, and glucose concentrations.

CONCLUSIONS:

Intake of 0.5 L/d of whole milk did not adversely affect fasting blood lipids, glucose, or insulin compared to skimmed milk. Moreover, intake of whole milk increased HDL cholesterol concentration compared to skimmed milk. These findings suggest that if the higher energy content is taken into account, whole milk might be considered a part of a healthy diet among the normocholesterolemic population.

"TT has received research grants from Arla Foods, Denmark; The Danish Dairy Research Foundation; and the Dairy Research Industry, Rosemont, IL."

 

The association of sarcopenia, telomere length, and mortality: data from the NHANES 1999-2002.

Rippberger PL, Emeny RT, Mackenzie TA, Bartels SJ, Batsis JA.

Eur J Clin Nutr. 2018 Feb;72(2):255-263. doi: 10.1038/s41430-017-0011-z. Epub 2017 Dec 14.

PMID: 29238037

Abstract

BACKGROUND/OBJECTIVES:

Sarcopenia is defined as the loss of muscle mass or function with aging and is associated with adverse outcomes. Telomere shortening is associated with mortality, yet its relationship with sarcopenia is unknown.

SUBJECTS/METHODS:

Adults ≥60 years from the 1999-2002 NHANES with body composition measures were identified. Sarcopenia was defined using the two Foundation for the National Institute of Health definitions: appendicular lean mass (ALM) (men <19.75; women <15.02 kg); or ALM divided by body mass index (BMI) (ALM:BMI, men <0.789; women <0.512). Telomere length was assessed using quantitative PCR. Regression models predicted telomere length with sarcopenia (referent = no sarcopenia).

RESULTS:

We identified 2672 subjects. Mean age was 70.9 years (55.5% female). Prevalence of ALM and ALM:BMI sarcopenia was 29.2 and 22.1%. Deaths were higher in persons with sarcopenia as compared to those without sarcopenia (ALM: 46.4 vs. 33.4%, p < 0.001; ALM:BMI: 46.7 vs. 33.2%, p < 0.001). No adjusted differences were observed in telomere length in those with/without sarcopenia (ALM: 0.90 vs. 0.92, p = 0.74, ALM:BMI 0.89 vs. 0.92, p = 0.24). In men with ALM:BMI-defined sarcopenia, adjusted telomere length was significantly lower compared to men without sarcopenia (0.85 vs. 0.91, p = 0.013). With sarcopenia, we did not observe a significant association between telomere length and mortality (ALM: HR 1.11 [0.64,1.82], p = 0.68; ALM:BMI: HR 0.97 [0.53,1.77], p = 0.91), but noted significance in those without sarcopenia with mortality (ALM: HR 0.59 [0.40,0.86], p = 0.007; ALM:BMI: HR 0.62 [0.42,0.91]; p = 0.01).

CONCLUSIONS:

We observed a potentially inverse relationship between telomere length and mortality in those without sarcopenia but did not observe a significant relationship between telomere length and mortality in the presence of sarcopenia.

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Dietary intakes of fat soluble vitamins as predictors of mortality from heart failure in a large prospective cohort study.

Eshak ES, Iso H, Yamagishi K, Cui R, Tamakoshi A.

Nutrition. 2018 Mar;47:50-55. doi: 10.1016/j.nut.2017.09.009. Epub 2017 Oct 12.

PMID: 29429535

http://www.nutritionjrnl.com/article/S0899-9007(17)30210-1/fulltext

http://www.nutritionjrnl.com/article/S0899-9007(17)30210-1/pdf

Abstract

OBJECTIVES:

A few reports have investigated the association of dietary vitamin intakes with risk of heart failure in Asia. Therefore, we examined the relation between dietary intakes of fat-soluble vitamins A, K, E, and D and mortality from heart failure in the Japanese population.

METHODS:

A total of 23 099 men and 35 597 women ages 40 to 79 y participated in the Japan Collaborative Cohort Study and completed a food frequency questionnaire from which dietary intakes of vitamins A, K, E, and D were calculated. The Cox proportional hazard model was used to estimate the sex-specific risks of heart failure mortality according to increasing quintiles of fat-soluble vitamin intakes.

RESULTS:

During the median 19.3 y follow-up period, there were 567 deaths from heart failure (240 men, 327 women). Dietary vitamin A intake showed no association with heart failure mortality in both sexes; however, the reduced risk was observed in women but not in men with dietary intakes of vitamins K, E, and D. The multivariable hazard ratios (95% confidence interval) in the highest versus the lowest intake quintiles among women were 0.63 (0.45-0.87; P for trend = 0.006) for vitamin K, 0.55 (0.36-0.78; P for trend = 0.006) for vitamin E, and 0.66 (0.48-0.93; P for trend = 0.01) for vitamin D. The association for each vitamin was slightly attenuated but remained statistically significant after mutual adjustment for intakes of the other vitamins.

CONCLUSIONS:

High dietary intakes of fat-soluble vitamins K, E, and D were associated with a reduced risk of heart failure mortality in Japanese women but not men.

 

Randomized double-blind controlled clinical trial of the blood pressure-lowering effect of fermented milk with Lactococcus lactis: A pilot study.

Beltrán-Barrientos LM, González-Córdova AF, Hernández-Mendoza A, Torres-Inguanzo EH, Astiazarán-García H, Esparza-Romero J, Vallejo-Cordoba B.

J Dairy Sci. 2018 Feb 7. pii: S0022-0302(18)30104-8. doi: 10.3168/jds.2017-13189. [Epub ahead of print]

PMID: 29428751

Abstract

The blood pressure-lowering effect of fermented milk with Lactococcus lactis NRRL B-50571 was evaluated in a double-blind randomized controlled clinical trial with prehypertensive subjects. Participants were randomized into 2 groups (n = 18 each group): one group treated with fermented milk with Lactococcus lactis NRRL B-50571 and a control group treated with artificially acidified milk. Results revealed that during daily consumption of fermented milk for 5 wk, systolic [(116.55 ± 12.26 mmHg vs. 124.77 ± 11.04 mmHg) and diastolic blood pressure (80.7 ± 9 vs. 84.5 ± 8.5 mmHg)] from the fermented milk group was lower than the control group. Additionally, triglyceride, total cholesterol, and low-density lipoprotein in blood serum were lower in the fermented milk group than in the control group. Results demonstrated that daily consumption of fermented milk with Lactococcus lactis (NRRL B-50571) had a blood pressure-lowering effect on prehypertensive subjects. Regular consumption of this product may be used as a potential functional food.

KEYWORDS:

Lactococcus lactis; clinical study; fermented milk; functional food; hypertension

 

Butyrate: A Double-Edged Sword for Health?

Hu Liu Ji Wang Ting He Sage Becker Guolong Zhang Defa Li Xi Ma

Advances in Nutrition, Volume 9, Issue 1, 1 January 2018, Pages 21–29, https://doi.org/10.1093/advances/nmx009

Published: 09 February 2018

https://academic.oup.com/advances/article/9/1/21/4849000

Abstract

Butyrate, a four-carbon short-chain fatty acid, is produced through microbial fermentation of dietary fibers in the lower intestinal tract. Endogenous butyrate production, delivery, and absorption by colonocytes have been well documented. Butyrate exerts its functions by acting as a histone deacetylase (HDAC) inhibitor or signaling through several G protein–coupled receptors (GPCRs). Recently, butyrate has received particular attention for its beneficial effects on intestinal homeostasis and energy metabolism. With anti-inflammatory properties, butyrate enhances intestinal barrier function and mucosal immunity. However, the role of butyrate in obesity remains controversial. Growing evidence has highlighted the impact of butyrate on the gut-brain axis. In this review, we summarize the present knowledge on the properties of butyrate, especially its potential effects and mechanisms involved in intestinal health and obesity.

Keywords:

butyrate, G protein–coupled receptors, gut-brain axis, histone deacetylase, inflammation, intestinal barrier, intestinal microbiota, obesity

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Objectively measured physical activity, sedentary behaviour and all-cause mortality in older men: does volume of activity matter more than pattern of accumulation?

Jefferis BJ, Parsons TJ, Sartini C, Ash S, Lennon LT, Papacosta O, Morris RW, Wannamethee SG, Lee IM, Whincup PH.

Br J Sports Med. 2018 Feb 12. pii: bjsports-2017-098733. doi: 10.1136/bjsports-2017-098733. [Epub ahead of print]

PMID: 29440040

Abstract

OBJECTIVES:

To understand how device-measured sedentary behaviour and physical activity are related to all-cause mortality in older men, an age group with high levels of inactivity and sedentary behaviour.

METHODS:

Prospective population-based cohort study of men recruited from 24 UK General Practices in 1978-1980. In 2010-2012, 3137 surviving men were invited to a follow-up, 1655 (aged 71-92 years) agreed. Nurses measured height and weight, men completed health and demographic questionnaires and wore an ActiGraph GT3x accelerometer. All-cause mortality was collected through National Health Service central registers up to 1 June 2016.

RESULTS:

After median 5.0 years' follow-up, 194 deaths occurred in 1181 men without pre-existing cardiovascular disease. For each additional 30 min in sedentary behaviour, or light physical activity (LIPA), or 10 min in moderate to vigorous physical activity (MVPA), HRs for mortality were 1.17 (95% CI 1.10 to 1.25), 0.83 (95% CI 0.77 to 0.90) and 0.90 (95% CI 0.84 to 0.96), respectively. Adjustments for confounders did not meaningfully change estimates. Only LIPA remained significant on mutual adjustment for all intensities. The HR for accumulating 150 min MVPA/week in sporadic minutes (achieved by 66% of men) was 0.59 (95% CI 0.43 to 0.81) and 0.58 (95% CI 0.33 to 1.00) for accumulating 150 min MVPA/week in bouts lasting ≥10 min (achieved by 16% of men). Sedentary breaks were not associated with mortality.

CONCLUSIONS:

In older men, all activities (of light intensity upwards) were beneficial and accumulation of activity in bouts ≥10 min did not appear important beyond total volume of activity. Findings can inform physical activity guidelines for older adults.

KEYWORDS:

accelerometer; bouts.; mortality; physical activity; sedentary behaviour

 

A sarcopenia screening test predicts mortality in hospitalized older adults.

Tang T, Wu L, Yang L, Jiang J, Hao Q, Dong B, Yang M.

Sci Rep. 2018 Feb 13;8(1):2923. doi: 10.1038/s41598-018-21237-9.

PMID: 29440681

https://www.nature.com/articles/s41598-018-21237-9

https://www.nature.com/articles/s41598-018-21237-9.pdf

Abstract

The aim of this study is to investigate the validation of a sarcopenia screening test (Ishii's formula) for predicting long-term mortality among older adult inpatients. A prospective, observational study was conducted in acute geriatric wards at three hospitals in western China. Sarcopenia was estimated using Ishii's formula. Survival status was assessed at 12, 24, and 36 months after the baseline investigation. Cox proportional-hazard models were applied to calculate the hazard ratio for mortality associated with sarcopenia. Three hundred and eighty participants (100 women) with a mean age of 80.2 ± 7.1 years were included. According to Ishii's formula, 264 participants (69.5%) were sarcopenic. The prevalence of sarcopenia was similar in men and women (71.1% vs. 65.0%, respectively, P = 0.258). Sixty-seven participants (17.6%) died during the 3-year follow-up period. The all-cause mortality was significantly higher in the sarcopenia group than in the non-sarcopenia group (20.1% vs. 12.1%, respectively, P < 0.05). Multivariate Cox proportional hazards analysis identified sarcopenia as a significant predictor of 3-year all-cause mortality (adjusted hazard ratio


: 2.06; 95% confidence interval [CI]: 1.02-4.15). In conclusion, sarcopenia, estimated by Ishii's formula, can predict 3-year all-cause mortality in a study population of hospitalized older adults.

 

Maternal Influenza Immunization and Prevention of Severe Clinical Pneumonia in Young Infants: Analysis of Randomized Controlled Trials Conducted in Nepal, Mali, and South Africa.

Omer SB, Clark DR, Aqil AR, Tapia MD, Nunes MC, Kozuki N, Steinhoff MC, Madhi SA, Wairagkar N; for BMGF Supported Maternal Influenza Immunization Trials Investigators Group.

Pediatr Infect Dis J. 2018 Feb 13. doi: 10.1097/INF.0000000000001914. [Epub ahead of print]

PMID: 29443825

Abstract

BACKGROUND:

To evaluate the effect of antenatal influenza vaccination on all-cause severe infant pneumonia, we performed pooled analysis of three randomized-controlled trials conducted in Nepal, Mali, and South Africa.

METHODS:

The trials were coordinated from the planning phase. The follow-up period was 0-6 months post-partum in Nepal and Mali, and 0-24 weeks in South Africa. Pregnant women with gestational age 17-34 weeks in Nepal, ≥28 weeks in Mali, and 20-36 weeks in South Africa were enrolled. Trivalent Inactivated Influenza Vaccine (IIV). was compared with either saline placebo (Nepal and South Africa) or quadrivalent meningococcal conjugate vaccine (MCV) (Mali). In South Africa, cases were hospitalized, and were therefore considered to have severe pneumonia. In Nepal and Mali, severe infant pneumonia diagnosis was based on the WHO Integrated Management of Childhood Illness (IMCI) definition.

RESULTS:

A total of 10,002 mothers and 9,801 live-born eligible infants were included in the present analysis. Incidence rate of severe pneumonia was 31% lower in the IIV group compared to the control group (incidence rate ratio [iRR]: 0.69, 95% CI: 0.50 - 0.94, P = 0.02). During periods with high influenza circulation there was lower incidence of severe pneumonia among the IIV group (IRR: 0.20, 95% CI: 0.06 - 0.74, P = 0.02), however, there was no difference in pneumonia incidence between study groups during periods of low and no influenza circulation.

CONCLUSIONS:

Maternal influenza immunization may reduce severe pneumonia episodes among infants -particularly those too young to be completely vaccinated against S. pneumoniae and influenza.

 

Association of Hemoglobin Concentration and Its Change With Cardiovascular and All-Cause Mortality.

Lee G, Choi S, Kim K, Yun JM, Son JS, Jeong SM, Kim SM, Park SM.

J Am Heart Assoc. 2018 Jan 29;7(3). pii: e007723. doi: 10.1161/JAHA.117.007723.

PMID: 29378732

Free Article

http://jaha.ahajournals.org/content/7/3/e007723.long

Abstract

BACKGROUND:

Anemia is thought to increase mortality risks, but the effects of high hemoglobin concentration on survival are unclear. The effect of change in hemoglobin concentrations on survival in the general population is also unknown. This study aimed to examine the effect of hemoglobin concentrations and their changes on cardiovascular and all-cause mortality risks.

METHODS AND RESULTS:

We retrospectively analyzed a cohort from the NHIS-HEALS (National Health Insurance Service-National Health Screening Cohort) database, including 170 078 men and 122 116 women without cardiovascular diseases, aged >40 years at baseline, with hemoglobin concentrations available for both first and second health examinations. We assessed 2 independent variables: "One-time" hemoglobin concentrations and changes in hemoglobin from first to second examination. Participants were followed up for a median of 8 years to determine mortality related to myocardial infarction, stroke, all cardiovascular diseases, and all causes. Hemoglobin concentrations showed a U- or J-shaped association with cardiovascular and all-cause mortality after adjusting for cardiovascular risk factors. When anemic men achieved normal hemoglobin concentrations, the all-cause mortality risk decreased, with an adjusted hazard ratio of 0.67 (95% confidence interval, 0.59-0.77), in comparison with those whose anemia persisted. Both increases and decreases of hemoglobin concentration outside the normal range elevated all-cause mortality risk (adjusted hazard ratio: 1.39 [95% confidence interval, 1.28-1.49] and 1.10 [95% confidence interval, 1.01-1.20], respectively), compared with persistent normal hemoglobin concentrations. The trend was similar in women but was less significant.

CONCLUSIONS:

Low or high hemoglobin concentrations were associated with elevated cardiovascular and all-cause mortality. Reaching and maintaining hemoglobin concentrations within the normal range correlated with decreased all-cause mortality.

KEYWORDS:

anemia; hemoglobin; mortality; myocardial infarction; stroke

 

 

Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study.

Kabootari M, Asgari S, Mansournia MA, Khalili D, Valizadeh M, Azizi F, Hadaegh F.

J Am Heart Assoc. 2018 Feb 10;7(4). pii: e006924. doi: 10.1161/JAHA.117.006924.

PMID: 29440011

http://jaha.ahajournals.org/content/7/4/e006924.long

Abstract

BACKGROUND:

This study aimed to determine the association between different weight histories, including cumulative excess weight, cumulative excess waist circumference (WC), duration of general and central adiposity, current and maximum body mass index, and current and maximum WC, and incident coronary heart disease (CHD) and stroke.

METHODS AND RESULTS:

The study population consisted of 4398 adults aged ≥40 years without CHD or stroke at baseline. Associations between different weight histories and CHD and stroke were determined by multivariable time-varying Cox regression models after adjustment for age, sex, and time-varying confounders. Further adjustment was also done for mediators (eg, diabetes mellitus, hypercholesterolemia, and hypertension). During median follow-up of 13.9 years, 718 incident CHD and 158 stroke events were documented. Multivariable adjusted hazard ratios (HRs) were calculated in the sex and confounder adjusted model for CHD per 1-SD increase in cumulative excess weight (HR: 1.02; 95% confidence interval [CI], 0.96-1.07), cumulative excess WC (HR: 1.14; 95% CI, 1.04-1.24), duration of general adiposity (HR: 1.00; 95% CI, 0.92-1.08), duration of central adiposity (HR: 1.01; 95% CI, 0.93-1.09), current body mass index (HR: 1.03; 95% CI, 0.99-1.07), current WC (HR: 1.21; 95% CI, 1.11-1.32), maximum body mass index (HR: 1.01; 95% CI, 0.95-1.07), and maximum WC (HR: 1.17; 95% CI, 1.07-1.28). After further adjustment for mediators, current and maximum WC still showed a significant risk (HR: 1.13 [95% CI, 1.03-1.23] and 1.09 [95% CI, 1.00-1.20], respectively). Moreover, in the sex and confounder adjusted model, cumulative excess WC and maximum WC were associated with higher risk of stroke (hazard ratio: 1.21 [95% CI, 0.99-1.48] and 1.25 [95% CI, 1.02-1.55], respectively).

CONCLUSIONS:

Exposure to cumulative excess weight and cumulative excess WC confers little additional risk beyond their current and maximum values. Even current and maximum WC were associated with incident CHD in the presence of obesity mediators, and the latter was a significant predictor of stroke in the presence of confounders.

KEYWORDS:

body mass index; coronary heart disease; stroke; waist circumference

 

U-Shaped Association Between Serum Uric Acid Levels With Cardiovascular and All-Cause Mortality in the Elderly: The Role of Malnourishment.

Tseng WC, Chen YT, Ou SM, Shih CJ, Tarng DC; Taiwan Geriatric Kidney Disease (TGKD) Research Group.

J Am Heart Assoc. 2018 Feb 10;7(4). pii: e007523. doi: 10.1161/JAHA.117.007523.

PMID: 29440009

http://jaha.ahajournals.org/content/7/4/e007523.long

Abstract

BACKGROUND:

The link between elevated serum uric acid (SUA) levels and cardiovascular disease (CVD)-related mortality in the elderly population remains inconclusive. Nutritional status influences both SUA and CVD outcomes. Therefore, we investigated whether SUA-predicted mortality and the effect-modifying roles of malnourishment in older people.

METHODS AND RESULTS:

A longitudinal Taiwanese cohort including 127 771 adults 65 years and older participating in the Taipei City Elderly Health Examination Program from 2001 to 2010 were stratified by 1-mg/dL increment of SUA. Low SUA (<4 mg/dL) strata was categorized by malnourishment status defined as Geriatric Nutritional Risk Index <98, serum albumin <38 g/L, or body mass index <22 kg/m2. Study outcomes were all-cause and CVD-related mortality. Cox models were used to estimate hazard ratios (HRs) of mortality, after adjusting for 20 demographic and comorbid covariates. Over a median follow-up of 5.8 years, there were 16 439 all-cause and 3877 CVD-related deaths. Compared with the reference SUA strata of 4 to <5 mg/dL, all-cause mortality was significantly higher at SUA <4 mg/dL (HR, 1.16; 95% confidence interval, 1.07-1.25) and ≥8 mg/dL (HR, 1.13; confidence interval, 1.06-1.21), with progressively elevated risks at both extremes. Similarly, increasingly higher CVD-related mortality was found at the SUA level <4 mg/dL (HR, 1.19; confidence interval, 1.00-1.40) and ≥7 mg/dL (HR, 1.17; confidence interval, 1.04-1.32). Remarkably, among the low SUA (<4 mg/dL) strata, only malnourished participants had greater all-cause and CVD-related mortality. This modifying effect of malnourishment remained consistent across subgroups.

CONCLUSIONS:

SUA ≥8 or <4 mg/dL independently predicts higher all-cause and CVD-related mortality in the elderly, particularly in those with malnourishment.

KEYWORDS:

elderly; malnourishment; mortality; uric acid

 

Trajectories of Long-Term Normal Fasting Plasma Glucose and Risk of Coronary Heart Disease: A Prospective Cohort Study.

Yuan Z, Yang Y, Wang C, Liu J, Sun X, Liu Y, Li S, Xue F.

J Am Heart Assoc. 2018 Feb 13;7(4). pii: e007607. doi: 10.1161/JAHA.117.007607.

PMID: 29440033

Abstract

BACKGROUND:

Fasting plasma glucose (FPG) levels can vary over time and its longitudinal changing patterns may predict cardiometabolic risk. We aim to identify different trajectories of FPG in those who remained normoglycemic and investigate the association between trajectory groups and coronary heart disease risk in a large prospective cohort study.

METHODS AND RESULTS:

A total of 20 514 subjects between ages 20 and 80 years were included at baseline. All participants had maintained normal FPG throughout an average follow-up period of 5.8 years. We identified 3 distinct trajectories using a group-based trajectory model, labeled by initial value and changing pattern: low-increasing (n=12 694), high-increasing-decreasing (n=5330), and high-decreasing-increasing (n=2490). The coronary heart disease incidence density among these 3 groups (3.00, 4.05, and 3.26 per 1000 person-years, respectively) was significantly different (P=0.038). The high-increasing-decreasing group was characterized by a starting FPG of 4.80 mmol/L, and increased up to 5.42 mmol/L at age 55, then decreased thereafter. Treating the low-increasing group as the reference, the age- and sex-adjusted hazard ratio was 1.58 (95% confidence interval, 1.23-2.02) for the high-increasing-decreasing group by Cox proportional hazard regression. After adjustment for other potential confounding factors, the hazard ratio is 1.40 (95% confidence interval, 1.08-1.81). The association persisted after adjustment for baseline FPG, mean, or SD of FPG.

CONCLUSIONS:

Distinct trajectories of long-term normal FPG are associated with the development of coronary heart disease, which is independent of other metabolic factors including FPG levels. These findings have implications for intervention and prevention of coronary heart disease among individuals who are normoglycemic.

KEYWORDS:

cardiovascular disease risk factors; epidemiology; fasting plasma glucose; group‐based trajectory model; proportional hazard regression

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Dietary intake of nutrients involved in one-carbon metabolism and risk of urothelial cell carcinoma: A prospective cohort study.

Dugué PA, Brinkman MT, Hodge AM, Bassett JK, Bolton D, Longano A, Hopper JL, Southey MC, English DR, Milne RL, Giles GG.

Int J Cancer. 2018 Feb 15. doi: 10.1002/ijc.31319. [Epub ahead of print]

PMID: 29446079

Abstract

Nutrients involved in one-carbon metabolism may play a role in carcinogenesis through DNA replication, repair and methylation mechanisms. Most studies on urothelial cell carcinoma (UCC) have focused on folate. We sought to examine the association between B-group vitamins and methionine intake and UCC risk, overall and by subtype, and to test whether these associations are different for population subgroups whose nutritional status may be compromised. We followed participants in the Melbourne Collaborative Cohort Study (N=41,513) for over 20 years, and observed 500 UCC cases (89% originating in the bladder; superficial: 279, invasive: 221). Energy-adjusted dietary intakes of B vitamins (B1, B2, B3, B5, B6, B8, B9, and B12) and methionine were estimated from a 121-item food frequency questionnaire administered at baseline (1990-1994), using the residuals method. We used Cox regression models to compute hazard ratios (HR) of UCC risk per standard deviation of log-transformed nutrient intakes and 95% confidence intervals (CI), adjusted for potential confounders. We investigated associations by tumour subtype, and tested interactions with sex, country of birth, smoking, and alcohol drinking. The risk of UCC appeared not to be associated with intake of B-group vitamins or methionine, and findings were consistent across tumour subtypes and across demographic and lifestyle characteristics of the participants. A potential interaction between vitamin B1 and alcohol drinking was observed (all participants: HR per 1 SD=0.99 (0.91-1.09), never drinkers: HR=0.81 (0.69-0.97), P-interaction=0.02), which needs to be confirmed by other studies. Our findings do not indicate that dietary intake of nutrients involved in one-carbon metabolism are associated with UCC risk.

KEYWORDS:

B vitamin; bladder cancer; diet; folate; methionine; one-carbon metabolism; urothelial cell carcinoma

 

Vitamin D status and risk of dementia and Alzheimer's disease: A meta-analysis of dose-response.

Jayedi A, Rashidy-Pour A, Shab-Bidar S.

Nutr Neurosci. 2018 Feb 15:1-10. doi: 10.1080/1028415X.2018.1436639. [Epub ahead of print]

PMID: 29447107

Abstract

OBJECTIVE:

We aimed to test the dose-response association of serum 25(OH)D and risk of dementia and Alzheimer's disease (AD).

METHODS:

We performed a systematic search of PubMed and Scopus from database inception up to September 2017. Longitudinal cohort studies reporting risk estimates of incident dementia or AD in the general population, and for three or more quantitative categories of serum 25(OH)D were included. Pooled hazard ratios (HRs) were calculated using fixed-effects/random-effects models.

RESULTS:

Seven prospective cohort studies and one retrospective cohort study (total n = 28,354) involving 1953 cases of dementia and 1607 cases of AD were included. The pooled HRs of dementia and AD were 1.09 (95%CI: 0.95, 1.24) and 1.19 (95%CI: 0.96, 1.41) for vitamin D insufficiency (10-20 ng/ml), and 1.33 (95%CI: 1.08, 1.58) and 1.31 (95%CI: 0.98, 1.65) for deficiency (<10 ng/ml), respectively. The lower risk of dementia was observed at serum 25(OH)D of ∼25 ng/ml, whereas the risk of AD decreased continuously along with the increase of serum 25(OH)D up to ∼35 ng/ml.

CONCLUSION:

Higher levels of serum 25(OH)D was associated with a lower risk of dementia and AD, but we have no conclusive evidence regarding serum 25(OH)D levels of >35 ng/ml.

KEYWORDS:

Alzheimer disease; Dementia; Meta-analysis; Vitamin D deficiency

 

Asparagine bioavailability governs metastasis in a model of breast cancer.

Knott SRV, Wagenblast E, Khan S, Kim SY, Soto M, Wagner M, Turgeon MO, Fish L, Erard N, Gable AL, Maceli AR, Dickopf S, Papachristou EK, D'Santos CS, Carey LA, Wilkinson JE, Harrell JC, Perou CM, Goodarzi H, Poulogiannis G, Hannon GJ.

Nature. 2018 Feb 15;554(7692):378-381. doi: 10.1038/nature25465. Epub 2018 Feb 7.

PMID: 29414946

Abstract

Using a functional model of breast cancer heterogeneity, we previously showed that clonal sub-populations proficient at generating circulating tumour cells were not all equally capable of forming metastases at secondary sites. A combination of differential expression and focused in vitro and in vivo RNA interference screens revealed candidate drivers of metastasis that discriminated metastatic clones. Among these, asparagine synthetase expression in a patient's primary tumour was most strongly correlated with later metastatic relapse. Here we show that asparagine bioavailability strongly influences metastatic potential. Limiting asparagine by knockdown of asparagine synthetase, treatment with l-asparaginase, or dietary asparagine restriction reduces metastasis without affecting growth of the primary tumour, whereas increased dietary asparagine or enforced asparagine synthetase expression promotes metastatic progression. Altering asparagine availability in vitro strongly influences invasive potential, which is correlated with an effect on proteins that promote the epithelial-to-mesenchymal transition. This provides at least one potential mechanism for how the bioavailability of a single amino acid could regulate metastatic progression.

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Early and long period follow-up results of low glycemic index diet for migraine prophylaxis.

Evcili G, Utku U, Öğün MN, Özdemir G.

Agri. 2018 Jan;30(1):8-11. doi: 10.5505/agri.2017.62443.

PMID: 29450870

https://www.journalagent.com/agri/pdfs/AGRI_30_1_8_11.pdf

Abstract

OBJECTIVES:

The role of dietary restriction in the management of patients with migraine is still a controversial topic in the headache field. The aim of this study was to evaluate the efficacy of dietary restriction on migraine attacks.

METHODS:

Patients diagnosed with migraine without aura according to the International Classification of Headaches were enrolled. Our study included 350 migraine patients evaluated at the neurology headache outpatient clinic. They were randomly divided into two groups: diet group as the study group and medication group as the control group. We told migraine patients to make lifestyle changes, especially those with low glycemic index in the diet group. On the other hand, propranolol, amitriptyline, flunarizine, and topiramate were used for the prophylaxis in the medication group. The frequency and severity of attacks [using the visual analog scale (VAS)] were recorded before starting dietary restriction and 1 and 3 months after the dietary restriction.

RESULTS:

There were 350 participants in this study. After 3 months, a total of 147 patients (male/female: 17/130, mean age: 34.7±5.9) were evaluated in the diet group. The control group consisted of 147 age- and sex-matched, randomly selected patients with migraine without aura. In the first month after dietary restriction, monthly attack frequency significantly decreased in both groups but not the VAS score. The mean scores of VAS significantly decreased later in the diet group compared with those in the medication group (after 3 months).

CONCLUSION:

The results of the study revealed that low glycemic index diet intake can be an effective and reliable method to reduce migraine attacks.

 

The Effect of Omega-3 Fatty Acids, EPA, and/or DHA on Male Infertility: A Systematic Review and Meta-analysis.

Hosseini B, Nourmohamadi M, Hajipour S, Taghizadeh M, Asemi Z, Keshavarz SA, Jafarnejad S.

J Diet Suppl. 2018 Feb 16:1-12. doi: 10.1080/19390211.2018.1431753. [Epub ahead of print]

PMID: 29451828

Abstract

The objective was to evaluate the effect of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) on sperm parameters including total sperm concentration, sperm motility, sperm DHA, and seminal plasma DHA concentration in infertile men. The literature search was conducted in PubMed, Google Scholar, and Scopus from January 1, 1990 to December 20, 2017. The systematic review and meta-analysis were based on randomized controlled trials in infertile men with DHA or EPA treatments, either alone or in combination with other micronutrients. Three studies met the inclusion criteria: 147 patients in the intervention group and 143 patients in the control group. The analysis showed that omega-3 treatments significantly increased the sperm motility (RR 5.82, 95% CI [2.91, 8.72], p <. 0001, I2 = 76%) and seminal DHA concentration (RR 1.61, 95% CI [0.15, 3.07], p =. 03, I2 = 98%). Compared with the controls, the interventions did not affect the sperm concentration (RR 0.31, 95% CI [-8.13, 8.76], p =. 94, I2 = 95%) or sperm DHA (RR 0.50, 95% CI [-4.17, 5.16], p =. 83, I2 = 99%). The observed heterogeneity may be due to administration period and dosage of omega-3 fatty acids across the studies. Funnel plot shows no evidence of publication bias. This meta-analysis indicates that supplementing infertile men with omega-3 fatty acids resulted in a significant improvement in sperm motility and concentration of DHA in seminal plasma.

KEYWORDS:

docosahexaenoic acid; eicosapentaenoic acid; infertility; meta-analysis; omega-3 fatty acids

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Impact of post-diagnostic statin use on ovarian cancer mortality: a systematic review and meta-analysis of observational studies.

Li X, Zhou J.

Br J Clin Pharmacol. 2018 Feb 17. doi: 10.1111/bcp.13559. [Epub ahead of print]

PMID: 29453799

Abstract

AIM:

To comprehensively evaluate the association between post-diagnostic statin use and mortality of ovarian cancer (OC) patients.

METHODS:

Using a comprehensive strategy, multiple databases (Medline, Embase, and Web of Science) were systematically searched to identify observational studies that examined the correlation between statin use and OC mortality up to December 31, 2017. The studies were independently reviewed and selected based on predetermined selection criteria. Data were extracted independently and in duplicate. The risk of bias was evaluated with the Newcastle-Ottawa scale. Hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were summarized with a profile likelihood random effects models.

RESULTS:

Of 269 studies, eight cohort studies of 19,904 OC patients met the inclusion criteria. Post-diagnostic statin use was inversely associated with all-cause mortality/overall survival (summarized HR=0.74; 95%CI=0.63-0.87; I2 =55%; n=7) and cancer-specific mortality (summarized HR=0.87; 95%CI=0.80-0.95; I2 =0%; n=3) of OC patients. These findings were consistent by subgroup analyses stratified by study and patients characteristics as well as adjustments made for potential confounders. A meta-regression analysis found no effect of modification by these variables. Of note, similar significant inverse effects were also observed when increasing the intensity (highest vs. lowest) of post-diagnostic statin use (summarized HR=0.84; 95%CI=0.74-0.96; I2 =0%; n=3).

CONCLUSION:

Post-diagnostic statin use can improve the survival of patients with OC. Further prospective cohort and randomized controlled trials are warranted to confirm the therapeutic role of statin use on the outcome of OC.

KEYWORDS:

meta-analysis; mortality; ovarian cancer; post-diagnostic; statin

 

High phosphorus intake and gut-related parameters - results of a randomized placebo-controlled human intervention study.

Trautvetter U, Camarinha-Silva A, Jahreis G, Lorkowski S, Glei M.

Nutr J. 2018 Feb 16;17(1):23. doi: 10.1186/s12937-018-0331-4.

PMID: 29452584

https://nutritionj.biomedcentral.com/track/pdf/10.1186/s12937-018-0331-4?site=nutritionj.biomedcentral.com

Abstract

BACKGROUND:

In recent years, high phosphate intakes were discussed critically. In the small intestine, a part of the ingested phosphate and calcium precipitates to amorphous calcium phosphate (ACP), which in turn can precipitate other intestinal substances, thus leading to a beneficial modulation of the intestinal environment. Therefore, we analysed faecal samples obtained from a human intervention study regarding gut-related parameters.

METHODS:

Sixty-two healthy subjects (men, n = 30; women, n = 32) completed the double-blind, placebo-controlled and parallel designed study (mean age: 29 ± 7 years; mean BMI: 24 ± 3 kg/m2). Supplements were monosodium phosphate and calcium carbonate. During the first 2 weeks, all groups consumed a placebo sherbet powder, and afterwards a sherbet powder for 8 weeks according to the intervention group: P1000/Ca0 (1000 mg/d phosphorus), P1000/Ca500 (1000 mg/d phosphorus and 500 mg/d calcium) and P1000/Ca1000 (1000 mg/d phosphorus and 1000 mg/d calcium). After the placebo period and after 8 weeks of intervention faecal collections took place. We determined in faeces: short-chain fatty acids (SCFA) and fat as well as the composition of the microbiome (subgroup) and cyto- and genotoxicity of faecal water (FW). By questionnaire evaluation we examined tolerability of the used phosphorus supplement.

RESULTS:

Faecal fat concentrations did not change significantly due to the interventions. Concentrations of faecal total SCFA and acetate were significantly higher after 8 weeks of P1000/Ca500 supplementation compared to the P1000/Ca0 supplementation. In men, faecal total SCFA and acetate concentrations were significantly higher after 8 weeks in the P1000/Ca1000 group compared to the P1000/Ca0 one. None of the interventions markedly affected cyto- and genotoxic activity of FW. Men of the P1000/Ca1000 intervention had a significantly different gut microbial community compared to the men of the P1000/Ca0 and P1000/Ca500 ones. The genus Clostridium XVIII was significantly more abundant in men of the P1000/Ca1000 intervention group compared to the other groups. Supplementations did not cause increased intestinal distress.

CONCLUSIONS:

The used high phosphorus diet did not influence cyto- and genotoxicity of FW and the concentrations of faecal fat independent of calcium intake. Our study provides first hints for a potential phosphorus-induced modulation of the gut community and the faecal total SCFA content.

KEYWORDS:

Calcium intake; Cytotoxicity; Faecal water; Genotoxicity; Human study; Phosphate intake; Phosphorus intake; Short-chain fatty acids

 

Effect of long-term selenium supplementation on mortality: results from a multiple-dose, randomised controlled trial.

Rayman MP, Winther KH, Pastor-Barriuso R, Cold F, Thvilum M, Stranges S, Guallar E, Cold S.

Free Radic Biol Med. 2018 Feb 14. pii: S0891-5849(18)30070-4. doi: 10.1016/j.freeradbiomed.2018.02.015. [Epub ahead of print] Review.

PMID: 29454039

Abstract

BACKGROUND:

Selenium, an essential trace element, is incorporated into selenoproteins with a wide range of health effects. Selenoproteins may reach repletion at a plasma selenium concentration of ~125µg/L, at which point the concentration of selenoprotein P reaches a plateau; whether sustained concentrations higher than this are beneficial, or indeed detrimental, is unknown.

OBJECTIVE:

In a population of relatively low selenium status, we aimed to determine the effect on mortality of long-term selenium supplementation at different dose levels.

DESIGN:

The Denmark PRECISE study was a single-centre, randomised, double-blinded, placebo-controlled, multi-arm, parallel clinical trial with four groups. Participants were 491 male and female volunteers aged 60-74 years, recruited at Odense University Hospital, Denmark. The trial was initially designed as a 6-month pilot study, but supplemental funding allowed for extension of the study and mortality assessment. Participants were randomly assigned to treatment with 100, 200, or 300µg selenium/d as selenium-enriched-yeast or placebo-yeast for 5 years from randomization in 1998-1999 and were followed up for mortality for a further 10 years (through March 31, 2015).

RESULTS:

During 6,871 person-years of follow-up, 158 deaths occurred. In an intention-to-treat analysis, the hazard ratio (95% confidence interval) for all-cause mortality comparing 300µg selenium/d to placebo was 1.62 (0.66, 3.96) after 5 years of treatment and 1.59 (1.02, 2.46) over the entire follow-up period. The 100 and 200µg/d doses showed non-significant decreases in mortality during the intervention period that disappeared after treatment cessation. Although we lacked power for endpoints other than all-cause mortality, the effects on cancer and cardiovascular mortality appeared similar.

CONCLUSIONS:

A 300µg/d dose of selenium taken for 5 years in a country with moderately-low selenium status increased all-cause mortality 10 years later. While our study was not initially designed to evaluate mortality and the sample size was limited, our findings indicate that total selenium intake over 300µg/d and high-dose selenium supplements should be avoided.

KEYWORDS:

Denmark PRECISE; cancer mortality; cardiovascular mortality; mortality; plasma selenium concentration; randomised controlled trial; selenium; selenium dose; selenium intake; selenium toxicity

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[The below paper is pdf-availed.]

An Integrated Understanding of the Rapid Metabolic Benefits of a Carbohydrate-Restricted Diet on Hepatic Steatosis in Humans.

Mardinoglu A, Wu H, Bjornson E, Zhang C, Hakkarainen A, Räsänen SM, Lee S, Mancina RM, Bergentall M, Pietiläinen KH, Söderlund S, Matikainen N, Ståhlman M, Bergh PO, Adiels M, Piening BD, Granér M, Lundbom N, Williams KJ, Romeo S, Nielsen J, Snyder M, Uhlén M, Bergström G, Perkins R, Marschall HU, Bäckhed F, Taskinen MR, Borén J.

Cell Metab. 2018 Feb 7. pii: S1550-4131(18)30054-8. doi: 10.1016/j.cmet.2018.01.005. [Epub ahead of print]

PMID: 29456073

Abstract

A carbohydrate-restricted diet is a widely recommended intervention for non-alcoholic fatty liver disease (NAFLD), but a systematic perspective on the multiple benefits of this diet is lacking. Here, we performed a short-term intervention with an isocaloric low-carbohydrate diet with increased protein content in obese subjects with NAFLD and characterized the resulting alterations in metabolism and the gut microbiota using a multi-omics approach. We observed rapid and dramatic reductions of liver fat and other cardiometabolic risk factors paralleled by (1) marked decreases in hepatic de novo lipogenesis; (2) large increases in serum β-hydroxybutyrate concentrations, reflecting increased mitochondrial β-oxidation; and (3) rapid increases in folate-producing Streptococcus and serum folate concentrations. Liver transcriptomic analysis on biopsy samples from a second cohort revealed downregulation of the fatty acid synthesis pathway and upregulation of folate-mediated one-carbon metabolism and fatty acid oxidation pathways. Our results highlight the potential of exploring diet-microbiota interactions for treating NAFLD.

KEYWORDS:

FGF21; NAFLD; PPAR-α; Streptococcus; carbohydrate-restricted diet; folate; inflammation; microbiome; multi-omics; β-oxidation

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"The study diet provided approximately 4% energy from carbohydrate, 72% energy from fat and 24% energy from

protein whereas the corresponding macronutrient composition in the baseline diet was 40%, 42% and 18%, respectively (Figure 1A).

The carbohydrate content of the diet was restricted to 23-30 g per day."

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

"There were no changes in waist circumference during the

study (Table S1). Despite good compliance, we observed a slight

weight loss (1.8% ± 0.2% of their body weight; Figure 1C). Body

composition analysis at baseline and after 14 days on the diet

revealed that decreases in fat mass and water were the major

contributors to this minor weight loss (Figure 1D)."

 

https://euroqol.org/wp-content/uploads/2016/09/EQ-5D-3L_UserGuide_2015.pdf

Preadmission quality of life as predictor of outcome after acute care: The role of emotional well-being.

Belayachi J, El Khattate A, Bizrane M, Madani N, Abouqal R.

QJM. 2017 Oct 27. doi: 10.1093/qjmed/hcx209. [Epub ahead of print]

PMID: 29088410

Abstract

PURPOSE:

We sought to investigate whether preadmission quality of life could act as a predictor of mortality among acutely ill patients, and which dimension of QOL has the greater impact on outcomes.

METHODS:

Prospective cohort study including patients admitted to an acute medical unit (AMU) of Rabat Ibn Sina University Hospital, Morocco, between June and September 2014. Characteristics of patients were recorded at admission. The primary exposure was Preadmission quality of life recorded using Euroqol 5 dimensions three level (EQ-5D-3L) and the primary outcome was 90 days mortality. We fit a Cox proportional hazards model to assess their association. We constructed six prediction models; each model included either EQ5D index or one of the 5 dimensions. We allowed all continuous variables to have a nonlinear relationship with the primary outcome using restricted cubic spline with 3 knots.

RESULTS:

We included 251 patients. The mean EQ5D index was 0.46 ± 0.5. The design of each prediction model was based on the significant findings of the univariate analysis including; bedside EQ5D index or one of the 5 dimensions of the EQ5D; age, history of chronic disease, CCI, and hemoglobinemia. Multivariate Cox proportional adjusted hazard ratio derived from the six models, identified that EQ5D index was independently associated with 90 days mortality (HR:0.48;95%CI:0.25;0.91,P=0.02), and that anxiety and depression dimension has the greater impact on outcome (HR:2.97;95%CI:1.38;6.41,P=0.005).

CONCLUSIONS:

This study revealed that preadmission HRQOL, and particularly pre-admission psychological HRQOL was associated with outcome of acutely ill patients 90 days after discharge.

KEYWORDS:

Acute care; EQ5D3L; Health related quality of life; preadmission

 

New acne diagnoses linked to increased depression risk

Among acne patients, probability of developing major depressive disorder was 18.5%

Thomson Reuters Posted: Feb 19, 2018

http://www.cbc.ca/news/health/acne-patients-depressive-disorder-1.4541864

 

Association of visit-to-visit blood pressure variability with the risk of all-cause mortality and cardiovascular events in general population.

Dai L, Song L, Li X, Yang Y, Zheng X, Wu Y, Li C, Zhao H, Wang Y, Wu S, Wang Y.

J Clin Hypertens (Greenwich). 2018 Feb 19. doi: 10.1111/jch.13192. [Epub ahead of print]

PMID: 29457332

Abstract

The association between blood pressure variability (BPV) and the risk of all-cause mortality and cardiovascular diseases (CVD) is not well understood. The Kailuan study is a prospective longitudinal cohort study on cerebrovascular events and cardiovascular factors. In this study, resting blood pressure was measured at baseline and every 2 years from 2006 to 2007. BPV is mainly defined as the coefficient of variation (CV). Hazard ratio (HR), with 95% confidence intervals (CI) was calculated using Cox regression model. Among 52 387 participants, we identified 1817 who ended up with all-cause death and 1198 with CVD. Each 4.68% increase in BPV was associated with a 13% increase in the risk of mortality (HR = 1.13, 95% CI = 1.09-1.18) and a 7% increase in CVD (HR = 1.07, 95% CI = 1.02-1.13), respectively. After adjustment of confounding factors, the HR of comparing participants in the highest versus lowest quartile of CV of systolic blood pressure (SBP) was 1.37 (1.19, 1.57) for all-cause death, 1.18 (1.01, 1.39) for CVD. Similar results were also observed when BPV was measured by different parameters. We concluded that visit-to-visit BPV was associated with all-cause death and cardiovascular and cerebrovascular events in Chinese general population.

KEYWORDS:

all-cause mortality; blood pressure variability; cardiovascular diseases; epidemiology

 

Low Magnesium Intake is Associated With Increased Knee Pain in Subjects with Radiographic Knee Osteoarthritis: Data From the Osteoarthritis Initiative.

Shmagel A, Onizuka N, Langsetmo L, Vo T, Foley R, Ensrud K, Valen P.

Osteoarthritis Cartilage. 2018 Feb 15. pii: S1063-4584(18)30102-X. doi: 10.1016/j.joca.2018.02.002. [Epub ahead of print]

PMID: 29454594

Abstract

OBJECTIVE:

As magnesium mediates bone and muscle metabolism, inflammation, and pain signaling, we aimed to evaluate whether magnesium intake is associated with knee pain and function in radiographic knee osteoarthritis.

METHODS:

We investigated the associations between knee pain/function metrics and magnesium intake from food and supplements in 2548 Osteoarthritis Initiative cohort participants with prevalent radiographic knee OA (Kellgren-Lawrence score ≥2). Magnesium intake was assessed by Food Frequency Questionnaire at baseline. WOMAC and KOOS scores were reported annually with total follow up of 48 months. Analyses used linear mixed models.

RESULTS:

Among participants with baseline radiographic knee OA the mean total magnesium intake was 309.9 mg/day (SD 132.6) for men, and 287.9 mg/day (SD 118.1) for women, with 68% of men and 44% of women below the estimated average requirement. Subjects with lower magnesium intake had worse knee OA pain and function scores, throughout the 48 months (p <0.001). After adjustment for age, sex, race, BMI, calorie intake, fiber intake, pain medication use, physical activity, renal insufficiency, smoking, and alcohol use, lower magnesium intake remained associated with worse pain and function outcomes (1.4 points higher WOMAC and 1.5 points lower KOOS scores for every 50 mg of daily magnesium intake, p<0.05). Fiber intake was an effect modifier (p for interaction <0.05). The association between magnesium intake and knee pain and function scores was strongest among subjects with low fiber intake.

CONCLUSION:

Lower magnesium intake was associated with worse pain and function in knee OA, especially among individuals with low fiber intake.

 

Treatment of coenzyme Q10 for 24 weeks improves lipid and glycemic profile in dyslipidemic individuals.

Zhang P, Yang C, Guo H, Wang J, Lin S, Li H, Yang Y, Ling W.

J Clin Lipidol. 2017 Dec 21. pii: S1933-2874(17)30541-X. doi: 10.1016/j.jacl.2017.12.006. [Epub ahead of print]

PMID: 29454678

Abstract

BACKGROUND:

The use of coenzyme Q10 (CoQ10) as an adjuvant treatment with routine clinical therapy against metabolic diseases has shown benefit. However, the effect of CoQ10 as a primary preventive agent against cardiovascular diseases (CVDs) has not been well studied.

OBJECTIVE:

The objective of this study was to investigate the effect of CoQ10 on CVD risk factors in dyslipidemic patients.

METHODS:

In this randomized, double-blinded, placebo-controlled trial, 101 dyslipidemic subjects without taking any hypoglycemic or hypolipidemic drugs were administrated to 120 mg CoQ10 or placebo daily for 24 weeks. Anthropometric parameters, lipid and glycemic profile, biomarkers of inflammation, and antioxidant capacity were evaluated before and after 12 and 24 weeks of intervention.

RESULTS:

All 101 subjects were included in the analysis. On the 12th week, compared to placebo, CoQ10 supplementation decreased systolic (P = .010) and diastolic pressure (P = .001) and increased serum total antioxidant capacity (TAC; P = .003). On the 24th week, compared to placebo, CoQ10 supplementation further lowered blood pressure and TAC, reduced triglyceride (P = .020) and low-density lipoprotein cholesterol (P = .016), and increased ApoA-I (P < .001) while decreasing homeostasis model assessment of insulin resistance index (P = .009). Adjustment for change of physical activity and energy intake did not alter the effect of CoQ10 on the aforementioned parameters but led to significant decrease of non-high-density lipoprotein cholesterol in CoQ10 group compared to placebo (P = .031).

CONCLUSIONS:

Twenty-four-week treatment of CoQ10 ameliorates multiple CVD risk factors. The versatility and safety of CoQ10 makes it a potential candidate for the primary prevention of CVD.

KEYWORDS:

Clinical trial; CoQ10; Dyslipidemia; Insulin resistance

 

Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin SecretionThe DIETFITS Randomized Clinical Trial

Christopher D. Gardner, PhD; John F. Trepanowski, PhD; Liana C. Del Gobbo, PhD; et al.

Abstract

JAMA. 2018;319(7):667-679. doi:10.1001/jama.2018.0245

This randomized clinical trial compares the effects of a healthy low-fat vs a healthy low-carbohydrate diet on 12-month weight change among adults aged 18 to 50 years with a body mass index of 28 to 40 without diabetes, and investigates modification of the diet effect by genotype pattern or insulin secretion.

Abstract

Importance Dietary modification remains key to successful weight loss. Yet, no one dietary strategy is consistently superior to others for the general population. Previous research suggests genotype or insulin-glucose dynamics may modify the effects of diets.

Objective To determine the effect of a healthy low-fat (HLF) diet vs a healthy low-carbohydrate (HLC) diet on weight change and if genotype pattern or insulin secretion are related to the dietary effects on weight loss.

Design, Setting, and Participants The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) randomized clinical trial included 609 adults aged 18 to 50 years without diabetes with a body mass index between 28 and 40. The trial enrollment was from January 29, 2013, through April 14, 2015; the date of final follow-up was May 16, 2016. Participants were randomized to the 12-month HLF or HLC diet. The study also tested whether 3 single-nucleotide polymorphism multilocus genotype responsiveness patterns or insulin secretion (INS-30; blood concentration of insulin 30 minutes after a glucose challenge) were associated with weight loss.

Interventions Health educators delivered the behavior modification intervention to HLF (n = 305) and HLC (n = 304) participants via 22 diet-specific small group sessions administered over 12 months. The sessions focused on ways to achieve the lowest fat or carbohydrate intake that could be maintained long-term and emphasized diet quality.

Main Outcomes and Measures Primary outcome was 12-month weight change and determination of whether there were significant interactions among diet type and genotype pattern, diet and insulin secretion, and diet and weight loss.

Results Among 609 participants randomized (mean age, 40 [sD, 7] years; 57% women; mean body mass index, 33 [sD, 3]; 244 [40%] had a low-fat genotype; 180 [30%] had a low-carbohydrate genotype; mean baseline INS-30, 93 μIU/mL), 481 (79%) completed the trial. In the HLF vs HLC diets, respectively, the mean 12-month macronutrient distributions were 48% vs 30% for carbohydrates, 29% vs 45% for fat, and 21% vs 23% for protein. Weight change at 12 months was −5.3 kg for the HLF diet vs −6.0 kg for the HLC diet (mean between-group difference, 0.7 kg [95% CI, −0.2 to 1.6 kg]). There was no significant diet-genotype pattern interaction (P = .20) or diet-insulin secretion (INS-30) interaction (P = .47) with 12-month weight loss. There were 18 adverse events or serious adverse events that were evenly distributed across the 2 diet groups.

Conclusions and Relevance In this 12-month weight loss diet study, there was no significant difference in weight change between a healthy low-fat diet vs a healthy low-carbohydrate diet, and neither genotype pattern nor baseline insulin secretion was associated with the dietary effects on weight loss. In the context of these 2 common weight loss diet approaches, neither of the 2 hypothesized predisposing factors was helpful in identifying which diet was better for whom.

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