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Cognitive response to fish oil, blueberry, and combined supplementation in older adults with subjective cognitive impairment.

McNamara RK, Kalt W, Shidler MD, McDonald J, Summer SS, Stein AL, Stover AN, Krikorian R.

Neurobiol Aging. 2018 Apr;64:147-156. doi: 10.1016/j.neurobiolaging.2017.12.003. Epub 2017 Dec 12.

PMID: 29458842

Abstract

Given evidence that eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and anthocyanin-rich blueberries provide neurocognitive benefit, we investigated long-term supplementation in older adults with cognitive complaints. In a 24-week randomized, double-blind, placebo-controlled trial, elderly men and women received daily fish oil (FO) or blueberry (BB) or both. Diet records confirmed that participants reduced background consumption of EPA, DHA, and anthocyanins as prescribed. Erythrocyte EPA + DHA composition increased in the FO groups (p = 0.0001). Total urinary anthocyanins did not differ between the groups after supplementation but glycoside and native (food) forms increased only in the BB-supplemented groups. The FO (p = 0.03) and BB (p = 0.05) groups reported fewer cognitive symptoms, and the BB group showed improved memory discrimination (p = 0.04), indicating that supplementation improved cognition. Cognitive benefit in the BB group was associated with the presence of urinary anthocyanins reflecting recent BB intake but not with anthocyanin metabolites. However, combined FO + BB treatment was not associated with cognitive enhancement as expected.

KEYWORDS:

Aging; Anthocyanins; Blueberries; Dementia; Memory; Omega-3 fatty acids

 

Perfluoroalkyl substances, glucose homeostasis, and gestational diabetes mellitus in Chinese pregnant women: A repeat measurement-based prospective study.

Wang H, Yang J, Du H, Xu L, Liu S, Yi J, Qian X, Chen Y, Jiang Q, He G.

Environ Int. 2018 Feb 16;114:12-20. doi: 10.1016/j.envint.2018.01.027. [Epub ahead of print]

PMID: 29459131

Abstract

BACKGROUND:

Exposure to perfluoroalkyl substances (PFASs) can affect glucose homeostasis and has been suggested as a potential risk of diabetes mellitus, but data are limited for pregnant women.

OBJECTIVES:

We aimed to explore the associations of exposure to PFASs with glucose homeostasis and gestational diabetes mellitus (GDM) in Chinese pregnant women.

METHODS:

The current study was conducted in Hebei Province of Northern China between 2013 and 2014 and 560 pregnant women were recruited in their early term of pregnancy and two representative serum PFASs, perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), were measured. In 385 pregnant women who completed oral glucose tolerance test (OGTT), the associations of serum PFOA and PFOS concentrations with fasting blood glucose (FBG), fasting insulin (FIns), and homeostasis model assessment of insulin resistance (HOMA-IR) in the early, middle, and late terms of pregnancy and occurrence of GDM were examined using linear and Cox proportional hazard regression models. The reproducibility of serum PFASs during pregnancy was assessed in 230 pregnant women.

RESULTS:

The intraclass correlation coefficients of serum PFASs, covariates, and outcomes based on averaged repeat measurement (0.35-0.96) were higher than those based on single measurement (0.16-0.92). Serum PFOA was positively associated with averaged FIns and HOMA-IR in the early, middle, and late terms of pregnancy and averaged blood glucose level at 1 h and 2 h of OGTT, but serum PFOS tended to be negatively associated with averaged FBG and OGTT blood glucose. The adjusted hazard ratios of GDM associated with serum PFOA and PFOS were 1.98 (95% confidence interval: 0.70-5.57; p-value: 0.197) and 0.71 (0.29-1.75; 0.453), respectively.

CONCLUSIONS:

Our data raised a possibility that exposure to PFASs might have different influences on glucose homeostasis and GDM in Chinese pregnant women. More lab and human studies are needed to further test the hypothesis and investigate potential mechanisms.

KEYWORDS:

Chinese pregnant women; Gestational diabetes mellitus; Glucose homeostasis; Perfluoroalkyl substances; Prospective study; Repeat measurement

 

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies.

Zhu D, Chung HF, Pandeya N, Dobson AJ, Kuh D, Crawford SL, Gold EB, Avis NE, Giles GG, Bruinsma F, Adami HO, Weiderpass E, Greenwood DC, Cade JE, Mitchell ES, Woods NF, Brunner EJ, Simonsen MK, Mishra GD.

Eur J Epidemiol. 2018 Feb 19. doi: 10.1007/s10654-018-0367-y. [Epub ahead of print]

PMID: 29460096

Abstract

Current evidence on the association between body mass index (BMI) and age at menopause remains unclear. We investigated the relationship between BMI and age at menopause using data from 11 prospective studies. A total of 24,196 women who experienced menopause after recruitment was included. Baseline BMI was categorised according to the WHO criteria. Age at menopause, confirmed by natural cessation of menses for ≥ 12 months, was categorised as < 45 years (early menopause), 45-49, 50-51 (reference category), 52-53, 54-55, and ≥ 56 years (late age at menopause). We used multinomial logistic regression models to estimate multivariable relative risk ratios (RRRs) and 95% confidence intervals (CI) for the associations between BMI and age at menopause. The mean (standard deviation) age at menopause was 51.4 (3.3) years, with 2.5% of the women having early and 8.1% late menopause. Compared with those with normal BMI (18.5-24.9 kg/m2), underweight women were at a higher risk of early menopause (RRR 2.15, 95% CI 1.50-3.06), while overweight (1.52, 1.31-1.77) and obese women (1.54, 1.18-2.01) were at increased risk of late menopause. Overweight and obesity were also significantly associated with around 20% increased risk of menopause at ages 52-53 and 54-55 years. We observed no association between underweight and late menopause. The risk of early menopause was higher among obese women albeit not significant (1.23, 0.89-1.71). Underweight women had over twice the risk of experiencing early menopause, while overweight and obese women had over 50% higher risk of experiencing late menopause.

KEYWORDS:

Age at menopause; Obesity; Prospective studies; Underweight

 

Alcohol consumption and risk of hematological malignancies: A meta-analysis of prospective studies.

Psaltopoulou T, Sergentanis TN, Ntanasis-Stathopoulos I, Tzanninis IG, Tsilimigras DI, Dimopoulos MA.

Int J Cancer. 2018 Feb 20. doi: 10.1002/ijc.31330. [Epub ahead of print]

PMID: 29460427

Abstract

Current convincing evidence suggests that alcohol intake increases the risk of several carcinomas, which might subsequently lead to a recommendation towards limiting alcohol consumption. However, there are accumulating data worth meta-analyzing that show a different effect on the risk of hematological malignancies. Eligible cohort studies were sought in PubMed database up to August 31, 2016. Separate analyses were performed by subtype of hematological malignancy (non-Hodgkin lymphoma [NHL] and subtypes, Hodgkin lymphoma [HL], leukemia and subtypes), time status (ever, current, former), level of consumption (light, moderate, heavy), alcoholic beverage (total alcohol, beer, liquor, wine), and gender. Moderate and heavy alcohol consumption were significantly associated with reduced risk of NHL (relative risk [RR]=0.85, 95% confidence interval [CI]: 0.80-0.90 and RR=0.73, 95%CI: 0.60-0.89, respectively); a protective trend was also shown for light alcohol intake (RR=0.93, 95%CI:0.87-1.00). Specifically, beer consumption was associated with reduced NHL risk (RR=0.88, 95%CI: 0.81-0.95). However, the association regarding other alcoholic beverages seemed null. The beneficial effects of alcohol mainly pertained to Diffuse Large B-Cell Lymphoma (DLBCL) (RR=0.83, 95%CI:0.77-0.89) and Follicular Lymphoma (FL) (RR=0.85, 95%CI:0.78-0.93). There was also no association between alcohol consumption and risk of HL or leukemias. In contrast to most solid malignancies, alcohol seems to confer a protective effect on NHL risk, especially on DLBCL and FL subtypes, with beer being notably beneficial.

KEYWORDS:

Alcohol; Hodgkin lymphoma; leukemia; meta-analysis; non-Hodgkin lymphoma

 

Chilli intake is inversely associated with hypertension among adults.

Shi Z, Riley M, Brown A, Page A.

Clin Nutr ESPEN. 2018 Feb;23:67-72. doi: 10.1016/j.clnesp.2017.12.007. Epub 2017 Dec 26.

PMID: 29460816

Abstract

BACKGROUND & AIMS:

This study aimed to examine the association between chilli intake and the incidence of hypertension in a Chinese adult population.

METHODS:

Adults aged 20-75 years in the China Health and Nutrition Survey were followed from 1991 to 2011. Dietary data were collected during home visits using a 3-day food record in 1991, 1993, 1997, 2000, 2004, 2006, 2009 and 2011. Cox regression was used in the analysis. Blood pressure was measured at each data collection point.

RESULTS:

13,670 adults were followed for a median of 9.0 years. During 132,089 person years of follow-up 4040 subjects developed hypertension. Chilli consumption was inversely associated with the incidence of hypertension. The incidence rate of hypertension was 30.5, 33.4, 31.9, and 24.0 per 1000 person years among those who consumed no chilli or 1-20, 20.1-50, ≥50.1 g/day respectively. Adjusting for age, gender, energy intake, sodium and fat intake, smoking, alcohol consumption and physical activity, those with increasing cumulative average chilli intake were less likely to develop hypertension: 0, 1-20, 20.1-50 and ≥50.1 g/day had a hazard ratio (HR) for hypertension of 1.00, 0.80 (95%CI 0.73-0.88), 0.81 (0.73-0.89) and 0.65 (0.57-0.75) (p for trend <0.001) respectively. The association was independent of overall dietary patterns and BMI. There was no significant interaction between chilli intake and gender, income, education and residence (urban/rural) in relation to the risk of hypertension.

CONCLUSIONS:

Chilli intake is inversely associated with the risk of developing hypertension in Chinese adults.

KEYWORDS:

Chilli intake; Cohort study; Hypertension

 

The relation between dietary intake and glaucoma: a systematic review.

Ramdas WD.

Acta Ophthalmol. 2018 Feb 20. doi: 10.1111/aos.13662. [Epub ahead of print] Review.

PMID: 29461678

Abstract

PURPOSE:

A common question of patients to their physician is what they can do themselves against glaucoma, except taking their daily medication. However, for ophthalmologists, it is often hard to give their patients an advice on their dietary intake. To help ophthalmologists in answering this question, an overview of the current scientific literature on the association of nutrients with glaucoma is presented.

METHODS:

A comprehensive systematic review was conducted in which articles published up to September 2017 were identified in PubMed and reference lists. Nutrients were categorized into minerals and trace elements, nutrition with antioxidative properties and omega-fatty acids.

RESULTS:

The literature search revealed a total of 407 articles of which a total of 46 met the inclusion criteria. Most of these articles studied the effect of nutrients on open-angle glaucoma. Many trace elements have been investigated in the literature, but the most interesting are selenium and iron (both may increase the risk of glaucoma). Investigated nutrients with antioxidative properties and omega-fatty acids included glutathione, nitric oxide, carotenoids, flavonoids, and omega-3 and omega-6 fatty acids. Of these, glutathione, nitric oxide, and flavonoids had a significant protective effect on glaucoma.

CONCLUSION:

Intake of selenium and iron may increase the risk of glaucoma, though, only few studies have been done on this topic. Nitric oxide present in other dark green leafy vegetables seems to have a beneficial effect on glaucoma. However, the evidence for an association of dietary intake with glaucoma is still not strong. More (longitudinal and randomized clinical trials) studies are required to make the presented findings clinically applicable.

KEYWORDS:

antioxidants; dietary intake; fatty acids; glaucoma; glutathione; minerals; nitric oxide; trace elements

 

Regular Yogurt Intake and Risk of Cardiovascular Disease Among Hypertensive Adults.

Buendia JR, Li Y, Hu FB, Cabral HJ, Bradlee ML, Quatromoni PA, Singer MR, Curhan GC, Moore LL.

Am J Hypertens. 2018 Feb 15. doi: 10.1093/ajh/hpx220. [Epub ahead of print]

PMID: 29462263

Abstract

BACKGROUND:

High blood pressure (HBP) is a major cardiovascular disease (CVD) risk factor. Clinical trials including Dietary Approaches to Stop Hypertension (DASH) have demonstrated beneficial effects of dairy consumption on risks of HBP and CVD. Yogurt, a fermented dairy product, may independently be related to CVD risk.

OBJECTIVE:

To evaluate the association between yogurt consumption and CVD risk among hypertensive individuals in 2 large cohorts and to determine whether the association differs among those whose eating pattern more closely resembles the DASH diet.

METHODS:

Overall, 55,898 female Nurses' Health Study (NHS) and 18,232 male Health Professionals Follow-Up Study (HPFS) participants with prevalent HBP were included. Cumulative average estimates of yogurt intake from validated food frequency questionnaires were related to verified self-reported CVD outcomes using Cox proportional hazards models. Hazard ratios and 95% confidence intervals (CI) were adjusted for CVD risk factors, medications, and diet covariates.

RESULTS:

Yogurt intake was inversely associated with CVD risk (myocardial infarction and stroke) among hypertensive participants (P <0.01 in both cohorts). Among participants consuming ≥2 servings/week of yogurt, NHS women had a 17% (95% CI: 0.74-0.92) lower risk while HPFS men experienced a 21% (95% CI: 0.66-0.96) lower CVD risk compared to those who consumed <1 serving/month. Regular yogurt consumers with higher DASH diet scores had 16% (95% CI: 0.73-0.96) and 30% (95% CI: 0.57-0.85) CVD risk reductions in the 2 cohorts, respectively.

CONCLUSION:

Hypertensive men and women who consumed ≥2 servings/week of yogurt, especially in the context of a healthy diet, were at lower risk for developing CVD.

 

Prediagnostic Serum Vitamin D Levels and the Risk of Crohn's Disease and Ulcerative Colitis in European Populations: A Nested Case-Control Study.

Opstelten JL, Chan SSM, Hart AR, van Schaik FDM, Siersema PD, Lentjes EGWM, Khaw KT, Luben R, Key TJ, Boeing H, Bergmann MM, Overvad K, Palli D, Masala G, Racine A, Carbonnel F, Boutron-Ruault MC, Tjønneland A, Olsen A, Andersen V, Kaaks R, Kühn T, Tumino R, Trichopoulou A, Peeters PHM, Verschuren WMM, Witteman BJM, Oldenburg B.

Inflamm Bowel Dis. 2018 Feb 15;24(3):633-640. doi: 10.1093/ibd/izx050.

PMID: 29462382

Abstract

BACKGROUND:

A low vitamin D status has been put forward as a potential risk factor for the development of inflammatory bowel disease (IBD). This study investigated the association between prediagnostic circulating vitamin D concentrations and dietary intakes of vitamin D, and the risk of Crohn's disease (CD) and ulcerative colitis (UC).

METHODS:

Among 359,728 participants of the European Prospective Investigation into Cancer and Nutrition cohort, individuals who developed CD or UC after enrollment were identified. Each case was matched with2 controls by center, gender, age, date of recruitment, and follow-up time. At cohort entry, blood samples were collected and dietary vitamin D intakes were obtained from validated food frequency questionnaires. Serum 25-hydroxyvitamin D levels were measured using liquid chromatography-tandem mass spectrometry. Conditional logistic regression was performed to determine the odds of CD and UC.

RESULTS:

Seventy-two participants developed CD and 169 participants developed UC after a median follow-up of 4.7 and 4.1 years, respectively. Compared with the lowest quartile, no associations with the 3 higher quartiles of vitamin D concentrations were observed for CD (p trend = 0.34) or UC (p trend = 0.66). Similarly, no associations were detected when serum vitamin D levels were analyzed as a continuous variable. Dietary vitamin D intakes were not associated with CD (p trend = 0.39) or UC (p trend = 0.83).

CONCLUSIONS:

Vitamin D status was not associated with the development of CD or UC. This does not suggest a major role for vitamin D deficiency in the etiology of IBD, although larger studies are needed to confirm these findings.

 

The Quest to Define Individual Risk After Living Kidney Donation.

Poggio ED, Reese PP.

Ann Intern Med. 2018 Feb 20;168(4):296-297. doi: 10.7326/M17-3249. Epub 2018 Jan 30. No abstract available.

PMID: 29379960

Living-donor kidney transplantation has been a cornerstone treatment for patients with end-stage renal disease (ESRD) since the first living donation in the mid-1950s. In the United States, approximately 140 000 living persons have chosen to donate a kidney since 1988 and their kidneys currently account for about one third of all kidney transplants. Primary care physicians and other internists should have insight into donor outcomes because patients with kidney disease and potential donors may seek their advice. Despite more than 6 decades of living kidney donation, large and high-quality studies of ESRD and other relevant outcomes after donation have been completed only in the past decade. O'Keeffe and colleagues (1) report a meta-analysis that concludes that living kidney donors face elevated relative risks for ESRD, preeclampsia, and high diastolic blood pressure. Unfortunately, the field is still a long way from offering precise estimates to potential donors about donation-related risk.

Determining the health consequences of kidney donation poses major methodological challenges, which include identifying an equally healthy group of nondonors for comparison. O'Keeffe and colleagues rated the quality of these comparison groups in the studies in their analysis and found that most comparison nondonors were probably not as healthy as living kidney donors. An additional challenge is that although a reduction in glomerular filtration rate of 25% to 40% and small perturbations in renal metabolism (such as higher levels of uric acid and fibroblast growth factor 23) are evident by the early postdonation period (2), clinically meaningful consequences of having a single kidney may not manifest for decades. The meta-analysis found no evidence of higher mortality or cardiovascular disease rates associated with kidney donation—an important finding because a higher risk for death among donors was reported in a Scandinavian cohort (3). However, on the basis of 3 studies, the meta-analysis found that living kidney donation was associated with a relative risk for ESRD of 8.83. Based on 2 studies, the relative risk for preeclampsia for donors who subsequently became pregnant was 2.12.

The limited evidence related to key outcomes in kidney donors is concerning. Median follow-up in the 3 largest donor cohorts was less than 10 years. For studies with more than 100 donors, the longest follow-up was a mean of 24 years. Potential donors should be cognizant that the absolute rate of ESRD after nephrectomy was low (about 0.5 event per 1000 person-years). However, we must also recognize that a low ESRD rate reported for 8 years of follow-up (from a U.S. cohort) or 15 years of follow-up (from a Norwegian cohort) should not be particularly reassuring when advising a 25-year-old donor. The authors also correctly acknowledge that the findings may not apply to donors in low- and middle-income countries.

Disclosure of the risks reported by O'Keeffe and colleagues should be standard practice when counseling potential kidney donors, and such disclosures are incorporated into some existing guidelines (4, 5). Similarly, potential donors should understand how complications of nephrectomy will or will not be addressed by transplant programs or the health system. For example, in some nations, prior living donors who develop ESRD are awarded substantial priority in allocation of deceased-donor kidneys (6). However, whether this counseling influences many donation decisions is unclear because most donors are already highly motivated by sympathy for a loved one. Many are young: 28% of U.S. donors in 2016 were younger than 35 years (7), and these persons may have difficulty imagining the possibility of ESRD or other problems far in the future.

For those of us who counsel potential donors, there is reason for pessimism that we will soon be able to estimate individual risk with any precision. Three issues inhibit prediction (8, 9). First, because rates of ESRD are so low, only a handful among many donors with highly similar characteristics at donation will develop ESRD. Second, the risk for ESRD (or other complications) probably depends substantially on factors unexamined in current studies. If validated by future research, some of these risks might be uncovered during donor evaluation (such as an APOL1 high-risk genetic variant or low birthweight). However, other unforeseeable events many years after donation likely provide the “second hit” that predisposes a person to ESRD (for example, diabetes or acute kidney injury). A third barrier is that times change, which can undermine research relevance. Although we might need cohorts with 30-year follow-up to accrue sufficient events to identify at-risk subgroups, population demographics and medical practice will also evolve. For example, the prevalence of obesity—a risk factor for ESRD—has rapidly increased. One cohort from 3 large centers reported that obesity rates among living donors more than tripled from 8% in 1963 to 1974 to 26% in 1997 to 2007 (10).

In the absence of precision risk prediction, the transplant field has some immediate opportunities. The first is orienting selection toward older donors. This orientation would have a strong ethical foundation: A 15-year ESRD risk horizon is more meaningful for a 55-year-old than a 25-year-old potential donor. The second is candid discussion with all potential donors about the limits of knowledge about long-term outcomes. The third opportunity is determining how best to counsel potential donors. We lack guidance about whether and how to consider the motives that drive an individual to donate a kidney. For many, kidney donation is affirming and meaningful. We need to hear what donors feel, think, want, and understand about excess risk and how they use this information to reconcile long-term medical risk with psychosocial health and quality of life while making the decision. The meaning an individual might find through donation is very difficult to quantify. Yet, the field must contend with these issues when determining acceptable risk thresholds that are based on highly uncertain estimates at the individual level (5). Finally, transplant programs and primary care physicians should help prior donors adopt healthy lifestyles to prevent and treat threats to kidney health after donation, such as diabetes, that may harm their kidneys later in life.

O'Keeffe and colleagues have provided a definitive analysis of the known medical risks associated with donor nephrectomy in the medium-term after donation. However, a close look at the data reminds us that long-term outcomes are uncertain and that precision medicine has not arrived for risk prediction in kidney donors. In the meantime, we should do our best to protect potential donors with careful selection, candor about harms, open discussion about unknowns, and a commitment to their lifelong health after nephrectomy. Those goals give us plenty of work to do.

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

Mid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis.

O'Keeffe LM, Ramond A, Oliver-Williams C, Willeit P, Paige E, Trotter P, Evans J, Wadström J, Nicholson M, Collett D, Di Angelantonio E.

Ann Intern Med. 2018 Feb 20;168(4):276-284. doi: 10.7326/M17-1235. Epub 2018 Jan 30.

PMID: 29379948

Abstract

BACKGROUND:

Long-term health risks for adults who donate kidneys are unclear.

PURPOSE:

To summarize evidence about mid- and long-term health risks associated with living kidney donation in adults.

DATA SOURCES:

PubMed, Embase, Scopus, and PsycINFO without language restriction from April 1964 to July 2017.

STUDY SELECTION:

Observational studies with at least 1 year of follow-up that compared health outcomes in adult living kidney donors versus nondonor populations.

DATA EXTRACTION:

Two investigators independently extracted study data and assessed study quality.

DATA SYNTHESIS:

52 studies, comprising 118 426 living kidney donors and 117 656 nondonors, were included. Average follow-up was 1 to 24 years. No evidence suggested higher risk for all-cause mortality, cardiovascular disease, hypertension, type 2 diabetes, or adverse psychosocial health outcomes in living kidney donors than in nondonor populations. Donors had higher diastolic blood pressure, lower estimated glomerular filtration rates, and higher risk for end-stage renal disease (ESRD) (relative risk [RR], 8.83 [95% CI, 1.02 to 20.93]) and preeclampsia in female donors (RR, 2.12 [CI, 1.06 to 4.27]). Despite the increased RR, donors had low absolute risk for ESRD (incidence rate, 0.5 event [CI, 0.1 to 4.9 events] per 1000 person-years) and preeclampsia (incidence rate, 5.9 events [CI, 2.9 to 8.9 events] per 100 pregnancies).

LIMITATION:

Generalizability was limited by selected control populations, few studies reported pregnancy-related outcomes, and few studies were from low- and middle-income countries.

CONCLUSION:

Although living kidney donation is associated with higher RRs for ESRD and preeclampsia, the absolute risk for these outcomes remains low. Compared with nondonor populations, living kidney donors have no increased risk for other major chronic diseases, such as type 2 diabetes, or for adverse psychosocial outcomes.

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The effect of consumption temperature on the homeostatic and hedonic responses to glucose ingestion in the hypothalamus and the reward system.

van Opstal AM, van den Berg-Huysmans AA, Hoeksma M, Blonk C, Pijl H, Rombouts SARB, van der Grond J.

Am J Clin Nutr. 2018 Jan 1;107(1):20-25. doi: 10.1093/ajcn/nqx023.

PMID: 29381802

Abstract

BACKGROUND:

Excessive consumption of sugar-sweetened beverages (SSBs) has been associated with obesity and related diseases. SSBs are often consumed cold, and both the energy content and temperature might influence the consumption behavior for SSBs.

OBJECTIVE:

The main aim of this study was to elucidate whether consumption temperature and energy (i.e., glucose) content modulate homeostatic (hypothalamus) and reward [ventral tegmental area (VTA)] responses.

DESIGN:

Sixteen healthy men participated in our study [aged 18-25 y; body mass index (kg/m2): 20-23]. High-resolution functional magnetic resonance imaging data were collected after ingestion of 4 different study stimuli: plain tap water at room temperature (22°C), plain tap water at 0°C, a glucose-containing beverage (75 g glucose dissolved in 300 mL water) at 22°C, and a similar glucose drink at 0°C. Blood oxygen level-dependent (BOLD) changes from baseline (7 min preingestion) were analyzed over time in the hypothalamus and VTA for individual stimulus effects and for effects between stimuli.

RESULTS:

In the hypothalamus, water at 22°C led to a significantly increased BOLD response; all other stimuli resulted in a direct, significant decrease in BOLD response compared with baseline. In the VTA, a significantly decreased BOLD response compared with baseline was found after the ingestion of stimuli containing glucose at 0°C and 22°C. These responses were not significantly modulated by consumption temperature. The consumption of plain water did not have a significant VTA BOLD effect.

CONCLUSIONS:

Our data show that glucose at 22°C, glucose at 0°C, and water at 0°C lowered hypothalamic activity, which is associated with increased satiation. On the contrary, the consumption of water at room temperature increased activity. All stimuli led to a similar VTA response, which suggests that all drinks elicited a similar hedonic response. Our results indicate that, in addition to glucose, the low temperature at which SSBs are often consumed also leads to a response from the hypothalamus and might strengthen the response of the VTA.

KEYWORDS:

energy sensing; glucose; hypothalamus; reward system; temperature; ventral tegmental area

 

Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: a potential strategy for decreasing intake of free sugars? A randomized controlled pilot study.

Al Khatib HK, Hall WL, Creedon A, Ooi E, Masri T, McGowan L, Harding SV, Darzi J, Pot GK.

Am J Clin Nutr. 2018 Jan 1;107(1):43-53. doi: 10.1093/ajcn/nqx030.

PMID: 29381788

Abstract

BACKGROUND:

Evidence suggests that short sleep duration may be a newly identified modifiable risk factor for obesity, yet there is a paucity of studies to investigate this.

OBJECTIVE:

We assessed the feasibility of a personalized sleep extension protocol in adults aged 18-64 y who are habitually short sleepers (5 to <7 h), with sleep primarily measured by wrist actigraphy. In addition, we collected pilot data to assess the effects of extended sleep on dietary intake and quality measured by 7-d food diaries, resting and total energy expenditure, physical activity, and markers of cardiometabolic health.

DESIGN:

Forty-two normal-weight healthy participants who were habitually short sleepers completed this free-living, 4-wk, parallel-design randomized controlled trial. The sleep extension group (n = 21) received a behavioral consultation session targeting sleep hygiene. The control group (n = 21) maintained habitual short sleep.

RESULTS:

Rates of participation, attrition, and compliance were 100%, 6.5%, and 85.7%, respectively. The sleep extension group significantly increased time in bed [0:55 hours:minutes (h:mm); 95% CI: 0:37, 1:12 h:mm], sleep period (0:47 h:mm; 95% CI: 0:29, 1:05 h:mm), and sleep duration (0:21 h:mm; 95% CI: 0:06, 0:36 h:mm) compared with the control group. Sleep extension led to reduced intake of free sugars (-9.6 g; 95% CI: -16.0, -3.1 g) compared with control (0.7 g; 95% CI: -5.7, 7.2 g) (P = 0.042). A sensitivity analysis in plausible reporters showed that the sleep extension group reduced intakes of fat (percentage), carbohydrates (grams), and free sugars (grams) in comparison to the control group. There were no significant differences between groups in markers of energy balance or cardiometabolic health.

CONCLUSIONS:

We showed the feasibility of extending sleep in adult short sleepers. Sleep extension led to reduced free sugar intakes and may be a viable strategy to facilitate limiting excessive consumption of free sugars in an obesity-promoting environment.

KEYWORDS:

RCT; diet; energy balance; energy intake; randomized controlled trial; sleep extension

 

Red meat consumption and risk of cardiovascular diseases-is increased iron load a possible link?

Quintana Pacheco DA, Sookthai D, Wittenbecher C, Graf ME, Schübel R, Johnson T, Katzke V, Jakszyn P, Kaaks R, Kühn T.

Am J Clin Nutr. 2018 Jan 1;107(1):113-119. doi: 10.1093/ajcn/nqx014.

PMID: 29381787

https://watermark.silverchair.com/nqx014.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAaYwggGiBgkqhkiG9w0BBwagggGTMIIBjwIBADCCAYgGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMtT_vn1dTXe-3bBrPAgEQgIIBWbYegosENyQU6Qhq01P2Y6Zf5KovGrEpRnuQa_uHgSGSoa_L2I7gPfW_aKQfKbMPm6O-mB3gAJMHPS6DMfPospU7EW1SZFWi26JtobLt4XfSekyAw9vXb0dR7D52R1ze_22Bmi54-N196ftgZ59Ix3k-Eg1HP93PRJ0aMqn9ZgWG2dTJmnFj_pyNqF_1nWmFzAUbYZ7I_18skf04VvbwuAxTx5kTATrtbtFUt1iQZveyGqYNYBF2esQQhOaY-3CkCXS_xYcFp-ggzpfuPLtkq-bswQ27dZO4ahw6AsMa7xtLfCyQws5lTnUjurQ7q_UQE5Pl7mwI4_8jju15JTKjN9PBGLRg6WOhX7dXKfJ8aR0dL92ZVSZhx-I5EfEEHJvJ1I7z3MZYaKVo9gBpz0naL8-GjANaWmRHk_1IiJ3srcF5XrLYnd7pV5I24ziHSnt2HudfIJCFP8LbeQ

Abstract

BACKGROUND:

High iron load and red meat consumption could increase the risk of cardiovascular diseases (CVDs). As red meat is the main source of heme iron, which is in turn a major determinant of increased iron load, adverse cardiometabolic effects of meat consumption could be mediated by increased iron load.

OBJECTIVE:

The object of the study was to assess whether associations between red meat consumption and CVD risk are mediated by iron load in a population-based human study.

DESIGN:

We evaluated relations between red meat consumption, iron load (plasma ferritin), and risk of CVD in the prospective EPIC-Heidelberg Study using a case-cohort sample including a random subcohort (n = 2738) and incident cases of myocardial infarction (MI, n = 555), stroke (n = 513), and CVD mortality (n = 381). Following a 4-step mediation analysis, associations between red meat consumption and iron load, red meat consumption and CVD risk, and iron load and CVD risk were assessed by multivariable regression models before finally testing to which degree associations between red meat consumption and CVD risk were attenuated by adjustment for iron status.

RESULTS:

Red meat consumption was significantly positively associated with ferritin concentrations and MI risk [hr per 50 g daily intake: 1.18 (95% CI: 1.05, 1.33)], but no significant associations with stroke risk and CVD mortality were observed. While direct associations between ferritin concentrations and MI risk as well as CVD mortality were significant in age- and sex-adjusted Cox regression models, these associations were substantially attenuated and no longer significant after multivariable adjustment for classical CVD risk factors. Strikingly, ferritin concentrations were positively associated with a majority of classical CVD risk factors (age, male sex, alcohol intake, obesity, inflammation, and lower education).

CONCLUSION:

Increased ferritin concentrations may be a marker of an overall unfavorable risk factor profile rather than a mediator of greater CVD risk due to meat consumption.

KEYWORDS:

cardiovascular disease; ferritin; iron status; myocardial infarction; red meat; stroke

 

Impact of Dietary Fiber Consumption on Insulin Resistance and the Prevention of Type 2 Diabetes.

Weickert MO, Pfeiffer AFH.

J Nutr. 2018 Jan 1;148(1):7-12. doi: 10.1093/jn/nxx008.

PMID: 29378044

https://watermark.silverchair.com/nxx008.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAZ4wggGaBgkqhkiG9w0BBwagggGLMIIBhwIBADCCAYAGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM3P_dydCnd2uCmD9MAgEQgIIBUZQuntWN46ikKPMgU6tZdF5k_Pb_iisqZNqyab6r32pDyKnkvreteH-V_sZeTEmKEz9OQi2GJOyTb7X0M6UwmFy6tn7dh_0oJKQZTuBMWJ77MuqlROy9rr5sMOzqBBcGih8_rTsq2fAGxdXRTXFupYT52AfDeEOj4m2_49bHy87HNMWoGC10suYzFraFadzc5WfUkTS71EAUHhxzQrS8nOckv5GPvf7QpzoshlR1l5xq3twneg6_NkvhG0mXAlQxe_evBrCSqVCeRNa1NkDu2xd0sNir7khyUy00ehYnDbpAI1gvM1q35v56-avdCEywJoEqFinVjDz6lB1zMW4DlJ3e3J8MnU0Bw0wA9kECPttG-CMCyurrEk3ThMYdO9-Z6mk23ehjb9sguyGtH9b_g_NEdGH4VKTIeMGLzbjppAQpCAZxm3AbrqrHJbdlFdR6OBw

Abstract

Large prospective cohort studies consistently show associations of a high dietary fiber intake (>25 g/d in women and >38 g/d in men) with a 20-30% reduced risk of developing type 2 diabetes (T2D), after correction for confounders. It is less well recognized that these effects appear to be mainly driven by high intakes of whole grains and insoluble cereal fibers, which typically are nonviscous and do not relevantly influence postprandial glucose responses [i.e., glycemic index (GI)] or are strongly fermented by the gut microbiota in the colon. In contrast, a dietary focus on soluble, viscous, gel-forming, more readily fermentable fiber intakes derived from fruit and certain vegetables yields mixed results and generally does not appear to reduce T2D risk. Although disentangling types of fiber-rich foods and separating these from possible effects related to the GI is an obvious challenge, the common conclusion that key metabolic effects of high-fiber intake are explained by mechanisms that should mainly apply to the soluble, viscous type can be challenged. More recently, studies in humans and animal models focused on gaining mechanistic insights into why especially high-cereal-fiber (HCF) diets appear to improve insulin resistance (IR) and diabetes risk. Although effects of HCF diets on weight loss are only moderate and comparable to other types of dietary fibers, possible novel mechanisms have emerged, which include the prevention of the absorption of dietary protein and modulation of the amino acid metabolic signature. Here we provide an update of our previous review from 2008, with a focus on mechanistic insights of how HCF diets may improve IR and the risk of developing T2D.

KEYWORDS:

amino acid metabolic signature; dietary fiber; insulin resistance; short-chain fatty acids; type 2 diabetes

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Epigenetic alterations in longevity regulators, reduced life span, and exacerbated aging-related pathology in old father offspring mice.

Xie K, Ryan DP, Pearson BL, Henzel KS, Neff F, Vidal RO, Hennion M, Lehmann I, Schleif M, Schröder S, Adler T, Rathkolb B, Rozman J, Schütz AL, Prehn C, Mickael ME, Weiergräber M, Adamski J, Busch DH, Ehninger G, Matynia A, Jackson WS, Wolf E, Fuchs H, Gailus-Durner V, Bonn S, Hrabě de Angelis M, Ehninger D.

Proc Natl Acad Sci U S A. 2018 Feb 21. pii: 201707337. doi: 10.1073/pnas.1707337115. [Epub ahead of print]

PMID: 29467291

Abstract

Advanced age is not only a major risk factor for a range of disorders within an aging individual but may also enhance susceptibility for disease in the next generation. In humans, advanced paternal age has been associated with increased risk for a number of diseases. Experiments in rodent models have provided initial evidence that paternal age can influence behavioral traits in offspring animals, but the overall scope and extent of paternal age effects on health and disease across the life span remain underexplored. Here, we report that old father offspring mice showed a reduced life span and an exacerbated development of aging traits compared with young father offspring mice. Genome-wide epigenetic analyses of sperm from aging males and old father offspring tissue identified differentially methylated promoters, enriched for genes involved in the regulation of evolutionarily conserved longevity pathways. Gene expression analyses, biochemical experiments, and functional studies revealed evidence for an overactive mTORC1 signaling pathway in old father offspring mice. Pharmacological mTOR inhibition during the course of normal aging ameliorated many of the aging traits that were exacerbated in old father offspring mice. These findings raise the possibility that inherited alterations in longevity pathways contribute to intergenerational effects of aging in old father offspring mice.

KEYWORDS:

aging; epigenetics; intergenerational inheritance; mTOR; sperm

 

Impacts of maternal dietary protein intake on fetal survival, growth, and development.

Herring CM, Bazer FW, Johnson GA, Wu G.

Exp Biol Med (Maywood). 2018 Jan 1:1535370218758275. doi: 10.1177/1535370218758275. [Epub ahead of print]

PMID: 29466875

Abstract

Maternal nutrition during gestation, especially dietary protein intake, is a key determinant in embryonic survival, growth, and development. Low maternal dietary protein intake can cause embryonic losses, intra-uterine growth restriction, and reduced postnatal growth due to a deficiency in specific amino acids that are important for cell metabolism and function. Of note, high maternal dietary protein intake can also result in intra-uterine growth restriction and embryonic death, due to amino acid excesses, as well as the toxicity of ammonia, homocysteine, and H2S that are generated from amino acid catabolism. Maternal protein nutrition has a pronounced impact on fetal programming and alters the expression of genes in the fetal genome. As a precursor to the synthesis of molecules (e.g. nitric oxide, polyamines, and creatine) with cell signaling and metabolic functions, L-arginine (Arg) is essential during pregnancy for growth and development of the conceptus. With inadequate maternal dietary protein intake, Arg and other important amino acids are deficient in mother and fetus. Dietary supplementation of Arg during gestation has been effective in improving embryonic survival and development of the conceptus in many species, including humans, pigs, sheep, mice, and rats. Both the balance among amino acids and their quantity are critical for healthy pregnancies and offspring. Impact statement This review aims at: highlighting adverse effects of elevated levels of ammonia in mother or fetus on embryonic/fetal survival, growth, and development; helping nutritionists and practitioners to understand the mechanisms whereby elevated levels of ammonia in mother or fetus results in embryonic/fetal death, growth restriction, and developmental abnormalities; and bringing, into the attention of nutritionists and practitioners, the problems of excess or inadequate dietary intake of protein or amino acids on pregnancy outcomes in animals and humans. The article provides new, effective means to improve embryonic/fetal survival and growth in mammals.

KEYWORDS:

Protein; fetus; growth; nutrition; placenta; reproduction

 

Association between marriage and outcomes in patients with acute ischemic stroke.

Liu Q, Wang X, Wang Y, Wang C, Zhao X, Liu L, Li Z, Meng X, Guo L, Wang Y.

J Neurol. 2018 Feb 20. doi: 10.1007/s00415-018-8793-z. [Epub ahead of print]

PMID: 29464375

Abstract

BACKGROUNDS:

The previous studies on the association between marital status and stroke outcomes were rare. Furthermore, the existing studies mostly focused on the protective effect of marriage on survival. We conducted the study to evaluate the association between marital status and adverse stroke outcomes in patients with AIS based on China national stroke registry.

METHODS:

This was a multicenter, prospective cohort study of patients with AIS. Patients were classified into two groups based on marital status at admission: married and unmarried. The primary outcomes included all-cause mortality, stroke recurrence, combined endpoint, and stroke disability. Stroke disability was defined as modified Rankin Scale of 2-6.

RESULTS:

Of 12,118 patients, 1220 were unmarried and 10,898 married. Unmarried patients had higher proportion of 1-year post-stroke events than married patients did. As compared with being unmarried, the adjusted odds ratios with 95% confidence interval of being married for outcomes were as follows: 0.70 (0.58-0.84) for all-cause mortality, 0.78 (0.66-0.91) for stroke recurrence, 0.77 (0.66-0.90) for combined endpoint, and 0.75 (0.65-0.88) for stroke disability. Interactions between marital status and education were significant for all outcomes except for stroke disability.

CONCLUSIONS:

Marital status was associated with all adverse stroke outcomes in patients with acute ischemic stroke, especially in those with middle-school education.

KEYWORDS:

Acute ischemic stroke; All-cause death; Marital status; Stroke disability; Stroke recurrence

 

Pregnancy diet and offspring asthma risk over a 10-year period: the Lifeways Cross Generation Cohort Study, Ireland.

Viljoen K, Segurado R, O'Brien J, Murrin C, Mehegan J, Kelleher CC; DMed on behalf of the Lifeways Cross Generation Cohort Study Steering Group.

BMJ Open. 2018 Feb 20;8(2):e017013. doi: 10.1136/bmjopen-2017-017013.

PMID: 29463584

Abstract

OBJECTIVE:

The association of maternal pregnancy diet with offspring asthma risk have been reported. However, literature on longitudinal patterns of asthma risk relative to intrauterine nutrient exposure is limited. We aimed to establish whether vegetable, oily fish and vitamin D intake during pregnancy are associated with childhood asthma risk over a 10-year period in the Irish Republic.

DESIGN:

Mother-child pairs (n=897) from the Lifeways prospective birth cohort, with data on nutrient intake during pregnancy and asthma status, respectively, were eligible for inclusion in the analysis. Data on socioeconomic and morbidity indicators over 10 years of follow-up on mothers and the index child were collected through self-administered questionnaires. Asthma status as diagnosed by the general practitioner at any time point over 10 years was related to maternal vegetable, oily fish and vitamin D intake during pregnancy, while adjusting for gestational age, socioeconomic status, smoking at delivery, breast feeding, season of birth and supplement use. Data were modelled with a marginal model on correlated observations over time within individuals.

RESULTS:

In the fully adjusted model, asthma was inversely associated with higher daily average intake of oily fish (OR 0.23 per serving/day, 95% CI 0.04 to 1.41) and of vegetables (OR 0.96 per serving/day, 95% CI 0.88 to 1.05), but the confidence limits overlapped 1. A higher daily vitamin D intake was associated with reduced odds of asthma (OR 0.93 per μg/day, 95% CI 0.89 to 0.98).

CONCLUSION:

This analysis suggests higher daily average intake of vitamin D in pregnancy is associated with asthma risk in offspring over the first 10 years of life.

KEYWORDS:

DOHaD; asthma; childhood; pregnancy; vitamin D

 

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

Gardner CD, Trepanowski JF, Del Gobbo LC, Hauser ME, Rigdon J, Ioannidis JPA, Desai M, King AC.

JAMA. 2018 Feb 20;319(7):667-679. doi: 10.1001/jama.2018.0245.

PMID: 29466592

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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Long-Term Change in Cardiorespiratory Fitness in Relation to Atrial Fibrillation and Heart Failure (from the Kuopio Ischemic Heart Disease Risk Factor Study).

Khan H, Kunutsor SK, Rauramaa R, Merchant FM, Laukkanen JA.

Am J Cardiol. 2018 Feb 2. pii: S0002-9149(18)30096-1. doi: 10.1016/j.amjcard.2018.01.003. [Epub ahead of print]

PMID: 29472009

Abstract

The benefits of aerobic fitness in relation to all-cause and cardiovascular mortality is well established; however, the associations of long-term change in cardiorespiratory fitness (CRF) with incident heart failure (HF) and atrial fibrillation (AF) have not been studied before. The Kuopio Ischaemic Heart Disease Risk Factor Study is a prospective cohort comprising men aged 42 to 60 years from the city of Kuopio and its surroundings, with a baseline examination between 1984 and 1989 (V1), a re-examination at 11 years (V2), and up to 15 years of follow-up from V2. CRF, as assessed by VO2max, was measured at both visits using respiratory gas exchange during maximal exercise tolerance test. The difference (ΔVO2max) was estimated as VO2max (V2) - VO2max (V1). Participants with no missing data on both baseline and 11-year exercise test were included (n = 481). The mean ΔVO2max was -5.4 ml/min⋅kg (standard deviation 5.4). During a median follow-up of 14.3 years (interquartile range 13.3 to 15.1), 46 incident HF (9.6%) and 73 incident AF (15.2%) events were recorded. In a multivariate analysis adjusted for baseline age, baseline VO2max, systolic blood pressure, smoking, type 2 diabetes, and cardiovascular disease, per 1 ml/min⋅kg higher ΔVO2max was log linearly associated with incident HF with a 10% relative risk reduction of HF (hazard ratio 0.90, 95% confidence interval 0.83 to 0.97). No significant relation of ΔVO2max with incident AF was observed. In conclusion, overall long-term improvement in CRF is associated with reduced risk of HF, indicating the importance of maintaining good CRF over time.

 

Coffee for Cardioprotection and Longevity.

O'Keefe JH, DiNicolantonio JJ, Lavie CJ.

Prog Cardiovasc Dis. 2018 Feb 20. pii: S0033-0620(18)30039-2. doi: 10.1016/j.pcad.2018.02.002. [Epub ahead of print] Review.

PMID: 29474816

Abstract

Coffee, a complex brew containing hundreds of biologically active compounds, exerts potent effects on long-term human health. Recently, a plethora of studies have been published focusing on health outcomes associated with coffee intake. An inverse association between coffee consumption and all-cause mortality has been seen consistently in large prospective studies. Habitual coffee consumption is also associated with lower risks for cardiovascular (CV) death and a variety of adverse CV outcomes, including coronary heart disease (CHD), congestive heart failure (HF), and stroke; coffee's effects on arrhythmias and hypertension are neutral. Coffee consumption is associated with improvements in some CV risk factors, including type 2 diabetes (T2D), depression, and obesity. Chronic coffee consumption also appears to protect against some neurodegenerative diseases, and is associated with improved asthma control, and lower risks for liver disease and cancer. Habitual intake of 3 to 4 cups of coffee appears to be safe and is associated with the most robust beneficial effects. However, most of the studies regarding coffee's health effects are based on observational data, with very few randomized controlled trials. Furthermore, the possible benefits of coffee drinking must be weighed against potential risks, which are generally due to its high caffeine content, including anxiety, insomnia, headaches, tremulousness, and palpitations. Coffee may also increase risk of fracture in women, and when consumed in pregnancy coffee increases risk for low birth weight and preterm labor.

KEYWORDS:

Coffee; cancer; cardiovascular disease; coronary heart disease; diabetes; heart failure; stroke

 

Animal versus plant protein and adult bone health: A systematic review and meta-analysis from the National Osteoporosis Foundation.

Shams-White MM, Chung M, Fu Z, Insogna KL, Karlsen MC, LeBoff MS, Shapses SA, Sackey J, Shi J, Wallace TC, Weaver CM.

PLoS One. 2018 Feb 23;13(2):e0192459. doi: 10.1371/journal.pone.0192459. eCollection 2018.

PMID: 29474360

Abstract

BACKGROUND:

Protein may have both beneficial and detrimental effects on bone health depending on a variety of factors, including protein source.

OBJECTIVE:

The aim was to conduct a systematic review and meta-analysis evaluating the effects of animal versus plant protein intake on bone mineral density (BMD), bone mineral content (BMC) and select bone biomarkers in healthy adults.

METHODS:

Searches across five databases were conducted through 10/31/16 for randomized controlled trials (RCTs) and prospective cohort studies in healthy adults that examined the effects of animal versus plant protein intake on 1) total body (TB), total hip (TH), lumbar spine (LS) or femoral neck (FN) BMD or TB BMC for at least one year, or 2) select bone formation and resorption biomarkers for at least six months. Strength of evidence (SOE) was assessed and random effect meta-analyses were performed.

RESULTS:

Seven RCTs examining animal vs. isoflavone-rich soy (Soy+) protein intake in 633 healthy peri-menopausal (n = 1) and post-menopausal (n = 6) women were included. Overall risk of bias was medium. Limited SOE suggests no significant difference between Soy+ vs. animal protein on LS, TH, FN and TB BMD, TB BMC, and bone turnover markers BSAP and NTX. Meta-analysis results showed on average, the differences between Soy+ and animal protein groups were close to zero and not significant for BMD outcomes (LS: n = 4, pooled net % change: 0.24%, 95% CI: -0.80%, 1.28%; TB: n = 3, -0.24%, 95% CI: -0.81%, 0.33%; FN: n = 3, 0.13%, 95% CI: -0.94%, 1.21%). All meta-analyses had no statistical heterogeneity.

CONCLUSIONS:

These results do not support soy protein consumption as more advantageous than animal protein, or vice versa. Future studies are needed examining the effects of different protein sources in different populations on BMD, BMC, and fracture.

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Superagers' youthful brains offer clues to keeping sharp

Researchers work to figure out what we might need to maximize our memory

The Associated Press Posted: Feb 23, 201

http://www.cbc.ca/news/health/superager-brain-1.4548868

 

Extent of, and variables associated with, blood pressure variability among older subjects.

Morano A, Ravera A, Agosta L, Sappa M, Falcone Y, Fonte G, Isaia G, Isaia GC, Bo M.

Aging Clin Exp Res. 2018 Feb 23. doi: 10.1007/s40520-018-0917-x. [Epub ahead of print]

PMID: 29476481

Abstract

BACKGROUND:

Blood pressure variability (BPV) may have prognostic implications for cardiovascular risk and cognitive decline; however, BPV has yet to be studied in old and very old people.

AIMS:

Aim of the present study was to evaluate the extent of BPV and to identify variables associated with BPV among older subjects.

METHODS:

A retrospective study of patients aged ≥ 65 years who underwent 24-h ambulatory blood pressure monitoring (ABPM) was carried out. Three different BPV indexes were calculated for systolic and diastolic blood pressure (SBP and DBP): standard deviation (SD), coefficient of variation (CV), and average real variability (ARV). Demographic variables and use of antihypertensive medications were considered.

RESULTS:

The study included 738 patients. Mean age was 74.8 ± 6.8 years. Mean SBP and DBP SD were 20.5 ± 4.4 and 14.6 ± 3.4 mmHg. Mean SBP and DBP CV were 16 ± 3 and 20 ± 5%. Mean SBP and DBP ARV were 15.7 ± 3.9 and 11.8 ± 3.6 mmHg. At multivariate analysis older age, female sex and uncontrolled mean blood pressure were associated with both systolic and diastolic BPV indexes. The use of calcium channel blockers and alpha-adrenergic antagonists was associated with lower systolic and diastolic BPV indexes, respectively.

CONCLUSIONS:

Among elderly subjects undergoing 24-h ABPM, we observed remarkably high indexes of BPV, which were associated with older age, female sex, and uncontrolled blood pressure values.

KEYWORDS:

Ambulatory; Blood pressure monitoring; Blood pressure variability; Elderly; Indexes of blood pressure variability

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Coffee consumption and risk of hypertension: a systematic review and dose-response meta-analysis of cohort studies.

Xie C, Cui L, Zhu J, Wang K, Sun N, Sun C.

J Hum Hypertens. 2018 Feb;32(2):83-93. doi: 10.1038/s41371-017-0007-0. Epub 2018 Jan 4. Review.

PMID: 29302055

Abstract

Some debates exist regarding the association of coffee consumption with hypertension risk. We performed a meta-analysis including dose-response analysis aimed to derive a more quantitatively precise estimation of this association. PubMed and Embase were searched for cohort studies published up to 18 July 2017. Fixed-effects generalized least-squares regression models were used to assess the quantitative association between coffee consumption and hypertension risk across studies. Restricted cubic spline was used to model the dose-response association. We identified eight articles (10 studies) investigating the risk of hypertension with the level of coffee consumption, including 243,869 individuals and 58,094 incident cases of hypertension. We found no evidence of a nonlinear dose-response association of coffee consumption and hypertension (P nonlinearity = 0.243). The risk of hypertension was reduced by 2% (relative risk (RR) = 0.98, 95% confidence interval (CI) 0.98-0.99) with each one cup/day increment of coffee consumption. With the linear cubic spline model, the RRs of hypertension risk were 0.97 (95% CI 0.95-0.99), 0.95 (95% CI 0.91-0.99), 0.92 (95% CI 0.87-0.98), and 0.90 (95% CI 0.83-0.97) for 2, 4, 6, and 8 cups/day, respectively, compared with individuals with no coffee intakes. This meta-analysis provides quantitative evidence that consumption of coffee was inversely associated with the risk of hypertension in a dose-response manner.

 

Relationship between body mass and ambulatory blood pressure: comparison with office blood pressure measurement and effect of treatment.

Baird SW, Jin Z, Okajima K, Russo C, Schwartz JE, Elkind MSV, Rundek T, Homma S, Sacco RL, Di Tullio MR.

J Hum Hypertens. 2018 Feb;32(2):122-128. doi: 10.1038/s41371-017-0021-2. Epub 2017 Dec 4.

PMID: 29203908

Abstract

Epidemiologic studies assessing the relationship between blood pressure (BP), body mass, and cardiovascular events have primarily been based on office BP measurements, and few data are available in the elderly. The aim of the present study was to evaluate the relationship between body mass index (BMI) and BP values obtained by ambulatory blood pressure monitoring (ABPM) as compared to office BP measurements, and the effect of anti-hypertensive treatment on the relationship. The study population consisted of 813 subjects participating in the cardiovascular abnormalities and brain lesions (CABL) study who underwent 24-h ABPM. Office BP (mean of two measurements) was found to be associated with increasing BMI, for both SBP (p ≤ 0.05) and DBP (p ≤ 0.001). In contrast, there was no association seen of increasing BMI with ABPM parameters in the overall cohort, even after adjusting for age and gender. However, among subjects not on anti-hypertensive treatment, office SBP and DBP measurements were significantly correlated with increasing BMI (p ≤ 0.01) as were daytime SBP and 24-h SBP, although with a smaller spread across BMI subgroups compared with office readings. In treated hypertensives, there was only a trend toward increasing office DBP and increasing DBP variability with higher BMI. Our results suggest that body mass may have a less significant influence on BP values in the elderly when ABPM rather than office measurements are considered, particularly in patients receiving anti-hypertensive treatment.

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The state of testosterone therapy since the fda's 2015 labeling changes: indications and cardiovascular risk.

Miner M, Morgentaler A, Khera M, Traish AM.

Clin Endocrinol (Oxf). 2018 Feb 27. doi: 10.1111/cen.13589. [Epub ahead of print]

PMID: 29486065

Abstract

OBJECTIVE:

A label change for testosterone (T) products in March 2015 followed a highly-publicized FDA advisory committee meeting in September 2014. Changes included a warning of possible increased cardiovascular (CV) risks and restriction of indicated populations to younger men with a limited set of known etiologies of testosterone deficiency (TD). These changes greatly impacted clinical practice and public perception of T therapy (TTh). Our aim was to review these changes in light of subsequently published studies.

DESIGN:

We identified 23 studies through June 2017, including 12 clinical trials and 11 observational studies. The Testosterone Trials included 790 men 65y and older with TD without known etiology, assigned to 1y T gel or placebo.

RESULTS:

Demonstrated benefits of T included sexual activity and desire, physical activity, and mood. There were 9 major adverse CV events (MACE) in the T arm and 16 in the placebo arm. No study reported increased MACE with TTh. A 3y RCT showed no difference in carotid atherosclerosis. Several large observational studies reported reduced CV events with TTh, including one showing progressively reduced CV and mortality risk with greater duration of TTh. Men whose serum T normalized with TTh had reduced risk of MI and death compared with men whose T levels failed to normalize.

CONCLUSION:

We conclude that existing evidence fails to support increased CV risk with TTh; on the contrary, there is evidence suggestive of real-world CV benefits. Finally, existing evidence provides benefits of TTh in older men without known etiology for T deficiency.

KEYWORDS:

Cardiovascular Disease; FDA Labeling; Food & Drug Administration; Testosterone; Testosterone Deficiency

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Cardiovascular Risks of Exogenous Testosterone Use Among Men: A Systematic Review and Meta-Analysis.

Alexander GC, Iyer G, Lucas E, Lin D, Singh S.

Am J Med. 2017 Mar;130(3):293-305. doi: 10.1016/j.amjmed.2016.09.017. Epub 2016 Oct 14. Review.

PMID: 27751897

Abstract

PURPOSE:

We sought to evaluate whether exogenous testosterone therapy is associated with increased risk of serious cardiovascular events as compared with other treatments or placebo.

METHODS:

Study selection included randomized controlled trials (RCTs) and observational studies that enrolled men aged 18 years or older receiving exogenous testosterone for 3 or more days. The primary outcomes were death due to all causes, myocardial infarction, and stroke. Secondary outcomes were other hard clinical outcomes such as heart failure, arrhythmia, and cardiac procedures. Peto odds ratio was used to pool data from RCTs. Risk of bias was assessed using Cochrane Collaboration tool and Newcastle and Ottawa scale, respectively. The strength of evidence was evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation Working Group approach.

RESULTS:

A total of 39 RCTs and 10 observational studies were included. Meta-analysis was done using data from 30 RCTs. Compared with placebo, exogenous testosterone treatment did not show any significant increase in risk of myocardial infarction (odds ratio [OR] 0.87; 95% CI, 0.39-1.93; 16 RCTs), stroke (OR 2.17; 95% CI, 0.63-7.54; 9 RCTs), or mortality (OR 0.88; 95% CI, 0.55-1.41; 20 RCTs). Observational studies showed marked clinical and methodological heterogeneity. The evidence was rated as very low quality due to the high risk of bias, imprecision, and inconsistency.

CONCLUSIONS:

We did not find any significant association between exogenous testosterone treatment and myocardial infarction, stroke, or mortality in randomized controlled trials. The very low quality of the evidence precludes definitive conclusion on the cardiovascular effects of testosterone.

KEYWORDS:

Cardiovascular risks; Exogenous testosterone; Meta-analysis; Systematic review

 

Diet and primary prevention of stroke: Systematic review and dietary recommendations by the ad hoc Working Group of the Italian Society of Human Nutrition.

Iacoviello L, Bonaccio M, Cairella G, Catani MV, Costanzo S, D'Elia L, Giacco R, Rendina D, Sabino P, Savini I, Strazzullo P; Working Group for Nutrition and Stroke.

Nutr Metab Cardiovasc Dis. 2018 Jan 17. pii: S0939-4753(18)30001-2. doi: 10.1016/j.numecd.2017.12.010. [Epub ahead of print]

PMID: 29482962

http://www.nmcd-journal.com/article/S0939-4753(18)30001-2/fulltext

Abstract

BACKGROUND AND AIMS:

To systematically review the latest evidence on established and emerging nutrition-related risk factors for incidence of and mortality from total, ischemic and haemorrhagic strokes. The present review was conducted in the framework of the work carried out through 2015 and 2016 for the preparation of the Italian Guidelines for the Prevention and Treatment of Stroke, 8th Edition, by ISO-SPREAD (Italian Stroke Organization and the Stroke Prevention and Educational Awareness Diffusion).

METHODS AND RESULTS:

Systematic review of articles focused on primary prevention of stroke published between January 2013 to May 2016 through an extensive search of the literature using MEDLINE/PUBMED, EMBASE and the Cochrane Library. Articles were ranked according to the SIGN methodology while the GRADE system was used to establish the strength of recommendations. As a result of our literature search, we examined 87 meta-analyses overall (mainly of prospective studies), a few isolated more recent prospective studies not included in the meta-analyses, and a smaller number of available randomized controlled trials and case-control studies. Based on the analysis of the above articles, 36 Syntheses of the available evidence and 36 Recommendations were eventually prepared. The present document was developed by organizing the available evidence into three individual areas (nutrients, food groups and dietary patterns) to provide a systematic and user-friendly overview of the available evidence on the relationship between nutrition and primary prevention of stroke. Yet analysis of foods and food patterns allowed translating the information about nutrients in a tool more amenable to use in daily life also in the light of the argument that people eat foods rather than nutrients.

CONCLUSIONS:

The present literature review and dietary recommendations provide healthcare professionals and all interested readers with a useful overview for the reduction of the risk of total, ischemic and haemorrhagic stroke through dietary modifications.

KEYWORDS:

Diet; Dietary recommendations; Nutrition; Stroke; Systematic review

 

Low-Calorie Vegetarian Versus Mediterranean Diets for Reducing Body Weight and Improving Cardiovascular Risk Profile: CARDIVEG Study (Cardiovascular Prevention With Vegetarian Diet).

Sofi F, Dinu M, Pagliai G, Cesari F, Gori AM, Sereni A, Becatti M, Fiorillo C, Marcucci R, Casini A.

Circulation. 2018 Feb 26. pii: CIRCULATIONAHA.117.030088. doi: 10.1161/CIRCULATIONAHA.117.030088. [Epub ahead of print]

PMID: 29483085

http://circ.ahajournals.org/content/circulationaha/early/2018/02/14/CIRCULATIONAHA.117.030088.full.pdf

Abstract

Background -Only a few randomized dietary intervention studies that investigated the effects of lacto-ovo vegetarian diet (VD) in clinically healthy omnivorous subjects are available. Methods -We randomly assigned to overweight omnivores with a low-to-moderate cardiovascular risk profile a low-calorie VD compared with a low-calorie Mediterranean diet (MD), each lasting 3 months, with a crossover design. The primary outcome was the difference in body weight, body mass index, and fat mass changes between the 2 groups. Secondary outcomes were differences in circulating cardiovascular disease risk parameters changes between the 2 groups. Results -One hundred eighteen subjects (mean age: 51.1 years, females: 78%) were enrolled. The total participation rate at the end of the study was 84.7%. No differences between the 2 diets in body weight were observed, as reported by similar and significant reductions obtained by both VD (‒1.88 kg) and MD (‒1.77 kg). Similar results were observed for body mass index and fat mass. In contrast, significant differences between the 2 interventions were obtained for low-density lipoprotein cholesterol, triglycerides, and vitamin B12 levels. The difference between the VD and MD groups, in terms of end-of-diet values, was recorded at 9.10 mg/dL for low-density lipoprotein cholesterol (P=0.01), 12.70 mg/dL for triglycerides (P<0.01), and 32.32 pg/mL for vitamin B12 (P<0.01). Finally, no significant difference was found between VD and MD interventions in oxidative stress markers and inflammatory cytokines, except for interleukin-17, which improved only in the MD group. Forty-six participants during the VD period and 35 during the MD period reached the target values for ≥1 cardiovascular risk factor. Conclusions -Both VD and MD were effective in reducing body weight, body mass index, and fat mass, with no significant differences between them. However, VD was more effective in reducing low-density lipoprotein cholesterol levels, whereas MD led to a greater reduction in triglyceride levels.

KEYWORDS:

Mediterranean; Vegetarian; cardiovascular disease; diet

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NEWS FEATURE 28 FEBRUARY 2018

How flashing lights and pink noise might banish Alzheimer’s, improve memory and more

Helen Thomson

Nature 555, 20-22 (2018)

Neuroscientists are getting excited about non-invasive procedures to tune the brain’s natural oscillations.

https://www.nature.com/articles/d41586-018-02391-6?WT.ec_id=NATURE-20180302&spMailingID=56095976&spUserID=MjA1NzQwNzAwNwS2&spJobID=1360109627&spReportId=MTM2MDEwOTYyNwS2

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Gamma frequency entrainment attenuates amyloid load and modifies microglia.

Iaccarino HF, Singer AC, Martorell AJ, Rudenko A, Gao F, Gillingham TZ, Mathys H, Seo J, Kritskiy O, Abdurrob F, Adaikkan C, Canter RG, Rueda R, Brown EN, Boyden ES, Tsai LH.

Nature. 2016 Dec 7;540(7632):230-235. doi: 10.1038/nature20587.

PMID: 27929004 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656389/

Abstract

Changes in gamma oscillations (20-50 Hz) have been observed in several neurological disorders. However, the relationship between gamma oscillations and cellular pathologies is unclear. Here we show reduced, behaviourally driven gamma oscillations before the onset of plaque formation or cognitive decline in a mouse model of Alzheimer's disease. Optogenetically driving fast-spiking parvalbumin-positive (FS-PV)-interneurons at gamma (40 Hz), but not other frequencies, reduces levels of amyloid-β (Aβ)1-40 and Aβ 1-42 isoforms. Gene expression profiling revealed induction of genes associated with morphological transformation of microglia, and histological analysis confirmed increased microglia co-localization with Aβ. Subsequently, we designed a non-invasive 40 Hz light-flickering regime that reduced Aβ1-40 and Aβ1-42 levels in the visual cortex of pre-depositing mice and mitigated plaque load in aged, depositing mice. Our findings uncover a previously unappreciated function of gamma rhythms in recruiting both neuronal and glial responses to attenuate Alzheimer's-disease-associated pathology.

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Comment in

Neurodegenerative disorders: Neural synchronization in Alzheimer's disease.

Aron L, Yankner BA.

Nature. 2016 Dec 7;540(7632):207-208. doi: 10.1038/540207a. No abstract available.

PMID: 27929001

https://www.nature.com/articles/540207a

Electrical oscillations generated by neural circuits are disrupted in Alzheimer's disease. Restoring these oscillations in mouse models activates immune cells to clear disease-associated amyloid-β protein from the brain. See Article p.230

 

Aspirin Recapitulates Features of Caloric Restriction.

Pietrocola F, Castoldi F, Markaki M, Lachkar S, Chen G, Enot DP, Durand S, Bossut N, Tong M, Malik SA, Loos F, Dupont N, Mariño G, Abdelkader N, Madeo F, Maiuri MC, Kroemer R, Codogno P, Sadoshima J, Tavernarakis N, Kroemer G.

Cell Rep. 2018 Feb 27;22(9):2395-2407. doi: 10.1016/j.celrep.2018.02.024.

PMID: 29490275

http://www.cell.com/cell-reports/fulltext/S2211-1247(18)30192-X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS221112471830192X%3Fshowall%3Dtrue

Abstract

The age-associated deterioration in cellular and organismal functions associates with dysregulation of nutrient-sensing pathways and disabled autophagy. The reactivation of autophagic flux may prevent or ameliorate age-related metabolic dysfunctions. Non-toxic compounds endowed with the capacity to reduce the overall levels of protein acetylation and to induce autophagy have been categorized as caloric restriction mimetics (CRMs). Here, we show that aspirin or its active metabolite salicylate induce autophagy by virtue of their capacity to inhibit the acetyltransferase activity of EP300. While salicylate readily stimulates autophagic flux in control cells, it fails to further increase autophagy levels in EP300-deficient cells, as well as in cells in which endogenous EP300 has been replaced by salicylate-resistant EP300 mutants. Accordingly, the pro-autophagic activity of aspirin and salicylate on the nematode Caenorhabditis elegans is lost when the expression of the EP300 ortholog cpb-1 is reduced. Altogether, these findings identify aspirin as an evolutionary conserved CRM.

KEYWORDS:

EP300; acetylation; aging; autophagy; longevity; metabolome; salicylate

 

Association of leisure-time physical activity with total and cause-specific mortality: a pooled analysis of nearly a half million adults in the Asia Cohort Consortium.

Liu Y, Shu XO, Wen W, Saito E, Rahman MS, Tsugane S, Tamakoshi A, Xiang YB, Yuan JM, Gao YT, Tsuji I, Kanemura S, Nagata C, Shin MH, Pan WH, Koh WP, Sawada N, Cai H, Li HL, Tomata Y, Sugawara Y, Wada K, Ahn YO, Yoo KY, Ashan H, Chia KS, Boffetta P, Inoue M, Kang D, Potter JD, Zheng W.

Int J Epidemiol. 2018 Feb 27. doi: 10.1093/ije/dyy024. [Epub ahead of print]

PMID: 29490039

https://academic.oup.com/ije/advance-article/doi/10.1093/ije/dyy024/4911904

https://watermark.silverchair.com/dyy024.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAbMwggGvBgkqhkiG9w0BBwagggGgMIIBnAIBADCCAZUGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMXvxL9ClsAaKenb7aAgEQgIIBZuiJ7OoZgQuyHVkIhjlK7rD5wGB_VZYWGulo35EVJ7sK0OJV74bXV_zT2Qnn0pKfqhAAYoIqqF_exwXxwK2knYs7W22zylw2rSC7KtcZO7cWAuL-0unFsi2TkFPcDdWmajIk-ry5aNoub8dsRG2QTWvztiXQc2A43P0YP-RCzLUsLtfPy9Y_JAr6TyC33UUdH4ubSbdaoAhDipaN2vK_is5CjV4-2Vbz9_cqNrPQj_4tN1-qYT0QFYJzDSeCnI6R5hPLH_zLxYWFAhKwZWkwwTLF2hXl2jeeDDnKUV3rAd6sXs_CFIo2xFazvIDyekXlnuNhIaAcV9IDKRewD21cXHzFn0KwTriBrNAW7IzYXknDhKW5CSwMi3HOKWT65N52jAqI5tRauxKcaQBSB2WGJmKNPAcgEwLwj3SSViQ5s1LQ5t71WwHJbUlkL5pNUHQYqL-t-UFDITF0190RgpT_u3T_0Jbx3fo

Abstract

BACKGROUND:

Most previous studies evaluating the association between leisure-time physical activity (LTPA) and risk of death were conducted among generally healthy individuals of European ancestry. We investigated the association of LTPA with all-cause and cause-specific mortality among East Asian populations, including healthy individuals and those with existing chronic diseases, which has been less well characterized.

METHODS:

We performed pooled analyses among 467 729 East Asian individuals recruited in nine prospective cohorts included in the Asia Cohort Consortium. Cox proportional hazards regressions were used to derive hazard ratios (HRs) and 95% confidence intervals (CIs) associated with LTPA after adjusting for age, sex, education and marital and smoking status.

RESULTS:

During a mean follow-up period of 13.6 years, 65 858 deaths were identified. Compared with those who reported no or less than 1 h of LTPA per week, an inverse association was observed between the amount of LTPA and all-cause and cause-specific mortality (P for trend < 0.001). The strength of the inverse association was stronger for death due to cardiovascular diseases and causes other than cancer deaths. An inverse association of LTPA with total mortality was observed among individuals with a severe and often life-threatening disease: cancer, stroke or coronary heart disease [hazard ratio (HR) = 0.81, 95% CI = 0.73-0.89 for high vs low LTPA) and those with other chronic diseases such as diabetes or hypertension (HR = 0.86, 95% CI = 0.80-0.93 for high vs low LTPA). No clear modifying effects by sex, body mass index or smoking status were identified.

CONCLUSIONS:

Regular participation in LTPA is associated with reduced mortality in middle-aged and elder Asians regardless pre-existing health conditions.

 

Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity.

Khan SS, Ning H, Wilkins JT, Allen N, Carnethon M, Berry JD, Sweis RN, Lloyd-Jones DM.

JAMA Cardiol. 2018 Feb 28. doi: 10.1001/jamacardio.2018.0022. [Epub ahead of print]

PMID: 29490333

Abstract

IMPORTANCE:

Prior studies have demonstrated lower all-cause mortality in individuals who are overweight compared with those with normal body mass index (BMI), but whether this may come at the cost of greater burden of cardiovascular disease (CVD) is unknown.

OBJECTIVE:

To calculate lifetime risk estimates of incident CVD and subtypes of CVD and to estimate years lived with and without CVD by weight status.

DESIGN, SETTING, AND PARTICIPANTS:

In this population-based study, we used pooled individual-level data from adults (baseline age, 20-39, 40-59, and 60-79 years) across 10 large US prospective cohorts, with 3.2 million person-years of follow-up from 1964 to 2015. All participants were free of clinical CVD at baseline with available BMI index and CVD outcomes data. Data were analyzed from October 2016 to July 2017.

EXPOSURES:

World Health Organization-standardized BMI categories.

MAIN OUTCOMES AND MEASURES:

Total CVD and CVD subtype, including fatal and nonfatal coronary heart disease, stroke, congestive heart failure, and other CVD deaths. Heights and weights were measured directly by investigators in each study, and BMI was calculated as weight in kilograms divided by height in meters squared. We performed (1) modified Kaplan-Meier analysis to estimate lifetime risks, (2) adjusted competing Cox models to estimate joint cumulative risks for CVD or noncardiovascular death, and (3) the Irwin restricted mean to estimate years lived free of and with CVD.

RESULTS:

Of the 190 672 in-person examinations included in this study, the mean (SD) age was 46.0 (15.0) years for men and 58.7 (12.9) years for women, and 140 835 patients (73.9%) were female. Compared with individuals with a normal BMI (defined as a BMI of 18.5 to 24.9), lifetime risks for incident CVD were higher in middle-aged adults in the overweight and obese groups. Compared with normal weight, among middle-aged men and women, competing hazard ratios for incident CVD were 1.21 (95% CI, 1.14-1.28) and 1.32 (95% CI, 1.24-1.40), respectively, for overweight (BMI, 25.0-29.9), 1.67 (95% CI, 1.55-1.79) and 1.85 (95% CI, 1.72-1.99) for obesity (BMI, 30.0-39.9), and 3.14 (95% CI, 2.48-3.97) and 2.53 (95% CI, 2.20-2.91) for morbid obesity (BMI, ≥40.0). Higher BMI had the strongest association with incident heart failure among CVD subtypes. Average years lived with CVD were longer for middle-aged adults in the overweight and obese groups compared with adults in the normal BMI group. Similar patterns were observed in younger and older adults.

CONCLUSIONS AND RELEVANCE:

In this study, obesity was associated with shorter longevity and significantly increased risk of cardiovascular morbidity and mortality compared with normal BMI. Despite similar longevity compared with normal BMI, overweight was associated with significantly increased risk of developing CVD at an earlier age, resulting in a greater proportion of life lived with CVD morbidity.

 

Nut Consumption and Survival in Patients With Stage III Colon Cancer: Results From CALGB 89803 (Alliance).

Fadelu T, Zhang S, Niedzwiecki D, Ye X, Saltz LB, Mayer RJ, Mowat RB, Whittom R, Hantel A, Benson AB, Atienza DM, Messino M, Kindler HL, Venook A, Ogino S, Ng K, Wu K, Willett W, Giovannucci E, Meyerhardt J, Bao Y, Fuchs CS.

J Clin Oncol. 2018 Feb 28:JCO2017755413. doi: 10.1200/JCO.2017.75.5413. [Epub ahead of print]

PMID: 29489429

Abstract

Purpose Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia, including type 2 diabetes, obesity, sedentary lifestyle, and high glycemic load diet. Nut intake has been associated with a lower risk of type 2 diabetes, metabolic syndrome, and insulin resistance. However, the effect of nut intake on colon cancer recurrence and survival is not known. Patients and Methods We conducted a prospective, observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency questionnaires while enrolled onto a randomized adjuvant chemotherapy trial. Using Cox proportional hazards regression, we assessed associations of nut intake with cancer recurrence and mortality. Results After a median follow-up of 6.5 years, compared with patients who abstained from nuts, individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio (HR) for disease-free survival of 0.58 (95% CI, 0.37 to 0.92; Ptrend = .03) and an HR for overall survival of 0.43 (95% CI, 0.25 to 0.74; Ptrend = .01). In subgroup analysis, the apparent benefit was confined to tree nut intake (HR for disease-free survival, 0.54; 95% CI, 0.34 to 0.85; Ptrend = .04; and HR for overall survival, 0.47; 95% CI, 0.27 to 0.82; Ptrend = .04). The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality. Conclusion Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer.

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Skinfold thickness measurements and mortality in white males during 27.7 years of follow-up.

Loh WJ, Johnston DG, Oliver N, Godsland IF.

Int J Obes (Lond). 2018 Feb 20. doi: 10.1038/s41366-018-0034-0. [Epub ahead of print]

PMID: 29491491

Abstract

INTRODUCTION:

Obesity is a major risk factor for mortality from a range of causes. We investigated whether skinfold measurements were associated with mortality independently of variation in body mass index (BMI).

METHODS:

A prospective analysis of mortality in 870 apparently healthy adult Caucasian men participating in an occupational health cohort was undertaken. At baseline, skinfold measurements were taken at biceps, triceps, iliac and subscapular sites. Derived measurements included the sum of all four skinfolds and subscapular to triceps, subscapular to iliac and BMI to iliac ratios. All-cause mortality was analysed by Cox proportional hazards modelling and death in specific mortality subcategories by competing risks analysis.

RESULTS:

During a mean of 27.7 years follow up, there were 303 deaths (119 cancer, 101 arteriovascular, 40 infection, 43 other). In univariable analysis, BMI was associated with all-cause, cancer, arteriovascular and other mortality and subscapular skinfold with all-cause and arteriovascular mortality. On bivariable analysis, with inclusion of BMI, subscapular skinfold ceased to be a associated with mortality but iliac skinfold emerged as strongly, negatively associated with all-cause and arteriovascular mortality. In multivariable analysis, with inclusion of age, BMI, smoking, alcohol and exercise, iliac skinfold was negatively associated with all-cause (Hazard ratio HR 0.77, 95% confidence interval CI 0.66-0.90, p = 0.002), arteriovascular (HR 0.75, 95%CI 0.58,0.97, p = 0.02) and infection (HR 0.63, 95%CI 0.42,0.94, p = 0.02) death. Among obese participants (BMI ≥ 30 kg/m2), iliac skinfold of ≤9.7 mm was associated with a six-fold increase in all-cause mortality risk.

CONCLUSION:

Low iliac skinfold thickness is an independent risk factor for all-cause mortality in adult white males with risk apparently concentrated among people who are obese.

 

 

Fibre supplementation for the prevention of type 2 diabetes and improvement of glucose metabolism: the randomised controlled Optimal Fibre Trial (OptiFiT).

Honsek C, Kabisch S, Kemper M, Gerbracht C, Arafat AM, Birkenfeld AL, Dambeck U, Osterhoff MA, Weickert MO, Pfeiffer AFH.

Diabetologia. 2018 Feb 28. doi: 10.1007/s00125-018-4582-6. [Epub ahead of print]

PMID: 29492637

Abstract

AIMS/HYPOTHESIS:

Insoluble cereal fibres have been shown in large prospective cohort studies to be highly effective in preventing type 2 diabetes, but there is a lack of interventional data. Our 2 year randomised double-blind prospective intervention study compared the effect of an insoluble oat fibre extract with that of placebo on glucose metabolism and incidence of diabetes.

METHODS:

A total of 180 participants with impaired glucose tolerance underwent a modified version of the 1 year lifestyle training programme PREvention of DIAbetes Self-management (PREDIAS) and were randomised to receive a fibre supplement (n = 89; 7.5 g of insoluble fibre per serving) or placebo (n = 91; 0.8 g of insoluble fibre per serving) twice daily for 2 years. Eligible participants were men and women, were at least 18 years old and did not report corticosteroid or other intensive anti-inflammatory treatment, fibre intolerance or any of the following disorders: overt diabetes, chronic or malignant disease, or severe cardiopulmonary, endocrine, psychiatric, gastrointestinal, autoimmune or eating disorder. Participants were recruited at two clinical wards in Berlin and Nuthetal. The allocation was blinded to participants and study caregivers (physicians, dietitians, study nurses). Randomisation was conducted by non-clinical staff, providing neutrally numbered supplement tins. Both supplements were similar in their visual, olfactory and gustatory appearance. Intention-to-treat analysis was applied to all individuals.

RESULTS:

After 1 year, 2 h OGTT levels decreased significantly in both groups but without a significant difference between the groups (fibre -0.78 ± 1.88 mmol/l [p ≤ 0.001] vs placebo -0.46 ± 1.80 mmol/l [p = 0.020]; total difference 0.32 ± 0.29 mmol/l; not significant). The 2 year incidence of diabetes was 9/89 (fibre group) compared with 16/91 (placebo group; difference not significant). As secondary outcomes, the change in HbA1c level was significantly different between the two groups (-0.2 ± 4.6 mmol/mol [-0.0 ± 0.0%; not significant] vs +1.2 ± 5.2 mmol/mol [+0.1 ± 0.0%; not significant]; total difference 1.4 ± 0.7 mmol/mol [0.1 + 0.0%]); p = 0.018); insulin sensitivity and hepatic insulin clearance increased in both groups. After 2 years, improved insulin sensitivity was still present in both groups, although the effect size had diminished. Separate analysis of the sexes revealed a significantly greater reduction in 2 h glucose levels for women in the fibre group (-0.88 ± 1.59 mmol/l [p ≤ 0.001] vs -0.22 ± 1.52 mmol/l [p = 0.311]; total difference 0.67 ± 0.31 mmol/l; p = 0.015). Levels of fasting glucose, adipokines and inflammatory markers remained unchanged in the two groups. Significantly increased fibre intake was restricted to the fibre group, despite dietary counselling for both groups. No severe side effects occurred.

CONCLUSIONS/INTERPRETATION:

We cannot currently provide strong evidence for a beneficial effect of insoluble cereal fibre on glycaemic metabolism, although further studies may support minor effects of fibre supplementation in reducing glucose levels, insulin resistance and the incidence of type 2 diabetes.

KEYWORDS:

Cellulose; Diabetes mellitus type 2; Hemicellulose; Hepatic insulin clearance; Impaired glucose tolerance; Insoluble dietary fibre; Insulin sensitivity; Prediabetes

 

Probiotic supplementation increases obesity with no detectable effects on liver fat or gut microbiota in obese Hispanic adolescents: a 16-week, randomized, placebo-controlled trial.

Jones RB, Alderete TL, Martin AA, Geary BA, Hwang DH, Palmer SL, Goran MI.

Pediatr Obes. 2018 Feb 28. doi: 10.1111/ijpo.12273. [Epub ahead of print]

PMID: 29493105

Abstract

BACKGROUND:

Numerous studies have shown that there are links between obesity, liver fat and the gut microbiome. However, there are mixed results on whether probiotics could impact the gut microbiome and/or help to decrease liver fat and obesity outcomes.

OBJECTIVE:

This study aimed to determine whether a probiotic supplement (VSL#3® ) intervention altered gut microbiota and/or gut hormones associated with appetite regulation. The secondary aim of this study was to determine whether VSL#3® altered body composition and liver fat and fibrosis.

METHODS:

We conducted a double-blind, randomized placebo-controlled trial in 19 obese Latino adolescents. The intervention consisted of three packets per day of VSL#3® or a matched placebo for 16 weeks. Pre-intervention and post-intervention measures included gut microbial abundance, gut appetite regulating hormones, anthropometrics, body composition, liver fat and liver fibrosis. We conducted linear models to determine whether there were any significant differences in the changes in these outcomes following VSL#3® intervention.

RESULTS:

Compared with placebo, adolescents that received VSL#3 had significant increases in total adiposity (%) (+1.7 ± 0.6 vs. -1.3 ± 0.5, p < 0.01) and trunk adiposity (%) (+3.3 ± 0.8 vs. -1.8 ± 0.8, p < 0.01) with no significant effects on liver fat/fibrosis, insulin/glucose, gut microbial abundances or gut hormones.

CONCLUSION:

VSL#3 supplementation may lead to increased adiposity in obese Latino adolescents with no significant detectable changes in gut microbiota, gut appetite-regulating hormones, liver fat and fibrosis and dietary intake. However, it is important to note that recruitment efforts were terminated early and the sample size fell short of what was planned for this trial.

KEYWORDS:

Liver fat; microbiome; probiotic; trial

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Meta-Analysis of the Effects of Foods and Derived Products Containing Ellagitannins and Anthocyanins on Cardiometabolic Biomarkers: Analysis of Factors Influencing Variability of the Individual Responses.

García-Conesa MT, Chambers K, Combet E, Pinto P, Garcia-Aloy M, Andrés-Lacueva C, de Pascual-Teresa S, Mena P, Konic Ristic A, Hollands WJ, Kroon PA, Rodríguez-Mateos A, Istas G, Kontogiorgis CA, Rai DK, Gibney ER, Morand C, Espín JC, González-Sarrías A.

Int J Mol Sci. 2018 Feb 28;19(3). pii: E694. doi: 10.3390/ijms19030694. Review.

PMID: 29495642

file:///C:/Users/Owner/Downloads/ijms-19-00694-v2.pdf

Abstract

Understanding interindividual variability in response to dietary polyphenols remains essential to elucidate their effects on cardiometabolic disease development. A meta-analysis of 128 randomized clinical trials was conducted to investigate the effects of berries and red grapes/wine as sources of anthocyanins and of nuts and pomegranate as sources of ellagitannins on a range of cardiometabolic risk biomarkers. The potential influence of various demographic and lifestyle factors on the variability in the response to these products were explored. Both anthocyanin- and ellagitannin-containing products reduced total-cholesterol with nuts and berries yielding more significant effects than pomegranate and grapes. Blood pressure was significantly reduced by the two main sources of anthocyanins, berries and red grapes/wine, whereas waist circumference, LDL-cholesterol, triglycerides, and glucose were most significantly lowered by the ellagitannin-products, particularly nuts. Additionally, we found an indication of a small increase in HDL-cholesterol most significant with nuts and, in flow-mediated dilation by nuts and berries. Most of these effects were detected in obese/overweight people but we found limited or non-evidence in normoweight individuals or of the influence of sex or smoking status. The effects of other factors, i.e., habitual diet, health status or country where the study was conducted, were inconsistent and require further investigation.

KEYWORDS:

anthocyanins; berries; cardiometabolic disorders; ellagitannins; interindividual variability; meta-analysis; nuts; pomegranate; red grapes; red wine

 

Saturday March 03, 2018

The vampire molecule: scientists discover why young blood helps reverse aging

http://www.cbc.ca/radio/quirks/detecting-the-first-stars-young-blood-rejuvenates-old-brains-acoustic-tractor-beam-and-more-1.4557129/the-vampire-molecule-scientists-discover-why-young-blood-helps-reverse-aging-1.4557132

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Tet2 Rescues Age-Related Regenerative Decline and Enhances Cognitive Function in the Adult Mouse Brain.

Gontier G, Iyer M, Shea JM, Bieri G, Wheatley EG, Ramalho-Santos M, Villeda SA.

Cell Rep. 2018 Feb 20;22(8):1974-1981. doi: 10.1016/j.celrep.2018.02.001.

PMID: 29466726 Free Article

http://www.cell.com/cell-reports/fulltext/S2211-1247(18)30156-6?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211124718301566%3Fshowall%3Dtrue

Abstract

Restoring adult stem cell function provides an exciting approach for rejuvenating the aging brain. However, molecular mechanisms mediating neurogenic rejuvenation remain elusive. Here we report that the enzyme ten eleven translocation methylcytosine dioxygenase 2 (Tet2), which catalyzes the production of 5-hydroxymethylcytosine (5hmC), rescues age-related decline in adult neurogenesis and enhances cognition in mice. We detected a decrease in Tet2 expression and 5hmC levels in the aged hippocampus associated with adult neurogenesis. Mimicking an aged condition in young adults by abrogating Tet2 expression within the hippocampal neurogenic niche, or adult neural stem cells, decreased neurogenesis and impaired learning and memory. In a heterochronic parabiosis rejuvenation model, hippocampal Tet2 expression was restored. Overexpressing Tet2 in the hippocampal neurogenic niche of mature adults increased 5hmC associated with neurogenic processes, offset the precipitous age-related decline in neurogenesis, and enhanced learning and memory. Our data identify Tet2 as a key molecular mediator of neurogenic rejuvenation.

KEYWORDS:

Tet2; adult neurogenesis; aging; cognition; hippocampus; hydroxymethylation; rejuvenation

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Effect of two different sublingual dosages of vitamin B<sub>12</sub> on cobalamin nutritional status in vegans and vegetarians with a marginal deficiency: A randomized controlled trial.

Del Bo' C, Riso P, Gardana C, Brusamolino A, Battezzati A, Ciappellano S.

Clin Nutr. 2018 Feb 15. pii: S0261-5614(18)30071-2. doi: 10.1016/j.clnu.2018.02.008. [Epub ahead of print]

PMID: 29499976

Abstract

BACKGROUND & AIMS:

Vegetarians and vegans are more vulnerable to vitamin B12 deficiency with severe risks of megaloblastic anemia, cognitive decline, neuropathy, and depression. An easy and simple method of supplementation consists of taking one weekly dosage of 2000 μg. However, single large oral doses of vitamin B12 are poorly absorbed. The present research evaluates the ability of two different sublingual dosages of vitamin B12 (350 μg/week vs 2000 μg/week) in improving cyanocobalamin (vitamin B12) nutritional status in vegans and vegetarians with a marginal deficiency.

METHODS:

A 12-week randomized, double-blind, controlled, parallel intervention trial was performed. Forty subjects with marginal vitamin B12 deficiency were enrolled and randomly divided into two groups: test group Ld (low dose, 350 μg/week) and control group Hd (high dose, 2000 μg/week) vitamin B12 supplementation. Blood samples were collected at baseline and after 15, 30, 60, and 90 days from the intervention for the determination of vitamin B12, related metabolic markers, and blood cell counts.

RESULTS:

Two-way analysis of variance showed a significant effect of time (P < 0.0001) and of time × treatment interaction (P = 0.012) on serum concentration of vitamin B12 that increased after 90-day supplementation (Ld and Hd) compared to baseline. Both the supplements increased (P < 0.0001, time effect) the levels of holotranscobalamin, succinic acid, methionine and wellness parameter, while decreased (P < 0.0001, time effect) the levels of methylmalonic acid, homocysteine and folate compared to baseline. No difference was observed between groups (LdvsHd). No effect was detected for vitamin B6 and blood cell count.

CONCLUSIONS:

In our experimental conditions, both supplements were able to restore adequate serum concentrations of vitamin B12 and to improve the levels of related metabolic blood markers in subjects with a marginal deficiency. The results support the use of a sublingual dosage of 50 μg/day (350 μg/week) of cobalamin, instead of 2000 μg/week (provided as a single dose), to reach a state of nutritional adequacy of vitamin B12 in this target population.

KEYWORDS:

Metabolites; Sublingual supplements; Vegans; Vegetarians; Vitamin B(12)

 

The effects of apples and apple juice on acute plasma uric acid concentration: a randomized controlled trial

Sara J White ; Emma L Carran; Andrew N Reynolds; Jillian J Haszard; Bernard J Venn

The American Journal of Clinical Nutrition, Volume 107, Issue 2, 1 February 2018, Pages 165–172, https://doi.org/10.1093/ajcn/nqx059

Published: 26 February 2018

ABSTRACT

Background

The consumption of large amounts of fructose from added sugars results in the hepatic production and export of uric acid into the circulation.

Objective

Our aim was to test whether fructose present in fruit is of sufficient quantity or in a form that will increase uric acid concentration.

Design

Seventy-three participants were randomly assigned to 1 of 3 groups to ingest small (205 g) and large (410 g) servings of apple segments, small (170 mL) and large (340 mL) servings of apple juice, or a glucose and a fructose control beverage. Within each group, participants ingested both treatments in a crossover design. The fructose control and the large servings of apple and juice contained 26.7 g fructose. Test foods were ingested within 10 min. Blood samples were taken at baseline and at 30 and 60 min after intake.

Results

Plasma uric acid concentrations increased after the intake of all fructose-containing treatments and decreased after the glucose beverage. The mean (95% CI) increase in uric acid at 30 min was 15 µmol/L (10, 21 µmol/L) for the fructose control and 19 µmol/L (8, 30 µmol/L) and 17 µmol/L (9, 24 µmol/L) for the large servings of apple and apple juice, respectively. There was no difference in change in uric acid between baseline and 30 min when comparing the apple (3 µmol/L; 95% CI: −8, 14 µmol/L) and apple juice (−7 µmol/L; 95% CI: −18, 5 µmol/L) with the fructose control. Blood pressure taken 70 min after ingestion was unaffected by any treatment (P > 0.05). There was no difference in change in satiety scores between the fructose and glucose control beverages (P > 0.05). Participants felt more satiated 30 min after ingesting whole apple than after apple juice. The glycemic response reflected the amount of glucose in each treatment.

Conclusions

The body acutely responds to fructose regardless of source. Longer-term studies are required to assess how small and transient increases in plasma uric acid contribute to health.

Keywords:

fruit, fructose, uric acid, sugar, glycemia

 

Protein leucine content is a determinant of shorter- and longer-term muscle protein synthetic responses at rest and following resistance exercise in healthy older women: a randomized, controlled trial

Michaela C Devries; Christopher McGlory ; Douglas R Bolster; Alison Kamil; Maike Rahn ...

The American Journal of Clinical Nutrition, Volume 107, Issue 2, 1 February 2018, Pages 217–226, https://doi.org/10.1093/ajcn/nqx028

Published: 26 February 2018

ABSTRACT

Background

Older women may not be consuming enough protein to maintain muscle mass. Augmentation of protein intake with leucine may enhance the muscle protein synthetic response in older women to aid in maintaining muscle mass.

Objective

We measured the acute (hourly) and integrated (daily) myofibrillar protein synthesis (myoPS) response to consumption of a high-quality mixed protein beverage compared with an isonitrogenous protein beverage with added leucine.

Design

In a parallel design, free-living, healthy older women (aged 65–75 y, n = 11/group) consumed a fixed, weight-maintaining diet with protein at 1.0 g · kg–1 · d–1 and were randomly assigned to twice-daily consumption of either 15 g milk protein beverage containing 4.2 g leucine (LEU) or 15 g mixed protein (milk and soy) beverage containing 1.3 g leucine (CON). Unilateral leg resistance exercise allowed a determination of acute ([13C6]-phenylalanine infusion, hourly rate) and integrated (deuterated water ingestion, daily rate) exercised and rested myoPS responses.

Results

Acute myoPS increased in response to feeding in the rested (CON: 13% ± 4%; LEU: 53% ± 5%) and exercised (CON: 30% ± 4%; LEU: 87% ± 7%) leg in both groups, but the increase was greater in LEU (P < 0.001). Integrated myoPS increased during the supplementation period in both legs (rested: 9% ±1%; exercised: 17% ± 2%; P < 0.001) in LEU, but in the exercised leg only (7% ± 2%; P < 0.001) in CON.

Conclusions

A 15-g protein-containing beverage with ∼4 g leucine induced greater increases in acute and integrated myoPS than did an isonitrogenous, isoenergetic mixed-protein beverage. Declines in muscle mass in older women may be attenuated with habitual twice-daily consumption of a protein beverage providing 15 g protein and higher (4.2 g/serving) amounts of leucine. This trial was registered at clinicaltrials.gov as NCT02282566.

Keywords:

muscle protein synthesis, aging, sarcopenia, leucine, protein quality

 

Carbohydrate quality and quantity and risk of coronary heart disease among US women and men

Hala B AlEssa ; Randy Cohen; Vasanti S Malik; Sally N Adebamowo; Eric B Rimm ...

The American Journal of Clinical Nutrition, Volume 107, Issue 2, 1 February 2018, Pages 257–267, https://doi.org/10.1093/ajcn/nqx060

Published: 26 February 2018

ABSTRACT

Background

The carbohydrate-to-fiber ratio is a recommended measure of carbohydrate quality; however, its relation to incident coronary heart disease (CHD) is not currently known.

Objective

We aimed to assess the relation between various measures of carbohydrate quality and incident CHD.

Design

Data on diet and lifestyle behaviors were prospectively collected on 75,020 women and 42,865 men participating in the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) starting in 1984 and 1986, respectively, and every 2–4 y thereafter until 2012. All participants were free of known diabetes mellitus, cancer, or cardiovascular disease at baseline. Cox proportional hazards regression models were used to assess the relation between dietary measures of carbohydrate quality and incident CHD.

Results

After 1,905,047 (NHS) and 921,975 (HPFS) person-years of follow-up, we identified 7,320 cases of incident CHD. In models adjusted for age, lifestyle behaviors, and dietary variables, the highest quintile of carbohydrate intake was not associated with incident CHD (pooled-RR = 1.04; 95% CI: 0.96, 1.14; P-trend = 0.31). Total fiber intake was not associated with risk of CHD (pooled-RR = 0.94; 95% CI: 0.85, 1.03; P-trend = 0.72), while cereal fiber was associated with a lower risk for incident CHD (pooled-RR = 0.80; 95% CI: 0.74, 0.87; P-trend < 0.0001). In fully adjusted models, the carbohydrate-to–total fiber ratio was not associated with incident CHD (pooled-RR = 1.04; 95% CI: 0.96, 1.13; P-trend = 0.46). However, the carbohydrate-to–cereal fiber ratio and the starch-to–cereal fiber ratio were associated with an increased risk for incident CHD (pooled-RR = 1.20; 95% CI: 1.11, 1.29; P-trend < 0.0001, and pooled-RR = 1.17; 95%CI: 1.09, 1.27; P-trend < 0.0001, respectively).

Conclusion

Dietary cereal fiber appears to be an important component of carbohydrate quality. The carbohydrate-to–cereal fiber ratio and the starch-to–cereal fiber ratio, but not the carbohydrate-to-fiber ratio, was associated with an increased risk for incident CHD. Future research should focus on how various measures of carbohydrate quality are associated with CHD prevention. This trial was registered at clinicaltrials.gov as NCT03214861.

Keywords:

carbohydrates, carbohydrate quality, diet quality, whole grains, type 2 diabetes, starch, fiber

 

Sarcopenic obesity and overall mortality: Results from the application of novel models of body composition phenotypes to the National Health and Nutrition Examination Survey 1999-2004.

Van Aller C, Lara J, Stephan BCM, Donini LM, Heymsfield S, Katzmarzyk PT, Wells JCK, Prado CM, Siervo M.

Clin Nutr. 2018 Feb 15. pii: S0261-5614(18)30042-6. doi: 10.1016/j.clnu.2018.01.022. [Epub ahead of print]

PMID: 29499977

Abstract

BACKGROUND/OBJECTIVES:

There is no consensus on the definition of sarcopenic obesity (SO), resulting in inconsistent associations of SO with mortality risk. We aim to evaluate association of dual energy x-ray absorptiometry (DXA) SO models with mortality risk in a US adult population (≥50 years).

SUBJECTS/METHODS:

The study population consisted of 3577 participants aged 50 years and older from the 1999-2004 National Health and Nutrition and Examination Survey with mortality follow-up data through December 31, 2011. Difference in survival time in people with and without SO defined by three body composition DXA models (Model 1: body composition phenotype model; Model 2: Truncal Fat Mass (TrFM)/Appendicular Skeletal Muscle Mass (ASM) ratio model; Model 3: Fat Mass (FM)/Fat Free Mass (FFM) ratio). The differences between the models were assessed by the acceleration failure time model, and expressed as time ratios (TR).

RESULTS:

Participants age 50-70 years with SO had a significantly decreased survival time, according to the body composition phenotype model (TR: 0.92; 95% CI: 0.87-0.97), and TrFM/ASM ratio model (TR: 0.88; 95% CI: 0.81-0.95). The FM/FFM ratio model did not detect significant differences in survival time. Participants with SO aged 70 years and older did not have a significantly decreased survival time, according to all three models.

CONCLUSIONS:

A SO phenotype increases mortality risk in people of age 50-70 years, but not in people aged 70 years and older. The application of the body composition phenotype and the TrFM/ASM ratio models may represent useful diagnostic approaches to improve the prediction of disease and mortality risk.

KEYWORDS:

Body composition; Mortality; Sarcopenic obesity

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Health Benefits of the Mediterranean Diet: Metabolic and Molecular Mechanisms

Valeria Tosti, MD Beatrice Bertozzi, PhD Luigi Fontana, MD, PhD

The Journals of Gerontology: Series A, Volume 73, Issue 3, 2 March 2018, Pages 318–326, https://doi.org/10.1093/gerona/glx227

Published: 13 December 2017

Abstract

Consuming a Mediterranean diet rich in minimally processed plant foods has been associated with a reduced risk of developing multiple chronic diseases and increased life expectancy. Data from several randomized clinic trials have demonstrated a beneficial effect in the primary and secondary prevention of cardiovascular disease, type 2 diabetes, atrial fibrillation, and breast cancer. The exact mechanism by which an increased adherence to the traditional Mediterranean diet exerts its favorable effects is not known. However, accumulating evidence indicates that the five most important adaptations induced by the Mediterranean dietary pattern are: (a) lipid-lowering effect, (b) protection against oxidative stress, inflammation and platelet aggregation, © modification of hormones and growth factors involved in the pathogenesis of cancer, (d) inhibition of nutrient sensing pathways by specific amino acid restriction, and (e) gut microbiota-mediated production of metabolites influencing metabolic health. More studies are needed to understand how single modifications of nutrients typical of the Mediterranean diet interact with energy intake, energy expenditure, and the microbiome in modulating the key mechanisms that promote cellular, tissue, and organ health during aging.

Keywords: Mediterranean diet, Cardiovascular disease, Cancer

Topic: mediterranean diet amino acids cancer diet food nutrients microbiome

 

The Components of Age-Dependent Effects of Dietary Methionine Restriction on Energy Balance in Rats.

Wanders D, Forney LA, Stone KP, Hasek BE, Johnson WD, Gettys TW.

Obesity (Silver Spring). 2018 Mar 4. doi: 10.1002/oby.22146. [Epub ahead of print]

PMID: 29504255

Abstract

OBJECTIVE:

Dietary methionine restriction (MR) improves biomarkers of metabolic health, in part through coordinated increases in energy intake and energy expenditure (EE). Some metabolic benefits of dietary MR are secondary to its effects on energy balance, so this study's purpose was to examine how age at initiation of MR influences its effects on energy balance and body composition.

METHODS:

Energy balance was examined in rats provided control or MR diets for 9 months after weaning or in rats between 6 and 12 months of age.

RESULTS:

Rats provided the control diet for 9 months after weaning increased their body weight (BW) and fat mass by five- and eightfold, respectively, while BW and fat accumulation in the MR group were reduced to 50% of that of controls. In adult rats fed the respective diets between 6 and 12 months of age, dietary MR increased energy intake by ∼23%, but the 15% increase in EE was sufficient to prevent increases in BW or fat mass.

CONCLUSIONS:

Dietary MR produces comparable increases in EE in young, growing animals and in mature animals, but young animals continue to deposit new tissue because of the proportionately larger effect of MR on energy intake relative to maintenance requirements.

 

Effect of Vitamin D Supplementation on Obesity-Induced Insulin Resistance: A Double-Blind, Randomized, Placebo-Controlled Trial.

Cefalo CMA, Conte C, Sorice GP, Moffa S, Sun VA, Cinti F, Salomone E, Muscogiuri G, Brocchi AAG, Pontecorvi A, Mezza T, Giaccari A.

Obesity (Silver Spring). 2018 Mar 4. doi: 10.1002/oby.22132. [Epub ahead of print]

PMID: 29504254

Abstract

OBJECTIVE:

The aim was to investigate whether vitamin D supplementation, combined with a hypocaloric diet, could have an independent effect on insulin sensitivity in subjects with both overweight and hypovitaminosis D. Changes from baseline in anthropometric parameters, body composition, glucose tolerance, and insulin secretion were considered as secondary outcomes.

METHODS:

Eighteen volunteers who were nondiabetic and vitamin D deficient and had BMI > 25 kg/m2 were randomized (1:1) in a double-blind manner to a hypocaloric diet + either oral cholecalciferol at 25,000 IU/wk or placebo for 3 months. Hyperinsulinemic-euglycemic clamp to measure insulin sensitivity was performed at baseline and after intervention.

RESULTS:

Body weight in both groups decreased significantly (-7.5% in the vitamin D group and -10% in the placebo group; P < 0.05 for both), with no between-group differences. Serum 25-hydroxyvitamin D levels in the vitamin D group increased considerably (from 36.7 ± 13.2 nmol/L to 74.8 ± 18.7 nmol/L; P < 0.001). Insulin sensitivity in the vitamin D group improved (from 4.6 ± 2.0 to 6.9 ± 3.3 mg·kg-1 ·min-1 ; P < 0.001), whereas no changes were observed in the placebo group (from 4.9 ± 1.1 to 5.1 ± 0.3 mg·kg-1 ·min-1 ; P = 0.84).

CONCLUSIONS:

Cholecalciferol supplementation, combined with a weight loss program, significantly improves insulin sensitivity in healthy subjects with obesity and might represent a personalized approach for insulin-resistant subjects with obesity.

 

Reference values of hand-grip dynamometry and the relationship between low strength and mortality in older Chileans.

Lera L, Albala C, Leyton B, Márquez C, Angel B, Saguez R, Sánchez H.

Clin Interv Aging. 2018 Feb 22;13:317-324. doi: 10.2147/CIA.S152946. eCollection 2018.

PMID: 29503536

Abstract

AIM:

This study was aimed to set reference values of hand-grip strength by age and sex and validate cut points for risk of functional limitation and mortality in older Chileans.

METHODS:

This was a pooled analysis of four studies including 6,426 people ≥60 years of nondependent community-dwelling Chileans. After exclusion criteria, the final sample included 5,250 subjects, from whom 2,193 were followed to study all-cause mortality associated with low hand-grip strength. Face-to-face interviews registering sociodemographic characteristics, self-reported chronic diseases, and functional limitations were conducted. Anthropometric measurements and observed mobility were performed by trained professionals. Hand-grip strength was measured with a hand dynamometer T-18 (Country Technology, Inc.) before 2008 or with JAMAR brand from 2008 onwards. Percentiles were calculated through descriptive analysis and quantile regression models for specific groups of age and sex. Adjusted Cox regression hazard models for mortality risk according to low dynamometry condition and covariates were developed.

RESULTS:

We deliver reference values of hand-grip strength for older Chileans proposing the 25th percentile as the cut-off point for low dynamometry risk: men ≤27 kg, women ≤15 kg. Low hand-grip strength was associated with Instrumental Activities of Daily Living limitations (p=0.001), and altered physical performance evaluated through the Timed Up and Go test (p=0.0001), grasping (p=0.001), bending (p<0.0001), and lifting (p<0.0001). After Cox proportional hazard regression models were assessed with a median follow-up of 9.2 years, the adjusted risk of all-cause mortality associated with a hand-grip strength lower than the 25th percentile in older Chileans showed a hazard ratio of 1.39 (95% confidence interval: 1.13-1.71).

CONCLUSION:

The cut-off points of dynamometry validated for the older Chileans allow the incorporation in the geriatric evaluation in primary health care of an easy-to-use, inexpensive indicator to identify older adults at risk of sarcopenia, frailty, and dismobility. In addition this also helps to optimize the evaluation of intervention strategies focused on the maintenance of functionality.

KEYWORDS:

aging; dynamometry; functional limitation; hand-grip strength; mortality

 

Mediterranean Dietary Patterns and Impaired Physical Function in Older Adults.

Struijk EA, Guallar-Castillón P, Rodríguez-Artalejo F, López-García E.

J Gerontol A Biol Sci Med Sci. 2016 Oct 19. doi: 10.1093/gerona/glw208. [Epub ahead of print]

PMID: 28329809

Abstract

BACKGROUND:

Information about nutritional risk factors of functional limitation is scarce. The aim of this study was to examine the association between the Mediterranean diet and risk of physical function impairment in older adults.

METHODS:

We used data from 1,630 participants in the Seniors-ENRICA cohort aged ≥60 years. In 2008-2010, adherence to the Mediterranean diet pattern was measured with the Mediterranean Diet Score (MDS) and the Mediterranean Diet Adherence Screener (MEDAS). Study participants were followed up through 2012 to assess incident impairment in agility and mobility as well as impairment in overall physical functioning, defined as a ≥5-point decrease from baseline to follow-up in the physical component summary of the 12-Item Short-Form Health Survey.

RESULTS:

Over a median follow-up of 3.5 years, we identified 343 individuals with agility limitation, 212 with mobility limitation, and 457 with decreased overall physical functioning. No association was found between the MDS score and the likelihood of impaired agility or mobility, although a 2-point increment in the MDS score was marginally associated with lower likelihood for decreased overall physical function. Compared to individuals in the lowest tertile of the MEDAS score, those in the highest tertile showed a lower odds of agility limitation (odds ratio: 0.67, 95% confidence interval: 0.48; 0.94, p trend = .02), mobility limitation (odds ratio: 0.69, 95% confidence interval: 0.40; 0.88, p trend = .01), and decreased overall physical functioning (odds ratio: 0.60, 95% confidence interval: 0.45; 0.79, p trend < .001).

CONCLUSIONS:

In this prospective cohort study, a Mediterranean-style dietary pattern, especially when measured with the MEDAS, was associated with a lower likelihood of physical function impairment in older adults.

KEYWORDS:

Agility; MDS; MEDAS; Mobility

 

Prevalence and Risk of Severe Cognitive Impairment in Advanced Chronic Kidney Disease.

Burns CM, Knopman DS, Tupper DE, Davey CS, Slinin YM, Lakshminarayan K, Rossom RC, Pederson SL, Gilbertson DT, Murray AM.

J Gerontol A Biol Sci Med Sci. 2017 Dec 13. doi: 10.1093/gerona/glx241. [Epub ahead of print]

PMID: 29244090

https://academic.oup.com/biomedgerontology/article/73/3/393/4737238

Abstract

BACKGROUND:

Our primary goal is to describe the prevalence, severity, and risk of cognitive impairment (CI) by estimated glomerular filtration rate (eGFR, in ml/min/1.73 m 2) in a cohort enriched for advanced CKD (eGFR < 45), adjusting for albuminuria, as measured by urine albumin-to-creatinine ratio (UACR, in mg/g). As both eGFR and albuminuria are associated with CI risk in CKD, we also seek to determine the extent that eGFR remains a useful biomarker for risk of CI in those with CKD and concomitant albuminuria.

METHODS:

Chi-square tests measured the prevalence of severe CI and mild cognitive impairment (MCI) by eGFR level. Logistic regression models and generalized linear models measured risk of CI by eGFR, adjusted for UACR.

RESULTS:

Participants were 574 adults with a mean age of 69; 433 with CKD (eGFR <60, non-dialysis) and 141 controls (eGFR ≥ 60). Forty-eight percent of participants with CKD had severe CI or MCI. The prevalence of severe CI was highest (25%) in those with eGFR <30. eGFR <30 was only associated with severe CI in those without albuminuria (UACR <30; OR = 3.3; p = .02) and was not associated with MCI in similar models.

CONCLUSIONS:

One quarter of those with eGFR <30 had severe CI. eGFR <30 was associated with over threefold increased odds of severe CI in those with UACR < 30, but not with UACR > 30, suggesting that eGFR < 30 is a valid biomarker for increased risk of severe CI in those without concomitant albuminuria.

KEYWORDS:

cognitive aging; dementia; epidemiology; renal

 

Association Between Adherence to the Mediterranean Diet at Midlife and Healthy Aging in a Cohort of French Adults.

Assmann KE, Adjibade M, Andreeva VA, Hercberg S, Galan P, Kesse-Guyot E.

J Gerontol A Biol Sci Med Sci. 2017 Apr 29. doi: 10.1093/gerona/glx066. [Epub ahead of print]

PMID: 28460137

Abstract

BACKGROUND:

The Mediterranean diet has been suggested as a key element for the prevention of age-related chronic diseases. However, very few studies have examined its relation with multidimensional concepts of healthy aging (HA). Our objective was thus to investigate the association between adherence to the Mediterranean diet at midlife and HA.

METHODS:

We analyzed data from 3,012 participants of the French SUpplémentation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) study aged 45-60 years at baseline (1994-1995) and initially free of major chronic diseases, with available data on HA status in 2007-2009. We defined HA as not developing major chronic disease (cancer, cardiovascular disease, or diabetes), good physical and cognitive functioning (evaluated by validated, standardized tests), independence in instrumental activities of daily living, no depressive symptoms, good social functioning, good self-perceived health, and no function-limiting pain. An index assessing adherence to the Mediterranean diet, the Literature-based Adherence Score to the Mediterranean Diet (LAMD) was calculated using baseline data from repeated 24-hour dietary records.

RESULTS:

In 2007-2009, 38% of participants met the HA criteria. Multivariable logistic regression revealed that higher scores on the LAMD (ORTertile 3 vs Tertile 1: 1.36 [1.12; 1.65]) were associated with higher odds of HA. Supplementary analyses using structural equation modeling revealed a potential mediation of the observed associations by metabolic health-related factors.

CONCLUSIONS:

Our results suggest a favorable role of a high adherence to the Mediterranean diet at midlife for maintaining good overall health during aging.

KEYWORDS:

Epidemiology; Metabolic health; Nutrition; Risk factors; Successful aging

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High salt intake causes leptin resistance and obesity in mice by stimulating endogenous fructose production and metabolism.

Lanaspa MA, Kuwabara M, Andres-Hernando A, Li N, Cicerchi C, Jensen T, Orlicky DJ, Roncal-Jimenez CA, Ishimoto T, Nakagawa T, Rodriguez-Iturbe B, MacLean PS, Johnson RJ.

Proc Natl Acad Sci U S A. 2018 Mar 5. pii: 201713837. doi: 10.1073/pnas.1713837115. [Epub ahead of print]

PMID: 29507217

Abstract

Dietary guidelines for obesity typically focus on three food groups (carbohydrates, fat, and protein) and caloric restriction. Intake of noncaloric nutrients, such as salt, are rarely discussed. However, recently high salt intake has been reported to predict the development of obesity and insulin resistance. The mechanism for this effect is unknown. Here we show that high intake of salt activates the aldose reductase-fructokinase pathway in the liver and hypothalamus, leading to endogenous fructose production with the development of leptin resistance and hyperphagia that cause obesity, insulin resistance, and fatty liver. A high-salt diet was also found to predict the development of diabetes and nonalcoholic fatty liver disease in a healthy population. These studies provide insights into the pathogenesis of obesity and diabetes and raise the potential for reduction in salt intake as an additional interventional approach for reducing the risk for developing obesity and metabolic syndrome.

KEYWORDS:

NAFLD; fructose; metabolic syndrome; obesity; salt

 

Type of dietary fat intakes in relation to all-cause and cause-specific mortality in US adults: an iso-energetic substitution analysis from the American National Health and Nutrition Examination Survey linked to the US mortality registry.

Ricci C, Baumgartner J, Zec M, Kruger HS, Smuts CM.

Br J Nutr. 2018 Feb;119(4):456-463. doi: 10.1017/S0007114517003889.

PMID: 29498349

Abstract

Accumulating evidence indicates that saturated fat intake is related to mortality risk increase, whereas unsaturated fat intake is associated with reduced mortality risk. The aim of the present study was to estimate the mortality risk reduction related to a dietary change from saturated fat to mono- or polyunsaturated fat intake. The American National Health and Nutrition Examination Surveys conducted between 1999 and 2010 were linked to the 2011 national US death registry resulting in an observational prospective mortality study. Proportional hazards Cox models were used to evaluate the association between saturated, monounsaturated and polyunsaturated fat with all-cause and cause-specific mortality. Substitution analysis was conducted to estimate an iso-energetic substitution of 10 % of the energy from dietary fat intake applied to the substitution of saturated fat with an equal amount of energy from monounsaturated or polyunsaturated fat. The highest tertile intakes of saturated fat resulted in an increased risk (12 %) of all-cause and specific-cause mortality, whereas the highest tertile intakes of polyunsaturated fat resulted in a reduced risk (7 %) of all-cause and specific-cause mortality when compared with the corresponding lowest tertile. Iso-energetic substitution revealed that a substitution of 10 % of energy (from total fat) from saturated fat to an equal amount of energy from monounsaturated or polyunsaturated fat resulted in a significant reduction of the mortality risk ranging from 4 to 8 %. Iso-energetic substitution of saturated fat with monounsaturated and polyunsaturated fat reduced all-cause and specific-cause mortality in US adults.

KEYWORDS:

NHANES National Health and Nutrition Examination Survey; All-cause mortality; Dietary fats; Specific mortality; Substitution analyses

 

Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial.

Martin RM, Donovan JL, Turner EL, Metcalfe C, Young GJ, Walsh EI, Lane JA, Noble S, Oliver SE, Evans S, Sterne JAC, Holding P, Ben-Shlomo Y, Brindle P, Williams NJ, Hill EM, Ng SY, Toole J, Tazewell MK, Hughes LJ, Davies CF, Thorn JC, Down E, Davey Smith G, Neal DE, Hamdy FC; CAP Trial Group.

JAMA. 2018 Mar 6;319(9):883-895. doi: 10.1001/jama.2018.0154.

PMID: 29509864

Abstract

IMPORTANCE:

Prostate cancer screening remains controversial because potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment.

OBJECTIVE:

To evaluate the effect of a single prostate-specific antigen (PSA) screening intervention and standardized diagnostic pathway on prostate cancer-specific mortality.

DESIGN, SETTING, AND PARTICIPANTS:

The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) included 419 582 men aged 50 to 69 years and was conducted at 573 primary care practices across the United Kingdom. Randomization and recruitment of the practices occurred between 2001 and 2009; patient follow-up ended on March 31, 2016.

INTERVENTION:

An invitation to attend a PSA testing clinic and receive a single PSA test vs standard (unscreened) practice.

MAIN OUTCOMES AND MEASURES:

Primary outcome: prostate cancer-specific mortality at a median follow-up of 10 years. Prespecified secondary outcomes: diagnostic cancer stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostate cancers identified, all-cause mortality, and an instrumental variable analysis estimating the causal effect of attending the PSA screening clinic.

RESULTS:

Among 415 357 randomized men (mean [sD] age, 59.0 [5.6] years), 189 386 in the intervention group and 219 439 in the control group were included in the analysis (n = 408 825; 98%). In the intervention group, 75 707 (40%) attended the PSA testing clinic and 67 313 (36%) underwent PSA testing. Of 64 436 with a valid PSA test result, 6857 (11%) had a PSA level between 3 ng/mL and 19.9 ng/mL, of whom 5850 (85%) had a prostate biopsy. After a median follow-up of 10 years, 549 (0.30 per 1000 person-years) died of prostate cancer in the intervention group vs 647 (0.31 per 1000 person-years) in the control group (rate difference, -0.013 per 1000 person-years [95% CI, -0.047 to 0.022]; rate ratio [RR], 0.96 [95% CI, 0.85 to 1.08]; P = .50). The number diagnosed with prostate cancer was higher in the intervention group (n = 8054; 4.3%) than in the control group (n = 7853; 3.6%) (RR, 1.19 [95% CI, 1.14 to 1.25]; P < .001). More prostate cancer tumors with a Gleason grade of 6 or lower were identified in the intervention group (n = 3263/189 386 [1.7%]) than in the control group (n = 2440/219 439 [1.1%]) (difference per 1000 men, 6.11 [95% CI, 5.38 to 6.84]; P < .001). In the analysis of all-cause mortality, there were 25 459 deaths in the intervention group vs 28 306 deaths in the control group (RR, 0.99 [95% CI, 0.94 to 1.03]; P = .49). In the instrumental variable analysis for prostate cancer mortality, the adherence-adjusted causal RR was 0.93 (95% CI, 0.67 to 1.29; P = .66).

CONCLUSIONS AND RELEVANCE:

Among practices randomized to a single PSA screening intervention vs standard practice without screening, there was no significant difference in prostate cancer mortality after a median follow-up of 10 years but the detection of low-risk prostate cancer cases increased. Although longer-term follow-up is under way, the findings do not support single PSA testing for population-based screening.

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Dietary fibre intake in relation to the risk of incident chronic kidney disease.

Mirmiran P, Yuzbashian E, Asghari G, Sarverzadeh S, Azizi F.

Br J Nutr. 2018 Mar;119(5):479-485. doi: 10.1017/S0007114517003671. Epub 2018 Jan 21.

PMID: 29352819

Abstract

The purpose of this study was primarily to evaluate the association of total fibre intake with the risk of incident chronic kidney disease (CKD). We also evaluated the association of dietary fibre from fruits, vegetables, cereals and legumes with the incidence of CKD in a population-based prospective study. We followed up 1630 participants of the Tehran Lipid and Glucose Study for 6·1 years, who were initially free of CKD. Baseline diet was assessed by a valid and reliable FFQ. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease Study equation, and CKD was defined as eGFR <60 ml/min per 1·73 m2. OR using multivariable logistic regression was reported for the association of incident CKD with tertiles of dietary fibre intake. After adjustment for age, sex, smoking, total energy intake, physical activity, diabetes and using angiotensin-converting-enzyme inhibitor, the OR for subjects in the highest compared with the lowest tertile of total fibre intake was 0·47 (95 % CI 0·27, 0·86). In addition, for every 5 g/d increase in total fibre intake, the risk of incident CKD decreased by 11 %. After adjusting for potential confounders, OR for participants in the highest compared with the lowest tertile of fibre from vegetables was 0·63 (95 % CI 0·43, 0·93) and from legumes it was 0·68 (95 % CI 0·47, 0·98). We observed inverse associations between total fibre intake and risk of incident CKD, which demonstrate that high fibre intake, mainly from legumes and vegetables, may reduce the occurrence of CKD.

KEYWORDS:

CKD chronic kidney disease; TLGS Tehran Lipid and Glucose Study; eGFR estimated glomerular filtration rate; Fruits; Kidney function; Legumes; Vegetables

 

Randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women.

Khaw KT, Sharp SJ, Finikarides L, Afzal I, Lentjes M, Luben R, Forouhi NG.

BMJ Open. 2018 Mar 6;8(3):e020167. doi: 10.1136/bmjopen-2017-020167.

PMID: 29511019

http://bmjopen.bmj.com/content/8/3/e020167

http://bmjopen.bmj.com/content/bmjopen/8/3/e020167.full.pdf

Abstract

INTRODUCTION:

High dietary saturated fat intake is associated with higher blood concentrations of low-density lipoprotein cholesterol (LDL-C), an established risk factor for coronary heart disease. However, there is increasing interest in whether various dietary oils or fats with different fatty acid profiles such as extra virgin coconut oil may have different metabolic effects but trials have reported inconsistent results. We aimed to compare changes in blood lipid profile, weight, fat distribution and metabolic markers after four weeks consumption of 50 g daily of one of three different dietary fats, extra virgin coconut oil, butter or extra virgin olive oil, in healthy men and women in the general population.

DESIGN:

Randomised clinical trial conducted over June and July 2017.

SETTING:

General community in Cambridgeshire, UK.

PARTICIPANTS:

Volunteer adults were recruited by the British Broadcasting Corporation through their websites. Eligibility criteria were men and women aged 50-75 years, with no known history of cancer, cardiovascular disease or diabetes, not on lipid lowering medication, no contraindications to a high-fat diet and willingness to be randomised to consume one of the three dietary fats for 4 weeks. Of 160 individuals initially expressing an interest and assessed for eligibility, 96 were randomised to one of three interventions; 2 individuals subsequently withdrew and 94 men and women attended a baseline assessment. Their mean age was 60 years, 67% were women and 98% were European Caucasian. Of these, 91 men and women attended a follow-up assessment 4 weeks later.

INTERVENTION:

Participants were randomised to extra virgin coconut oil, extra virgin olive oil or unsalted butter and asked to consume 50 g daily of one of these fats for 4 weeks, which they could incorporate into their usual diet or consume as a supplement.

MAIN OUTCOMES AND MEASURES:

The primary outcome was change in serum LDL-C; secondary outcomes were change in total and high-density lipoprotein cholesterol (TC and HDL-C), TC/HDL-C ratio and non-HDL-C; change in weight, body mass index (BMI), waist circumference, per cent body fat, systolic and diastolic blood pressure, fasting plasma glucose and C reactive protein.

RESULTS:

LDL-C concentrations were significantly increased on butter compared with coconut oil (+0.42, 95% CI 0.19 to 0.65 mmol/L, P<0.0001) and with olive oil (+0.38, 95% CI 0.16 to 0.60 mmol/L, P<0.0001), with no differences in change of LDL-C in coconut oil compared with olive oil (-0.04, 95% CI -0.27 to 0.19 mmol/L, P=0.74). Coconut oil significantly increased HDL-C compared with butter (+0.18, 95% CI 0.06 to 0.30 mmol/L) or olive oil (+0.16, 95% CI 0.03 to 0.28 mmol/L). Butter significantly increased TC/HDL-C ratio and non-HDL-C compared with coconut oil but coconut oil did not significantly differ from olive oil for TC/HDL-C and non-HDL-C. There were no significant differences in changes in weight, BMI, central adiposity, fasting blood glucose, systolic or diastolic blood pressure among any of the three intervention groups.

CONCLUSIONS AND RELEVANCE:

Two different dietary fats (butter and coconut oil) which are predominantly saturated fats, appear to have different effects on blood lipids compared with olive oil, a predominantly monounsaturated fat with coconut oil more comparable to olive oil with respect to LDL-C. The effects of different dietary fats on lipid profiles, metabolic markers and health outcomes may vary not just according to the general classification of their main component fatty acids as saturated or unsaturated but possibly according to different profiles in individual fatty acids, processing methods as well as the foods in which they are consumed or dietary patterns. These findings do not alter current dietary recommendations to reduce saturated fat intake in general but highlight the need for further elucidation of the more nuanced relationships between different dietary fats and health.

KEYWORDS:

blood lipids; coconut oil; dietary fats; olive oil; randomized trial

 

Was Luigi Cornaro a Dietary Expert?

Shapin S.

J Hist Med Allied Sci. 2018 Mar 5. doi: 10.1093/jhmas/jry007. [Epub ahead of print]

PMID: 29514305

Abstract

Luigi Cornaro (d. 1566) was a Venetian nobleman whose book De Vita Sobria (On the Temperate Life) was an instant success and has proved to be one of the most long-lasting and influential works of practical medical advice, counseling readers how to live long and healthily. Yet Cornaro was not a physician and his account raises a series of questions about the nature and location of medical expertise. Who can have that expertise? Can you, and should you, be your own physician, and, if so, on what grounds? I situate Cornaro's claims to expertise within a historically specific culture of medical dietetics in which personal experience counted for much. How did certain dietary practices "agree with" individuals? How did personal experience figure in constituting expertise? Was a healthy regime compatible with ordinary civic life and, if not, did it matter? What was the role of precise quantitative measure in prescribing the regime making for health and longevity? I address these questions with respect to Cornaro's historical setting and also in relation to pervasive commentary on his text over the centuries that followed.

 

Relationships between socio-clinico-demographic factors and global cognitive function in the oldest old living in the Tokyo Metropolitan area: Reanalysis of the Tokyo Oldest Old Survey on Total Health (TOOTH).

Eguchi Y, Tasato K, Nakajima S, Noda Y, Tsugawa S, Shinagawa S, Niimura H, Hirose N, Arai Y, Mimura M.

Int J Geriatr Psychiatry. 2018 Mar 7. doi: 10.1002/gps.4873. [Epub ahead of print] Review.

PMID: 29514399

Abstract

BACKGROUND:

Despite a steady increase in life expectancy, a few studies have investigated cross-sectional correlates and longitudinal predictors of cognitive function, a core domain of the successful aging, among socio-clinico-demographic factors in the oldest-old exclusively.

OBJECTIVES:

The aims of this study were to examine socio-clinico-demographic characteristics associated with global cognition and its changes in the oldest-old.

METHODS:

We reanalyzed a dataset of cognitively preserved community-dwelling subjects aged 85 years and older in the Tokyo Oldest Old Survey on Total Health, a 6-year longitudinal observational study. This study consisted of (1) baseline cross-sectional analyses examining correlates of global cognition (n = 248) among socio-clinico-demographic factors and (2) longitudinal analyses examining baseline predictors for changes of global cognition in 3-year follow-up (n = 195). The Mini-Mental State Examination was used as a screening test to assess global cognition.

RESULTS:

At baseline, higher weights were related to higher cognitive function in the oldest-old. The baseline predictors of global cognitive decline in 3-year follow-up were higher global cognition, shorter education period, and lower sociocultural activities and lower instrumental activity of daily living, in this order.

CONCLUSIONS:

The present study suggests that it is crucial to attain higher education during early life and avoid leanness or obesity, participate in sociocultural cognitive activities during late life, and maintain instrumental activity of daily living to preserve optimal cognitive function in the oldest-old, which will facilitate developing prevention strategies for cognitive decline and promoting successful aging in this increasing population.

KEYWORDS:

cognitive function; instrumental activity of daily living; physical function; social activity; the oldest-old

Move over blueberries — wild B.C. shrub produces contender for world's healthiest berry

Salal berries rate high in tannins, antioxidants, says University of Victoria scientist

By Deborah Wilson, CBC News Posted: Mar 07, 2018

http://www.cbc.ca/news/canada/british-columbia/blueberries-superfoods-salal-berries-uvic-antioxidants-tannins-1.4565091

 

Adherence to a Dietary Approaches to Stop Hypertension (DASH)-type diet over the life course and associated vascular function: a study based on the MRC 1946 British birth cohort.

Maddock J, Ziauddeen N, Ambrosini GL, Wong A, Hardy R, Ray S.

Br J Nutr. 2018 Mar;119(5):581-589. doi: 10.1017/S0007114517003877.

PMID: 29508688

Abstract

Little is known about long-term associations between the Dietary Approaches to Stop Hypertension (DASH) diet and conventional cardiovascular (CV)-risk factors as well as novel measures of vascular function. This study aimed to examine whether long-term adherence to a DASH-type diet in a British birth cohort is associated with conventional CV-risk factors and two vascular function markers, carotid intima-media thickness (cIMT) and pulse wave velocity (PWV). Data came from 1409 participants of the Medical Research Council (MRC) National Survey of Health and Development. Dietary intake was assessed at 36, 43, 53 and 60-64 years using 5-d estimated food diaries. The DASH-type diet score was calculated using the Fung index. Conventional CV-risk factors (blood pressure (BP) and lipids), cIMT in the right and/or left common carotid artery and PWV was measured when participants were 60-64 years. Associations between the DASH-type diet score and outcomes were assessed using multiple regression models adjusted for socioeconomic position, BMI, smoking and physical activity. Participants in higher sex-specific quintiles (Q) of the long-term DASH-type diet had lower BP (P≤0·08), higher HDL-cholesterol (P<0·001) and lower TAG (P<0·001) compared with people in Q1. Participants in Q5 of the long-term DASH-type diet had lower PWV (-0·28 sd; 95 % CI -0·50, -0·07, P trend=0·01) and cIMT (-0·24 sd; 95 % CI -0·44, -0·04, P trend=0·02) compared with participants in the Q1. This association was independent of the conventional CV-risk factors. Greater adherence to a DASH diet over the life course is associated with conventional CV-risk factors and independently associated with cIMT and PWV.

KEYWORDS:

BP blood pressure; CV cardiovascular; DASH Dietary Approaches to Stop Hypertension; DBP diastolic blood pressure; MRC Medical Research Council; NSHD National Survey of Health and Development; PVW pulse wave velocity; Q quintiles; RCT randomised controlled trials; SBP systolic blood pressure; SEP socioeconomic position; cIMT carotid intima–media thickness; British birth cohort; Dietary Approaches to Stop Hypertension diet; Life course epidemiology; Vascular function

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Benefits of summer sun to reduce risk of multiple sclerosis may extend beyond childhood

'You need safe sun exposure, but at the same time don't be afraid to go outside,' professor says

CBC News · Posted: Mar 08, 2018

http://www.cbc.ca/news/health/multiple-sclerosis-sun-1.4566429

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Sun exposure over the life course and associations with multiple sclerosis

Helen Tremlett, Feng Zhu, Alberto Ascherio and Kassandra L. Munger

Neurology First published March 7, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005257

Abstract

Objective To examine sun exposure and multiple sclerosis (MS) over the life course (ages 5–15 and 16–20 years, every 10 years thereafter).

Methods Cases with MS (n = 151) and age-matched controls (n = 235) from the Nurses' Health Study cohorts completed summer, winter, and lifetime sun exposure history questionnaires. Cumulative ambient ultraviolet (UV)-B (based on latitude, altitude, cloud cover) exposure before MS onset was expressed as tertiles. Seasonal sun exposure was defined as low vs high hours per week (summer [≤9 vs >10 h/wk]; winter [≤3 vs >4 h/wk]). Relative risks (RRs) and 95% confidence intervals (CIs) were estimated via conditional logistic regression with adjustment for body mass index, ancestry, smoking, and vitamin D supplementation.

Results Most participants were white (98%); the mean age at MS onset was 39.5 years. Living in high (vs low) UV-B areas before MS onset was associated with a 45% lower MS risk (adjusted RR 0.55, 95% CI 0.42–0.73). Similar reduced risks (51%–52%) for medium or high exposure were observed at ages 5 to 15 years and at 5 to 15 years before MS onset (adjusted p < 0.05). At age 5 to 15 years, living in a high (vs low) UV-B area and having high (vs low) summer sun exposure were associated with a lower MS risk (RR 0.45, 95% CI 0.21–0.96).

Conclusion Living in high ambient UV-B areas during childhood and the years leading up to MS onset was associated with a lower MS risk. High summer sun exposure in high ambient UV-B areas was also associated with a reduced risk.

 

Balancing Safety and Innovation for Cell-Based Regenerative Medicine

P. Marks and S. Gottlieb

N Engl J Med 2018;378:954-959

FREE

http://www.nejm.org/doi/full/10.1056/NEJMsr1715626?query=TOC

 

Outcome age-based prediction of successful cognitive aging by total cholesterol.

Silverman JM, Schmeidler J.

Alzheimers Dement. 2018 Mar 1. pii: S1552-5260(18)30028-1. doi: 10.1016/j.jalz.2018.01.009. [Epub ahead of print]

PMID: 29514768

Abstract

INTRODUCTION:

Some associations of high total cholesterol with dementia risk diminish as the outcome age-age at cognitive assessment-increases.

METHODS:

The Framingham Heart Study provided 1897 participants with intact cognition at entry. Cox regression analysis for incident marked cognitive decline included "time-dependent" coefficients, with associations between total cholesterol and covariates changing by outcome age. Decline within age categories of 75-84 and 85-94 years was also examined.

RESULTS:

Significant associations of rising total cholesterol linear slope, low entry age, low education, and statin nonuse with risk diminished significantly by outcome age. At 85-94 years, falling linear slope was significant.

DISCUSSION:

The protected survival model posits a minority subpopulation with protection against mortality and cognitive decline associated with total cholesterol risk factors. It predicts the observed diminished or reversed cholesterol associations with increasing age. Protection is particularly likely for successful cognitive aging-intact cognition at very old age-despite increased risk from cholesterol.

KEYWORDS:

Dementia; Oldest-old; Protected survivor; Protective factors; Risk factors; Survival analysis; Time-dependent coefficients

 

Rectangularization of the survival curve reconsidered: The maximum inner rectangle approach.

Ebeling M, Rau R, Baudisch A.

Popul Stud (Camb). 2018 Mar 8:1-11. doi: 10.1080/00324728.2017.1414299. [Epub ahead of print]

PMID: 29517414

Abstract

Rectangularization of the survival curve-a key analytical framework in mortality research-relies on assumptions that have become partially obsolete in high-income countries due to mortality reductions among the oldest old. We propose refining the concept to adjust for recent and potential future mortality changes. Our framework, the 'maximum inner rectangle approach' (MIRA) considers two types of rectangularization. Outer rectangularization captures progress in mean lifespan relative to progress in maximum lifespan. Inner rectangularization captures progress in lifespan equality relative to progress in mean lifespan. Empirical applications show that both processes have generally increased since 1850. However, inner rectangularization has displayed country-specific patterns since the onset of sustained old-age mortality declines. Results from separating premature and old-age mortality, using the MIRA, suggest there has been a switch from reducing premature deaths to extending the premature age range; a shift potentially signalling a looming limit to the share of premature deaths.

KEYWORDS:

compression; lifespan variability; mortality; rectangularization; survival curve

 

 

Common dietary patterns and risk of cancers of the colon and rectum: Analysis from the United Kingdom Women's Cohort Study (UKWCS).

Rada-Fernandez de Jauregui D, Evans CEL, Jones P, Greenwood DC, Hancock N, Cade JE.

Int J Cancer. 2018 Mar 8. doi: 10.1002/ijc.31362. [Epub ahead of print]

PMID: 29516512

Abstract

Few prospective cohort studies in the UK have specifically focused on the associations between commonly consumed dietary patterns and colorectal cancer (CRC). The aim of this study was to assess whether red meat, poultry, fish and vegetarian dietary patterns are associated with differences in the incidence of cancers of colon and rectum in the UKWCS. Four common dietary patterns were defined based on a hierarchy of consumption of red meat, poultry, and fish for each cohort participant, using a 217-item food frequency questionnaire. Cox proportional hazards regression was used to provide adjusted hazard ratios (HR) and 95% confidence intervals (CI) for CRC. A total of 32,147 women recruited and surveyed between 1995 and 1998 were followed up for a mean of 17.2 years (426,798 person-years). A total of 462 incident CRC cases were documented; 335 colon cancers (172 proximal and 119 distal) and 152 in the rectum. In multivariable-adjusted models, there was no evidence of a reduction in risk of overall CRC (HR=0.86, 95% CI: 0.66 to 1.12), colon cancer (HR=0.77, 95% CI: 0.56 to 1.05), or rectal cancer (HR=1.04, 95% CI: 0.66 to 1.63) when comparing grouped red meat free diets with diets containing red meat. Exploratory analysis suggested a reduced risk of distal colon cancer in grouped red meat free diets (HR=0.56, 95% CI: 0.34 to 0.95), though numbers with this outcome were small. These results indicate that a protective association of red meat free diets specifically on distal colon cancer merits confirmation in a larger study.

KEYWORDS:

Cohort study; colonic neoplasm; dietary patterns; fish; poultry; rectal neoplasm and epidemiology; red meat; vegetarian

 

Effect of Physical Activity on Frailty: Secondary Analysis of a Randomized Controlled Trial.

Trombetti A, Hars M, Hsu FC, Reid KF, Church TS, Gill TM, King AC, Liu CK, Manini TM, McDermott MM, Newman AB, Rejeski WJ, Guralnik JM, Pahor M, Fielding RA; LIFE Study Investigators.

Ann Intern Med. 2018 Mar 6;168(5):309-316. doi: 10.7326/M16-2011. Epub 2018 Jan 9.

PMID: 29310138

Abstract

BACKGROUND:

Limited evidence suggests that physical activity may prevent frailty and associated negative outcomes in older adults. Definitive data from large long-term randomized trials are lacking.

OBJECTIVE:

To determine whether a long-term, structured, moderate-intensity physical activity program is associated with a lower risk for frailty and whether frailty status alters the effect of physical activity on the reduction in major mobility disability (MMD) risk.

DESIGN:

Multicenter, single-blind, randomized trial.

SETTING:

8 centers in the United States.

PARTICIPANTS:

1635 community-dwelling adults, aged 70 to 89 years, with functional limitations.

INTERVENTION:

A structured, moderate-intensity physical activity program incorporating aerobic, resistance, and flexibility activities or a health education program consisting of workshops and stretching exercises.

MEASUREMENTS:

Frailty, as defined by the SOF (Study of Osteoporotic Fractures) index, at baseline and 6, 12, and 24 months, and MMD, defined as the inability to walk 400 m, for up to 3.5 years.

RESULTS:

Over 24 months of follow-up, the risk for frailty (n = 1623) was not statistically significantly different in the physical activity versus the health education group (adjusted prevalence difference, -0.021 [95% CI, -0.049 to 0.007]). Among the 3 criteria of the SOF index, the physical activity intervention was associated with improvement in the inability to rise from a chair (adjusted prevalence difference, -0.050 [CI, -0.081 to -0.020]). Baseline frailty status did not modify the effect of physical activity on reducing incident MMD (P for interaction = 0.91).

LIMITATION:

Frailty status was neither an entry criterion nor a randomization stratum.

CONCLUSION:

A structured, moderate-intensity physical activity program was not associated with a reduced risk for frailty over 2 years among sedentary, community-dwelling older adults. The beneficial effect of physical activity on the incidence of MMD did not differ between frail and nonfrail participants.

 

Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Synopsis of the 2017 American College of Cardiology/American Heart Association Hypertension Guideline.

Carey RM, Whelton PK; 2017 ACC/AHA Hypertension Guideline Writing Committee.

Ann Intern Med. 2018 Mar 6;168(5):351-358. doi: 10.7326/M17-3203. Epub 2018 Jan 23.

PMID: 29357392

http://annals.org/aim/fullarticle/2670318/prevention-detection-evaluation-management-high-blood-pressure-adults-synopsis-2017

Abstract

DESCRIPTION:

In November 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a clinical practice guideline for the prevention, detection, evaluation, and treatment of high blood pressure (BP) in adults. This article summarizes the major recommendations.

METHODS:

In 2014, the ACC and the AHA appointed a multidisciplinary committee to update previous reports of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The committee reviewed literature and commissioned systematic reviews and meta-analyses on out-of-office BP monitoring, the optimal target for BP lowering, the comparative benefits and harms of different classes of antihypertensive agents, and the comparative benefits and harms of initiating therapy with a single antihypertensive agent or a combination of 2 agents.

RECOMMENDATIONS:

This article summarizes key recommendations in the following areas: BP classification, BP measurement, screening for secondary hypertension, nonpharmacologic therapy, BP thresholds and cardiac risk estimation to guide drug treatment, treatment goals (general and for patients with diabetes mellitus, chronic kidney disease, and advanced age), choice of initial drug therapy, resistant hypertension, and strategies to improve hypertension control.

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Purpose in Life Among Centenarian Offspring.

Marone S, Bloore K, Sebastiani P, Flynn C, Leonard B, Whitaker K, Mostowy M, Perls T, Andersen SL.

J Gerontol B Psychol Sci Soc Sci. 2018 Mar 7. doi: 10.1093/geronb/gby023. [Epub ahead of print]

PMID: 29522128

Abstract

OBJECTIVES:

Purpose in life (PIL), a feeling of meaning and direction in life, is associated with favorable health outcomes including lower mortality and reduced risk of disease, disability, and cognitive impairment. Since centenarian offspring have been shown to have long health spans we sought to examine whether they have higher PIL than individuals without familial longevity.

METHOD:

We compared PIL scores from the Ryff Scales of Psychological Well-Being in centenarian offspring from the New England Centenarian Study (N=361, mean age=82.0 years) with three referent groups: spouses, birth cohort-matched referents, and Health and Retirement Study (HRS) participants.

RESULTS:

Logistic regression analyses adjusted for age, sex, education, and marital status indicated greater odds of high PIL among centenarian offspring compared with spouse (adjusted odds ratio [aOR] 1.92, 95% CI 1.002-3.68, p=.049) and birth cohort referents (aOR 2.64, 95% CI 1.36-5.14, p=.004). Offspring had an almost three times greater odds of having high PIL than HRS participants (OR 2.93, 95% CI 2.17-3.96, p<0.0001).

DISCUSSION:

Higher PIL is associated with being an offspring of a long-lived parent and may play a role in the ability to delay age-associated illnesses and functional decline. Increasing purposefulness may be a target for interventions to promote healthy aging.

 

Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes

Liping Zhao1,2,*,†, Feng Zhang1,*, Xiaoying Ding3,*, Guojun Wu1,*, Yan Y. Lam2,*, Xuejiao Wang3, Huaqing Fu1, Xinhe Xue1, Chunhua Lu4, Jilin Ma4, Lihua Yu4, Chengmei Xu4, Zhongying Ren4, Ying Xu5, Songmei Xu5, Hongli Shen5, Xiuli Zhu5, Yu Shi6, Qingyun Shen6, Weiping Dong3, Rui Liu1, Yunxia Ling3, Yue Zeng7, Xingpeng Wang7, Qianpeng Zhang1, Jing Wang1, Linghua Wang1, Yanqiu Wu1, Benhua Zeng8, Hong Wei8, Menghui Zhang1, Yongde Peng3,†, Chenhong Zhang1,†

Science 09 Mar 2018:

Vol. 359, Issue 6380, pp. 1151-1156

DOI: 10.1126/science.aao5774

Microbial modulation of diabetes

Short-chain fatty acids (SCFAs) are produced by various human gut microbes. SCFAs act as an energy source to the colonic epithelium and are also sensed by host signaling pathways that modulate appetite and inflammation. Deficiency of gut SCFAs is associated with type 2 diabetes. Zhao et al. found that adopting a high-fiber diet promoted the growth of SCFA-producing organisms in diabetic humans. The high-fiber diet induced changes in the entire gut microbe community and correlated with elevated levels of glucagon-like peptide-1, a decline in acetylated hemoglobin levels, and improved blood-glucose regulation.

Science, this issue p. 1151

Abstract

The gut microbiota benefits humans via short-chain fatty acid (SCFA) production from carbohydrate fermentation, and deficiency in SCFA production is associated with type 2 diabetes mellitus (T2DM). We conducted a randomized clinical study of specifically designed isoenergetic diets, together with fecal shotgun metagenomics, to show that a select group of SCFA-producing strains was promoted by dietary fibers and that most other potential producers were either diminished or unchanged in patients with T2DM. When the fiber-promoted SCFA producers were present in greater diversity and abundance, participants had better improvement in hemoglobin A1c levels, partly via increased glucagon-like peptide-1 production. Promotion of these positive responders diminished producers of metabolically detrimental compounds such as indole and hydrogen sulfide. Targeted restoration of these SCFA producers may present a novel ecological approach for managing T2DM.

 

Journal of the American College of Cardiology Volume 71, Issue 10, March 2018

DOI: 10.1016/j.jacc.2018.01.011

Sustained Physical Activity, Not Weight Loss, Associated With Improved Survival in Coronary Heart Disease

Trine Moholdt, Carl J. Lavie and Javaid Nauman

Abstract

Background Individuals with coronary heart disease (CHD) are recommended to be physically active and to maintain a healthy weight. There is a lack of data on how long-term changes in body mass index (BMI) and physical activity (PA) relate to mortality in this population.

Objectives This study sought to determine the associations among changes in BMI, PA, and mortality in individuals with CHD.

Methods The authors studied 3,307 individuals (1,038 women) with CHD from the HUNT (Nord-Trøndelag Health Study) with examinations in 1985, 1996, and 2007, followed until the end of 2014. They calculated the hazard ratio (HR) for all-cause and cardiovascular disease (CVD) mortality according to changes in BMI and PA, and estimated using Cox proportional hazards regression models adjusted for age, smoking, blood pressure, diabetes, alcohol, and self-reported health.

Results There were 1,493 deaths during 30 years of follow-up (55% from CVD, median 15.7 years). Weight loss, classified as change in BMI <–0.10 kg/m2/year, associated with increased all-cause mortality (adjusted HR: 1.30; 95% confidence interval [CI]: 1.12 to 1.50). Weight gain, classified as change in BMI ≥0.10 kg/m2/year, was not associated with increased mortality (adjusted HR: 0.97; 95% CI: 0.87 to 1.09). Weight loss only associated with increased risk in those who were normal weight at baseline (adjusted HR: 1.38; 95% CI: 1.11 to 1.72). There was a lower risk for all-cause mortality in participants who maintained low PA (adjusted HR: 0.81; 95% CI: 0.67 to 0.97) or high PA (adjusted HR: 0.64; 95% CI: 0.50 to 0.83), compared with participants who were inactive over time. CVD mortality associations were similar as for all-cause mortality.

Conclusions The study observed no mortality risk reductions associated with weight loss in individuals with CHD, and reduced mortality risk associated with weight gain in individuals who were normal weight at baseline. Sustained PA, however, was associated with substantial risk reduction.

Key Words

body mass indexexerciseHUNTmortalitymyocardial infarctionobesity paradox

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Risk of breast cancer and residential proximity to industrial installations: New findings from a multicase-control study (MCC-Spain).

García-Pérez J, Lope V, Pérez-Gómez B, Molina AJ, Tardón A, Díaz Santos MA, Ardanaz E, O'Callaghan-Gordo C, Altzibar JM, Gómez-Acebo I, Moreno V, Peiró R, Marcos-Gragera R, Kogevinas M, Aragonés N, López-Abente G, Pollán M.

Environ Pollut. 2018 Mar 7;237:559-568. doi: 10.1016/j.envpol.2018.02.065. [Epub ahead of print]

PMID: 29524878

Abstract

Breast cancer is the most frequent tumor in women worldwide, although well-established risk factors account for 53%-55% of cases. Therefore, other risk factors, including environmental exposures, may explain the remaining variation. Our objective was to assess the relationship between risk of breast cancer and residential proximity to industries, according to categories of industrial groups and specific pollutants released, in the context of a population-based multicase-control study of incident cancer carried out in Spain (MCC-Spain). Using the current residence of cases and controls, this study was restricted to small administrative divisions, including both breast cancer cases (452) and controls (1511) in the 10 geographical areas recruiting breast cancer cases. Distances were calculated from the respective woman's residences to the 116 industries located in the study area. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (between 1 km and 3 km) to industrial plants, adjusting for matching variables and other confounders. Excess risk (OR; 95%CI) of breast cancer was found near industries overall (1.30; 1.00-1.69 at 3 km), particularly organic chemical industry (2.12; 1.20-3.76 at 2.5 km), food/beverage sector (1.87; 1.26-2.78 at 3 km), ceramic (4.71; 1.62-13.66 at 1.5 km), surface treatment with organic solvents (2.00; 1.23-3.24 at 3 km), and surface treatment of plastic and metals (1.51; 1.06-2.14 at 3 km). By pollutants, the excess risk (OR; 95%CI) was detected near industries releasing pesticides (2.09; 1.14-3.82 at 2 km), and dichloromethane (2.09; 1.28-3.40 at 3 km). Our results suggest a possible increased risk of breast cancer in women living near specific industrial plants and support the need for more detailed exposure assessment of certain agents released by these plants.

KEYWORDS:

Breast cancer; Case-control study; Endocrine disrupting chemicals; Industrial pollution; Pesticides; Residential proximity

 

Lifestyle factors, cardiovascular disease and all-cause mortality in middle-aged and elderly women: a systematic review and meta-analysis.

Colpani V, Baena CP, Jaspers L, van Dijk GM, Farajzadegan Z, Dhana K, Tielemans MJ, Voortman T, Freak-Poli R, Veloso GGV, Chowdhury R, Kavousi M, Muka T, Franco OH.

Eur J Epidemiol. 2018 Mar 10. doi: 10.1007/s10654-018-0374-z. [Epub ahead of print]

PMID: 29524110

Abstract

Cardiovascular disease (CVD) risk factors, incidence and death increases from around the time of menopause comparing to women in reproductive age. A healthy lifestyle can prevent CVD, but it is unclear which lifestyle factors may help maintain and improve cardiovascular health for women after menopausal transition. We conducted a systematic review and meta-analysis of prospective cohort studies to evaluate the association between modifiable lifestyle factors (specifically smoking, physical activity, alcohol intake, and obesity), with CVD and mortality in middle-aged and elderly women. Pubmed, Embase, among other databases and reference lists were searched until February 29th, 2016. Study specific relative risks (RR) were meta-analyzed using random effect models. We included 59 studies involving 5,358,902 women. Comparing current versus never smokers, pooled RR were 3.12 (95% CI 2.15-4.52) for CHD incidence, 2.09 (95% CI 1.51-2.89) for stroke incidence, 2.76 (95% CI 1.62-4.71) for CVD mortality and 2.22 (95% CI 1.92-2.57) for all-cause mortality. Physical activity was associated with a decreased risk of 0.74 (95% CI 0.67-0.80) for overall CVD, 0.71 (95% CI 0.67-0.75) for CHD, 0.77 (95% CI 0.70-0.85) for stroke, 0.70 (95% CI 0.58-0.84) for CVD mortality and 0.71 (95% CI 0.65-0.78) for all-cause mortality. Comparing moderate drinkers versus non-drinkers, the RR was 0.72 (95% CI 0.56-0.91) for CHD, 0.63 (95% CI 0.57-0.71) for CVD mortality and 0.80 (95% CI 0.76-0.84) for all-cause mortality. For women with BMI 30-35 kg/m2 the risk was 1.67 (95% CI 1.24-2.25) for CHD and 2.3 (95% CI 1.56-3.40) for CVD mortality, compared to normal weight. Each 5 kg/m2 increase in BMI was associated with 24% (95% CI 16-33%) higher risk for all-cause mortality. This meta-analysis suggests that physical activity and moderate alcohol intake were associated with a reduced risk for CVD and mortality. Smoking and higher BMI were associated with an increased risk of these endpoints. Adherence to a healthy lifestyle may substantially lower the burden of CVD and reduce the risk of mortality among middle-aged and elderly women. However, this review highlights important gaps, as lack of standardized methods in assessing lifestyle factors and lack of accurate information on menopause status, which should be addressed by future studies in order to understand the role of menopause on the association between lifestyle factors and cardiovascular events.

KEYWORDS:

Cardiovascular disease; Lifestyle; Menopause; Mortality; Women

 

Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study.

Naudin S, Li K, Jaouen T, Assi N, Kyrø C, Tjønneland A, Overvad K, Boutron-Ruault MC, Rebours V, Védié AL, Boeing H, Kaaks R, Katzke V, Bamia C, Naska A, Trichopoulou A, Berrino F, Tagliabue G, Palli D, Panico S, Tumino R, Sacerdote C, Peeters PH, Bueno-de-Mesquita B, Weiderpass Vainio E, Gram IT, Skeie G, Chirlaque MD, Rodríguez-Barranco M, Barricarte A, Quirós JR, Dorronsoro M, Johansson I, Sund M, Sternby H, Bradbury KE, Wareham N, Riboli E, Gunter M, Brennan P, Duell EJ, Ferrari P.

Int J Cancer. 2018 Mar 9. doi: 10.1002/ijc.31367. [Epub ahead of print]

PMID: 29524225

Abstract

Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In this study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake.

 

The associations of serum n-6 polyunsaturated fatty acids with serum C-reactive protein in men: the Kuopio Ischaemic Heart Disease Risk Factor Study.

Virtanen JK, Mursu J, Voutilainen S, Tuomainen TP.

Eur J Clin Nutr. 2018 Mar;72(3):342-348. doi: 10.1038/s41430-017-0009-6. Epub 2017 Nov 6.

PMID: 29515239

Abstract

BACKGROUND/OBJECTIVES:

There are concerns that high intake of n-6 polyunsaturated fatty acids (PUFA) may promote inflammation, because the end-product of n-6 PUFA metabolism, arachidonic acid, is a precursor for pro-inflammatory eicosanoids. Our aim was to investigate cross-sectional associations of the serum n-6 PUFAs, objective biomarkers for exposure, with serum high-sensitivity C-reactive protein (CRP), a key inflammation marker.

SUBJECTS/METHODS:

The study included 1287 generally healthy men aged 42-60 years from the population-based Kuopio Ischaemic Heart Disease Risk Factor Study, examined in 1984-1989. ANCOVA and logistic regression were used for analyses.

RESULTS:

In the multivariable-adjusted analyses, both serum total n-6 PUFA and linoleic acid, the predominant n-6 PUFA, were associated with lower CRP. The mean CRP concentrations in quartiles of linoleic acid were 1.86, 1.51, 1.53, and 1.37 mg/L (P-trend = 0.001). The odds ratio for elevated CRP (>3 mg/L) in the highest vs. the lowest quartile was 0.47 (95% confidence interval (CI) 0.25-0.87, P-trend = 0.01). Arachidonic acid or the mainly endogenously produced n-6 PUFAs, gamma-linolenic acid and dihomo-gamma-linolenic acid, were not associated with higher CRP, either. Age, body mass index, or serum long-chain n-3 PUFA concentration did not modify the associations (P-interactions > 0.14).

CONCLUSIONS:

Serum n-6 PUFAs were not associated with increased inflammation in men. In contrast, the main n-6 PUFA linoleic acid had a strong inverse association with the key inflammation marker, CRP.

 

Body composition and development of diabetes: a 15-year follow-up study in a Japanese population.

Tatsukawa Y, Misumi M, Kim YM, Yamada M, Ohishi W, Fujiwara S, Nakanishi S, Yoneda M.

Eur J Clin Nutr. 2018 Mar;72(3):374-380. doi: 10.1038/s41430-017-0077-7. Epub 2018 Jan 23.

PMID: 29362458

Abstract

BACKGROUND/OBJECTIVES:

Few longitudinal studies have examined the association between diabetes risk and body composition in Asians. The aim of this prospective cohort study was to determine the role of body composition, estimated by whole-body dual-energy X-ray absorptiometry, in the development of diabetes and to examine the impact of body composition on diabetes risk in normal weight (body mass index (BMI) <23 kg/m2) and overweight/obese groups (≥23 kg/m2).

SUBJECTS/METHODS:

We measured the body composition for 1532 diabetes-free subjects (463 men and 1069 women), aged 48-79 years, at the baseline examination period from 1994-96 and followed-up to detect new cases of diabetes over the next 15 years (median 13.4 years).

RESULTS:

After being adjusted for BMI and other potential confounding factors, body fat distribution was associated with diabetes risk. Percentage of trunk fat was positively associated with the development of diabetes (hazards ratio (HR) per 1 SD (95% confidential interval (CI)), 1.58 (1.10-2.28) in men, and 1.34 (0.99-1.83) in women), and percentage of leg fat was negatively associated with the development of diabetes (HR per 1 SD (95% CI), 0.68 (0.50-0.91) in men and 0.68 (0.55-0.85) in women). The estimated HRs of % trunk and leg fat on the development of diabetes differed little between normal weight and overweight/obese subjects. Appendicular lean mass was also negatively associated with diabetes risk only in normal weight men.

CONCLUSIONS:

Opposite associations of trunk fat and leg fat with diabetes risk were observed. Assessment of body composition might help in the evaluation of diabetes risk.

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Does soy protein affect circulating levels of unbound IGF-1?

Messina M, Magee P.

Eur J Nutr. 2018 Mar;57(2):423-432. doi: 10.1007/s00394-017-1459-2. Epub 2017 Apr 22. Review.

PMID: 28434035

Abstract

INTRODUCTION:

Despite the enormous amount of research that has been conducted on the role of soyfoods in the prevention and treatment of chronic disease, the mechanisms by which soy exerts its physiological effects are not fully understood. The clinical data show that neither soyfoods nor soy protein nor isoflavones affect circulating levels of reproductive hormones in men or women. However, some research suggests that soy protein, but not isoflavones, affects insulin-like growth factor I (IGF-1).

METHODS:

Since IGF-1 may have wide-ranging physiological effects, we sought to determine the effect of soy protein on IGF-1 and its major binding protein insulin-like growth factor-binding protein (IGFBP-3). Six clinical studies were identified that compared soy protein with a control protein, albeit only two studies measured IGFBP-3 in addition to IGF-1.

RESULTS:

Although the data are difficult to interpret because of the different experimental designs employed, there is some evidence that large amounts of soy protein (>25 g/day) modestly increase IGF-1 levels above levels observed with the control protein.

CONCLUSION:

The clinical data suggest that a decision to incorporate soy into the diet should not be based on its possible effects on IGF-1.

KEYWORDS:

Cancer; Clinical trials; IGF-1; IGFBP-3; Isoflavones; Soy

 

Soy isoflavone intake and prevalence of depressive symptoms during pregnancy in Japan: baseline data from the Kyushu Okinawa Maternal and Child Health Study.

Miyake Y, Tanaka K, Okubo H, Sasaki S, Furukawa S, Arakawa M.

Eur J Nutr. 2018 Mar;57(2):441-450. doi: 10.1007/s00394-016-1327-5. Epub 2016 Oct 15.

PMID: 27744546

Abstract

OBJECTIVE:

Several observational studies and trials examined the relationship between isoflavones or soybeans and depressive symptoms among peri- and postmenopausal women. We cross-sectionally evaluated the associations between intake of soy products and isoflavones and depressive symptoms during pregnancy in Japan.

METHODS:

Study subjects were 1745 pregnant women. Dietary intake during the preceding month was assessed using a self-administered diet history questionnaire. Depressive symptoms were defined by a score of 16 or over in the Center for Epidemiologic Studies Depression Scale.

RESULTS:

Higher intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones was independently related to a lower prevalence of depressive symptoms during pregnancy: The adjusted prevalence ratios (95 % confidence intervals, P for trend) between extreme quartiles were 0.63 (0.47-0.85, 0.002), 0.72 (0.54-0.96, 0.007), 0.74 (0.56-0.98, 0.04), 0.57 (0.42-0.76, <0.0001), 0.73 (0.55-0.98, 0.03), 0.65 (0.49-0.87, 0.003), and 0.63 (0.46-0.86, 0.002), respectively. A significant positive exposure-response relationship was found between miso intake and depressive symptoms during pregnancy. No material relationship was observed between soymilk intake and depressive symptoms during pregnancy.

CONCLUSIONS:

Our study is the first to show independent inverse relationships between intake of total soy products, tofu, tofu products, fermented soybeans, boiled soybeans, miso soup, and isoflavones and depressive symptoms during pregnancy.

KEYWORDS:

Depressive symptoms; Intake; Isoflavones; Japanese; Pregnancy; Soy

 

Meat intake, cooking methods and doneness and risk of colorectal tumours in the Spanish multicase-control study (MCC-Spain).

de Batlle J, Gracia-Lavedan E, Romaguera D, Mendez M, Castaño-Vinyals G, Martín V, Aragonés N, Gómez-Acebo I, Olmedo-Requena R, Jimenez-Moleon JJ, Guevara M, Azpiri M, Llorens-Ivorra C, Fernandez-Tardon G, Lorca JA, Huerta JM, Moreno V, Boldo E, Pérez-Gómez B, Castilla J, Fernández-Villa T, Barrio JP, Andreu M, Castells A, Dierssen T, Altzibar JM, Kogevinas M, Pollán M, Amiano P.

Eur J Nutr. 2018 Mar;57(2):643-653. doi: 10.1007/s00394-016-1350-6. Epub 2016 Nov 24.

PMID: 27885555

Abstract

PURPOSE:

Although there is convincing evidence that red and processed meat intake increases the risk of colorectal cancer (CRC), the potential role of meat cooking practices has not been established yet and could partly explain the current heterogeneity of results among studies. Therefore, we aimed to investigate the association between meat consumption and cooking practices and the risk of CRC in a population-based case-control study.

METHODS:

A total of 1671 CRC cases and 3095 controls recruited in Spain between September 2008 and December 2013 completing a food frequency questionnaire with a meat-specific module were included in the analyses. Odds ratios (OR) and confidence intervals (CI) were estimated by logistic regression models adjusted for known confounders.

RESULTS:

Total meat intake was associated with increased risk of CRC (OR T3-T1 1.41; 95% CI 1.19-1.67; p trend < 0.001), and similar associations were found for white, red and processed/cured/organ meat. Rare-cooked meat preference was associated with low risk of CRC in red meat (ORrare vs. medium 0.66; 95% CI 0.51-0.85) and total meat (ORrare vs. medium 0.56; 95% CI 0.37-0.86) consumers, these associations being stronger in women than in men. Griddle-grilled/barbecued meat was associated with an increased CRC risk (total meat: OR 1.45; 95% CI 1.13-1.87). Stewing (OR 1.25; 95% CI 1.04-1.51) and oven-baking (OR 1.18; 95% CI 1.00-1.40) were associated with increased CRC risk of white, but not red, meat.

CONCLUSIONS:

Our study supports an association of white, red, processed/cured/organ and total meat intake with an increased risk of CRC. Moreover, our study showed that cooking practices can modulate such risk.

KEYWORDS:

Colorectal cancer; Cooking; Epidemiology; Meat

 

Fruit and vegetable consumption and risk of cholecystectomy: a prospective cohort study of women and men.

Nordenvall C, Oskarsson V, Wolk A.

Eur J Nutr. 2018 Feb;57(1):75-81. doi: 10.1007/s00394-016-1298-6. Epub 2016 Aug 20.

PMID: 27544676

Abstract

PURPOSE:

Epidemiologic data on whether consumption of fruit and vegetables (FVs) decreases the risk of gallstone disease are sparse. Therefore, we examined the association between FV consumption and the 14-year risk of symptomatic gallstone disease (defined as occurrence of cholecystectomy) in a large group of middle-aged and elderly persons.

METHODS:

Data from two population-based cohorts were used, which included 74,554 men and women (born 1914-1952). Participants filled in a food frequency questionnaire in the late fall of 1997 and were followed up for cholecystectomy between 1998 and 2011 via linkage to the Swedish Patient Register. Cox regression models were used to obtain hazard ratios (HRs).

RESULTS:

During 939,715 person-years of follow-up, 2120 participants underwent a cholecystectomy (1120 women and 1000 men). An inverse association between FV consumption and risk of cholecystectomy was observed in age- and sex-adjusted analyses (P trend = .036) but not in confounder-adjusted analyses (P trend = .43). The multivariable-adjusted HR was 0.95 (95 % CI 0.83-1.08) for the highest compared with the lowest sex-specific quartile of FV consumption. There was no evidence of interactions with age (P = .25) or sex (P = .72) in analyses pooled by sex. However, an age-by-FV consumption interaction was observed in separate analyses of women (P = .010), with decreased HRs of cholecystectomy for ages up to 60 years.

CONCLUSIONS:

This study supports an inverse association between FV consumption and risk cholecystectomy in women, although the association was restricted to women aged 48-60 years. In contrast, the study does not support an association in men.

KEYWORDS:

Cohort study; Fruit consumption; Gallbladder disease; Vegetable consumption

 

Effect of probiotics and synbiotics on blood glucose: a systematic review and meta-analysis of controlled trials.

Nikbakht E, Khalesi S, Singh I, Williams LT, West NP, Colson N.

Eur J Nutr. 2018 Feb;57(1):95-106. doi: 10.1007/s00394-016-1300-3. Epub 2016 Sep 3.

PMID: 27590729

Abstract

PURPOSE:

High fasting blood glucose (FBG) can lead to chronic diseases such as diabetes mellitus, cardiovascular and kidney diseases. Consuming probiotics or synbiotics may improve FBG. A systematic review and meta-analysis of controlled trials was conducted to clarify the effect of probiotic and synbiotic consumption on FBG levels.

METHODS:

PubMed, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature databases were searched for relevant studies based on eligibility criteria. Randomized or non-randomized controlled trials which investigated the efficacy of probiotics or synbiotics on the FBG of adults were included. Studies were excluded if they were review articles and study protocols, or if the supplement dosage was not clearly mentioned.

RESULTS:

A total of fourteen studies (eighteen trials) were included in the analysis. Random-effects meta-analyses were conducted for the mean difference in FBG. Overall reduction in FBG observed from consumption of probiotics and synbiotics was borderline statistically significant (-0.18 mmol/L 95 % CI -0.37, 0.00; p = 0.05). Neither probiotic nor synbiotic subgroup analysis revealed a significant reduction in FBG. The result of subgroup analysis for baseline FBG level ≥7 mmol/L showed a reduction in FBG of 0.68 mmol/L (-1.07, -0.29; ρ < 0.01), while trials with multiple species of probiotics showed a more pronounced reduction of 0.31 mmol/L (-0.58, -0.03; ρ = 0.03) compared to single species trials.

CONCLUSION:

This meta-analysis suggests that probiotic and synbiotic supplementation may be beneficial in lowering FBG in adults with high baseline FBG (≥7 mmol/L) and that multispecies probiotics may have more impact on FBG than single species.

KEYWORDS:

Fasting blood glucose; Hyperglycemia; Probiotics; Synbiotics

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The Secret to a Longer Life? Don’t Ask These Dead Longevity Researchers

Pagan Kennedy MARCH 9, 2018

https://www.nytimes.com/2018/03/09/opinion/sunday/longevity-pritikin-atkins.html

 

Run Clever - No difference in risk of injury when comparing progression in running volume and running intensity in recreational runners: A randomised trial.

Ramskov D, Rasmussen S, Sørensen H, Parner ET, Lind M, Nielsen RO.

BMJ Open Sport Exerc Med. 2018 Feb 7;4(1):e000333. doi: 10.1136/bmjsem-2017-000333. eCollection 2018.

PMID: 29527322

Abstract

BACKGROUND/AIM:

The Run Clever trial investigated if there was a difference in injury occurrence across two running schedules, focusing on progression in volume of running intensity (Sch-I) or in total running volume (Sch-V). It was hypothesised that 15% more runners with a focus on progression in volume of running intensity would sustain an injury compared with runners with a focus on progression in total running volume.

METHODS:

Healthy recreational runners were included and randomly allocated to Sch-I or Sch-V. In the first eight weeks of the 24-week follow-up, all participants (n=839) followed the same running schedule (preconditioning). Participants (n=447) not censored during the first eight weeks entered the 16-week training period with a focus on either progression in intensity (Sch-I) or volume (Sch-V). A global positioning system collected all data on running. During running, all participants received real-time, individualised feedback on running intensity and running volume. The primary outcome was running-related injury (RRI).

RESULTS:

After preconditioning a total of 80 runners sustained an RRI (Sch-I n=36/Sch-V n=44). The cumulative incidence proportion (CIP) in Sch-V (reference group) were CIP2 weeks 4.6%; CIP4 weeks 8.2%; CIP8 weeks 13.2%; CIP16 weeks 28.0%. The risk differences (RD) and 95% CI between the two schedules were RD2 weeks=2.9%(-5.7% to 11.6%); RD4 weeks=1.8%(-9.1% to 12.8%); RD8 weeks=-4.7%(-17.5% to 8.1%); RD16 weeks=-14.0% (-36.9% to 8.9%).

CONCLUSION:

A similar proportion of runners sustained injuries in the two running schedules.

KEYWORDS:

Injury; Recreational runners; Running intensity; Running volume; injury risk difference

 

Associations between copper and zinc intakes from diet and mortality from cardiovascular disease in a large population-based prospective cohort study.

Eshak ES, Iso H, Yamagishi K, Maruyama K, Umesawa M, Tamakoshi A.

J Nutr Biochem. 2018 Feb 13;56:126-132. doi: 10.1016/j.jnutbio.2018.02.008. [Epub ahead of print]

PMID: 29529560

Abstract

Several studies have related cardiovascular disease (CVD) to serum concentrations of copper and zinc but not to their dietary intakes. We thought to examine the association between dietary intakes of copper and zinc with risk of mortality from CVD in a prospective study encompassing 58,646 healthy Japanese men and women aged 40-79 years. The intakes of copper and zinc were determined by a validated self-administered food frequency questionnaire, and their associations with risk of mortality from CVD were evaluated by Cox proportional hazard modelling. During 965, 970 person-years of follow-up between 1989-2009, we documented 3,388 CVD deaths [1,514 from stroke, 702 from coronary heart disease (CHD) and 1,172 from other CVD]. Copper intake was not associated with CHD mortality; however, the multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) for mortality from stroke, other CVD and total CVD in the highest versus the lowest quintiles of copper intake among men were 1.78 (1.16-2.77; P-trend=0.007), 1.61 (1.01-2.81; P-trend =0.03) and 1.63 (1.21-2.33; P-trend=0.001), respectively, and those among women were 1.49 (1.00-2.19; P-trend=0.04), 1.59 (1.09-2.55; P-trend =0.02) and 1.36 (1.06-1.69; P-trend=0.01), respectively. Higher intakes of zinc was inversely associated with mortality from CHD in men; 0.68 (0.58-1.03; P-trend=0.05) but not women; 1.13 (0.71- 1.49; P-trend=0.61). No associations were observed with other mortality endpoints. In conclusion, dietary copper intake was positively associated with mortality from CVD in both genders; whereas, higher dietary zinc intake was inversely associated with mortality from CHD in men but not women.

KEYWORDS:

Cardiovascular diseases; Copper; Coronary heart disease; Japanese; Stroke; Zinc

 

Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study.

Gunderson EP, Lewis CE, Lin Y, Sorel M, Gross M, Sidney S, Jacobs DR Jr, Shikany JM, Quesenberry CP Jr.

JAMA Intern Med. 2018 Mar 1;178(3):328-337. doi: 10.1001/jamainternmed.2017.7978.

PMID: 29340577

Abstract

IMPORTANCE:

Lactation duration has shown weak protective associations with incident diabetes (3%-15% lower incidence per year of lactation) in older women based solely on self-report of diabetes, studies initiated beyond the reproductive period are vulnerable to unmeasured confounding or reverse causation from antecedent biochemical risk status, perinatal outcomes, and behaviors across the childbearing years.

OBJECTIVE:

To evaluate the association between lactation and progression to diabetes using biochemical testing both before and after pregnancy and accounting for prepregnancy cardiometabolic measures, gestational diabetes (GD), and lifestyle behaviors.

DESIGN, SETTING, AND PARTICIPANTS:

For this US multicenter, community-based 30-year prospective cohort study, there were 1238 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study of young black and white women ages 18 to 30 years without diabetes at baseline (1985-1986) who had 1 or more live births after baseline, reported lactation duration, and were screened for diabetes up to 7 times during 30 years after baseline (1986-2016).

EXPOSURES:

Time-dependent lactation duration categories (none, >0 to 6 months, >6 to <12 months, and ≥12 months) across all births since baseline through 30 years.

MAIN OUTCOMES AND MEASURES:

Diabetes incidence rates per 1000 person-years and adjusted relative hazards (RH) with corresponding 95% CIs, as well as proportional hazards regression models adjusted for biochemical, sociodemographic, and reproductive risk factors, as well as family history of diabetes, lifestyle, and weight change during follow-up.

RESULTS:

Overall 1238 women were included in this analysis (mean [sD] age, 24.2 [3.7] years; 615 black women). There were 182 incident diabetes cases during 27 598 person-years for an overall incidence rate of 6.6 cases per 1000 person-years (95% CI, 5.6-7.6); and rates for women with GD and without GD were 18.0 (95% CI, 13.3-22.8) and 5.1 (95% CI, 4.2-6.0), respectively (P for difference < .001). Lactation duration showed a strong, graded inverse association with diabetes incidence: adjusted RH for more than 0 to 6 months, 0.75 (95% CI, 0.51-1.09); more than 6 months to less than 12 months, 0.52 (95% CI, 0.31-0.87), and 12 months or more 0.53 (0.29-0.98) vs none (0 days) (P for trend = .01). There was no evidence of effect modification by race, GD, or parity.

CONCLUSIONS AND RELEVANCE:

This study provides longitudinal biochemical evidence that lactation duration is independently associated with lower incidence of diabetes. Further investigation is required to elucidate mechanisms that may explain this relationship.

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Meat Cooking Methods and Risk of Type 2 Diabetes: Results From Three Prospective Cohort Studies.

Liu G, Zong G, Wu K, Hu Y, Li Y, Willett WC, Eisenberg DM, Hu FB, Sun Q.

Diabetes Care. 2018 Mar 12. pii: dc171992. doi: 10.2337/dc17-1992. [Epub ahead of print]

PMID: 29530926

Abstract

OBJECTIVE:

To examine open-flame and/or high-temperature cooking (grilling/barbecuing, broiling, or roasting) and doneness preferences (rare, medium, or well done) for red meat, chicken, and fish in relation to type 2 diabetes (T2D) risk among U.S. adults who consumed animal flesh regularly (≥2 servings/week).

RESEARCH DESIGN AND METHODS:

The prospective studies included 52,752 women from the Nurses' Health Study (NHS, followed during 1996-2012), 60,809 women from NHS II (followed during 2001-2013), and 24,679 men from the Health Professionals Follow-up Study (HPFS, followed during 1996-2012) who were free of diabetes, cardiovascular disease, and cancer at baseline. Incident cases of T2D were confirmed by validated supplementary questionnaires.

RESULTS:

We documented 7,895 incident cases of T2D during 1.74 million person-years of follow-up. After multivariate adjustments including baseline BMI and total consumption of red meat, chicken, and fish, higher frequency of open-flame and/or high-temperature cooking was independently associated with an elevated T2D risk. When comparing open-flame and/or high-temperature cooking >15 times/month with <4 times/month, the pooled hazard ratio (HR) (95% CI) of T2D was 1.28 (1.18, 1.39; Ptrend <0.001). When comparing the extreme quartiles of doneness-weighted frequency of high-temperature cooking, the pooled HR (95% CI) of T2D was 1.20 (1.12, 1.28; Ptrend <0.001). These associations remained significant when red meat and chicken were examined separately. In addition, estimated intake of heterocyclic aromatic amines was also associated with an increased T2D risk.

CONCLUSIONS:

Independent of consumption amount, open-flame and/or high-temperature cooking for both red meat and chicken is associated with an increased T2D risk among adults who consume animal flesh regularly.

 

Effects of dietary and exercise intervention on weight loss and body composition in obese postmenopausal women: a systematic review and meta-analysis.

Cheng CC, Hsu CY, Liu JF.

Menopause. 2018 Mar 12. doi: 10.1097/GME.0000000000001085. [Epub ahead of print]

PMID: 29533366

Abstract

OBJECTIVE:

This study examined the effects of dietary and exercise interventions on weight loss and body composition in overweight/obese peri- and postmenopausal women.

METHODS:

Medline, Central, Embase, and Google Scholar databases were searched for relevant trials conducted until December 31, 2016. Randomized controlled trials (RCTs) and prospective studies of overweight/obese peri- or postmenopausal women that examined the effects of dietary or exercise interventions, alone or combined, on weight loss were included. The primary outcome was percentage reduction in body weight.

RESULTS:

From 292 studies initially identified, 11 studies with 12 sets of participants were included. Both dietary and exercise intervention groups had significantly greater weight loss than control groups (diet vs control: difference in means = -6.55, 95% CI, -9.51 to -3.59, P < 0.001; exercise vs control: difference in means = -3.49, 95% CI, -6.96 to -0.02, P = 0.049). Combined dietary and exercise interventions resulted in greater weight loss than dietary interventions alone (diet plus exercise vs diet: difference in means = -1.22, 95% CI, -2.14 to -0.29, P = 0.010). Diet plus exercise resulted in greater fat loss (difference in means = -0.44, 95% CI, -0.67 to -0.20, P < 0.001) and greater lean mass loss (difference in means = -0.84, 95% CI, -1.13 to -0.55, P < 0.001) than diet alone.

CONCLUSIONS:

Dietary interventions reduced body weight and body composition profile parameters in peri- and postmenopausal women more than exercise alone. The addition of exercise reinforced the effect of dietary interventions on changing body weight and composition.

 

Physical activity across the lifespan and liver cancer incidence in the NIH-AARP Diet and Health Study cohort.

Arem H, Loftfield E, Saint-Maurice PF, Freedman ND, Matthews CE.

Cancer Med. 2018 Mar 13. doi: 10.1002/cam4.1343. [Epub ahead of print]

PMID: 29533015

Abstract

While liver cancer rates in the United States are increasing, 5-year survival is only 17.6%, underscoring the importance of prevention. Physical activity has been associated with lower risk of developing liver cancer, but most studies assess physical activity only at a single point in time, often in midlife. We utilized physical activity data from 296,661 men and women in the NIH-AARP Diet and Health Study cohort to test whether physical activity patterns over the life course could elucidate the importance of timing of physical activity on liver cancer risk. We used group modeling of longitudinal data to create physical activity trajectories using four time points across the life course from teenage years through middle age, identifying seven distinct trajectories. We then used Cox proportional hazards regression to assess the association between the physical activity trajectories and risk of hepatocellular carcinoma, the most common type of liver cancer. We found that, in adjusted analyses, compared to those with consistently low physical activity patterns, those who maintained activity levels over time had a 26-36% lower risk of liver cancer and those who increased physical activity over time had no associations with risk, while those who decreased activity over time had a nonsignificantly higher risk of liver cancer. Our results suggest that sustained physical activity is associated with lower risk of hepatocellular carcinoma, while increasing physical activity later in life may not yield the same benefit. Future research with larger sample sizes and more detailed data on dose and timing of physical activity may continue to yield insight into this association between physical activity and liver cancer risk.

KEYWORDS:

Epidemiology and prevention; life course; liver cancer; physical activity

 

Nutritionally recommended food for semi- to strict vegetarian diets based on large-scale nutrient composition data.

Kim S, Fenech MF, Kim PJ.

Sci Rep. 2018 Mar 12;8(1):4344. doi: 10.1038/s41598-018-22691-1.

PMID: 29531252

https://www.nature.com/articles/s41598-018-22691-1

https://www.nature.com/articles/s41598-018-22691-1.pdf

Abstract

Diet design for vegetarian health is challenging due to the limited food repertoire of vegetarians. This challenge can be partially overcome by quantitative, data-driven approaches that utilise massive nutritional information collected for many different foods. Based on large-scale data of foods' nutrient compositions, the recent concept of nutritional fitness helps quantify a nutrient balance within each food with regard to satisfying daily nutritional requirements. Nutritional fitness offers prioritisation of recommended foods using the foods' occurrence in nutritionally adequate food combinations. Here, we systematically identify nutritionally recommendable foods for semi- to strict vegetarian diets through the computation of nutritional fitness. Along with commonly recommendable foods across different diets, our analysis reveals favourable foods specific to each diet, such as immature lima beans for a vegan diet as an amino acid and choline source, and mushrooms for ovo-lacto vegetarian and vegan diets as a vitamin D source. Furthermore, we find that selenium and other essential micronutrients can be subject to deficiency in plant-based diets, and suggest nutritionally-desirable dietary patterns. We extend our analysis to two hypothetical scenarios of highly personalised, plant-based methionine-restricted diets. Our nutrient-profiling approach may provide a useful guide for designing different types of personalised vegetarian diets.

 

Front. Mol. Neurosci., 12 March 2018 | https://doi.org/10.3389/fnmol.2018.00065

Low-Fat Diet With Caloric Restriction Reduces White Matter Microglia Activation During Aging

Zhuoran Yin1,2†, Divya D. Raj2†, Wandert Schaafsma2‡, Roel A. van der Heijden3‡, Susanne M. Kooistra2‡, Aaffien C. Reijne4,5,6, Xiaoming Zhang2, Jill Moser7, Nieske Brouwer2, Peter Heeringa3, Chun-Xia Yi8, Gertjan van Dijk5,6,9, Jon D. Laman2, Erik W. G. M. Boddeke2 and Bart J. L. Eggen2*

https://www.frontiersin.org/articles/10.3389/fnmol.2018.00065/full

Rodent models of both aging and obesity are characterized by inflammation in specific brain regions, notably the corpus callosum, fornix, and hypothalamus. Microglia, the resident macrophages of the central nervous system, are important for brain development, neural support, and homeostasis. However, the effects of diet and lifestyle on microglia during aging are only partly understood. Here, we report alterations in microglia phenotype and functions in different brain regions of mice on a high-fat diet (HFD) or low-fat diet (LFD) during aging and in response to voluntary running wheel exercise. We compared the expression levels of genes involved in immune response, phagocytosis, and metabolism in the hypothalamus of 6-month-old HFD and LFD mice. We also compared the immune response of microglia from HFD or LFD mice to peripheral inflammation induced by intraperitoneal injection of lipopolysaccharide (LPS). Finally, we investigated the effect of diet, physical exercise, and caloric restriction (40% reduction compared to ad libitum intake) on microglia in 24-month-old HFD and LFD mice. Changes in diet caused morphological changes in microglia, but did not change the microglia response to LPS-induced systemic inflammation. Expression of phagocytic markers (i.e., Mac-2/Lgals3, Dectin-1/Clec7a, and CD16/CD32) in the white matter microglia of 24-month-old brain was markedly decreased in calorically restricted LFD mice. In conclusion, LFD resulted in reduced activation of microglia, which might be an underlying mechanism for the protective role of caloric restriction during aging-associated decline.

 

Insulin-Like Growth Factor-1 and Receptor Contribute Genetic Susceptibility to Hypertension in a Han Chinese Population.

Yao Y, Zhu L, Fang Z, Yang S, Chen Y, Jin Y, Zhao X, Zhao H, Zhuang Q, Chen X, Shen C.

Am J Hypertens. 2017 Nov 6. doi: 10.1093/ajh/hpx195. [Epub ahead of print]

PMID: 29126188

Abstract

BACKGROUND:

Insulin-like growth factor 1 (IGF-1) and IGF-1 receptor (IGF-1R) have been suggested to mediate the pathophysiological response to elevated blood pressure. This study aims to evaluate the association of IGF-1 and IGF-1R with hypertension.

METHODS:

Overall, 2012 hypertensive cases and 2210 controls were included in a case-control study, and ten tagSNPs were selected. The association of these SNPs with hypertension was further evaluated in a follow-up analysis and in an adolescent population.

RESULTS:

A case-control study indicated that rs1815009 and rs2654981 in IGF-1R were significantly associated with hypertension, with ORs of 0.89 (P=0.009) and 1.19 (P=0.034), respectively, after adjusting for covariates. Stratification analyses revealed significant associations with hypertension (P<0.05) for rs35767 in normal weight and obese populations; for rs2229765 in individuals <55 years of age and in overweight and non-drinking populations; and for rs2002880 in overweight and drinking populations. In a follow-up study, rs13379905 in IGF-1R was associated with hypertension incidence (HR=1.24, P=0.042). This association was more significant in individuals with a hypertensive family history (HR=2.10, P=0.001). The association of rs13379905 with prehypertension and hypertension was further replicated in adolescent males (P=0.005). Significant associations with hypertension incidence (P<0.05) were observed for rs6219 in individuals <55 years of age and among those with obesity and a hypertensive family history as well as rs2002880 in obese individuals.

CONCLUSIONS:

Our findings suggest that IGF-1R may contribute to the genetic susceptibility to hypertension, with BMI, age and family history of hypertension all potentially modulating the genetic effects of IGF-1 on hypertension.

KEYWORDS:

IGF-1; IGF-1R; association study; hypertension; polymorphism

 

Digital rectal exams to screen for prostate cancer in family practice not recommended

There’s still no simple way to detect prostate cancer before it becomes a problem, family doctor says

CBC News Posted: Mar 12, 2018

http://www.cbc.ca/news/health/prostate-digital-rectal-exam-1.4570631

 

Hip and waist size may play role in heart attack risk for women, study says

Women at greater risk than men with similar 'apple' body shape

Thomson Reuters Posted: Mar 12, 2018

http://www.cbc.ca/news/health/hip-waist-size-heart-attack-risk-women-1.4573023

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Theranos founder Holmes stripped of control of embattled company

The SEC said Holmes must also return millions of shares to the privately-held company

Thomson Reuters · Posted: Mar 14, 2018

http://www.cbc.ca/news/business/theranos-elizabeth-holmes-fraud-1.4575955

Edited by AlPater

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Electrolyte minerals intake and cardiovascular health.

Mohammadifard N, Gotay C, Humphries KH, Ignaszewski A, Esmaillzadeh A, Sarrafzadegan N.

Crit Rev Food Sci Nutr. 2018 Mar 15:1-39. doi: 10.1080/10408398.2018.1453474. [Epub ahead of print]

PMID: 29543505

Abstract

Appropriate intake of micronutrient, such as electrolyte minerals is critical for the well-being of the cardiovascular health system. However, there are some debates regarding the impacts of dietary and/or supplemental intake of these minerals, on the risk of cardiovascular events and associated risk factors. High sodium intake is adversely associated with the risk of hypertension. Although many reports refered to the positive association of Na intake and cardiovascular events and all-cause mortality, however, other studies indicated that low Na intake is related to higher risk of all-cause mortality and HF-related events. By contrast, dietary potassium, magnesium and calcium have an inverse correlation with cardiovascular events and risk factors, especially with blood pressure. There are some controversies about cardiovascular effects and all-cause mortality of high Ca intake, including no effect, preventive or adverse effect with or without vitamin D. Calcium supplementation might be beneficial for prevention of cardiovascular events and all-cause mortality only in individuals with low intake. Moreover, calcium intake showed a J- or U-shaped association with the risk of cardiovascular diseases. Due to the controversies of the effect of electrolyte minerals especially sodium and calcium intake on cardiovascular events, large scale, well-designed long-term randomized clinical trials are required to evaluate the effect of minerals intake on cardiovascular events and all-cause mortality. In this review, we discuss the role of dietary and or supplemental sodium, potassium, magnesium, calcium, in cardiovascular health, as well as their clinical applications, benefits, and risks for the primary prevention of cardiovascular disease, in general population.

KEYWORDS:

Mineral; calcium; cardiovascular; magnesium; mortality; potassium; sodium

 

Systematic review and meta-analysis of omega-3-fatty acids in elderly patients with depression.

Bae JH, Kim G.

Nutr Res. 2018 Feb;50:1-9. doi: 10.1016/j.nutres.2017.10.013. Epub 2017 Dec 8. Review.

PMID: 29540267

Abstract

One of the typical symptoms of a psychological crisis is depression, an increasing concern in the elderly population. Although omega-3-polyunsaturated fatty acids (PUFAs) are reported to be promising nutrients for treating depression, currently, there are no systematic reviews or meta-analyses of randomized control trials that provide critical evidence regarding the potential benefits of omega-3 fatty acids in elderly patients with depression. This analysis was conducted to provide evidence for the clinical application of omega-3 fatty acids in the treatment of depressive symptoms of elderly subjects older than 65 years. Seven databases were searched from their inception date until September 2016. Following this search, 6 studies were selected, which included 4605 patients (mean age, 76.97 years; male-female ratio=3752:853; mean dose of omega 3 intake, 1.3 g/d). These results were divided into 2 categories: well-being mental health group and depressive group. In the well-being mental health group, the Hedges g was 0.12 (95% confidence interval, -0.05 to 0.29), which indicated no significant effect of n-3 PUFA supplementation on depressed mood compared with placebo. In the depressive group, the pooled Hedges g was -0.94 (95% CI, -1.37 to -0.50]) for the random-effects model, which indicated a large effect of n-3 PUFA supplementation on those with depressed mood compared with placebo. Although this review shows that omega-3 fatty acids are effective in the treatment of elderly depressed patients, the benefits of omega-3 fatty acid supplementation were significant only in the elderly patients with mild to moderate depression.

KEYWORDS:

Depression; Meta-analysis; Omega-3-fatty acids; Systematic review

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Anti/genotoxic, longevity inductive, cytotoxic, and clastogenic-related bioactivities of tomato andlycopene.

Fernández-Bedmar Z, Anter J, Alonso Moraga Á.

Environ Mol Mutagen. 2018 Mar 22. doi: 10.1002/em.22185. [Epub ahead of print]

PMID: 29569272

Abstract

The aim of this study was to evaluate some biological activities of tomato as well as lycopene and to consider a new nutraceutic value for this fruit regarding to the protection against genetic damage and as a chemopreventive agent. Genotoxicity, DNA-protection against hydrogen peroxide, and lifespan properties of tomato and lycopene were assessed through wing spot test and longevity assay using the Drosophila in vivo model. Additionally, chemopreventive activity was investigated through cytotoxicity, DNA-fragmentation comet and annexin V FITC/PI assays using HL60 in vitro model. Results showed that: (i) tomato and lycopene are not genotoxic and protect against H2 O2 -induced damage; (ii) with respect to the lifespan, tomato and lycopene are harmless at the lowest concentration; (iii) tomato is cytotoxic in a dose-dependent manner, but not lycopene; (iv) tomato and lycopene do not induce internucleosomal DNA-fragmentation although they induce significant clastogenic activity at low level in the leukemia cells. To sum up, tomato is a good candidate to be considered as a nutraceutical substance. Furthermore, synergistic action among other components within tomato matrix could be the cause of the health effects observed in this vegetable, which are not fully explained by lycopene.

KEYWORDS:

DNA-protection; cytotoxicity; food safety; lycopene; tomato

 

Association between cognitive function and supplementation with omega-3 PUFAs and other nutrients in ≥ 75 years old patients: A randomized multicenter study.

Baleztena J, Ruiz-Canela M, Sayon-Orea C, Pardo M, Añorbe T, Gost JI, Gomez C, Ilarregui B, Bes-Rastrollo M.

PLoS One. 2018 Mar 26;13(3):e0193568. doi: 10.1371/journal.pone.0193568. eCollection 2018.

PMID: 29579102 Free Article

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0193568

Abstract

A few studies have assessed the association between omega-3 polyunsaturated fatty acids (n-3 PUFA) and cognitive impairment (CI) in very old adults. The aim of this study was to evaluate the effect of a multinutrient supplementation rich in n-3 PUFA on the cognitive function in an institutionalized ≥75-year-old population without CI or with mild cognitive impairment (MCI). A multicenter placebo-controlled double-blind randomized trial was conducted between 2012 and 2013. Cognitive function was assessed at baseline and after one year using 4 neuropsychological tests. Nutritional status was assessed using Mini Nutritional Assessment (MNA). Interaction between Mini-Mental State Examination (MMSE) score and nutritional status were analyzed using linear regression models. A total of 99 participants were randomized to receive placebo or pills rich in n-3 PUFA. After 1-year follow-up, both groups decreased their MMSE score (-1.18, SD:0. 53 and -0.82, SD:0. 63, p = 0.67 for the control and the intervention group respectively). The memory subscale of the MMSE showed an improvement (+0.26, SD:0.18) in the intervention group against a worsening in the control group (-0.11, SD: 0.14; p = 0.09 for differences between groups). Patients at intervention group with normal nutritional status (MNA ≥24) showed an improvement in the MMSE (+1.03, p = 0.025 for differences between 1-y and baseline measurements) against a worsening in the group with malnutrition (MNA<24) (-0.4, p = 0.886 for differences between 1-y and baseline; p of interaction p = 0.05). Supplementation with n-3 PUFA did not show an improvement in the global cognitive function in institutionalized elderly people without CI or with MCI. They only suggest an apparent improvement in memory loss if previously they were well nourished.

 

Biological, Psychological, and Social Predictors of Longevity Among Utah Centenarians.

Yorgason JB, Draper TW, Bronson H, Nielson M, Babcock K, Jones K, Hill MS, Howard M.

Int J Aging Hum Dev. 2018 Jan 1:91415018757211. doi: 10.1177/0091415018757211. [Epub ahead of print]

PMID: 29577740

Abstract

Studies of longevity among centenarians examine biological, psychological, and social factors, yet few consider these components concurrently. This study explores such factors individually and collectively, as they are related to days lived past the age of 100 years. Data from 268 family members of centenarians identified in the State of Utah between 2008 and 2015 were used in negative binomial models predicting number of days lived among the centenarians. Findings suggested that sleep latency (biological), life satisfaction (psychological), and attachment closeness (social) were predictive factors of more days lived within individual models. When considered together, sleep latency and life satisfaction remained significant predictors of days lived. Although biological factors are commonly considered in relation to longevity, this study further indicates that psychological and social factors may play important roles in life expectancy. Further examination is needed to explore how these factors link additionally to active life expectancy.

KEYWORDS:

attachment; centenarians; life satisfaction; longevity; sleep

 

The genetic component of human longevity: New insights from the analysis of pathway-based SNP-SNP interactions.

Dato S, Soerensen M, De Rango F, Rose G, Christensen K, Christiansen L, Passarino G.

Aging Cell. 2018 Mar 25:e12755. doi: 10.1111/acel.12755. [Epub ahead of print]

PMID: 29577582 Free Article

https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12755

Abstract

In human longevity studies, single nucleotide polymorphism (SNP) analysis identified a large number of genetic variants with small effects, yet not easily replicable in different populations. New insights may come from the combined analysis of different SNPs, especially when grouped by metabolic pathway. We applied this approach to study the joint effect on longevity of SNPs belonging to three candidate pathways, the insulin/insulin-like growth factor signalling (IIS), DNA repair and pro/antioxidant. We analysed data from 1,058 tagging SNPs in 140 genes, collected in 1825 subjects (1,089 unrelated nonagenarians from the Danish 1905 Birth Cohort Study and 736 Danish controls aged 46-55 years) for evaluating synergic interactions by SNPsyn. Synergies were further tested by the multidimensional reduction (MDR) approach, both intra- and interpathways. The best combinations (FDR<0.0001) resulted those encompassing IGF1R-rs12437963 and PTPN1-rs6067484, TP53-rs2078486 and ERCC2-rs50871, TXNRD1-rs17202060 and TP53-rs2078486, the latter two supporting a central role of TP53 in mediating the concerted activation of the DNA repair and pro-antioxidant pathways in human longevity. Results were consistently replicated with both approaches, as well as a significant effect on longevity was found for the GHSR gene, which also interacts with partners belonging to both IIS and DNA repair pathways (PAPPA, PTPN1, PARK7, MRE11A). The combination GHSR-MREA11, positively associated with longevity by MDR, was further found influencing longitudinal survival in nonagenarian females (p = .026). Results here presented highlight the validity of SNP-SNP interactions analyses for investigating the genetics of human longevity, confirming previously identified markers but also pointing to novel genes as central nodes of additional networks involved in human longevity.

KEYWORDS:

SNP ; aging; epistasis; genetic component of human longevity; pathway-based analysis; synergic interaction

 

Resting Heart Rate Is Not Associated with Cognitive Function.

Wod M, Jensen MT, Galatius S, Hjelmborg JB, Jensen GB, Christensen K.

Neuroepidemiology. 2018 Mar 22;50(3-4):160-167. doi: 10.1159/000487802. [Epub ahead of print]

PMID: 29566380

Abstract

AIMS:

In order to examine the hypothesis that elevated resting heart rate (RHR) is associated with impaired cognitive score, we investigated the relationship between RHR and cognitive score in middle-aged, elderly and old Danish subjects from the general population.

METHODS:

Composite cognitive scores derived from the result of 5 age-sensitive cognitive tests for a total of 7,002 individuals (Middle-aged Danish twin: n = 4,132, elderly Danish twins: n = 2,104 and Danish nonagenarian: n = 766) divided according to RHR and compared using linear regression models adjusted for sex, age, previous heart conditions and hypertension. RHR was assessed by palpating radial pulse. Genetic and shared environmental confounding was addressed in intrapair analyses of 2,049 twin pairs.

RESULTS:

In unadjusted multivariate models and in multivariable models adjusting for age, sex, heart conditions and hypertension, RHR was not associated with cognitive function. Furthermore, the intrapair analyses showed that RHR was not associated with cognitive score testing within twin pairs, as measured by the proportion of twin pairs in which the twin with higher RHR also was the twin with the lowest composite cognitive score (1,049 pairs of 2,049 pairs [51% (95% CI 49-53), p < 0.289]).

CONCLUSION:

While elevated RHR has been shown to be associated with adverse health events and poor fitness level, RHR has no relation to cognitive function in the general population.

KEYWORDS:

Cardiovascular; Cognitive function; Resting heart rate; Twin study

 

Protein restriction and cancer.

Yin J, Ren W, Huang X, Li T, Yin Y.

Biochim Biophys Acta. 2018 Mar 26;1869(2):256-262. doi: 10.1016/j.bbcan.2018.03.004. [Epub ahead of print] Review.

PMID: 29596961

Abstract

Protein restriction without malnutrition is currently an effective nutritional intervention known to prevent diseases and promote health span from yeast to human. Recently, low protein diets are reported to be associated with lowered cancer incidence and mortality risk of cancers in human. In murine models, protein restriction inhibits tumor growth via mTOR signaling pathway. IGF-1, amino acid metabolic programing, FGF21, and autophagy may also serve as potential mechanisms of protein restriction mediated cancer prevention. Together, dietary intervention aimed at reducing protein intake can be beneficial and has the potential to be widely adopted and effective in preventing and treating cancers.

KEYWORDS:

Amino acid; Autophagy; Cancer; FGF21; IGF-1; Protein restriction; mTOR

 

Calcium in drinking water: effect on iron stores in Danish blood donors-results from the Danish Blood Donor Study.

Rigas AS, Ejsing BH, Sørensen E, Pedersen OB, Hjalgrim H, Erikstrup C, Ullum H.

Transfusion. 2018 Mar 25. doi: 10.1111/trf.14600. [Epub ahead of print]

PMID: 29577328

Abstract

BACKGROUND:

Studies confirm that calcium inhibits iron absorption. Danish tap water comes from groundwater, which contains varying amounts of calcium depending on the subsoil. We investigated the association of calcium in drinking water with iron levels in Danish blood donors.

STUDY DESIGN AND METHODS:

We used data on Danish blood donors including dietary and lifestyle habits, blood donation history, and physiologic characteristics including measures of ferritin levels along with information on area of residence from The Danish Blood Donor Study. Data on calcium levels in groundwater ("water hardness") were obtained through the Geological Survey of Denmark and Greenland. We performed multiple linear and logistic regression analyses to evaluate the effect of water hardness on ferritin levels and risk of having iron deficiency (defined as ferritin levels <15 ng/mL), stratified by sex.

RESULTS:

There was a significant negative association between water hardness and ferritin levels in both men and women. Risk of iron deficiency was correspondingly increased in both men (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.14-2.12) and women (OR, 1.20; 95% CI, 1.03-1.40) with increasing water hardness. In analyses restricted to individuals who received supplemental iron tablets no significant association between groundwater hardness and ferritin levels was observed.

CONCLUSIONS:

As measured by ferritin levels, residential drinking water calcium content is associated with blood donors- iron levels and risk of iron deficiency. However, effect sizes are small.

 

The Best Source of Resveratrol

Michael Greger M.D. FACLM April 2nd, 2018 Volume 41

https://nutritionfacts.org/video/the-best-source-of-resveratrol/?utm_source=NutritionFacts.org&utm_campaign=f196185ef7-RSS_VIDEO_DAILY&utm_medium=email&utm_term=0_40f9e497d1-f196185ef7-23407281&mc_cid=f196185ef7&mc_eid=ce6b5c9b8a

 

Time-restricted feeding influences immune responses without compromising muscle performance in older men.

Gasmi M, Sellami M, Denham J, Padulo J, Kuvacic G, Selmi W, Khalifa R.

Lifelong calorie restriction affects indicators of colonic health in aging C57Bl/6J mice.

Kok DEG, Rusli F, van der Lugt B, Lute C, Laghi L, Salvioli S, Picone G, Franceschi C, Smidt H, Vervoort J, Kampman E, Müller M, Steegenga WT.

J Nutr Biochem. 2018 Mar 20;56:152-164. doi: 10.1016/j.jnutbio.2018.01.001. [Epub ahead of print]

PMID: 29571009

Abstract

Diminished colonic health is associated with various age-related pathologies. Calorie restriction (CR) is an effective strategy to increase healthy lifespan, although underlying mechanisms are not fully elucidated. Here, we report the effects of lifelong CR on indicators of colonic health in aging C57Bl/6J mice. Compared to an ad libitum control and moderate-fat diet, 30% energy reduction was associated with attenuated immune- and inflammation-related gene expression in the colon. Furthermore, expression of genes involved in lipid metabolism was higher upon CR, which may point towards efficient regulation of energy metabolism. The relative abundance of bacteria considered beneficial to colonic health, such as Bifidobacterium and Lactobacillus, increased in the mice exposed to CR for 28 months as compared to the other diet groups. We found lower plasma levels of interleukin-6 and lower levels of various metabolites, among which are bile acids, in the colonic luminal content of CR-exposed mice as compared to the other diet groups. Switching from CR to an ad libitum moderate-fat diet at old age (24 months) revealed remarkable phenotypic plasticity in terms of gene expression, microbiota composition and metabolite levels, although expression of a subset of genes remained CR-associated. This study demonstrated in a comprehensive way that CR affects indicators of colonic health in aging mice. Our findings provide unique leads for further studies that need to address optimal and feasible strategies for prolonged energy deprivation, which may contribute to healthy aging.

KEYWORDS:

Aging; Calorie restriction; Colonic health; Gene expression; Gut microbiota; Metabolites

 

Response of gastrointestinal melatonin, antioxidants, and digestive enzymes to altered feeding conditions in carp (Catla catla).

Pal PK, Maitra SK.

Fish Physiol Biochem. 2018 Mar 23. doi: 10.1007/s10695-018-0494-0. [Epub ahead of print]

PMID: 29572613

Abstract

The purpose of present study was to ascertain whether the response of gastrointestinal (gut) melatonin to altered feeding conditions was related to the levels of different antioxidants and digestive enzymes in the same gut tissues of a sub-tropical carp (Catla catla). Accordingly, the fish were subjected to food deprivation for 4 or 8 days and separately to re-feeding for 4 or 8 or 12 days after deprivation of food for 8 days, and their gut tissue homogenates were used to measure the levels of melatonin, both enzymatic [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST)] and non-enzymatic [reduced glutathione (GSH)] antioxidants, as well as different digestive enzymes (α-amylase, cellulase, protease, and lipase). Notably, the gut levels of melatonin, SOD, CAT, GPx, and GST underwent gradual increase with the progress of food deprivation, but a sudden fall after restoration of food supply for 4 days and a rise thereafter. Conversely, the activity of all the digestive enzymes significantly decreased after deprivation of food, but started increasing when food supply was reinforced. Gut melatonin concentrations by showing a positive correlation with the titers of different antioxidants (in both food-deprived and re-fed fish groups) and a negative (in food-deprived fish) or a positive (in re-fed fish) correlation with the activity of each digestive enzyme underlined possible physiological interplay between them. Collectively, our findings lend support to the hypothesis that gut melatonin response to altered feeding conditions in carp might be associated with the oxidative status as well as the digestive functions of the gastrointestinal tissues itself.

KEYWORDS:

Antioxidants; Carp; Digestive enzymes; Food deprivation; Gut melatonin; Re-feeding

 

Global remodeling of the mouse DNA methylome during aging and in response to calorie restriction.

Sziráki A, Tyshkovskiy A, Gladyshev VN.

Aging Cell. 2018 Mar 25:e12738. doi: 10.1111/acel.12738. [Epub ahead of print]

PMID: 29575528 Free Article

Abstract

Aging is characterized by numerous molecular changes, such as accumulation of molecular damage and altered gene expression, many of which are linked to DNA methylation. Here, we characterize the blood DNA methylome across 16 age groups of mice and report numerous global, region- and site-specific features, as well as the associated dynamics of methylation changes. Transition of the methylome throughout lifespan was not uniform, with many sites showing accelerated changes in late life. The associated genes and promoters were enriched for aging-related pathways, pointing to a fundamental link between DNA methylation and control of the aging process. Calorie restriction both shifted the overall methylation pattern and was accompanied by its gradual age-related remodeling, the latter contributing to the lifespan-extending effect. With age, both highly and poorly methylated sites trended toward intermediate levels, and aging was accompanied by an accelerated increase in entropy, consistent with damage accumulation. However, the entropy effects differed for the sites that increased, decreased and did not change methylation with age. Many sites trailed behind, whereas some followed or even exceeded the entropy trajectory and altered the developmental DNA methylation pattern. The patterns we observed in certain genomic regions were conserved between humans and mice, suggesting common principles of functional DNA methylome remodeling and its critical role in aging. The highly resolved DNA methylome remodeling provides an excellent model for understanding systemic changes that characterize the aging process.

KEYWORDS:

DNA methylation; aging; calorie restriction; entropy

 

Genomewide mechanisms of chronological longevity by dietary restriction in budding yeast.

Campos SE, Avelar-Rivas JA, Garay E, Juárez-Reyes A, DeLuna A.

Aging Cell. 2018 Mar 25:e12749. doi: 10.1111/acel.12749. [Epub ahead of print]

PMID: 29575540 Free Article

https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12749

Abstract

Dietary restriction is arguably the most promising nonpharmacological intervention to extend human life and health span. Yet, only few genetic regulators mediating the cellular response to dietary restriction are known, and the question remains which other regulatory factors are involved. Here, we measured at the genomewide level the chronological lifespan of Saccharomyces cerevisiae gene deletion strains under two nitrogen source regimens, glutamine (nonrestricted) and γ-aminobutyric acid (restricted). We identified 473 mutants with diminished or enhanced extension of lifespan. Functional analysis of such dietary restriction genes revealed novel processes underlying longevity by the nitrogen source quality, which also allowed us to generate a prioritized catalogue of transcription factors orchestrating the dietary restriction response. Importantly, deletions of transcription factors Msn2, Msn4, Snf6, Tec1, and Ste12 resulted in diminished lifespan extension and defects in cell cycle arrest upon nutrient starvation, suggesting that regulation of the cell cycle is a major mechanism of chronological longevity. We further show that STE12 overexpression is enough to extend lifespan, linking the pheromone/invasive growth pathway with cell survivorship. Our global picture of the genetic players of longevity by dietary restriction highlights intricate regulatory cross-talks in aging cells.

KEYWORDS:

Saccharomyces cerevisiae ; Ste12; aging; cell cycle; cell cycle arrest; chronological lifespan; dietary restriction; genomewide profiling; transcription factors

 

The effects of graded caloric restriction: XII. Comparison of mouse to human impact on cellular senescence in the colon.

Fontana L, Mitchell SE, Wang B, Tosti V, van Vliet T, Veronese N, Bertozzi B, Early DS, Maissan P, Speakman JR, Demaria M.

Aging Cell. 2018 Mar 25:e12746. doi: 10.1111/acel.12746. [Epub ahead of print]

PMID: 29575469 Free Article

https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12746

Abstract

Calorie restriction (CR) is an effective strategy to delay the onset and progression of aging phenotypes in a variety of organisms. Several molecular players are involved in the anti-aging effects of CR, but mechanisms of regulation are poorly understood. Cellular senescence-a cellular state of irreversible growth arrest-is considered a basic mechanism of aging. Senescent cells accumulate with age and promote a number of age-related pathologies. Whether environmental conditions such as diet affect the accumulation of cellular senescence with age is still unclear. Here, we show that a number of classical transcriptomic markers of senescent cells are reduced in adult but relatively young mice under CR. Moreover, we demonstrate that such senescence markers are not induced in the colon of middle-age human volunteers under CR in comparison with age-matched volunteers consuming normal Western diets. Our data support the idea that the improvement in health span observed in different organisms under CR might be partly due to a reduction in the number of senescent cells.

KEYWORDS:

SASP; ageing; aging; caloric restriction; cellular senescence

 

Nutrition. 2018 Feb 3;51-52:29-37. doi: 10.1016/j.nut.2017.12.014. [Epub ahead of print]

PMID: 29571007

Abstract

OBJECTIVE:

This study examined the effect of 12 wk of time-restricted feeding (TRF) on complete blood cell counts, natural killer cells, and muscle performance in 20- and 50-year-old men.

METHODS:

Forty active and healthy participants were randomly divided into young experimental, young control, aged experimental, and aged control group. Experimental groups participated in TRF. Before (P1) and after (P2) TRF, participants performed a maximal exercise test to quantify muscle power. Resting venous blood samples were collected for blood count calculation.

RESULTS:

No changes were identified in muscle power in all groups after TRF (P > 0.05). At P1, red cells, hemoglobin, and hematocrit were significantly higher in young participants compared with elderly participants (P < 0.05). At P2, this age effect was not found in red cells between the young experimental group and the aged experimental group (P > 0.05). At P1, white blood cells and neutrophils were significantly higher in young participants compared with elderly participants (P < 0.05). At P2, only neutrophils decreased significantly (P < 0.05) in experimental groups without significant (P > 0.05) difference among them. Lymphocytes decreased significantly in the aged experimental group at P2 (P < 0.05), whereas NKCD16+ and NKCD56+ decreased significantly in experimental groups at P2 (P < 0.05). TRF had no effect on CD3, CD4+, and CD8+ levels (P > 0.05).

CONCLUSION:

TRF decreases hematocrit, total white blood cells, lymphocytes, and neutrophils in young and older men. TRF may be effective in preventing inflammation by decreasing natural killer cells. As such, TRF could be a lifestyle strategy to reduce systemic low-grade inflammation and age-related chronic diseases linked to immunosenescence, without compromising physical performance.

KEYWORDS:

Caloric restriction, inflammation; Cytotoxic T cells; Immunosenescence; Natural killer T cells; Red cells; T cells

 

Impairment of an Endothelial NAD+-H2S Signaling Network Is a Reversible Cause of Vascular Aging.

Das A, Huang GX, Bonkowski MS, Longchamp A, Li C, Schultz MB, Kim LJ, Osborne B, Joshi S, Lu Y, Treviño-Villarreal JH, Kang MJ, Hung TT, Lee B, Williams EO, Igarashi M, Mitchell JR, Wu LE, Turner N, Arany Z, Guarente L, Sinclair DA.

Cell. 2018 Mar 22;173(1):74-89.e20. doi: 10.1016/j.cell.2018.02.008.

PMID: 29570999

Abstract

A decline in capillary density and blood flow with age is a major cause of mortality and morbidity. Understanding why this occurs is key to future gains in human health. NAD precursors reverse aspects of aging, in part, by activating sirtuin deacylases (SIRT1-SIRT7) that mediate the benefits of exercise and dietary restriction (DR). We show that SIRT1 in endothelial cells is a key mediator of pro-angiogenic signals secreted from myocytes. Treatment of mice with the NAD+ booster nicotinamide mononucleotide (NMN) improves blood flow and increases endurance in elderly mice by promoting SIRT1-dependent increases in capillary density, an effect augmented by exercise or increasing the levels of hydrogen sulfide (H2S), a DR mimetic and regulator of endothelial NAD+ levels. These findings have implications for improving blood flow to organs and tissues, increasing human performance, and reestablishing a virtuous cycle of mobility in the elderly.

KEYWORDS:

NAD(+); aging; angiogenesis; endurance; exercise; hydrogen sulfide; ischemia; nicotinamide mononucleotide; sirtuins; skeletal muscle capillaries

 

Effects of resveratrol on memory performance, hippocampus connectivity and microstructure in older adults - A randomized controlled trial.

Huhn S, Beyer F, Zhang R, Lampe L, Grothe J, Kratzsch J, Willenberg A, Breitfeld J, Kovacs P, Stumvoll M, Trampel R, Bazin PL, Villringer A, Witte AV.

Neuroimage. 2018 Mar 13;174:177-190. doi: 10.1016/j.neuroimage.2018.03.023. [Epub ahead of print]

PMID: 29548848

Abstract

INTRODUCTION:

The polyphenol resveratrol has been suggested to exert beneficial effects on memory and the aging hippocampus due to calorie-restriction mimicking effects. However, the evidence based on human interventional studies is scarce. We therefore aimed to determine the effects of resveratrol on memory performance, and to identify potential underlying mechanisms using a broad array of blood-based biomarkers as well as hippocampus connectivity and microstructure assessed with ultra-high field magnetic resonance imaging (UHF-MRI).

METHODS:

In this double-blind, randomized controlled trial, 60 elderly participants (60-79 years) with a wide body-mass index (BMI) range of 21-37 kg/m2 were randomized to receive either resveratrol (200 mg/day) or placebo for 26 weeks (registered at ClinicalTrials.gov: NCT02621554). Baseline and follow-up assessments included the California Verbal Learning Task (CVLT, main outcome), the ModBent task, anthropometry, markers of glucose and lipid metabolism, inflammation and neurotrophins derived from fasting blood, multimodal neuroimaging at 3 and 7 T, and questionnaires to assess confounding factors.

RESULTS:

Multivariate repeated-measures ANOVA did not detect significant time by group effects for CVLT performance. There was a trend for preserved pattern recognition memory after resveratrol, while performance decreased in the placebo group (n.s., p = 0.07). Further exploratory analyses showed increases in both groups over time in body fat, cholesterol, fasting glucose, interleukin 6, high sensitive C-reactive protein, tumor necrosis factor alpha and in mean diffusivity of the subiculum and presubiculum, as well as decreases in physical activity, brain-derived neurotrophic factor and insulin-like growth factor 1 at follow-up, which were partly more pronounced after resveratrol.

DISCUSSION:

This interventional study failed to show significant improvements in verbal memory after 6 months of resveratrol in healthy elderly with a wide BMI range. A non-significant trend emerged for positive effects on pattern recognition memory, while possible confounding effects of unfavorable changes in lifestyle behavior, neurotrophins and inflammatory markers occurred. Our findings also indicate the feasibility to detect (un)healthy aging-related changes in measures of hippocampus microstructure after 6 months using 7T diffusion MRI. More studies incorporating a longer duration and larger sample size are needed to determine if resveratrol enhances memory performance in healthy older adults.

KEYWORDS:

7 Tesla MRI; Hippocampus subfields; Mean diffusivity; Polyphenol; Resting-state fMRI; Subjective cognitive decline

 

High Salt Intake Attenuates Breast Cancer Metastasis to Lung.

Xu Y, Wang W, Wang M, Liu X, Lee MH, Wang M, Zhang H, Li H, Chen W.

J Agric Food Chem. 2018 Mar 22. doi: 10.1021/acs.jafc.7b05923. [Epub ahead of print]

PMID: 29553743

Abstract

Diet-related factors are thought to modify the risk of cancers, while the influence of high salt intake remains largely uncharacterized. Breast cancer is the most common cancer in women worldwide. In the present study, we examined the effect of salt intake on breast cancer by using a 4T1 mouse mammary tumor model. Unexpectedly, both the fitness and the survival rate of the tumor-bearing mice were improved by high salt intake. Similarly, high salt intake suppressed the primary tumor growth as well as metastasis to lung in mice. Mechanistically, high salt intake greatly reduced food intake and thus might exert antitumor effect through mimicking calorie restriction. Immunoblotting showed the lower proliferation marker Ki-67 and the higher expression of the tumor suppressor gene p53 in tumors of high salt intake mice. Importantly, high salt intake might induce hyperosmotic stress, which sensitized breast cancer cells to p53-dependent anoikis. Collectively, our findings raise the possibility that endogenous salt deposition might act as the first-line defense system against breast cancer progression as well as metastasis.

KEYWORDS:

anoikis; breast cancer; high salt intake; metastasis

 

Low-Protein Diet Induces IRE1α-Dependent Anticancer Immunosurveillance.

Rubio-Patiño C, Bossowski JP, De Donatis GM, Mondragón L, Villa E, Aira LE, Chiche J, Mhaidly R, Lebeaupin C, Marchetti S, Voutetakis K, Chatziioannou A, Castelli FA, Lamourette P, Chu-Van E, Fenaille F, Avril T, Passeron T, Patterson JB, Verhoeyen E, Bailly-Maitre B, Chevet E, Ricci JE.

Cell Metab. 2018 Mar 1. pii: S1550-4131(18)30120-7. doi: 10.1016/j.cmet.2018.02.009. [Epub ahead of print]

PMID: 29551590

Abstract

Dietary restriction (DR) was shown to impact on tumor growth with very variable effects depending on the cancer type. However, how DR limits cancer progression remains largely unknown. Here, we demonstrate that feeding mice a low-protein (Low PROT) isocaloric diet but not a low-carbohydrate (Low CHO) diet reduced tumor growth in three independent mouse cancer models. Surprisingly, this effect relies on anticancer immunosurveillance, as depleting CD8+ T cells, antigen-presenting cells (APCs), or using immunodeficient mice prevented the beneficial effect of the diet. Mechanistically, we established that a Low PROT diet induces the unfolded protein response (UPR) in tumor cells through the activation of IRE1α and RIG1 signaling, thereby resulting in cytokine production and mounting an efficient anticancer immune response. Collectively, our data suggest that a Low PROT diet induces an IRE1α-dependent UPR in cancer cells, enhancing a CD8-mediated T cell response against tumors.

KEYWORDS:

ER stress; IRE1α; RIG1; UPR; anti-tumor immunity; cancer; diet; dietary restriction; immunosurveillance

 

The influence of sodium and potassium intake and insulin resistance on blood pressure in normotensive individuals is more evident in women.

Murao S, Takata Y, Yasuda M, Osawa H, Kohi F.

Am J Hypertens. 2018 Mar 14. doi: 10.1093/ajh/hpy041. [Epub ahead of print]

PMID: 29547880

Abstract

BACKGROUND:

Considering sex differences, salt sensitivity and insulin resistance (IR), the effect of sodium restriction and increased potassium intake on blood pressure remains unclear in normotensive Asian individuals, compared to that in hypertensive patients.

METHODS:

To assess the influence of sodium and potassium intake in normotensive individuals, we evaluated the estimated 24-hour urinary sodium and potassium excretion rate in 3,392 drug-naïve normotensive Japanese individuals (average age: 48.4 years) and analyzed its relation to blood pressure using multivariate regression analysis (MRA).

RESULTS:

MRA revealed that a 10-mmol/day increment in urinary sodium excretion related to an elevation in systolic blood pressure of 0.16 mmHg in men and 0.37 mmHg in women, after adjusting for known risk factors to salt sensitivity, including age, body mass index, serum creatinine, homeostasis model assessment of IR, and urinary potassium excretion. For urinary potassium excretion, a 10-mmol/day increment was associated with a decrease in systolic blood pressure, -0.54 mmHg in men and -1.48 mmHg in women, respectively. Furthermore, involvement of insulin resistance on blood pressure was observed only in women.

CONCLUSIONS:

In drug-naïve normotensive individuals, the effects of a lower-salt and higher-potassium diet, and IR on blood pressure, were more evident in women. These results suggest that to prevent the new onset of hypertension and its complications, the balances of a sodium restriction and an increased potassium intake are important even in normotensive individuals, independent of known risk factors for salt sensitivity, especially in women.

 

Meal Fatty Acids Have Differential Effects on Postprandial Blood Pressure and Biomarkers of Endothelial Function but Not Vascular Reactivity in Postmenopausal Women in the Randomized Controlled Dietary Intervention and VAScular function (DIVAS)-2 Study

Kumari M Rathnayake; Michelle Weech; Kim G Jackson; Julie A Lovegrove

The Journal of Nutrition, Volume 148, Issue 3, 1 March 2018, Pages 348–357, https://doi.org/10.1093/jn/nxx042

Published: 12 March 2018

Abstract

Background

Elevated postprandial triacylglycerol concentrations, impaired vascular function, and hypertension are important independent cardiovascular disease (CVD) risk factors in women. However, the effects of meal fat composition on postprandial lipemia and vascular function in postmenopausal women are unknown.

Objective

This study investigated the impact of sequential meals rich in saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), or n–6 (ω-6) polyunsaturated fatty acids (PUFAs) on postprandial flow-mediated dilatation (FMD; primary outcome measure), vascular function, and associated CVD risk biomarkers (secondary outcomes) in postmenopausal women.

Methods

A double-blind, randomized, crossover, postprandial study was conducted in 32 postmenopausal women [mean ± SEM ages: 58 ± 1 y; mean ± SEM body mass index (in kg/m2): 25.9 ± 0.7]. After fasting overnight, participants consumed high-fat meals at breakfast (0 min; 50 g fat, containing 33–36 g SFAs, MUFAs, or n–6 PUFAs) and lunch (330 min; 30 g fat, containing 19–20 g SFAs, MUFAs, or n–6 PUFAs), on separate occasions. Blood samples were collected before breakfast and regularly after the meals for 480 min, with specific time points selected for measuring vascular function and blood pressure.

Results

Postprandial FMD, laser Doppler imaging, and digital volume pulse responses were not different after consuming the test fats. The incremental area under the curve (iAUC) for diastolic blood pressure was lower after the MUFA-rich meals than after the SFA-rich meals (mean ± SEM: −2.3 ± 0.3 compared with −1.5 ± 0.3 mm Hg × 450 min × 103; P = 0.009), with a similar trend for systolic blood pressure (P = 0.012). This corresponded to a lower iAUC for the plasma nitrite response after the SFA-rich meals than after the MUFA-rich meals (−1.23 ± 0.7 compared with -0.17 ± 0.4 μmol/L × 420 min P = 0.010). The soluble intercellular adhesion molecule 1 (sICAM-1) time-course profile, AUC, and iAUC were lower after the n–6 PUFA-rich meals than after the SFA- and MUFA-rich meals (P ≤ 0.001). Lipids, glucose, and markers of insulin sensitivity did not differ between the test fats.

Conclusion

Our study showed a differential impact of meal fat composition on blood pressure, plasma nitrite, and sICAM-1, but no effect on postprandial FMD or lipemia in postmenopausal women.

Keywords:

cell adhesion molecules, diastolic blood pressure, monounsaturated fat, n–6 polyunsaturated fat, nitrate and nitrite, postprandial lipemia, saturated fat, vascular function

 

n–3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis

Masha Shulkin Laura Pimpin David Bellinger Sarah Kranz Wafaie Fawzi Christopher Duggan Dariush Mozaffarian

The Journal of Nutrition, Volume 148, Issue 3, 1 March 2018, Pages 409–418, https://doi.org/10.1093/jn/nxx031

Published: 12 March 2018 Article history

https://academic.oup.com/jn/article/148/3/409/4930799

Abstract

Background

Epidemiologic studies link maternal seafood and n–3 (ω-3) polyunsaturated fatty acid (PUFA) consumption with improved childhood cognitive development; trials show mixed results.

Objective

We investigated effects of n–3 PUFA supplementation on child cognitive and visual outcomes.

Methods

We systematically reviewed and meta-analyzed randomized controlled trials of n–3 PUFA supplementation in mothers or infants (age ≤2 y) and evaluated standardized measures of cognitive or visual development up to age 18 y. Of 6286 abstracts and 669 full-text articles, 38 trials with 53 intervention arms were included. Data were extracted independently in duplicate. Findings were pooled using random-effects meta-analysis across supplementation periods (maternal, preterm, term infant); we also explored subgroup analyses stratified by supplementation period. Heterogeneity was explored using I2, stratified analysis, and meta-regression. Cognitive development was assessed by Bayley Scales of Infant Development mental and psychomotor developmental indexes (MDI, PDI) and intelligence quotient (IQ); visual acuity was assessed by electrophysiological or behavioral measures.

Results

The 38 trials (mothers: n = 13; preterm infants: n = 7; term infants: n = 18) included 5541 participants. When we explored effects during different periods of supplementation, n–3 PUFA supplementation improved MDI in preterm infants (3.33; 95% CI: 0.72, 5.93), without statistically significant effects on PDI or IQ in different intervention period subgroups. Visual acuity [measured as the logarithm of the minimum angle of resolution (logMAR)] was improved by supplementation in preterm (–0.08 logMAR; 95% CI: –0.14, –0.01 logMAR) and term infants (–0.08 logMAR; 95% CI: –0.11, –0.05 logMAR), with a nonsignificant trend for maternal supplementation (–0.02 logMAR; 95% CI: –0.04, 0.00 logMAR). In main analyses pooling all supplementation periods, compared with placebo, n–3 PUFA supplementation improved MDI (n = 21 trials; 0.91; 95% CI: 0.005, 1.81; P = 0.049), PDI (n = 21 trials; 1.06 higher index; 95% CI: 0.10, 2.03; P = 0.031), and visual acuity (n = 24; –0.063 logMAR; 95% CI: –0.084, –0.041 logMAR; P < 0.001) but not IQ (n = 7; 0.20; 95% CI: –1.56, 1.96, P = 0.83), although few studies assessed this endpoint. Potential publication bias was identified for MDI (Eggers P = 0.005), but not other endpoints. Significant differences in findings were not identified by world region, race, maternal education, age at outcome assessment, supplementation duration, DHA or EPA dose, DHA:AA ratio, or study quality score (P-interaction > 0.05 each).

Conclusions

n–3 PUFA supplementation improves childhood psychomotor and visual development, without significant effects on global IQ later in childhood, although the latter conclusion is based on fewer studies.

Keywords:

long-chain n–3 polyunsaturated fatty acids, supplementation trials, prenatal, infant formula, cognition, development, Bayley Scales of Infant Development, visual acuity, childhood, meta-analysis

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Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United States.

Pool LR, Burgard SA, Needham BL, Elliott MR, Langa KM, Mendes de Leon CF.

JAMA. 2018 Apr 3;319(13):1341-1350. doi: 10.1001/jama.2018.2055.

PMID: 29614178

Abstract

IMPORTANCE:

A sudden loss of wealth-a negative wealth shock-may lead to a significant mental health toll and also leave fewer monetary resources for health-related expenses. With limited years remaining to regain lost wealth in older age, the health consequences of these negative wealth shocks may be long-lasting.

OBJECTIVE:

To determine whether a negative wealth shock was associated with all-cause mortality during 20 years of follow-up.

DESIGN, SETTING, AND PARTICIPANTS:

The Health and Retirement Study, a nationally representative prospective cohort study of US adults aged 51 through 61 years at study entry. The study population included 8714 adults, first assessed for a negative wealth shock in 1994 and followed biennially through 2014 (the most recent year of available data).

EXPOSURES:

Experiencing a negative wealth shock, defined as a loss of 75% or more of total net worth over a 2-year period, or asset poverty, defined as 0 or negative total net worth at study entry.

MAIN OUTCOMES AND MEASURES:

Mortality data were collected from the National Death Index and postmortem interviews with family members. Marginal structural survival methods were used to account for the potential bias due to changes in health status that may both trigger negative wealth shocks and act as the mechanism through which negative wealth shocks lead to increased mortality.

RESULTS:

There were 8714 participants in the study sample (mean [sD] age at study entry, 55 [3.2] years; 53% women), 2430 experienced a negative wealth shock during follow-up, 749 had asset poverty at baseline, and 5535 had continuously positive wealth without shock. A total of 2823 deaths occurred during 80 683 person-years of follow-up. There were 30.6 vs 64.9 deaths per 1000 person-years for those with continuously positive wealth vs negative wealth shock (adjusted hazard ratio


, 1.50; 95% CI, 1.36-1.67). There were 73.4 deaths per 1000 person-years for those with asset poverty at baseline (adjusted HR, 1.67; 95% CI, 1.44-1.94; compared with continuously positive wealth).

CONCLUSIONS AND RELEVANCE:

Among US adults aged 51 years and older, loss of wealth over 2 years was associated with an increased risk of all-cause mortality. Further research is needed to better understand the possible mechanisms for this association and determine whether there is potential value for targeted interventions.

 

Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis.

Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, Edwards P, Woodcock J, Brage S, Wijndaele K.

Eur J Epidemiol. 2018 Mar 28. doi: 10.1007/s10654-018-0380-1. [Epub ahead of print] Review.

PMID: 29589226

Abstract

PURPOSE:

To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)).

CONCLUSIONS:

Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.

KEYWORDS:

Diabetes; Meta-analysis; Mortality; Prevention; Public health; Sedentary

 

The combination of cardiorespiratory fitness and muscle strength, and mortality risk.

Kim Y, White T, Wijndaele K, Westgate K, Sharp SJ, Helge JW, Wareham NJ, Brage S.

Eur J Epidemiol. 2018 Mar 28. doi: 10.1007/s10654-018-0384-x. [Epub ahead of print]

PMID: 29594847

https://link.springer.com/content/pdf/10.1007%2Fs10654-018-0384-x.pdf

Abstract

Little is known about the combined associations of cardiorespiratory fitness (CRF) and hand grip strength (GS) with mortality in general adult populations. The purpose of this study was to compare the relative risk of mortality for CRF, GS, and their combination. In UK Biobank, a prospective cohort of > 0.5 million adults aged 40-69 years, CRF was measured through submaximal bike tests; GS was measured using a hand-dynamometer. This analysis is based on data from 70,913 men and women (832 all-cause, 177 cardiovascular and 503 cancer deaths over 5.7-year follow-up) who provided valid CRF and GS data, and with no history of heart attack/stroke/cancer at baseline. Compared with the lowest CRF category, the hazard ratio (HR) for all-cause mortality was 0.76 [95% confidence interval (CI) 0.64-0.89] and 0.65 (95% CI 0.55-0.78) for the middle and highest CRF categories, respectively, after adjustment for confounders and GS. The highest GS category had an HR of 0.79 (95% CI 0.66-0.95) for all-cause mortality compared with the lowest, after adjustment for confounders and CRF. Similar results were found for cardiovascular and cancer mortality. The HRs for the combination of highest CRF and GS were 0.53 (95% CI 0.39-0.72) for all-cause mortality and 0.31 (95% CI 0.14-0.67) for cardiovascular mortality, compared with the reference category of lowest CRF and GS: no significant association for cancer mortality (HR 0.70; 95% CI 0.48-1.02). CRF and GS are both independent predictors of mortality. Improving both CRF and muscle strength, as opposed to either of the two alone, may be the most effective behavioral strategy to reduce all-cause and cardiovascular mortality risk.

KEYWORDS:

Cardiorespiratory fitness; Grip strength; Mortality; UK Biobank

 

Time-dependent depressive symptoms and risk of cardiovascular and all-cause mortality among the Chinese elderly: The Beijing Longitudinal Study of Aging.

Li H, Van Halm-Lutterodt N, Zheng D, Liu Y, Guo J, Feng W, Li X, Wang A, Liu X, Tao L, Hou C, Luo Y, Zhang F, Yang X, Gao Q, Wang W, Tang Z, Guo X.

J Cardiol. 2018 Mar 27. pii: S0914-5087(18)30066-2. doi: 10.1016/j.jjcc.2018.02.015. [Epub ahead of print]

PMID: 29602649

Abstract

BACKGROUND:

Depressive symptoms tend to fluctuate over time. Data on the relationship between time-dependent depressive symptoms and the risk of cardiovascular and all-cause mortality among the elderly in China are lacking.

METHODS AND RESULTS:

A prospective cohort of 1999 subjects aged ≥55 years were enrolled in the Beijing Longitudinal Study of Aging since 1992. Depressive symptoms were assessed at baseline (0 years) and after 2, 5, 8, and 12 years, defined as a score of ≥16 on the 20-item Center for Epidemiological Studies Depression Scale. Mortality status was obtained from the local death registry until December 31st, 2012. Hazard ratio (HR) for all-cause mortality and sub-distribution HR (SHR) for cardiovascular mortality were respectively deduced from time-dependent Cox and competing risk models. During 19,658 person-years of follow-up, 1127 (55.65%) deaths were recorded, of which 483 (23.85%) were attributable to cardiovascular inclinations. Baseline depressive symptoms were neither associated with all-cause mortality (adjusted HR: 1.12, 95% confident interval, CI: 0.94-1.33) nor cardiovascular mortality (adjusted SHR: 1.10, 95% CI: 0.82-1.46) after adjustment of potential cardiac-risk factors. When depressive symptoms were used as time-dependent variable updated from 1992 to 2004, the associations were significant for both all-cause mortality (adjusted HR: 1.48, 95% CI: 1.26-1.73) and cardiovascular mortality (adjusted SHR: 1.40, 95% CI: 1.08-1.82) in the full adjusted model.

CONCLUSIONS:

Time-dependent depressive symptoms increased the risk of all-cause and cardiovascular mortality among the elderly in China.

KEYWORDS:

All-cause mortality; Cardiovascular disease; Depressive symptoms; Time-dependent

 

Effects of a low salt diet on isolated systolic hypertension: A community-based population study.

Yang GH, Zhou X, Ji WJ, Liu JX, Sun J, Shi R, Jiang TM, Li YM.

Medicine (Baltimore). 2018 Apr;97(14):e0342. doi: 10.1097/MD.0000000000010342.

PMID: 29620663

Abstract

Evidence has shown that long-term sodium reduction can not only reduce blood pressure, but also provide cardiovascular benefits. To date, there is little evidence related to the effects of salt reduction on isolated systolic hypertension (ISH).A total of 126 hypertensive patients were divided into an ISH group (n = 51) and a non-ISH (NISH) group (n = 75). The members of each group were then randomly assigned to low sodium salt (LSSalt) or normal salt (NSalt) diets for 6 months. Their blood pressure was measured every 2 months. Serum plasma renin-angiotensin activity, blood biochemical assays and urinary measurements were determined at the baseline and at the end of the 6 months.At the end of the study, the mean systolic blood pressure (SBP) of the ISH LSSalt group had significantly decreased by 10.18 mm Hg (95% confidence interval (CI): 3.13 to 17.2, P = .006) compared with that of the ISH NSalt group, while the mean SBP only decreased by 5.10 mm Hg (95% CI: -2.02 to 12.2, P = .158) in the NISH LSSalt group compared with that of the NISH NSalt group. The mean diastolic blood pressure (DBP) had no significant differences in the ISH and NISH groups. No obvious renin angiotensin system activation was found after LSSalt intervention. Regarding the urinary excretion of electrolytes and blood biochemical assays, the LSSalt treatment had the same effects on the ISH group as on the NISH group.The present study showed that the SBP of ISH patients was significantly decreased with the LSSalt intervention, while neither the SBP of the NISH patients nor the DBP of either group were similarly decreased, which indicated that ISH patients were more sensitive to salt restriction.

 

Physical frailty and mortality risk in Japanese older adults.

Yuki A, Otsuka R, Tange C, Nishita Y, Tomida M, Ando F, Shimokata H.

Geriatr Gerontol Int. 2018 Apr 2. doi: 10.1111/ggi.13316. [Epub ahead of print]

PMID: 29608043

Abstract

AIM:

The association between frailty and increased mortality risk is unknown. The present study assessed the longitudinal relationship between frailty and mortality risk in Japanese community-dwelling older adults.

METHODS:

Participants included 841 randomly chosen community-dwelling Japanese individuals, including 175 older adults aged 65-88 years with incomplete data at the baseline examination (July 2006-July 2008). Participants were followed from baseline to 31 December 2015 (mean 7.9 years). Frailty was diagnosed according to frailty criteria, including unintentional weight loss (shrinking), exhaustion, low activity, low grip strength and low gait speed. Information on deaths was obtained from a population dynamics survey. The relationship between frailty and mortality was assessed using Kaplan-Meier survival curves and Cox proportional hazards regression. The Cox proportional hazards model was used to control for potential confounders, including age at baseline, body fat, education, the Mini-Mental State Examination score, the Center for Epidemiologic Studies Depression Scale score, total physical activity, total caloric intake, alcohol intake, current smoking, household income and the number of current diseases.

RESULTS:

The fully adjusted hazard ratio for all-cause mortality in the frailty group was 2.63 (95% confidence interval, 1.28-5.39; P for trend <0.01). The age- and sex-adjusted hazard ratio for mortality of cancer in the frailty group was 3.33 (95% confidence interval, 1.15-9.62; P for trend <0.05).

CONCLUSION:

Complications of frailty, which include shrinking, exhaustion, low activity, weakness, and slowness, appear to be significant risks for mortality in Japanese older adults. Geriatr Gerontol Int 2018; ••: ••-••.

KEYWORDS:

Cox proportional hazards regression; National Institute for Longevity Sciences-Longitudinal Study of Aging; community-dwelling elderly; frailty characteristics; mortality risk

 

Differential effects of leucine and leucine-enriched whey protein on skeletal muscle protein synthesis in aged mice.

Dijk FJ, van Dijk M, Walrand S, van Loon LJC, van Norren K, Luiking YC.

Clin Nutr ESPEN. 2018 Apr;24:127-133. doi: 10.1016/j.clnesp.2017.12.013. Epub 2018 Jan 11.

PMID: 29576350 Free Article

http://clinicalnutritionespen.com/article/S2405-4577(17)30518-1/fulltext

Abstract

BACKGROUND & AIMS:

It has been suggested that anabolic resistance, or a blunted protein synthetic response to anabolic stimuli, contributes to the failure of muscle mass maintenance in older adults. The amino acid leucine is one of the most prominent food-related anabolic stimuli. However, data on muscle protein synthesis (MPS) after administration of a single bolus of leucine in aged populations is lacking and long-term single leucine supplementation has not been shown to increase muscle mass. This study aimed to determine the MPS response to the administration of a single bolus of leucine or to leucine combined with whey protein, in aged mice.

METHODS:

Overnight fasted C57/BL6RJ mice at 25-mo of age received an oral gavage with leucine or whey-protein enriched with leucine (0.75 g/kg bodyweight total leucine in both) or 0.5 mL water (fasted control). Subsequently, mice were s.c. injected with puromycin (0.04 μmol/g bw at t = 30, 45 or 60 min) and were sacrificed 30 min thereafter. Amino acid concentrations were determined in plasma and right muscle tibialis anterior (TA). Left TA was used to analyse MPS by SUnSET method and phosphorylation rate of Akt, 4E-BP1 and p70S6k by western blot.

RESULTS:

In aged mice, leucine administration failed to increase MPS, despite a 6-fold increase in plasma leucine and elevated muscle free leucine levels (P < 0.05). In contrast, leucine-enriched whey protein significantly stimulated MPS in aged mice at 60 min after gavage (P < 0.05). Muscle free EAA, NEAA and the phosphorylation rate of Akt, 4E-BP1 and p70S6k increased significantly (P < 0.05), only after administration of leucine-enriched whey protein.

CONCLUSIONS:

MPS is stimulated in aged mice by leucine-enriched whey protein but not by leucine administration only. Administration of other amino acids may be required for leucine administration to stimulate muscle protein synthesis in aged mice.

KEYWORDS:

Ageing; Amino acids; Leucine; Muscle protein synthesis; Whey protein

 

Metformin reduces glucose intolerance caused by rapamycin treatment in genetically heterogeneous female mice.

Weiss R, Fernandez E, Liu Y, Strong R, Salmon AB.

Aging (Albany NY). 2018 Mar 22. doi: 10.18632/aging.101401. [Epub ahead of print]

PMID: 29579736 Free Article

http://www.aging-us.com/article/101401/text

Abstract

The use of rapamycin to extend lifespan and delay age-related disease in mice is well-established despite its potential to impair glucose metabolism which is driven partially due to increased hepatic gluconeogenesis. We tested whether a combination therapeutic approach using rapamycin and metformin could diminish some of the known metabolic defects caused by rapamycin treatment in mice. In genetically heterogeneous HET3 mice, we found that chronic administration of encapsulated rapamycin by diet caused a measurable defect in glucose metabolism in both male and female mice as early as 1 month after treatment. In female mice, this defect was alleviated over time by simultaneous treatment with metformin, also by diet, such that females treated with both drugs where indistinguishable from control mice during glucose tolerance tests. While rapamycin-mediated glucose intolerance was unaffected by metformin in males, we found metformin prevented rapamycin-mediated reduction in insulin and leptin concentrations following 9 months of co-treatment. Recently, the Interventions Testing Program showed that mice treated with metformin and rapamycin live at least as long as those treated with rapamycin alone. Together, our data provide compelling evidence that the pro-longevity effects of rapamycin can be uncoupled from its detrimental effects on metabolism through combined therapeutic approaches.

KEYWORDS:

AMPK; adiponectin; gluconeogenesis; insulin; interventions; leptin; mTOR

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Alcohol Consumption and Risk of Coronary Artery Disease (from the Million Veteran Program).

Song RJ, Nguyen XT, Quaden R, Ho YL, Justice AC, Gagnon DR, Cho K, O'Donnell CJ, Concato J, Gaziano JM, Djoussé L; VA Million Veteran Program.

Am J Cardiol. 2018 Feb 12. pii: S0002-9149(18)30186-3. doi: 10.1016/j.amjcard.2018.01.042. [Epub ahead of print]

PMID: 29580627

Abstract

Moderate alcohol consumption has been associated with a lower risk of coronary artery disease (CAD) in the general population but has not been well studied in US veterans. We obtained self-reported alcohol consumption from Million Veteran Program participants. Using electronic health records, CAD events were defined as 1 inpatient or 2 outpatient diagnosis codes for CAD, or 1 code for a coronary procedure. We excluded participants with prevalent CAD (n = 69,995) or incomplete alcohol information (n = 8,449). We used a Cox proportional hazards model to estimate hazard ratios and 95% confidence intervals for CAD, adjusting for age, gender, body mass index, race, smoking, education, and exercise. Among 156,728 participants, the mean age was 65.3 years (standard deviation = 12.1) and 91% were men. There were 6,153 CAD events during a mean follow-up of 2.9 years. Adjusted hazard ratios (95% confidence intervals) for CAD were 1.00 (reference), 1.02 (0.92 to 1.13), 0.83 (0.74 to 0.93), 0.77 (0.67 to 0.87), 0.71 (0.62 to 0.81), 0.62 (0.51 to 0.76), 0.58 (0.46 to 0.74), and 0.95 (0.85 to 1.06) for categories of never drinker; former drinker; current drinkers of ≤0.5 drink/day, >0.5 to 1 drink/day, >1 to 2 drinks/day, >2 to 3 drinks/day, and >3 to 4 drinks/day; and heavy drinkers (>4 drinks/day) or alcohol use disorder, respectively. For a fixed amount of ethanol, intake at ≥3 days/week was associated with lower CAD risk compared with ≤1 day/week. Beverage preference (beer, wine, or liquor) did not influence the alcohol-CAD relation. Our data show a lower risk of CAD with light-to-moderate alcohol consumption among US veterans, and drinking frequency may provide a further reduction in risk.

 

Effects of Sedentary Behavior, Physical Activity, Frequency of Protein Consumption, Lower Extremity Strength and Lean Mass on All-Cause Mortality.

Loprinzi PD, Frith E.

J Lifestyle Med. 2018 Jan;8(1):8-15. doi: 10.15280/jlm.2018.8.1.8. Epub 2018 Jan 31.

PMID: 29581955 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846639/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846639/pdf/jlm-08-008.pdf

Abstract

BACKGROUND:

No study has evaluated the potential independent and cumulative effects of physical activity, sedentary behavior, daily frequency of protein consumption, lean mass and muscular strength on mortality risk.

METHODS:

Data from the 1999-2002 NHANES were utilized (N = 1,079 adults 50-85 yr), with follow-up through 2011. Leg lean mass was estimated from DXA scans. Knee extensor strength was assessed using the Kin Com MP dynamometer. Physical activity and sedentary behavior were assessed via questionnaire, with the number of meals/day of ≥30 g of protein/meal assessed via a "multiple pass" 24-hour dietary interview. An index score was created (range = 0-5) indicating the number of these health characteristics each participant had.

RESULTS:

Only less sedentary behavior was independently associated with reduced mortality risk (HRadjustment = 0.46; 0.32-0.66). After adjustments, and compared to those with an index score of 0, those with an index score of 1, 2 and 3+, respectively, had a 34%, 49%, and 57% reduced risk of all-cause mortality.

CONCLUSION:

While considering physical activity, sedentary behavior, daily protein frequency consumption, lean mass and muscular strength, only sedentary behavior was independently associated with mortality risk among older adults.

KEYWORDS:

Epidemiology; Muscle mass; Muscle strength; Protein distribution

 

Intake of 25-Hydroxyvitamin D3 Reduces Duration and Severity of Upper Respiratory Tract Infection: A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Comparison Study.

Shimizu Y, Ito Y, Yui K, Egawa K, Orimo H.

J Nutr Health Aging. 2018;22(4):491-500. doi: 10.1007/s12603-017-0952-x.

PMID: 29582888 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866826/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866826/pdf/12603_2017_Article_952.pdf

Abstract

OBJECTIVES:

This study aimed to assess the effect of 25-hydroxyvitamin D3 (25OHD) which is a hydroxide of vitamin D3 ingestion on upper respiratory tract infection (URTI).

DESIGN AND SETTING:

A prospective, randomized, double-blind, placebo-controlled study was performed from December 2015 to September 2016 in the Nihonbashi Egawa Clinic, Kei Medical Office TOC Building Medical Clinic, and Medical Corporation Kaiseikai Kita-Shinyokohama Medical Clinic, in Japan.

PARTICIPANTS:

Four hundred twenty eight participants aged 45-74 years were screened by their serum 25-hydoroxyvitamin D concentration.

INTERVENTION:

The participants were randomized to either 25OHD (10 μg/day) or placebo capsule, daily, for 16 consecutive weeks.

MEASUREMENTS:

The primary outcome measure was the incidence proportion of URTI, and the secondary outcome measures were the physical severity score, the quality-of-life (QOL) score, the duration of URTI, and the incidence proportion of new URTI events every four weeks. Data were collected using cold diary Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) during the intervention.

RESULTS:

Of 428 participants screened, 252 with serum 25-hydroxyvitamn D levels were deficient or insufficient (75 nmol/L or less) were enrolled in this study. Of these, 105 placebo and 110 25OHD group subjects completed the study. For the incidence proportion of URTI, no effect of 25OHD intake was observed. On the other hand, the duration of URTI was shorter in the 25OHD (P = 0.061) compared to placebo. For the incidence proportion of URTI every four weeks, the incidence of new URTI was decreased in both groups over the time of intake. However, when the 25OHD and the placebo were compared, a decrease in the incidence proportion of URTI was seen earlier in the 25OHD. When the total physical severity score and the total QOL score during the study were assessed, they both were significantly improved in the 25OHD compared to placebo.

CONCLUSIONS:

The intake of 25OHD may reduce the duration of URTI, the physical severity, and the QOL when suffering from URTI.

KEYWORDS:

25-hydroxycholecalciferol; 25-hydroxyvitamin D3; calcifediol; common cold; upper respiratory tract infection; vitamin D3

 

A lecithin phosphatidylserine and phosphatidic acid complex (PAS) reduces symptoms of the premenstrual syndrome (PMS): Results of a randomized, placebo-controlled, double-blind clinical trial.

Schmidt K, Weber N, Steiner M, Meyer N, Dubberke A, Rutenberg D, Hellhammer J.

Clin Nutr ESPEN. 2018 Apr;24:22-30. doi: 10.1016/j.clnesp.2018.01.067. Epub 2018 Feb 9.

PMID: 29576358 Free Article

Abstract

BACKGROUND & AIMS:

Many women experience emotional and physical symptoms around the time of ovulation and more so before menstruation interfering with their daily normal life also known as premenstrual syndrome (PMS). Recent observational data suggest that supplementation with Lipogen's phosphatidylserine (PS) and phosphatidic acid (PA) complex (PAS) alleviates these PMS symptoms. The aim of this study was to confirm these observations on the effects of PAS on PMS symptom severity within a controlled clinical trial setting.

METHODS:

Forty women aged 18-45 years with a diagnosis of PMS were assigned to either take PAS (containing 400 mg PS & 400 mg PA per day) or a matching placebo. The study comprised 5 on-site visits including 1 baseline menstrual cycle followed by 3 treatment cycles. Treatment intake was controlled for by using an electronic device, the Medication Event Monitoring System (MEMS®). Primary outcome of the study was the PMS symptoms severity as assessed by using the Daily Record of Severity of Problems (DRSP). Further, SIPS questionnaire (a German version of the Premenstrual Symptoms Screening Tool (PSST)), salivary hormone levels (cortisol awakening response (CAR) and evening cortisol levels) as well as serum levels (cortisol, estradiol, progesterone and corticosteroid binding globulin (CBG)) were assessed.

RESULTS:

PMS symptoms as assessed by the DRSP Total score showed a significantly better improvement (p = 0.001) over a 3 cycles PAS intake as compared to placebo. In addition, PAS treated women reported a greater improvement in physical (p = 0.002) and depressive symptoms (p = 0.068). They also reported a lower reduction of productivity (p = 0.052) and a stronger decrease in interference with relationships with others (p = 0.099) compared to the placebo group. No other DRSP scale or item showed significant results. Likewise, the reduction in the number of subjects fulfilling PMS or premenstrual dysphoric disorder (PMDD) criteria as classified by the SIPS did not differ between the PAS and the placebo group. For the biomarkers, the salivary cortisol percentage increase of the CAR was significantly less pronounced in the follicular phase of cycle 4 than in the follicular phase of cycle 1 for subjects taking PAS when compared to subjects taking placebo (p = 0.018). Furthermore, the change of serum cortisol levels between visit 1 and visit 5 differed significantly between groups (p = 0.043). While serum cortisol levels of PAS treated females slightly decreased between visit 1 and visit 5, cortisol levels of females treated with placebo increased. For all other biomarkers, no treatment effects were observed over the 4 cycles study period. Overall, this study confirms that a daily intake of PAS, containing 400 mg PS and 400 mg PA, can be considered as safe.

CONCLUSIONS:

Results substantiate the efficacy of PAS in reducing symptoms of PMS. In view of the recent inclusion of severe PMS symptoms (PMDD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the positive results of this clinical study merits consideration of developing the PAS complex as a botanical drug for treatment of PMDD.

KEYWORDS:

Cortisol; Daily record of severity of problems; Phosphatidic acid; Phosphatidylserine; Premenstrual syndrome

 

High red and processed meat consumption is associated with non-alcoholic fatty liver disease and insulin resistance.

Zelber-Sagi S, Ivancovsky-Wajcman D, Fliss Isakov N, Webb M, Orenstein D, Shibolet O, Kariv R.

J Hepatol. 2018 Mar 15. pii: S0168-8278(18)30058-8. doi: 10.1016/j.jhep.2018.01.015. [Epub ahead of print]

PMID: 29571924

Abstract

BACKGROUND & AIMS:

High red and processed meat consumption is related to type 2 diabetes. In addition, cooking meat at high temperatures for a long duration forms heterocyclic amines (HCAs), which are related to oxidative stress. However, the association between meat consumption and non-alcoholic fatty liver disease (NAFLD) is yet to be thoroughly tested. Therefore, we aimed to test the association of meat type and cooking method with NAFLD and insulin resistance (IR).

METHODS:

This was a cross-sectional study in individuals who were 40-70 years old and underwent screening colonoscopy between 2013 and 2015 in a single center in Israel. NAFLD and IR were evaluated by ultrasonography and homeostasis model assessment. Meat type and cooking method were measured by a food frequency questionnaire (FFQ) and a detailed meat questionnaire. Unhealthy cooking methods were considered as frying and grilling to a level of well done and very well done. Dietary HCA intake was calculated.

RESULTS:

A total of 789 individuals had a valid FFQ and 357 had a valid meat questionnaire. High consumption of total meat (portions/day above the median) (odds ratio [OR] 1.49; 95% CI 1.05-2.13; p = 0.028; OR 1.63; 1.12-2.37; p = 0.011), red and/or processed meat (OR1.47; 95% CI 1.04-2.09; p = 0.031; OR1.55; 1.07-2.23; p = 0.020) was independently associated with higher odds of NAFLD and IR, respectively, when adjusted for: body mass index, physical activity, smoking, alcohol, energy, saturated fat and cholesterol intake. High intake of meat cooked using unhealthy methods (OR1.92; 95% CI 1.12-3.30; p = 0.018) and HCAs (OR2.22; 95% CI 1.28-3.86; p = 0.005) were independently associated with higher odds of IR.

CONCLUSION:

High consumption of red and/or processed meat is associated with both NAFLD and IR. High HCA intake is associated with IR. If confirmed in prospective studies, limiting the consumption of unhealthy meat types and improving preparation methods may be considered as part of NAFLD lifestyle treatment.

LAY SUMMARY:

High red and processed meat consumption is related to several diseases. In addition, cooking meat at high temperatures for a long duration forms heterocyclic amines, which have harmful health effects. Non-alcoholic fatty liver disease is a significant public health burden and its formation is strongly related to insulin resistance. In this study, both were found to be more frequent in people who consume relatively high quantities of red and processed meat. In addition, a high intake of heterocyclic amines was associated with insulin resistance.

KEYWORDS:

Diet; Fatty liver; Heterocyclic amines; Insulin resistance; Processed meat; Red meat

 

Coffee Consumption and Incident Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study.

Hu EA, Selvin E, Grams ME, Steffen LM, Coresh J, Rebholz CM.

Am J Kidney Dis. 2018 Mar 12. pii: S0272-6386(18)30109-4. doi: 10.1053/j.ajkd.2018.01.030. [Epub ahead of print]

PMID: 29571833

Abstract

BACKGROUND:

Moderate coffee consumption has been suggested to be associated with lower risk for chronic conditions such as diabetes, a major precursor to chronic kidney disease (CKD). However, the association between coffee and CKD has not been fully established. STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS:

14,209 participants aged 45 to 64 years from the Atherosclerosis Risk in Communities (ARIC) Study.

PREDICTORS:

Coffee consumption (cups per day) was assessed at visits 1 (1987-1989) and 3 (1993-1995) using food frequency questionnaires.

OUTCOMES:

Incident CKD defined as estimated glomerular filtration rate < 60mL/min/1.73m2 accompanied by ≥25% estimated glomerular filtration rate decline, CKD-related hospitalization or death, or end-stage renal disease.

RESULTS:

There were 3,845 cases of incident CKD over a median of 24 years of follow-up. Men, whites, current smokers, and participants without comorbid conditions were more likely to consume higher amounts of coffee per day. After adjustment for demographic, clinical, and dietary factors, higher categories of coffee consumption were associated with lower risk for incident CKD compared with those who never consumed coffee (HR for <1 cup per day, 0.90 [95% CI, 0.82-0.99]; 1-<2 cups per day, 0.90 [95% CI, 0.82-0.99]; 2-<3 cups per day, 0.87 [95% CI, 0.77-0.97]; and ≥3 cups per day, 0.84 [95% CI, 0.75-0.94]). In continuous analysis, for each additional cup of coffee consumed per day, risk for incident CKD was lower by 3% (HR, 0.97; 95% CI, 0.95-0.99; P<0.001).

LIMITATIONS:

Self-reported coffee consumption and observational design.

CONCLUSIONS:

Participants who drank higher amounts of coffee had lower risk for incident CKD after adjusting for covariates. Coffee consumers may not be at adverse risk for kidney disease.

KEYWORDS:

Coffee; beverages; chronic kidney disease (CKD); diet; incident CKD; kidney failure; modifiable risk factor

 

Predictors of long term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: The DE-PLAN study.

Gilis-Januszewska A, Barengo NC, Lindström J, Wójtowicz E, Acosta T, Tuomilehto J, Schwarz PEH, Piwońska-Solska B, Szybiński Z, Windak A, Hubalewska-Dydejczyk A.

PLoS One. 2018 Mar 23;13(3):e0194589. doi: 10.1371/journal.pone.0194589. eCollection 2018.

PMID: 29570724 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865727/

Abstract

Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.

 

Overall and Multiphasic Findings of the Prostate, Lung, Colorectal and Ovarian (PLCO) Randomized Cancer Screening Trial.

Prorok PC, Wright P, Riley TR, Kramer BS, Berg CD, Gohagan JK.

Rev Recent Clin Trials. 2018 Apr 9. doi: 10.2174/1574887113666180409153059. [Epub ahead of print]

PMID: 29629665

Abstract

BACKGROUND:

Screening tests are typically evaluated for a single disease, but multiple tests for multiple diseases are performed in practice. The Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial assessed testing for four cancers simultaneously and can be viewed as a multiphasic cancer intervention. This paper presents overall and multiphasic findings of this trial.

METHODS:

The PLCO trial was a randomized multi-center trial conducted at ten screening centers in the US. Participants were 76,682 men and 78,215 women ages 55 - 74 and free of the target cancers at trial entry. Screening tests were PSA and digital rectal examination for prostate cancer, chest x-ray for lung cancer, flexible sigmoidoscopy for colorectal cancer, CA125 and transvaginal ultrasound for ovarian cancer. Outcomes and harms of screening were assessed including compliance, test results, incidence, mortality, false positives and overdiagnosis.

RESULTS:

Screening compliance was 82%, 72,820 (8%) of 906,064 exams were positive, the overall PPV was 4.2 and the cancer detection rate was 3.38/1000. A mortality reduction was observed only for colorectal cancer (RR 0.72, 95% CI 0.61 - 0.85) with no effect on all-cause mortality. Ninety-six percent of positive exams were falsely positive and there was a suggestion of overdiagnosis of prostate and possibly ovarian cancers. Multiphasic testing resulted in 7374 men and 2748 women experiencing multiple false positive results from multiple types of tests.

CONCLUSION:

Multiphasic cancer screening led to reduced mortality for one target cancer and imposed a burden on the health care system that included substantial false positives and likely overdiagnosis.

KEYWORDS:

cancer; colon; lung; multiphasic testing; ovary ; prostate; screening

 

Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses.

Bellou V, Belbasis L, Tzoulaki I, Evangelou E.

PLoS One. 2018 Mar 20;13(3):e0194127. doi: 10.1371/journal.pone.0194127. eCollection 2018.

PMID: 29558518 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860745/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5860745/pdf/pone.0194127.pdf

Abstract

BACKGROUND:

Type 2 diabetes mellitus (T2DM) is a global epidemic associated with increased health expenditure, and low quality of life. Many non-genetic risk factors have been suggested, but their overall epidemiological credibility has not been assessed.

METHODS:

We searched PubMed to capture all meta-analyses and Mendelian randomization studies for risk factors of T2DM. For each association, we estimated the summary effect size, its 95% confidence and prediction interval, and the I2 metric. We examined the presence of small-study effects and excess significance bias. We assessed the epidemiological credibility through a set of predefined criteria.

RESULTS:

We captured 86 eligible papers (142 associations) covering a wide range of biomarkers, medical conditions, and dietary, lifestyle, environmental and psychosocial factors. Adiposity, low hip circumference, serum biomarkers (increased level of alanine aminotransferase, gamma-glutamyl transferase, uric acid and C-reactive protein, and decreased level of adiponectin and vitamin D), an unhealthy dietary pattern (increased consumption of processed meat and sugar-sweetened beverages, decreased intake of whole grains, coffee and heme iron, and low adherence to a healthy dietary pattern), low level of education and conscientiousness, decreased physical activity, high sedentary time and duration of television watching, low alcohol drinking, smoking, air pollution, and some medical conditions (high systolic blood pressure, late menarche age, gestational diabetes, metabolic syndrome, preterm birth) presented robust evidence for increased risk of T2DM.

CONCLUSIONS:

A healthy lifestyle pattern could lead to decreased risk for T2DM. Future randomized clinical trials should focus on identifying efficient strategies to modify harmful daily habits and predisposing dietary patterns.

 

Garlic intake and gastric cancer risk: Results from two large prospective US cohort studies.

Kim H, Keum N, Giovannucci EL, Fuchs CS, Bao Y.

Int J Cancer. 2018 Mar 23. doi: 10.1002/ijc.31396. [Epub ahead of print]

PMID: 29569711

Abstract

Although many case-control studies suggested that garlic intake may reduce gastric cancer risk, evidence from prospective cohort studies has been lacking. We examined the association between garlic intake and subsequent risk of gastric cancer among 77,086 women in the Nurses' Health Study (1984-2014) and 46,398 men in the Health Professionals Follow-Up Study (1986-2014). Relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards models. We additionally examined garlic intake in relation to Helicobacter pylori (H. pylori) infection among 613 participants using logistic regression. During up to 30 years of follow-up, 292 participants were diagnosed with gastric cancer. The pooled multivariable RR of gastric cancer among participants who ate garlic, as compared to those who did not, were 1.11 (95% CI = 0.81-1.51) for the intake of garlic less than once per week, 0.98 (95% CI = 0.71-1.36) for one to four times per week and 1.39 (95% CI = 0.89-2.17) for five or more times per week (p for trend = 0.23). Similarly, no statistically significant association was observed cross-sectionally between garlic intake and H. pylori infection (comparing five or more times per week to never, pooled multivariable odds ratio = 1.66, 95% CI = 0.89-3.09; p for trend = 0.11). The findings from this large prospective study do not support the hypothesis that high garlic intake reduces risk of gastric cancer.

KEYWORDS:

garlic; gastric cancer; prospective cohort study

 

n-3 Fatty Acid Supplementation in Mothers, Preterm Infants, and Term Infants and Childhood Psychomotor and Visual Development: A Systematic Review and Meta-Analysis.

Shulkin M, Pimpin L, Bellinger D, Kranz S, Fawzi W, Duggan C, Mozaffarian D.

J Nutr. 2018 Mar 1;148(3):409-418. doi: 10.1093/jn/nxx031.

PMID: 29546296

Abstract

BACKGROUND:

Epidemiologic studies link maternal seafood and n-3 (ω-3) polyunsaturated fatty acid (PUFA) consumption with improved childhood cognitive development; trials show mixed results.

OBJECTIVE:

We investigated effects of n-3 PUFA supplementation on child cognitive and visual outcomes.

METHODS:

We systematically reviewed and meta-analyzed randomized controlled trials of n-3 PUFA supplementation in mothers or infants (age ≤2 y) and evaluated standardized measures of cognitive or visual development up to age 18 y. Of 6286 abstracts and 669 full-text articles, 38 trials with 53 intervention arms were included. Data were extracted independently in duplicate. Findings were pooled using random-effects meta-analysis across supplementation periods (maternal, preterm, term infant); we also explored subgroup analyses stratified by supplementation period. Heterogeneity was explored using I2, stratified analysis, and meta-regression. Cognitive development was assessed by Bayley Scales of Infant Development mental and psychomotor developmental indexes (MDI, PDI) and intelligence quotient (IQ); visual acuity was assessed by electrophysiological or behavioral measures.

RESULTS:

The 38 trials (mothers: n = 13; preterm infants: n = 7; term infants: n = 18) included 5541 participants. When we explored effects during different periods of supplementation, n-3 PUFA supplementation improved MDI in preterm infants (3.33; 95% CI: 0.72, 5.93), without statistically significant effects on PDI or IQ in different intervention period subgroups. Visual acuity [measured as the logarithm of the minimum angle of resolution (logMAR)] was improved by supplementation in preterm (-0.08 logMAR; 95% CI: -0.14, -0.01 logMAR) and term infants (-0.08 logMAR; 95% CI: -0.11, -0.05 logMAR), with a nonsignificant trend for maternal supplementation (-0.02 logMAR; 95% CI: -0.04, 0.00 logMAR). In main analyses pooling all supplementation periods, compared with placebo, n-3 PUFA supplementation improved MDI (n = 21 trials; 0.91; 95% CI: 0.005, 1.81; P = 0.049), PDI (n = 21 trials; 1.06 higher index; 95% CI: 0.10, 2.03; P = 0.031), and visual acuity (n = 24; -0.063 logMAR; 95% CI: -0.084, -0.041 logMAR; P < 0.001) but not IQ (n = 7; 0.20; 95% CI: -1.56, 1.96, P = 0.83), although few studies assessed this endpoint. Potential publication bias was identified for MDI (Eggers P = 0.005), but not other endpoints. Significant differences in findings were not identified by world region, race, maternal education, age at outcome assessment, supplementation duration, DHA or EPA dose, DHA:AA ratio, or study quality score (P-interaction > 0.05 each).

CONCLUSIONS:

n-3 PUFA supplementation improves childhood psychomotor and visual development, without significant effects on global IQ later in childhood, although the latter conclusion is based on fewer studies.

 

Meal Fatty Acids Have Differential Effects on Postprandial Blood Pressure and Biomarkers of Endothelial Function but Not Vascular Reactivity in Postmenopausal Women in the Randomized Controlled Dietary Intervention and VAScular function (DIVAS)-2 Study.

Rathnayake KM, Weech M, Jackson KG, Lovegrove JA.

J Nutr. 2018 Mar 1;148(3):348-357. doi: 10.1093/jn/nxx042.

PMID: 29546297

Abstract

BACKGROUND:

Elevated postprandial triacylglycerol concentrations, impaired vascular function, and hypertension are important independent cardiovascular disease (CVD) risk factors in women. However, the effects of meal fat composition on postprandial lipemia and vascular function in postmenopausal women are unknown.

OBJECTIVE:

This study investigated the impact of sequential meals rich in saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), or n-6 (ω-6) polyunsaturated fatty acids (PUFAs) on postprandial flow-mediated dilatation (FMD; primary outcome measure), vascular function, and associated CVD risk biomarkers (secondary outcomes) in postmenopausal women.

METHODS:

A double-blind, randomized, crossover, postprandial study was conducted in 32 postmenopausal women [mean ± SEM ages: 58 ± 1 y; mean ± SEM body mass index (in kg/m2): 25.9 ± 0.7]. After fasting overnight, participants consumed high-fat meals at breakfast (0 min; 50 g fat, containing 33-36 g SFAs, MUFAs, or n-6 PUFAs) and lunch (330 min; 30 g fat, containing 19-20 g SFAs, MUFAs, or n-6 PUFAs), on separate occasions. Blood samples were collected before breakfast and regularly after the meals for 480 min, with specific time points selected for measuring vascular function and blood pressure.

RESULTS:

Postprandial FMD, laser Doppler imaging, and digital volume pulse responses were not different after consuming the test fats. The incremental area under the curve (iAUC) for diastolic blood pressure was lower after the MUFA-rich meals than after the SFA-rich meals (mean ± SEM: -2.3 ± 0.3 compared with -1.5 ± 0.3 mm Hg × 450 min × 103; P = 0.009), with a similar trend for systolic blood pressure (P = 0.012). This corresponded to a lower iAUC for the plasma nitrite response after the SFA-rich meals than after the MUFA-rich meals (-1.23 ± 0.7 compared with -0.17 ± 0.4 μmol/L × 420 min P = 0.010). The soluble intercellular adhesion molecule 1 (sICAM-1) time-course profile, AUC, and iAUC were lower after the n-6 PUFA-rich meals than after the SFA- and MUFA-rich meals (P ≤ 0.001). Lipids, glucose, and markers of insulin sensitivity did not differ between the test fats.

CONCLUSION:

Our study showed a differential impact of meal fat composition on blood pressure, plasma nitrite, and sICAM-1, but no effect on postprandial FMD or lipemia in postmenopausal women.

 

Adiposity and breast cancer risk in postmenopausal women: Results from the UK Biobank prospective cohort.

Guo W, Key TJ, Reeves GK.

Int J Cancer. 2018 Mar 23. doi: 10.1002/ijc.31394. [Epub ahead of print]

PMID: 29569713

Abstract

Body size is an important modifiable risk factor for postmenopausal breast cancer. However, it remains unclear whether direct measures of fat mass are better indicators of risk than anthropometric measures, or whether central adiposity may contribute to risk beyond overall adiposity. We analyzed data from 162,691 postmenopausal women in UK Biobank followed from 2006-2014. Body size was measured by trained technicians. Multivariable-adjusted Cox regression was used to estimate relative risks. Analyses were stratified by age at recruitment, region, and socioeconomic status, and adjusted for family history of breast cancer, age at menarche, age at first birth, parity, age at menopause, previous hormone replacement therapy use, smoking, alcohol intake, height, physical activity, and ethnicity. We observed 2,913 incident invasive breast cancers during a mean 5.7 years of follow-up. There was a continuous increase in risk of postmenopausal breast cancer with increasing adiposity, across all measures. The point estimate, comparing women in the top (median 37.6 kg) to bottom (median 17.6 kg) quartile of body fat mass was 1.70 (95% confidence interval 1.52-1.90). The magnitudes of the associations between per SD increase in BMI and body fat mass with breast cancer risk were similar, suggesting impedance measures of fat were not substantially better indicators of risk than anthropometric measures. After adjusting for body fat mass, the associations between anthropometric measures of central adiposity and breast cancer risk were attenuated. The magnitude of risk, across all measures of adiposity, was greater in women who had been postmenopausal for 12 or more years.

KEYWORDS:

UK Biobank; adiposity; bioelectrical impedance; breast cancer; obesity

 

Egg consumption and dyslipidemia in a Mediterranean cohort.

Vazquez-Ruiz Z, De la Fuente-Arrillaga C, Bes-Rastrollo M, Zazpe I, Santiago S, Razquin C, Toledo E, Martinez-Gonzalez MÁ.

Nutr Hosp. 2018 Jan 12;35(1):153-161. doi: 10.20960/nh.1347.

PMID: 29565164 Free Article

http://revista.nutricionhospitalaria.net/index.php/nh/article/view/1347/770

Abstract

INTRODUCTION AND OBJECTIVES:

Our aim was to prospectively evaluate the association between egg consumption and dyslipidemia in a Mediterranean cohort.

METHODS:

We followed-up 13,104 Spanish university graduates for a mean period of 8 years. Dietary habits at baseline were assessed using a validated semi-quantitative 136-item food-frequency questionnaire. Self-reported blood concentrations of total cholesterol, high-density lipoproteins cholesterol (HDL-c) and triglycerides were evaluated according to categories of egg consumption after 6 and 8 years of follow-up. We also assessed the association between baseline egg consumption and the incidence of hypercholesterolemia, low HDL-c concentrations and hypertriglyceridemia during follow-up.

RESULTS:

We observed a significant inverse association for intermediate levels of egg consumption (2 to 4 eggs/week vs. less than 1 egg/week) and hypertriglyceridemia with OR = 0.71 (95% confidence interval [CI]: 0.54 to 0.93, p < 0.05) in the multivariable-adjusted model. Using HDL-c values after 8-year follow-up, we found an association between higher egg consumption and lower HDL-c levels (p for trend = 0.02) with an adjusted difference of -4.01 mg/dl (-7.42 to -0.61) for > 4 vs. < 1 egg/week. Lower means of triglycerides were found in each of the three upper categories of egg consumption compared to the lowest category (< 1 egg/week) with significant results for some of these categories both after 6 and 8 year follow-up.

CONCLUSIONS:

Our data do not support that higher egg consumption was associated with abnormal blood levels of total cholesterol or triglycerides; an inverse association with HDL-c as a quantitative variable was found only in one of our analyses.

 

Relationship of Sodium Intake and Blood Pressure Varies With Energy Intake: Secondary Analysis of the DASH (Dietary Approaches to Stop Hypertension)-Sodium Trial.

Murtaugh MA, Beasley JM, Appel LJ, Guenther PM, McFadden M, Greene T, Tooze JA.

Hypertension. 2018 Mar 19. pii: HYPERTENSIONAHA.117.10602. doi: 10.1161/HYPERTENSIONAHA.117.10602. [Epub ahead of print]

PMID: 29555665

Abstract

Dietary Na recommendations are expressed as absolute amounts (mg/d) rather than as Na density (mg/kcal). Our objective was to determine whether the strength of the relationship of Na intake with blood pressure (BP) varied with energy intake. The DASH (Dietary Approaches to Stop Hypertension)-Sodium trial was a randomized feeding trial comparing 2 diets (DASH and control) and 3 levels of Na density. Participants with pre- or stage 1 hypertension consumed diets for 30 days in random order; energy intake was controlled to maintain body weight. This secondary analysis of 379 non-Hispanic black and white participants used mixed-effects models to assess the association of Na and energy intakes with BP. The relationships between absolute Na and both systolic and diastolic BP varied with energy intake. BP rose more steeply with increasing Na at lower energy intake than at higher energy intake (P interaction<0.001). On the control diet with 2300 mg Na, both systolic and diastolic BP were higher (3.0 mm Hg; 95% confidence interval, 0.2-5.8; and 2.7 mm Hg; 95% confidence interval, 1.0-4.5, respectively) among those with lower energy intake (higher Na density) than among those with higher energy intake (lower Na density). The association of Na with systolic BP was stronger at lower levels of energy intake in both blacks and whites (P<0.001). The association of Na and diastolic BP varied with energy intake only among blacks (P=0.001). Sodium density should be considered as a metric for expressing dietary Na recommendations.

KEYWORDS:

blood pressure; body weight; diet; energy intake; hypertension; sodium

 

Associations of hemoglobin biomarker levels of acrylamide and all-cause and cardiovascular disease mortality among U.S. adults: National Health and Nutrition Examination Survey 2003-2006.

Huang M, Jiao J, Wang J, Chen X, Zhang Y.

Environ Pollut. 2018 Apr 5;238:852-858. doi: 10.1016/j.envpol.2018.03.109. [Epub ahead of print]

PMID: 29627755

Abstract

BACKGROUND:

The potential hazards of acrylamide (AA) have been proposed due to its lifelong exposure. However, the association between AA exposure and mortality remains unclear.

OBJECTIVES:

We evaluated the prospective association of AA hemoglobin adducts (HbAA and HbGA) with all-cause and cardiovascular disease (CVD) mortality in U.S. population from National Health and Nutrition Examination Survey (NHANES) 2003-2006.

METHODS:

We followed 5504 participants who were ≥25 years of age for an average of 6.7 years at the baseline examination with annual linkage to the NHANES statistics database. Using AA hemoglobin biomarkers [HbAA, HbGA, sum of HbAA and HbGA (HbAA + HbGA), and ratio of HbGA to HbAA (HbGA/HbAA)], we determined mortality from all-causes and CVD through Cox proportional hazard regression analysis with multivariable adjustments both in non-smoker group and smoker group. In addition, subgroup analyses and sensitivity analyses were further conducted.

RESULTS:

After adjusting for sociodemographic, life behavioral and cardiovascular risk factors in non-smoker group, HbAA was positively associated with all-cause mortality (p for trend = 0.0197) and non-CVD mortality (p for trend = 0.0124). HbGA and HbGA/HbAA were inversely associated with all-cause mortality (p for trend = 0.0117 and 0.0098, respectively) and CVD mortality (p for trend=0.0009 and 0.0036, respectively). The multivariable adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] of the upper three quartiles were 0.472 (95% CI: 0.283-0.786), 0.517 (95% CI: 0.299-0.894) and 0.470 (95% CI: 0.288-0.766) between HbGA/HbAA and all-cause mortality comparing with the lowest quartile, respectively. No significant associations were found between HbAA + HbGA and mortality in non-smoker group, and between all AA hemoglobin biomarkers and mortality in smoker group.

CONCLUSIONS:

Hemoglobin biomarker levels of AA were strongly associated with mortality in general U.S. non-smoker adults. These findings proposed a continuous public health concern in relation to environmental and dietary exposure to AA.

KEYWORDS:

Acrylamide; Cardiovascular disease; Hemoglobin biomarkers; Mortality; NHANES

 

Polyunsaturated fatty acids intake, omega-6/omega-3 ratio and mortality: Findings from two independent nationwide cohorts.

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

Clin Nutr. 2018 Mar 3. pii: S0261-5614(18)30082-7. doi: 10.1016/j.clnu.2018.02.019. [Epub ahead of print]

PMID: 29551407

Abstract

BACKGROUND & AIMS:

Polyunsaturated fatty acids (PUFA) have been reported to exert pleiotropic protective effects against various chronic diseases. However, epidemiologic evidence linking specific PUFA intake to mortality has been limited and contradictory. We aim to assess the associations between specific dietary PUFA and mortality among adults in China and America, respectively.

METHODS:

Participants from China Health and Nutrition Survey (CHNS, n = 14,117) and National Health and Nutrition Examination Survey [NHANES (n = 36,032)] were prospectively followed up through the year 2011. Cox regression models were used to investigate hypothesized associations.

RESULTS:

A total of 1007 and 4826 deaths accrued over a median of 14 and 9.1 years of follow-up in CHNS and NHANES, respectively. Dietary marine omega-3 PUFA was robustly associated with a reduced all-cause mortality [Hazard ratio (HR) comparing extreme categories: 0.74, 95% CI: 0.61-0.89; P < 0.001 for trend] in CHNS. Nevertheless, this inverse relationship was not observed in NHANES. The overall mortality was positively associated with the intake of α-linolenic acid (ALA) (HR comparing extreme quartiles: 1.23, 95% CI: 1.01-1.50; P = 0.054 for trend) in CHNS, whereas weak inverse associations of ALA (P = 0.035 for trend) and LA (P = 0.027 for trend) with all-cause mortality were found in NHANES. Increased dietary intake of arachidonic acid was consistently linked with reduced all-cause mortality both in NHANES and CHNS. Importantly, consuming PUFA at an omega-6/omega-3 ratio of 6-10 was associated with a lower risk of death in CHNS.

CONCLUSIONS:

Intakes of different specific PUFA show distinct associations with mortality and these relationships also vary between Chinese and US populations. These findings suggest maintaining an omega-6/omega-3 balance diet for overall health promotion outcomes (NCT03155659).

KEYWORDS:

CHNS; Mortality; NHANES; Omega-3 PUFA; Omega-6 PUFA; Polyunsaturated fatty acids

 

Vegetarian diet, change in dietary patterns, and diabetes risk: a prospective study.

Chiu THT, Pan WH, Lin MN, Lin CL.

Nutr Diabetes. 2018 Mar 9;8(1):12. doi: 10.1038/s41387-018-0022-4.

PMID: 29549240 Free PMC Article

Abstract

BACKGROUND/OBJECTIVES:

Vegetarian diets are inversely associated with diabetes in Westerners but their impact on Asians-whose pathophysiology differ from Westerners-is unknown. We aim to investigate the association between a vegetarian diet, change in dietary patterns and diabetes risk in a Taiwanese Buddhist population.

METHODS:

We prospectively followed 2918 non-smoking, non-alcohol drinking Buddhists free of diabetes, cancer, and cardiovascular diseases at baseline, for a median of 5 years, with 183 incident diabetes cases confirmed. Diet was assessed through a validated food frequency questionnaire at baseline and a simple questionnaire during follow-ups. Incident cases of diabetes were ascertained through follow-up questionnaires, fasting glucose and HbA1C. Stratified Cox Proportional Hazards Regression was used to assess the effect of diets on risk of diabetes.

RESULTS:

Consistent vegetarian diet was associated with 35% lower hazards (HR: 0.65, 95% CI: 0.46, 0.92), while converting from a nonvegetarian to a vegetarian pattern was associated with 53% lower hazards (HR: 0.47, 95% CI: 0.30, 0.71) for diabetes, comparing with nonvegetarians while adjusting for age, gender, education, physical activity, family history of diabetes, follow-up methods, use of lipid-lowering medications, and baseline BMI.

CONCLUSION:

Vegetarian diet and converting to vegetarian diet may protect against diabetes independent of BMI among Taiwanese.

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